Mediterranean diet

Have you ever imagined a region where people have a high life expectancy and a low incidence of chronic diseases? Because it exists, it is the region bathed by the

Health System in France.

It is well known that every country, every government has its owned social security system whose function or objective is basically the same, to provide medical assistance to everybody, based

Mediterranean diet

Have you ever imagined a region where people have a high life expectancy and a low incidence of chronic diseases? Because it exists, it is the region bathed by the Mediterranean Sea, which encompasses the south of Spain, the south of France, Italy and Greece. When they realized that these places had so many healthy people, scientists began to study what was different there and arrived at the Mediterranean diet.

“Real food is the basis of this diet, which includes fruits, vegetables, fish, olive oil and a small amount of wine and milk products”, describes the nutritionist Guilherme Giorelli, director of SMEERJ (Society of Sports Medicine and Exercise of Rio de Janeiro) and juror of the Ranking of VivaBem Diets.

All of these items have nutrients that benefit health. And taking such a balanced diet helps with maintenance and even weight loss. That is why she was ranked 1st in the 2020 Ranking. Understand more about how to follow this diet.

How the Mediterranean Diet Works

Discovered in the 1950s, this diet has become popular over time. Its main diffuser was the American physician Ancel Keys, who carried out several studies in the region. Since then, the subject has become bestsellers (authored by Keys himself); it gave rise to Foundation Diet Mediterranean, a Catalan entity that promotes it through research and congresses; and, since 2010, UNESCO recognizes the Mediterranean diet as an intangible cultural heritage of humanity. Fame is not for nothing. The way of life of residents of regions bathed by the Mediterranean Sea such as Greece, Italy and southern Spain and France is associated with cardiovascular health and longevity.

Is this diet safe

The Mediterranean diet is considered safe because it combines not only diversity in food but also a healthier way of life . Those diagnosed with celiac disease and lactose restriction need medical attention to avoid the risk of becoming malnourished, as the dietary pattern recommends both wheat and dairy products.

Wine is not mandatory. People with restrictions on alcoholic beverages should remove it from the menu . It is also seen as a good diet for type 2 diabetics. In fact, a study showed that its supporters were 40% less likely to develop this disease than those who did not follow it.

Does the diet really lose weight?

The Mediterranean lifestyle is healthier, less stressful and less sedentary. It is linked to the cultural, religious and identity values of a people. Your goal is not weight loss. Choosing this dietary pattern will benefit your health, however, eating large quantities of these foods (even those recommended in the diet) and spending fewer calories can result in extra pounds.

If you want to reduce the number of scales, the ideal is to follow up with a health professional. Each has a different caloric requirement . Leaving sedentary lifestyle aside, what these people have been doing for a long time with their daily tasks, can also help you lose weight. So, move.

What to eat and drink in the Mediterranean diet.

One of the main precepts of the Mediterranean diet is natural food. Processed foods should be avoided, that is, those that have undergone industry changes and that have lost some nutrients and fibers in the procedure. Out of the diet are the sausages, canned and ultra-processed, those products formulated by the industry with little or no fresh food.

There are plenty of examples of these products on the supermarket shelves: soft drinks, energy drinks, snacks, stuffed cookies, treats, powdered juice, sausages, frozen products ready to heat, dehydrated products such as instant noodles, powdered soup, cake mix, seasoning ready. Here are the main foods that go into the Mediterranean diet.

– Chestnuts and seeds: almonds, walnuts, macadamia, hazelnuts, cashews, sunflower seeds, pumpkin seeds, and others. They are rich in calories and good fats and help with cardiovascular health. – Whole grains: pasta is a very common food in this region, and it is authorized, but as long as it is whole.

Whole grains must replace refined carbohydrates, that is, white flour. Prefer whole products that are a source of fiber, type E and B complex vitamins, minerals such as magnesium, iron, zinc, selenium, manganese, potassium, phosphorus, essential fatty acids, fibers and antioxidants such as flavonoids that contribute to risk reduction for diabetes and cardiovascular disease.

Mediterranean Diet Menu.

At the request of UOL Viva BEM, Monica Stockler, a nutritionist who is a member of the Society of Cardiology of the State of São Paulo (Soc esp) prepared a suggestion for a day’s menu for the Mediterranean diet.
Fresh herbal
A fruit

Mediterranean sandwich: two slices of whole grain bread; small piece of goat cheese; olive oil flavored with herbs and basil; cherry tomatoes and chopped cucumber; sea salt mixed with oregano, thyme and basil. Preparation: lightly toast the two slices of bread.

