Highlights
- The Mediterranean diet refers to a way of eating that focuses on the traditional foods eaten in the countries that surround the Mediterranean Sea.
- The Mediterranean diet is associated with cultures that emphasize health through more than just food—that also stress physical activity, social gatherings, and a moderate consumption of wine as well.
- This style of eating emphasizes plant-based foods, incorporates some animal foods—in particular, fish—and sparingly includes sweets, red meat and processed meats.
- The Mediterranean diet has been well researched and is associated with many health benefits, primarily heart health.
The basics of the Mediterranean diet
The Mediterranean diet first became of interest to researchers in the 1950s when certain populations in the Mediterranean Sea basin were observed to be healthier than wealthier nations of the developed world. Thus, the diet refers to the traditional food cultures of the countries that surround the Mediterranean Sea, including Greece, Italy and Spain. Staples of the Mediterranean diet include fruits and vegetables, whole grains, seafood, nuts and legumes, and olive oil. In lesser amounts, poultry, eggs, cheese and dairy are consumed. But this “diet” isn’t restrictive like many fad diets; rather, it emphasizes eating nutrient-dense foods without counting calories or completely omitting any one food.
Moreover, the Mediterranean diet encompasses more than just food; for this reason, it is often described as a way of life. Traditionally, people living in Mediterranean regions have emphasized physical activity, social gatherings and relaxation along with a moderate consumption of wine with meals. In the U.S., “moderate” consumption of wine is defined as five ounces or less each day for women—about one glass—and no more than ten ounces daily for men—about two glasses.
Guidelines for the Mediterranean diet
Unlike some diets, the Mediterranean diet does not have strict requirements. However, since many people may not be familiar with the Mediterranean diet, and because its parameters can vary, here is a quick overview:
- Most meals feature vegetables, fruits, whole grains (bread, pasta, rice, etc.), and extra virgin olive oil.
- Most days also include nuts, seeds, dairy (preferably low-fat), herbs and spices.
- Every week includes, at some point, white meat, seafood, fish, eggs, potatoes and legumes.
- Sugar-sweetened beverages, added sugars, processed meat, and red meat are consumed sparingly.
The Mediterranean diet and your health
There is a solid body of evidence that supports the positive health effects of adopting the Mediterranean diet. The Primary Prevention of Cardiovascular Disease with a Mediterranean Diet (PREDIMED) study is one of the most well-known studies to examine the effects of the Mediterranean diet on health. This study was published in the New England Journal of Medicine after tracking more than 7,000 Spanish participants over the age of 55 with no cardiovascular disease but a history of health risk factors. The subjects were randomly assigned to one of three groups—two intervention groups and one control group. The intervention groups followed a Mediterranean diet (one group was provided with free olive oil and the other with free mixed nuts—walnuts, almonds and hazelnuts). The control group was not given any supplemental foods. Instead, the control group was advised to reduce their fat intake. Diets for all three groups were not calorie controlled.
The intervention groups receiving olive oil and nuts, not surprisingly, consumed more olive oil and nuts than the control group. They also ate more fish and legumes during the study. The overall differences in nutrient intake between the Mediterranean diet groups and the control group was attributed to the fat content and composition of the foods provided to the Mediterranean diet groups: olive oil and nuts. Over the course of the five-year study period, the Mediterranean diet groups had a 30% lower relative risk of major cardiovascular events compared with the control group.
While the results from the PREDIMED study have been debated, the findings align with decades of observational and intervention-based research showing health benefits from eating the Mediterranean diet. For example, the Lyon Diet Heart Study, a randomized controlled trial, examined the effect of the Mediterranean diet versus a Western-style diet in men who had recently had a heart attack. After four years, those who followed the Mediterranean diet were 72% less likely to have experienced a heart attack or died from heart disease. More recently, observational evidence has associated adherence to the Mediterranean diet with a variety of health benefits, including reduced risk for: cardiovascular events in Swedish populations (and also Swedish men); weight gain in European, Spanish and French populations; and metabolic syndrome in the U.S. population.
The bottom line
The Mediterranean diet isn’t a “diet” in the same way that some people approach food today. It is a more traditional eating style that incorporates a wide range of nutrient-dense foods. The Mediterranean diet has been well researched and is shown to be associated with many health benefits, primarily heart health. And there may be more to the healthfulness of the traditional Mediterranean way of life. People living in the regions in which the diet originates tend to enjoy a lifestyle that values nutritious food along with physical activity, social gatherings and relaxation—all of which can positively influence health.
This article was co-authored by Alyssa Pike, RD and Kris Sollid, RD.