What Is the Mediterranean Diet?
The Mediterranean diet is a diet inspired by the eating habits of Greece, Southern Italy, and Spain in the 1940s and 1950s. The principal aspects of this diet include proportionally high consumption of olive oil, legumes, unrefined cereals, fruits, and vegetables, moderate to high consumption of fish, moderate consumption of dairy products (mostly as cheese and yogurt), moderate wine consumption, and low consumption of non-fish meat products.
What Is the Mediterranean Diet? A Meal Plan and Beginner’s Guide
The Mediterranean diet is based on the traditional foods eaten by people living in the Mediterranean region, especially Greece. It’s loaded with nutrient-dense choices, with an emphasis on vegetables, fruits, whole grains, fish, and olive oil. Research suggests following this diet may help reduce your risk of heart disease, cancer, diabetes, and other health concerns.
This eating pattern embraces whole foods, variety, and flavorful meals—rather than strict restriction—making the Mediterranean a healthy option for most people to follow long-term.
What Experts Say
“Mediterranean recipes are so flavorful that it is easy to follow this delicious dietary pattern long-term. Plus, by shifting the focus from a mindset of restriction to a mindset of flavor, community, and abundance, it is easier to embrace the Mediterranean lifestyle.”
Background
The Mediterranean diet is not a branded diet plan, but rather a style of eating that has evolved over thousands of years in countries surrounding the Mediterranean Sea.
The diet was first publicized in the 1970s by scientist Ancel Keys, most famously known for his Seven Countries Study. In this study, Keys examined connections between dietary fat intake and rates of heart disease.
Though many are quick to criticize Keys’ work, there were some important takeaways from his study—one of which was identifying that people in the Crete region of Greece had higher overall fat intake yet lower rates of heart disease. Keys believed their style of eating—the idea of the Mediterranean diet—was responsible for this.
However, the Mediterranean diet was not widely embraced by those in the United States at that time. In 1993, Oldways (a non-profit committed to helping people lead healthier lives through traditional diets) partnered with the Harvard School of Public Health and the World Health Organization to create the Mediterranean diet pyramid.
This alternative to the USDA’s original food pyramid emphasizes core foods of the Mediterranean region, along with physical activity and social connections.
Even though the Mediterranean diet has since been well-researched and become more of a household name, most Americans still do not follow it. Some of this is due to enjoyment of, or lack of desire to abandon, a standard Western diet which tends to be higher in processed foods and added sugar.
There has also been some criticism of the Mediterranean diet. In 2018, one major study was retracted due to issues with the randomization process. However, a revised analysis of the study after retraction still revealed promising results—as do many other pieces of research.
Other critics of the Mediterranean diet, most notably low-carbohydrate advocates, claim that a moderate carbohydrate eating plan and the inclusion of whole grains are not nutritious. However, there is a far greater abundance of scientific evidence supporting the efficacy of the Mediterranean diet compared to that which might support these fringe views.
How It Works
The Mediterranean diet promotes primarily unprocessed foods, with an emphasis on:
- Vegetables
- Fruits
- Whole grains
- Legumes
- Nuts
- Fish
- Olive oil
This winning combination provides vitamins, minerals, fiber, phytochemicals, and healthy fats—all of which are excellent for your health.
Dairy is also allowed on this diet, though generally in smaller amounts. In most traditional cultures, dairy servings are made up of cheese and yogurt, rather than fluid milk. Red meat is typically limited, but small amounts are OK to include occasionally. In addition, you’ll want to skip the added sugar, saving baked goods and sweet treats for more irregular indulgences.
When following this diet, you’ll want to stay hydrated by drinking plenty of water each day. You can also consume red wine in moderation—up to one 5-ounce glass per day for women, and one to two 5-ounce glasses per day for men.
Pros and Cons
Because the Mediterranean diet has been the subject of numerous research studies, there is solid data supporting its health benefits.
This eating pattern is associated with reduced risk of heart disease, certain types of cancer, and diabetes.
There are other surprising benefits too. For example, one study connected the Mediterranean diet to better mental health. And because the diet is packed with nutrient-dense foods while not eliminating any food groups, it meets your nutritional needs in a sustainable way.
With any diet though, there are of course potential downsides. Some feel that the Mediterranean diet is cost-prohibitive for those on lower income budgets, due to the abundance of produce, olive oil, and fish. There are certainly smart shopping tips that can be used to address this concern, though.
In addition, any diet—including the Mediterranean diet—can become detrimental if it’s used in an overly restrictive way. If you’re worried that you’re becoming preoccupied with controlling your food intake, seek help from a medical professional.
