I’ve been following the nutrition research for a long time, and every once in a while, a study comes along that just makes you want to stand up and say, “Yes. That’s what I’m talking about.” This is one of those studies. The Mediterranean Diet results point in the right direction, but I think you can do even better.
A team at Harvard’s Brigham and Women’s Hospital just published 25 years of follow-up data on 25,315 women in JAMA Network Open — and the results are hard to argue with. Women who followed a Mediterranean-style diet most closely had a 23% lower risk of dying from any cause compared to women who followed it least closely. That includes a 17% reduction in cardiovascular deaths and a 20% reduction in cancer deaths over the same 25-year period.
Those are pretty good results, and it wasn’t a short-term study. This was a quarter-century of a well-characterized cohort. The endpoint was death, so it was easy to track.
Let’s look at what this result actually means, what the biomarkers were that explain the results, and what you can do with this information today.
The Harvard Study and What Was Actually Measured
The research team, led by Dr. Shafqat Ahmad at Harvard Medical School, analyzed 25 years of data from the Women’s Hospital Study. They published the results in JAMA Network Open in May 2024.
They used a diet survey to collect results, and I think they follow up every two years with a new diet survey. They’ve done that for many years.
The surveys were scored on a standard nine-point Mediterranean diet scale. The score reflects how closely each woman’s diet resembled the Mediterranean pattern, with higher than average intake of vegetables, fruits, nuts, whole grains, legumes, and fish, along with a favorable fat ratio: more monounsaturated fat and less saturated fat, less red/processed meat, and moderate alcohol. On the nine-point scale, a score of six or higher was considered high adherence, and below four was low adherence.
Nearly 3,900 women died during the follow-up, but the women in the high adherence group had a 23% lower risk of dying than those in the low adherence group. The researchers didn’t just rely on survey results; they looked at 33 blood biomarkers, including inflammation markers, cholesterol, insulin resistance, blood sugar, and metabolic molecules, and tried to figure out which factors explained this benefit.
The Answer Wasn’t What You’d Expect
The answer wasn’t cholesterol. Most people think that diet helps lower their cholesterol, and if their cholesterol is low, then that means their diet is working for them.
But in this study, standard LDL cholesterol measurements didn’t explain the reduction in risk of early death. Neither did LDL particle concentration.
Here are the biggest contributors:
Inflammation
Markers like C-reactive protein, fibrinogen, and glycoprotein acetylation accounted for about 13% of the benefit. Women who ate well had measurably quieter immune systems. A quiet immune system is a healthy one. It’s not overreacting to everyday stresses, not producing low-grade inflammation all the time, and not wearing the body down with chronic activation. This means you have energy left over for productive tasks, rather than just mop-up activities.
Metabolic Small Molecules
This category, including homocysteine, citrate, and related metabolites, explained nearly 15% of the benefit. It reflects how efficiently your cells process energy and handle metabolic waste.
Triglyceride-Rich Lipoproteins
Not LDL, but TRL levels contributed about 10%. Elevated TRLs typically signal too much refined carbohydrate, added sugar, or alcohol in the diet, combined with insufficient omega-3 intake, all very fixable problems for most people.
Body Mass Index and Insulin Resistance
BMI contributed another 10%, and insulin resistance added about 7%. Both reflect how well your metabolism is functioning at a fundamental level.
When you put this all together, you have the picture of a person whose metabolism is running smoothly: low inflammation, great insulin signaling, a healthy weight, and blood that isn’t carrying a heavy metabolic burden. That’s what the diet is doing. It’s not primarily about lowering LDL; it’s about fixing the metabolic environment.
Your cholesterol numbers are only a very small part of your metabolism. There’s a lot more to measure than just that, and other parts are more important than cholesterol, according to the study’s results.
A Practical Self-Check: How Do You Know If Your Diet Is Working?
Here’s a practical application that I find interesting and worthwhile for you today. You don’t need a $2,000 panel of metabolomic biomarkers to know whether your diet is giving you great results.
You can look for the same signals in your own daily life and use the basic labs your doctor already runs for you. Here is a dietary health checklist. The more of these you can check off, the more likely your diet is already producing the protective effects identified in this study.
Signs your diet is working — without bloodwork:
- Your waist measurement. A healthy range is <37 inches (94 cm) for men and <31.5 inches (80 cm) for women.
- You don’t experience energy crashes after meals
- You’re sleeping better and waking up rested
- You’re not constantly hungry between meals
- Inflammation symptoms — joint pain, brain fog, skin issues — are calming down
- Digestion is regular and comfortable
Signs your diet is working — in basic labs:
- Fasting triglycerides below 100 mg/dL
- Fasting insulin trending down (or HOMA-IR below 1.5)
- High-sensitivity CRP below 1.0 mg/L (ideally below 0.5)
- Homocysteine below 10 µmol/L
- HbA1c below 5.4%
- HDL cholesterol above 55 mg/dL
If you’re hitting most of these, you’re producing the same biological profile that explained the longevity benefit in this study. Note that BMI isn’t on this list — it’s a population-level metric, not a great personal health gauge. Just measure your waistline; that will tell you what you need to know about your body size.