Add the flavored olive oil and the goat cheese. Complete with cherry tomatoes and cucumber, season with sea salt. Morning snack A portion of fruit or a handful of chestnuts. Lunch Salad with different types of green leaves and sunflower seeds. Fish baked with herbs and spices (thyme, nutmeg, rosemary and oregano) and seasoned with olive oil. Brown rice cooked with lentils, mushrooms, oregano and carrots.

Can vegetarians and vegans eat this diet

The Mediterranean diet consists of vegetables, fruits, cereals, seeds, eggs and derivatives, that is, foods present in the daily life of vegetarians. But the diet recommends eating fish and birds at least twice a week. So, to make adaptations and due substitutions, it is always recommended the guidance of a health professional.

For vegans, on the other hand, it is a more difficult task, because in addition to meat, eggs and dairy products would be left out of the menu. It is important to individually assess adaptations, but proteins of plant origin can be considered. Examples of vegetable protein sources are: mushrooms, black rice and buckwheat, peanuts, cashews and pine nuts, peas and lentils, and soy tofu.

Health System in France.

It is well known that every country, every government has its owned social security system whose function or objective is basically the same, to provide medical assistance to everybody, based in an automatically collection method from workers’ pay check. Some challenges have been founded in this system, a dilemma of increasing rates or leave it the way it is knowing that at some point the incomes won´t be enough to cover the increasing people`s demands. The intention to make some adjustments to the social security rates have become a cause for massive protests all around the world in so many different countries. However, some countries have found the way to overcome this challenge, by designing public policies with the intention to provide access to public healthcare system for everybody. One of those countries working hard to achieve that goal is France. With an average life expectancy of 82, according to the World Health Organization in 2000, France got ranked as the first country with the most effective healthcare system ( Geoallo dentiste de garde ) in the world, and it was exactly in that year when this country reached the goal of covering 100% of its population with a health insurance. Definitely that is not as easy as it sounds! That means that everybody in France is enrolled in the social security system, those who work and those who are jobless as well. Do you imagine going to a private healthcare center and getting medical attention for free? Well, that is possible in France, 75% of doctors are able to provide care to the patient for free based in a government refund program.

National Health Insurance (NHI) is universal and its coverage is granted for every French resident, and actually if you are not a resident, you are automatically enrolled in the system by applying for residence, even those who are in an illegal status can have access to this benefits in an emergency scenario.  We can basically define the French health system as a common good system, since those who are active cooperate to help those who aren`t. Another important fact to mention regarding the French social security system is that even in case that you are not eligible to be enrolled in the public healthcare system there are so many private options, that means that you can get an agreement with a healthcare private company for very reasonable rates. What about if you got sick but you don`t want to go out your home? You only has to pick up the phone and dial a toll free number to get a doctor appointment at home, it is important to be aware that you will be billed depending on time or day of the week. And, what happens if you are living in France but you don`t speak French? In France most professionals, including doctors, speak English which allows foreigners to get assistance in a language they understand.

The Reimbursement Method.

When going to the hospital looking for medical assistance you will be refunded by the government, however that doesn´t mean that will get a full reimbursement of the cost, most of the times you will have to pay a certain percentage. The amount you have to pay will depend on the kind of treatment you got and in some hospitals you will have to pay a fee for bed or room occupancy. Some kind of illnesses are fully covered by the government budget, those serious illnesses like cancer belong to that category where you can get a full refund. In the most common scenario the patient can get a 70% of the cost as a refund, the rest will have to be covered by the patient in a form of contribution including all other fees which all together reached that pending 30%. Like in any other country dental and optical treatments are considered as no serious suffering, because of that, most of the times this kind of medical conditions are not fully covered and the patient will have to pay a higher portion of the one calculated for other illnesses. However, French people have found a way to get covered in full in case an emergency comes, what they do is buying a complementary insurance policy that will help to cover the rest of the amount, in some cases even with that policy the full amount won`t be covered, but will, at least, get the gape reduced.

Protection Universelle Meladie (PUMA)

PUMA is the universal healthcare system, this had become a practice since 2000, however, in 2016 was adopted as legal. PUMA got created with the mission to grant the right to health to everybody, expanding public healthcare to those who were not included in the formal sectors; self-employed, unemployed, those with long term disabilities, young retired, in other words, everyone. This program has included family members to the health system, once they get enrolled in the insurance system will be there for their lifetime, no matter what, no matter how, the main goal was giving every French citizen the individual right to health, this obviously has improved the quality of life for those who are or were economically inactive for one or another reason. PUMA extracts a portion of taxes and allocates it to this program, granting in that way the human right to health for all.

