CARDIOVASCULAR DISEASE

Ancient Greek and Roman food-related information is widely diversified. While the
archaeological record is never complete and literary accounts are biased toward food
patterns exhibited by the educated elite, preliminary conclusions can be drawn
regarding what constituted Mediterranean dietary patterns through the ages.
In remote antiquity, from Neolithic through Iron ages, most ancient Greek
livestock included cattle, goats, pigs, and sheep; mutton and pork, presumably, were
the most widely consumed meats. Although ducks, geese, and pigeons appear in
Minoan art, they may not have been eaten. While bone evidence or drawings of
chickens are not present in Minoan art, an alternative line of evidence suggests their
use as food. This assertion is based on tomb art in Egypt, dated to ca. 2000 B.C.E,
where a chicken is included as a component of Minoan tribute offerings to the
Egyptian king.149-150 The most ancient Greeks also feasted on seafood, especially,
cockles, crab, fish of various types, limpets, lobster, oyster, and both terrestrial and
marine snails, while pottery decoration suggests that cephalopods such as octopus
and squid were eaten as well.
Despite apparent meat and protein consumption, osteological evidence suggests
that the most ancient Greeks were short in stature and the probability remains that
their food-intake pattern was based more on grains, fruits, legumes, nuts, and both
domesticated and wild vegetables.151
During Classical and Hellenistic periods, wealthy urban Greeks followed a
vegetable-based food pattern, one based on grains, legumes, olive oil, and wine:
barley and wheat were prepared as porridge and bread; fava beans, chickpeas, lentils,
lupines, and peas were served as specific dishes or as ingredient flours with breads
and porridges; olive oil dominated cooking; while water and wine were beverages
of choice.86-87,152
Foods of rural and poor urban Greeks, as well as Greeks living in the diaspora
in North Africa and elsewhere, were vegetable based and commonly included arti-
choke, cabbage, celery, cucumbers, garlic, leeks, lettuce, onions, radishes, and tur-
nips (Tables 1 and 3). Domesticated and wild fruits and leaves provided abundant
food to the rural poor. Eating patterns of poor Greeks focused on cereals served
with edible greens and roots, sometimes lentils and lupines. Still, some scholars
have noted that the dietary staples of poor Greeks consisted of barley porridge
flavored with salt or honey, barley cakes and loaves, commonly served with beans,
cabbage, figs, lentils, olives, onions, and peas. Vegetable foods would have been
complemented by cheese, dried and fresh fish, shellfish, also figs and honey. Butter
was not used and cooking oil would have been poorer grades of olive oil.11,153-155
In ancient Greece — as today — wealth and poverty existed side by side, as
noted in this passage on eating behavior recorded by Athenaeus, who credited Alexis
of Thurium with the observation:
When you see an ordinary citizen eating one meal a day, or a poet who has lost his
desire for songs and lyrics, then you may be sure the first has lost one half of his life,
the other, one half of his art; and both are scarcely alive.156
The diet and food patterns of most Romans also was simple fare, usually a
monotonous diet based on grains/bread, vegetables, and olive oil. Husked wheat,
collectively called far, was commonly prepared as porridge or puls. Wheat bread
was served with honey or cheese. Among the Roman elite, vegetable consumption
was limited, since vegetable consumption was viewed in some circles as a sign of
frugality. This view notwithstanding, recipes assembled by Apicius in his Art of
Cooking (Table 2), reveal the important role of vegetables in Roman diet.8 102 157-158
In summary, food patterns of both poor and elite Classical-Hellenistic Greeks
and Republican-Empire Romans were based on cereals, legumes, a wide range of
fruits, nuts, seeds, and vegetables, with relatively limited meat intake. Simply stated,
food was medicine — medicine was food. Expansion of Greeks and Romans into adjacent and distant lands produced three important changes in diet. First, soldiers
and subsequent colonists were exposed to different foods. Second, following gen-
erations of Greek and Roman colonists adopted some of the food practices of their
new land and ultimately practiced "blended" diets, for example, combinations of
Greek and Libyan or Roman and Egyptian foods. Third, expanded trade networks
ultimately reduced food-related differences between the periphery and heartland of
the Greek and Roman empires as foods of African, east and south Asian, and northern
European origin entered Byzantine and Medieval Mediterranean diets. Mediterra-
nean diets would change even more dramatically following 1492 after food
exchanges between Europe and the Americas.159-160
Through the centuries, Mediterranean foods have provided more than energy
and nutrients. They have served specific cultural functions: use of pork has united

or separated peoples; specific recipes and wines have provided social-dining plea-
sure; certain legumes and meats were identified with political parties, religious sects,
social status, or with wealth. Were treatments for obesity identified by Galen, Hippo-
crates, Paulus and others radically different from those prescribed by 21st-century
physicians? While Pliny's treatments for gout seem amusing from a 21st-century
observation, ancient Greek and Roman physicians recommended wine as a preven-
tative for cardiovascular disease, a practice that today has proven sound. Indeed, the
food classification system of Celsus, divided into strong, medium, and weak cate-
gories, has mirrored 20th- and 21st-century concepts of nutrient density. Thus, while
ancient and modern views commonly diverge, at other times they converge with an
almost uncanny parallel leading one to ponder — is there anything new under
the sun?