Eating a traditional Mediterranean diet, including a pound of vegetables and several tablespoons of olive oil a day, may reduce your risk of dying from heart disease, cancer and other causes, suggests a large new study from Greece. 

This adds to the growing body of evidence on the health benefits of this diet, which is rich in vegetables, fruits, beans, whole-grain breads and olive oil. In Greece, the diet contains a moderate amount of fish and dairy products and is low in meat. Wine is consumed in moderation and generally during meals.

The Mediterranean diet varies between countries and regions, but it usually gets about 30% to 40% of total calories from fat, mostly olive oil, a monounsaturated fat.

For the latest study, researchers at the University of Athens and Harvard University tracked more than 22,000 adults, ages 20 to 86, in Greece for almost four years.

Sample meal
Greek yogurt with fresh fruit and Greek honey: 
Greek cheese 
Tomatoes and cucumbers 
Toasted whole-grain bread or barley rusks (similar to zwieback) with olive oil 
Freshly squeezed fruit juice 
Coffee

Source: Oldways Preservation & Exchange Trust

They interviewed them about what they ate and drank, portion sizes and how often they ate. They also questioned them about their activity and smoking habits. They measured their height, weight and waist circumference. 

Then, participants were rated on a scale of 0 to 9, based on how closely they stuck to the traditional Mediterranean diet. The higher the score, the better the adherence.

Among the findings in Thursday's New England Journal of Medicine:

ˆ A two-point increase in the adherence score was associated with a 25% reduced risk of death from all causes, a 33% reduced risk of death from heart disease and a 24% reduced risk of death from cancer.
ˆ Individual foods alone did not have the same effect on the risk of death.

"It seems it's the total Mediterranean diet that's protective, rather than individual food groups," says lead author Antonia Trichopoulou, a professor of nutrition at the University of Athens Medical School.

People in Greece eat about a pound of vegetables a day, mostly cooked because it would be impossible to eat that quantity of raw vegetables, she says. "We cook a stew of vegetables with eggplant, zucchini, okra, wild greens in olive oil with garlic, onion and herbs."

Salads are served with fish, and vegetables like zucchini and spinach are boiled and seasoned with lemon and olive oil, she says. 

This Mediterranean diet probably has six to nine servings of vegetables a day, says Colleen Doyle, director of nutrition and physical activity for the American Cancer Society. That's far more than what most Americans eat, which is believed to be between two and three servings a day, she says. 

But would time-pressed Americans who were weaned on fast food and processed fare really want to eat this way?

With this diet, you may have to spend more time in the kitchen, "but you will live longer," says Dimitrios Trichopoulos, a co-author on the study and a professor of cancer prevention at the Harvard School of Public Health. "It's a matter of choice." 

For a lot of people, this diet probably seems like a stretch, but it's something they should be striving for, Doyle says.