Common Myths and Questions
When any diet is promoted to the masses, myths are bound to spread. Here are some common examples—and the facts setting them straight.
Myth: You can’t eat animal foods on the Mediterranean diet.
This diet is lower in animal foods than a Western diet, but still includes them. You’ll want to focus your animal foods on fish, moderate amounts of poultry, and portion-controlled servings of cheese and yogurt. Proponents of this diet recommend eating red meat less frequently, and saving the big steaks for a special occasion.
Myth: Any oil is fine on the Mediterranean diet.
A key ingredient to this eating pattern is olive oil, and this should not be substituted with other oils (with the exception of very high temperature cooking, where a higher smoke point oil may be used occasionally).
“There are many benefits to olive oil outside of its healthy macronutrient profile,” says Toups. “For example, foods cooked in olive oil are shown to have a higher antioxidant content. Olive oil has also been studied for its potential anticancer properties.”
Myth: All you need to do is follow the food recommendations to achieve all the health benefits.
The Mediterranean diet is more than just an eating plan; it’s also a lifestyle. At the base of the Mediterranean diet pyramid are two core components—social interaction and daily physical activity. Make an effort to integrate these into your life for optimal health.
Myth: You need to drink red wine to follow the Mediterranean diet.
Though red wine is a core component of this eating style in the countries of origin, you don’t have to start drinking just to follow this diet. You can still achieve certain health benefits by following the other dietary patterns without the wine. This is especially important if you’re pregnant or have a history of alcohol addiction.
Myth: The Mediterranean diet is too high in fat.
Despite the low-fat trends of the 1990’s, we now know that fat should not be feared. Healthy fats, such as those in the Mediterranean diet, help you feel satiated and full. Foods like oil and nuts also offer additional health benefits, like antioxidants.
How it Compares
If you’re comparing the Mediterranean diet to other popular diets, you’ll find some similarities. Here are a few quick comparisons to consider:
Flexitarian diet
- A semi-vegetarian meal plan with many similarities to the Mediterranean diet
- Not as well-researched but has some demonstrated health benefits
DASH diet
- An eating pattern designed to lower blood pressure
- Both this and the Mediterranean diet are linked to lower cardiovascular disease risk
- May be more difficult to follow than the Mediterranean diet
Keto diet
- An eating pattern with considerably higher fat intake compared to the Mediterranean diet
- More restrictive as far as compliant/non-compliant foods
- Useful in cases of epilepsy and some research suggests weight loss benefits, however long term health effects are unknown
The Mediterranean diet is less restrictive than many other popular diets, and with a few small exceptions, very similar to the USDA’s nutrition recommendations. The diet recommends the same five food groups, but offers additional guidance within some of the of those groups.
For example, the USDA does not specify preferences on the types of protein foods you should consume (other than emphasizing lean proteins). The Mediterranean diet, on the other hand, specifies that your protein foods should be made up of mostly legumes, nuts and seeds, fish, and moderate amounts of poultry—while limiting red meat.
Getting Started
Ready to get started? Good news! The Mediterranean diet doesn’t require any special branded foods or paid diet plans. To start eating according to this plan, just take a quick trip to the grocery store to stock up on the recommended foods.
Fill your cart with plenty of produce, grab a few pieces of fish, and choose a good high-quality olive oil—and you’re ready to get cooking!
When choosing a diet, it’s important to select a plan that promotes overall health and is feasible to follow long-term. No one diet will meet every person’s needs, but the Mediterranean diet will certainly fulfill these goals for many people.
It’s packed with nutritious choices, well-researched, and focuses on flavorful meals. Combine this diet with daily physical activity, regular social connections, and adequate sleep—and you may find yourself feeling energized and healthier.
Mediterranean diet: A heart-healthy eating plan
The heart-healthy Mediterranean diet is a healthy eating plan based on typical foods and recipes of Mediterranean-style cooking. Here’s how to adopt the Mediterranean diet.
If you’re looking for a heart-healthy eating plan, the Mediterranean diet might be right for you.
The Mediterranean diet incorporates the basics of healthy eating — plus a splash of flavorful olive oil and perhaps a glass of red wine — among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea.
Most healthy diets include fruits, vegetables, fish and whole grains, and limit unhealthy fats. While these parts of a healthy diet are tried-and-true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease.
Benefits of the Mediterranean diet
Research has shown that the traditional Mediterranean diet reduces the risk of heart disease. The diet has been associated with a lower level of oxidized low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol that’s more likely to build up deposits in your arteries.
In fact, a meta-analysis of more than 1.5 million healthy adults demonstrated that following a Mediterranean diet was associated with a reduced risk of cardiovascular mortality as well as overall mortality.