European Health Insurance Card (EHIC)

This is a kind of agreement that consists of providing medical assistance to anybody from any European country as long as the patient carries the EHIC, every European person most have this card when visiting France no matter what the reason is, in some cases this card is valid for up to five years. In case the reason for being in France is to work, the agreement states that the visitor might contribute to the French insurance system during the period spent in France. Getting one of this card is relatively easy, the visitor just needs to provide a national insurance number, another way to get this card is through the post office, by sending an email to [email protected] or accessing the EHIC Facebook page, it is important to know that getting the European Health Insurance Card is a service free of cost. The EHIC covers what is necessary, meaning that the person is not able to return home to get medical assistance, this also includes pre-existing medical conditions which brought up a symptom during the stay, maternity or renal dialysis are also covered by EHIC. However, it is not expected that the visitor will get fully assistance until the treatment is completed, it is expected that the patient will get the rest of the treatment once returns home.

Being aware of how France`s health system works will be vital when visiting the country, remember in France you get medical assistance, you pay for it and then by showing the receipt you are allowed to claim a refund from the government. No full refund can be expected, all European visitor will be treated as any other French citizen taking in consideration same circumstances to provide a proper refund.


As mentioned above, French insurance system consists of getting reimbursement for a portion of the medical assistance or prescription cost. With the purpose of providing a full insurance coverage, French people have decided to create something called Top-Up, which is basically a voluntary insurance policy which provides additional cover for the residual costs non reimbursable by the social security system. Full refund is not guaranteed, however the amount the patient will have to pay will be greatly lower, and that is something French people take as priority.


CMU or Free Health Insurance was designed for those with a very low income, all unemployed have access to this benefit, so when they go to the doctor are allowed to get medical assistance and prescriptions for free, they don’t have to look for a refund later, dental and optical issues are also included in the CMU.

Non-Reimbursable Charges

Some surcharges or fees are not reimbursable, neither by Social Security System, Voluntary Insurance Policy (Top-Up) or Free Health Insurance (CMU). The first of this non-reimbursable surcharges is the Consultant Fee, before explaining what consultant fee consists of, it is important to know that everybody in France is required to register with a specific doctor who will be called the family doctor, then every medical procedure needs to be treated by the family doctor in first instance, this doctor will refer the patient to a specialist or another doctor if needed. Going directly to a specialist or any other doctor will mean that a higher fee will be paid, the difference might be far greater and the amount refunded by the government will be also lower. The consultant fee if is the cost the doctor applies, this is regulated by the government also and is higher depending on what kind of doctor or specialist the patient sees, will be lower if the patient passed through the family doctor first and then was referred by him or her. In 2017 the consultant fee got an increase based on a reform made by the government in agreement with the medical sector. The second non-reimbursable surcharge will the Patient Contributions, these are small fees applied to the patient, one of this fee is the medical consultation charge, every time you visit the doctor you have to pay one euro for consultation, let´s say that the cost of normal doctor appointment is $30, so you are supposed to get $21 based in 70% refund policy, however, by taking out $1 for the medical consultation fee so you will get $20 refund. Another minor fee is “prescriptions”, this is calculated in 50 cents of the cost of medicines with the exception of those provided during hospitalization. Then we have auxiliary services, this is another 50 cents for auxiliary medical treatments like physiotherapy.

The third non-reimbursable fee is Branded Medicines, which means the insurance system provides generic medicines, so when it comes to branded medicine, which of course are more expensive, no refund is provided. Finally in the list of non-reimbursable charges are Medical Aids. The government has created a full list of circumstances which are or are not reimbursable, we can say that list is totally understandable.

Ophthalmic Treatment.

The social security system in France does not cover opticians, so unless the patient has an ophthalmic pathology it won´t be any coverage by the government, however going back to Top-Up, some of the voluntary insurance policies offer coverage for the cost of glasses. Since opticians are not covered by the public insurance so there is no need to go through the family doctor to get an appointment with an ophthalmologist.

Long Term Suffering

For all patients with a long term medical condition a fully refund policy applies. Cancer, diabetes, dementia are some of the pathologies considered as long term illnesses covered in full when require medical attention to the patient, the government has created a list of 30 illnesses in total which are considered in this category. There might be some minor fees or exceptions applied by the government which are reviewed every year by all involved sectors. In conclusion now we can say the French health system is not perfect, it has some aspects which will have to be reviewed and maybe modified in the future when it becomes necessary, however we cannot ignore the fact that the French social security model should be studied by some other countries in order to apply some of those policies to their own social security systems and bring to the people that kind of healthcare is required nowadays when the population is getting older at giant steps.  Health is a human right, it is intrinsically attached to the human being and it should be granted by every government no matter what ideology it represents, either left or right political ideologies should consider public insurance system as a priority in order to provide at least basic healthcare to all.