For decades, the Mediterranean diet has remained one of the most popular and healthiest dietary choices, advised by dietitians and health organizations around the globe. What is the Mediterranean diet, and what makes it healthy? This post reveals potential health benefits, suggested food list, and some transitioning tips for those of you willing to go Mediterranean!
The Mediterranean diet is based on the traditional cuisine from the Mediterranean regions. It abounds in fruits, vegetables, whole grains, and olive oil, with a moderate intake of fish, eggs, legumes, and dairy. Red meat and sweets are consumed sparingly.
The high content of vitamins, minerals, fiber, and unsaturated fatty acids makes the Mediterranean diet a healthy choice and a powerful disease prevention aid.
The Mediterranean diet may reduce the risk of heart disease, diabetes, Parkinson’s disease, and Alzheimer’s disease. People following this type of diet also tend to have lower rates of stroke, cognitive issues, depression, and cancer. Benefits for other conditions such as asthma, IBD, rheumatoid arthritis, and fatty liver lack stronger evidence.
If you’re transitioning to a Mediterranean-style diet, start by consuming more fruits and veggies, cooking with olive oil, snacking on nuts and seeds, and swapping red meat for fish.
What is the Mediterranean Diet?
The Mediterranean diet is based on the traditional cuisine of the Mediterranean regions, such as Greece, Spain, southern Italy, and southern France. It gained popularity when researchers noticed significantly lower heart disease rates and higher life expectancy among Mediterranean folks.
This diet doesn’t actually represent the way people eat in the Mediterranean regions today, given the growing influence of western dietary habits. A proper Mediterranean diet abounds in fruits, vegetables, whole grains, and olive oil, with a moderate intake of fish, eggs, legumes, and dairy; red meat and sweets are consumed sparingly [1, 2].
Definition
The Mediterranean diet doesn’t have a precise definition or strict rules to follow, so some dietitians prefer to call it a Mediterranean-style diet. This gives a person more freedom in meal planning, but it’s a significant limitation when studying the potential health benefits.
A group of Australian researchers emphasized this issue back in 2015 and provided more precise meal-planning guidelines for the Mediterranean diet by summarizing the available literature [3]:
- 3-9 daily servings of vegetables
- ½-2 daily servings of fruits
- Up to 8 daily servings of olive oil
- Up to 13 daily servings of cereals (mostly whole grains)
- 2-6 weekly servings of fish/seafood
- 2-4 weekly servings of eggs and poultry
- Up to 2 weekly servings of red meat
When it comes to macronutrients, the Mediterranean diet roughly contains [3]:
- 37% of daily calories as total fat (19% MUFA, 5% PUFA, 9% SFA)
- 43% of daily calories as carbs (33 g of dietary fiber)
- 15% of daily calories as protein
Mediterranean Diet Food List & Menu
Source: Oliviero et al. (2009), Mediterranean Food Pattern in Rheumatoid Arthritis https://www.researchgate.net/figure/Fig-1-The-Mediterranean-diet-pyramid-simple-graphic-format-of-the-most-up-to-date_fig1_228622489
The following is a general Mediterranean diet menu/food list [3, 4]:
Consumed generously:
- Vegetables (all kinds, cooked or fresh, mostly seasonal)
- Fruits (all kinds, mostly fresh & seasonal)
- Whole grains & their products (rice, wheat, oats, etc.)
- Olive oil
- Herbs and spices (rosemary, thyme, oregano, basil, etc.)
Consumed in moderation:
- Fatty fish & seafood (sardines, tuna, oysters, shellfish, etc.)
- Other plant oils such as sunflower oil
- Eggs
- Dairy (cheese and yogurt)
- Legumes (beans, peas, lentils, chickpeas, etc.)
- Nuts and seeds (almonds, walnuts, cashews, sunflower seeds, sesame seeds, etc.)
- Poultry (chicken & turkey)
Consumed sparingly:
- Red meat (pork, beef, lamb)
- Sweets
- White flour products
Sharing meals with others and drinking moderate amounts of red wine are also important aspects of the Mediterranean diet. According to the American Heart Association, you should limit daily alcohol intake to one drink (for women) or two drinks (for men). People prone to alcoholism and substance abuse should steer clear of alcohol in any amounts [5, 6].
Nutrients
What makes a Mediterranean-style diet healthy? The answer lies in a diversity of whole foods that deliver essential nutrients such as [7]:
- Vitamins and minerals
- Polyphenols and other antioxidants (from fruits and vegetables)
- Healthy unsaturated fats (from fish, olive oil, nuts, seeds & avocado)
- Dietary fiber (from whole grains, legumes, fruits, and veggies)
A moderate intake of animal products and a limited intake of saturated fat & refined sugar likely contribute to potential health benefits discussed in the following section [7].
Health Benefits
Likely Effective:
1) Heart Disease
In 2018, a group of Italian authors published a huge clinical review of the Mediterranean diet’s health effects, encompassing 29 meta-analyses and over 12,800,000 participants. They found 33% lower heart disease rates and 25% lower mortality from heart disease in people who followed this type of diet [8].
Another large meta-analysis of over 500K subjects found 9% lower mortality from heart disease in people on the Mediterranean diet [9].
