HEALTH / Second opinion

GREEK men live longer than the males of any other European country, yet they smoke heavily, rarely take recreational exercise, and the health system in Greece has few programmes for the detection and treatment of disorders such as raised blood pressure. The Greek diet contains a lot of fat - almost all in the form of olive oil. The leading position of Greece in the European health league is puzzling for health educators in countries such as Britain and the United States. No clear explanation has emerged from studies.

The latest investigation of the effects of Greek culture on health appears in a new medical journal, the Journal of Cardiovascular Risk. Greek men have low rates of coronary heart disease (though not Europe's lowest: the French have those) but it is their overall health that is striking. A 45-year-old Greek man can expect to live a further 32 years, as against 29 for men in Britain, the US and Italy, and only 25 in Hungary.

The Mediterranean diet is known to be healthier than that of northern European countries, but argument continues about which are its life-enhancing features. The first major international comparison study was done 40 years ago and focused on the small amounts of dairy and animal fats eaten in countries around the Mediterranean. The traditional Greek diet has a high proportion of vegetables and fruits, includes wine with meals, and has little protein. Greeks use olive oil in cooking, salad dressing, and with their bread - indeed, elderly Greeks following tradition may get as much as 42 per cent of their total energy from fat, almost all in olive oil. Health experts in Britain and North America tell people to eat a diet in which fat accounts for no more than 30-35 per cent of the total energy.

The new report, from the Athens School of Public Health, looks at aspects of Greek life besides diet. Until recently, people in the rural areas had a high energy expenditure and intake, and this may have played a part in their longevity. Other possibilities proposed include the stress-releasing effects of an afternoon siesta, the support offered by an extended family, even the mild climate.

Younger Greeks living in the cities are, however, abandoning the traditional diet and way of life, and research is showing that their blood levels of cholesterol are rising. Data recently published by the British Heart Foundation showed that, between 1979 and 1989, the mortality from heart disease in both men and women in Greece showed a slight rise, in contrast to the fall in most other Western countries.

For research workers, the data are both fascinating and frustrating. The effects of changes in lifestyle on health probably take 40 years or more to have their full impact, and only the very elderly will have lived their full lifespans following the old traditions. Researchers have little time left to identify the reasons why Greeks born in the first quarter of this century have lived longer than any other community in Europe (and longer than anyone else in the world except the Japanese). The Arcadian myth - long and contented life in a rural paradise - is fading before our eyes; and if the secrets of Greek longevity are not found quickly they may be gone for ever.

(Photograph omitted)