Two More Studies That Point in the Same Direction
This study isn’t an outlier. A 2018 randomized controlled trial led by Dr. Ramón Estruch and colleagues, published in the New England Journal of Medicine, tested a Mediterranean diet in 7,447 adults at high cardiovascular risk. Those assigned to the Mediterranean diet had roughly 30% fewer cardiovascular events than those on a low-fat control diet. This is a randomized control study, not an observational cohort study. So this is great data.
And then there’s the ATTICA study, a 20-year prospective cohort of Greek men and women followed from 2002 to 2022. The CVD analysis, led by Dr. Michael Georgoulis and colleagues at Harokopio University of Athens and published in Nutrition, Metabolism and Cardiovascular Diseases in January 2024, found that each one-point improvement in the Mediterranean diet adherence score reduced the 20-year risk of cardiovascular disease by 8%. The top third of the cohort with the highest adherence to the Mediterranean diet had a 44% lower risk of CVD incidence than the lowest adherence tertile. The researchers also found that the protection was partially explained by inflammation, uric acid levels, and kidney function, again pointing to the metabolic environment rather than just cholesterol.
So here are three studies with different designs and populations that found a consistent protective effect of the Mediterranean diet. This is what consistency looks like in the nutrition world.
A Hallelujah Diet Perspective
We don’t promote the Mediterranean diet directly, but the results can still be applicable to us. The Mediterranean diet is good; it’s better than what most Americans eat. And the overlap between the Mediterranean diet and the Hallelujah Diet is substantial. But there are differences.
The Mediterranean diet allows fish and a modest amount of meat, and it credits moderate alcohol consumption. On the other hand, the Hallelujah Diet goes further: there’s more raw vegetables and fresh juices, targeted supplement support, and no alcohol at all. I believe that a mostly raw, whole food, plant-based diet with proper supplementation reaches those same biomarker targets, such as lower inflammation, better insulin sensitivity, and lower homocysteine and other metabolic molecules, more completely than a Mediterranean diet does. The Hallelujah Diet is more nutrient-dense than the Mediterranean diet and has targeted supplements for holes that are common in every diet.
So a 23% reduction in all-cause mortality is just a great start. I think with the Hallelujah Diet, we’re doing much better than that.
Key Dietary Habits That Promote Longevity
There are some key habits that are an integral part of the Hallelujah Diet, which will really help you thrive. As detailed in the article, “Ignite Health: 12 Power Foods the New Guidelines Miss” these daily habits support heart health, brain function, and detoxification. These include:
- Fruits and Berries: Act as cleansers, nutrient powerhouses, and antioxidant sources to reduce inflammation.
- Flax Seeds: Provide dietary lignans, fiber, and omega-3 fatty acids.
- Leafy Greens and Raw Vegetables: Provide an abundance of micronutrients and phytochemicals.
- Vegetable Juicing: The best method to extract and absorb high levels of nutrients otherwise locked in plant fiber.
- Healthy Fats & Plant-Based Proteins: Avocados, nuts, seeds, and beans are included to promote satiety and heart health.
- Organic Whole Grains: Like quinoa and oats, suggested as sources of sustained energy and complex carbohydrates.
When you add in Barley Max, fish oil, curcumin, vitamin D3, vitamin C, iodine, and vitamin B12, you cover a lot of dietary holes, help with inflammation, and boost nutrients whose deficiencies can severely impair your lifespan. A 50% less risk of all-cause mortality isn’t an unreasonable goal. That’s the kind of results we’re aiming for.
This study does point out the benefits of checking biomarkers. You don’t have to wait for final endpoints (such as death) to see if your approach is working.
You can run a self-check: measure your HSCRP, fasting insulin level, and triglyceride and cholesterol levels. As mentioned above, there are several basic lab tests that give you some very important information, without having to get really fancy tests.
Our mission at Hallelujah Diet is to help you achieve optimal health so that you can finish the mission God has called you to do here on earth. Poor health shouldn’t be what cuts your story short — and with the right foundation in place, it doesn’t have to be.
References
- Ahmad S, Moorthy MV, Lee I, et al. “Mediterranean Diet Adherence and Risk of All-Cause Mortality in Women.” JAMA Network Open. 2024;7(5):e2414322. https://doi.org/10.1001/jamanetworkopen.2024.14322
- Estruch R, Ros E, Salas-Salvadó J, et al. “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts.” New England Journal of Medicine. 2018;378:e34. https://doi.org/10.1056/NEJMoa1800389
- Georgoulis M, Damigou E, Chrysohoou C, Barkas F, Anastasiou G, Kravvariti E, Tsioufis C, Liberopoulos E, Sfikakis PP, Pitsavos C, Panagiotakos DB; ATTICA study group. “Mediterranean diet trajectories and 20-year incidence of cardiovascular disease: The ATTICA cohort study (2002–2022).” Nutrition, Metabolism and Cardiovascular Diseases. 2024;34(1):153–166. https://doi.org/10.1016/j.numecd.2023.09.019