The Mediterranean diet is also associated with a reduced incidence of cancer, and Parkinson’s and Alzheimer’s diseases. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer.
For these reasons, most if not all major scientific organizations encourage healthy adults to adapt a style of eating like that of the Mediterranean diet for prevention of major chronic diseases.
Key components of the Mediterranean diet
The Mediterranean diet emphasizes:
- Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
- Replacing butter with healthy fats such as olive oil and canola oil
- Using herbs and spices instead of salt to flavor foods
- Limiting red meat to no more than a few times a month
- Eating fish and poultry at least twice a week
- Enjoying meals with family and friends
- Drinking red wine in moderation (optional)
- Getting plenty of exercise
Fruits, vegetables, nuts and grains
The Mediterranean diet traditionally includes fruits, vegetables, pasta and rice. For example, residents of Greece eat very little red meat and average nine servings a day of antioxidant-rich fruits and vegetables.
Grains in the Mediterranean region are typically whole grain and usually contain very few unhealthy trans fats, and bread is an important part of the diet there. However, throughout the Mediterranean region, bread is eaten plain or dipped in olive oil — not eaten with butter or margarines, which contain saturated or trans fats.
Nuts are another part of a healthy Mediterranean diet. Nuts are high in fat (approximately 80 percent of their calories come from fat), but most of the fat is not saturated. Because nuts are high in calories, they should not be eaten in large amounts — generally no more than a handful a day. Avoid candied or honey-roasted and heavily salted nuts.
Healthy fats
The focus of the Mediterranean diet isn’t on limiting total fat consumption, but rather to make wise choices about the types of fat you eat. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease.
The Mediterranean diet features olive oil as the primary source of fat. Olive oil provides monounsaturated fat — a type of fat that can help reduce LDL cholesterol levels when used in place of saturated or trans fats.
“Extra-virgin” and “virgin” olive oils — the least processed forms — also contain the highest levels of the protective plant compounds that provide antioxidant effects.
Monounsaturated fats and polyunsaturated fats, such as canola oil and some nuts, contain the beneficial linolenic acid (a type of omega-3 fatty acid). Omega-3 fatty acids lower triglycerides, decrease blood clotting, are associated with decreased sudden heart attack, improve the health of your blood vessels, and help moderate blood pressure.
Fatty fish — such as mackerel, lake trout, herring, sardines, albacore tuna and salmon — are rich sources of omega-3 fatty acids. Fish is eaten on a regular basis in the Mediterranean diet.
Wine
The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking.
However, alcohol — in moderation — has been associated with a reduced risk of heart disease in some research studies.
The Mediterranean diet typically includes a moderate amount of wine. This means no more than 5 ounces (148 milliliters) of wine daily for women (or men over age 65), and no more than 10 ounces (296 milliliters) of wine daily for men under age 65.
If you’re unable to limit your alcohol intake to the amounts defined above, if you have a personal or family history of alcohol abuse, or if you have heart or liver disease, refrain from drinking wine or any other alcohol.
Putting it all together
The Mediterranean diet is a delicious and healthy way to eat. Many people who switch to this style of eating say they’ll never eat any other way. Here are some specific steps to get you started:
- Eat your veggies and fruits — and switch to whole grains. An abundance and variety of plant foods should make up the majority of your meals. Strive for seven to 10 servings a day of veggies and fruits. Switch to whole-grain bread and cereal, and begin to eat more whole-grain rice and pasta products.
- Go nuts. Keep almonds, cashews, pistachios and walnuts on hand for a quick snack. Choose natural peanut butter, rather than the kind with hydrogenated fat added. Try tahini (blended sesame seeds) as a dip or spread for bread.
- Pass on the butter. Try olive or canola oil as a healthy replacement for butter or margarine. Use it in cooking. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter. Or try tahini as a dip or spread.
- Spice it up. Herbs and spices make food tasty and are also rich in health-promoting substances. Season your meals with herbs and spices rather than salt.
- Go fish. Eat fish once or twice a week. Fresh or water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it’s sauteed in a small amount of canola oil.
- Rein in the red meat. Substitute fish and poultry for red meat. When eaten, make sure it’s lean and keep portions small (about the size of a deck of cards). Also avoid sausage, bacon and other high-fat meats.
- Choose low-fat dairy. Limit higher fat dairy products such as whole or 2 percent milk, cheese and ice cream. Switch to skim milk, fat-free yogurt and low-fat cheese.
- Raise a glass to healthy eating. If it’s OK with your doctor, have a glass of wine at dinner. If you don’t drink alcohol, you don’t need to start. Drinking purple grape juice may be an alternative to wine.