Guide to the Mediterranean diet

Heralded as one of the healthiest diets in the world, the Mediterranean diet is one of the most popular diets today. Learn the essentials of this diet, including its health benefits, and how to start eating Mediterranean style.

What is the Mediterranean diet?

The Mediterranean diet is a style of eating that emphasizes minimally processed, plant-based foods. It includes fruits, vegetables, nuts, beans, whole grains including whole-grain pasta and breads, olive oil, red wine, and small amounts of fish, eggs, dairy, and meats.

As the name implies, the Mediterranean diet is inspired by the traditional eating habits of people living in countries bordering the Mediterranean Sea, particularly the olive-growing cultures of Southern Italy and Greece.

There is no single Mediterranean diet. The details of what characterizes Mediterranean-style eating can shift from country to country due to differences in culture, ethnic background, religion, economy, geography, and agricultural production. However, the various versions of a Mediterranean diet share common features such as:

• plentiful vegetables and fruits, whole grains, legumes, fish, nuts, seeds, and olive oil
• ample amounts of fish, in areas where it is easily available
• low to modest amounts of meat and dairy
• very limited processed foods or sugars.

Mediterranean diet food list

In general, the following foods are eaten frequently, moderately, and rarely as part of the Mediterranean diet:

High intake (several times a day)

• fruits
• vegetables
• whole grains
• nuts
• legumes
• extra virgin olive oil.

Moderate intake (several times a week)

• fish/seafood
• poultry
• eggs
• dairy foods such as cheese and yogurt.

Low intake (several times a month)

• sweets containing added sugars or honey
• red meat.

In addition, red wine may be consumed in low to moderate amounts, usually with meals.

Health benefits of the Mediterranean diet

Numerous studies have looked at the health effects of the Mediterranean diet over the years. Studies have linked the diet to lower risk of cardiovascular disease, cancer, diabetes, and other health conditions.

In one study, over a period of 12 years, women who most closely followed a Mediterranean diet had a 25% reduced risk of four cardiovascular events, including heart attack and stroke, compared to women whose diet least resembled a Mediterranean diet.

One large long‑term cohort study followed more than 25,000 women for nearly 25 years. It found that those with the highest adherence to a Mediterranean dietary pattern had about a 23% lower risk of dying from any cause compared with women whose diets were least like a Mediterranean diet.

Another study of over 450,000 participants from European countries found that people with the highest adherence to the diet had a lower risk of obesity-related cancers, suggesting that the diet may protect against both overall mortality and certain types of cancer. Obesity-related cancers include breast, pancreatic, kidney, and colorectal cancer.

Among the health benefits of following a Mediterranean diet is lower risk of the following:

• cardiovascular disease
• heart attack
• stroke
• various types of cancer
• Parkinson’s disease
• Alzheimer’s disease
• type 2 diabetes
• rheumatoid arthritis
• nonalcoholic fatty liver.

The Mediterranean diet may be especially helpful for keeping weight off over time. In one study, people who closely followed a Mediterranean-style eating pattern were about twice as likely to maintain weight loss after initially losing weight, compared with those whose diets were less Mediterranean. This supports the idea that the Mediterranean diet works as a sustainable eating pattern, even if early weight loss is modest.

Researchers have also studied associations between a Mediterranean diet and aging. One study of over 10,000 women ages 57 to 61 found that women who followed a Mediterranean-type eating pattern were 46% more likely to live to 70 or older without chronic disease.

The health benefits of this eating style make it a top recommendation of health experts. The American Heart Association (AHA) recommends the diet for the role it can play in preventing heart disease and stroke, and reducing risk factors such as obesity, diabetes, high cholesterol, and high blood pressure.

Benefits of a Mediterranean lifestyle

But diet isn't the only aspect of Mediterranean living that's important for health. Along with eating style, lifestyle habits that include regular physical activity, adequate rest, and social connections also contribute to health benefits.

A major long-term trial known as PREDIMED-Plus found that older adults at risk for diabetes who followed a Mediterranean-style diet, combined with moderate physical activity, calorie reduction, and professional support, had a 31% lower risk of developing type 2 diabetes over six years compared with those following the dietary pattern alone, even though average weight loss was modest.

And a previous study that looked at what type of impact these other lifestyle factors might have on the health of people following the Mediterranean diet found that people who adhered to the Mediterranean lifestyle's tenets of adequate rest, exercise, and socializing had a lower risk of dying from cancer or from any cause.

A 7-day sample Mediterranean-style diet meal plan

How can you bring the health benefits of a Mediterranean diet into your life? To get started, mix and match from the following list of breakfast, lunch, and dinner ideas for a week’s worth of Mediterranean diet-style meal inspiration.

Breakfast

• whole-grain bread topped with ricotta cheese, slices of fresh tomato, drizzled with a little extra virgin olive oil
• vegetable omelet with mushrooms, spinach, and onions cooked in olive oil with crusty whole-grain bread
• plain Greek yogurt topped with nuts and fresh berries
• oatmeal pecan waffles
• white bean and egg shakshuka
• overnight oatmeal
• citrus salad with lemon yogurt.

Lunch

• Greek salad made with chopped mixed greens, kalamata olives, tomatoes, fresh parsley, feta cheese, dressed with extra virgin olive oil and freshly squeezed lemon
• chickpea and farro salad with red peppers, spring onions, and fresh oregano, dressed with extra virgin olive oil and lemon juice
• vegetarian pizza topped with mozzarella cheese, roasted broccoli, onions, green peppers, and carrots
• lentil, farro, and vegetable soup
• Mediterranean couscous salad with chickpeas
• tomato and tomatillo gazpacho
• tomato and cucumber salad.

Dinner

• grilled vegetable kabobs with shrimp, toasted quinoa salad, and mixed green salad with pine nuts
• steamed mussels with spinach-orzo salad and minestrone soup
• salmon, whole-grain pilaf, roasted vegetables, green salad with olive oil vinaigrette
• buddha bowl with whole grain, vegetables, plant protein, and flavorful sauce
• Mediterranean bowl with whole-grain sorghum, peppers, feta
• farro and winter vegetables
• vegetable stir fry.