A calorie-unrestricted Mediterranean diet reduced heart disease risk by 30% in the well-known PREDIMED clinical trial of 7447 Spanish people [10].
2) Diabetes
The above-mentioned 2018 Italian review found 17% lower diabetes rates among Mediterranean diet followers [8].
In a meta-analysis of 20 clinical trials, this diet type was more effective at improving blood sugar control than low-carb and high-protein diets [11].
3) Parkinson’s Disease and Alzheimer’s Disease
Parkinson’s disease and Alzheimer’s disease are the most common neurodegenerative diseases in the elderly, severely impacting their life expectancy and quality of life [12].
Those who practiced the Mediterranean diet had 13-21% lower rates of neurodegenerative diseases in the 2018 Italian review [8].
Another meta-analysis of over 500K subjects observed 13% lower odds of Parkinson’s disease and Alzheimer’s disease among Mediterranean diet followers [9].
Possibly Effective:
4) Stroke Prevention
In a study involving over 23,000 subjects, women with the greatest adherence to the Mediterranean diet had 22% lower stroke rates. On the other hand, the protective effect was not significant in men [13].
5) Cognitive Decline
Greater long-term adherence to the Mediterranean diet is associated with 25-36% lower odds of cognitive impairment, according to a study of nearly 28K men [14].
According to a 2016 review, higher adherence to the Mediterranean diet is associated with better cognitive function and reduced progression of cognitive decline into dementia [15].
6) Depression
An extensive analysis of 41 studies found a link between a Mediterranean-style diet and 33% lower depression rates [16].
7) Cancer Prevention
The findings discussed below stem from preliminary clinical research. The existing data should guide further investigation but shouldn’t be interpreted as supportive of anticancer effects until more research is done.
The 2018 Italian review observed 5-14% lower cancer rates and mortality with greater adherence to the Mediterranean diet. The results for specific cancer types were variable. This type of diet may not help prevent bladder, endometrial, and ovarian cancers [8].
In a 2017 meta-analysis, the Mediterranean diet was associated with lower odds of different cancer types, especially colorectal cancer. According to the study authors, the protective effects likely stem from the increased intake of vegetables, fruits, and whole grains [17].
8) Weight Control
Following the Mediterranean diet for at least one year may result in a weight loss of 4.1-10.1 kg, according to a review comparing different types of diets. It was more effective than a low-fat diet and as effective as other studied diets [18].
In a meta-analysis of 20 clinical trials, the Mediterranean diet slightly reduced weight (by 1.84 kg) in people with diabetes [11].
Calorie control is a crucial aspect of any diet aiming to reduce body weight, regardless of its type [19].
Insufficient Evidence:
9) Asthma
A meta-analysis associated adherence to the Mediterranean diet with a slightly reduced incidence of wheezing (15%) and asthma (14%) in children [20].
10) Rheumatoid Arthritis
The Mediterranean diet is rich in anti-inflammatory components that may reduce swelling and pain in arthritic joints [21].
According to one study of 51 patients, those following this diet had significantly higher vitality scores (energy, quality of life, and general function) than those eating a typical western diet [21].
The Mediterranean diet’s anti-inflammatory effect may be due to its high olive oil and fish oil content. People who consume more of these healthy fat sources are significantly less likely to develop rheumatoid arthritis [22, 23, 24].
11) High Blood Pressure
In different meta-analyses and clinical reviews, the Mediterranean diet slightly reduced blood pressure, but the researchers were unsure if the reduction had clinical significance [25, 26, 27].
12) Fatty Liver
According to a 2018 review, the Mediterranean diet may be a promising approach to improve liver status in people with non-alcoholic fatty liver disease (NAFLD). However, the authors emphasized low evidence quality and significant limitations [28].
13) IBD
A recommended dietary pattern to keep IBD in remission includes [29]:
- Increased intake of omega-3 fatty acids
- Increased intake of fiber, especially from fruits and vegetables
- Avoiding processed vegetable oils
- Cutting back on red meat
- Reduced intake of sweets and refined carbs
The Mediterranean diet generally follows the above pattern. Some experts recommend it as a complementary approach to digestive disorders such as IBD. Compared with northern Europe, the incidence of IBD is lower in the Mediterranean regions [30, 31. 29].
Due to high fiber content, IBD patients may want to avoid this kind of diet during the active disease phases or “flares” [32].
14) Male-Pattern Baldness
In a study of over 200 men, male-pattern baldness incidence dropped by over 50% in those eating a Mediterranean diet rich in fresh vegetables and herbs [33].
Transitioning Tips
If you’re currently following a typical western diet, transitioning to the Mediterranean diet may be challenging. The following simple tips may help in the beginning:
- Include more fruits and vegetables in salads, snacks, and side dishes.
- Swap white flour and refined grains for whole grains and their products.
- Use olive oil instead of other fats for cooking.
- Snack on fruits, nuts, and seeds instead of processed foods.
- Swap red meat for fish or seafood at least twice a week.
- Have at least one meatless day a week (e.g., Meatless Monday)
What do you like/dislike about the Mediterranean diet? If you tried practicing it, what was your experience? Feel free to leave a comment below!
