The idea of the Mediterranean diet dates back to the 1960s, when researchers realized that heart disease was less common in Mediterranean countries like Greece and Italy than the U.S. and northern Europe. They linked this reduced risk to the traditional foods and cooking methods used by these cultures.
Decades later, the Mediterranean diet is one of the eating plans touted in the U.S. Department of Health and Human Services' Dietary Guidelines for Americans, as a diet that promotes health and helps prevent chronic disease, and it's also recognized by the World Health Organization as a healthy and sustainable dietary pattern, according to the Mayo Clinic. For these reasons, the Med diet was ranked number one for the third year in a row, per the annual U.S. News report.
Here's what you should know about this much-lauded diet, including the research-backed benefits, a few potential drawbacks and what to keep in mind as you get started.
What Is the Mediterranean Diet?
The Mediterranean diet can most simply be explained as an eating pattern based on the traditional foods of countries nestled around the Mediterranean Sea, such as Spain, Italy, Greece and Turkey.
The diet emphasizes vegetables, fruits, nuts and seeds, legumes and extra-virgin olive oil and encourages lean protein choices. Research has shown that it has a positive effect on heart and brain health, can help fight inflammation and may help you lose weight. But it lacks clear guidelines on portion sizes and can be high in carbohydrates, which means it may not be the best option for everyone.
The food eaten on the Mediterranean diet is simple in ingredients and preparation, but full of flavor. The United Nations Educational, Scientific, and Cultural Organization explains the diet as one that encompasses the original Greek meaning of the word "diet," meaning "way of life."
As a lifestyle, the diet encourages meals to be made at home with fresh and whole-food ingredients. It also focuses on the social aspect of the meal, and the importance of enjoying your food, and it encourages smaller portion sizes than what many people may be accustomed to.
Benefits of the Mediterranean Diet
The Mediterranean diet is linked to a longer life because of the health benefits research has uncovered in connection with the eating pattern.
1. You Might Lose Some Weight
The Mediterranean diet wasn't conceived as a weight-loss diet, but shedding pounds may be a positive side effect of the eating style for those who are overweight. In a March 2019 review published in Nutrients, researchers linked the diet to weight loss, lower body mass index and lower waist circumference — albeit, at a slower (but healthy) pace than other diets that are focused on weight loss.
2. Your Brain Will Probably Thank You
If you have type 2 diabetes, you'll want to hear this: According to an August 2019 study published in Diabetes Care, which followed nearly 1,500 people for two years, those who followed the Mediterranean diet and managed their type 2 diabetes had better cognitive function than those who followed different diet plans.
But the researchers also went a step further, concluding that healthy diets like the Mediterranean diet can help improve memory function among adults without diabetes.
And indeed, in a five-country study published February 2020 in the BMJ journal Gut, researchers concluded that eating a Mediterranean diet may help curb the advance of cognitive decline and frailty in older adults. The study found that the diet promotes healthy aging by promoting "good" gut bacteria and reducing inflammation — which brings us to the next benefit.
3. It May Tamp Down Inflammation
Inflammation is part of your body's natural reaction to illness or injury. It typically causes symptoms like redness and swelling, and in acute doses, it helps the body heal and repair itself.
But persistent, low-grade inflammation can be dangerous. It can be caused by a host of factors, from stress to inactivity, and it can up your risk for serious conditions like heart disease, diabetes and cancer.
But research supports the idea that eating healthy foods may help reduce chronic inflammation. And indeed, the Mediterranean diet is loaded with anti-inflammatory foods, according to Harvard Health Publishing, including antioxidant-rich fruits and vegetables (think tomatoes and leafy greens), as well as olive oil, nuts and fish.
4. You May Reap Heart-Healthy Benefits
Because the Mediterranean diet is in line with the American Heart Association (AHA)'s Diet and Lifestyle Recommendations, it's no surprise that the eating plan promotes heart health.
According to the AHA, the prevalence of heart disease is lower in Mediterranean countries than in the United States. One likely reason: A large percentage of fat in the Mediterranean diet is monounsaturated, from olive oil, which does not raise cholesterol levels the way saturated and trans fats do. Another possible reason, or at least contributor, may be differences in physical activity.
5. The Foods Are Budget-Friendly
Just because the Mediterranean diet sounds fancy doesn't mean the food is extravagant. On the contrary, the diet is rooted in the food traditionally eaten by the less affluent. Inexpensive vegetables, such as onions, carrots, tomatoes and cucumbers, are used widely in Mediterranean cuisine. Beans, legumes, pasta and cheese are also relatively inexpensive. The only item you may need to spring for? Extra-virgin olive oil, which can be pricier than butter or vegetable oils.
6. It's Easier to Stick With Than Some Other Diets
The Mediterranean diet seems to be more sustainable than some others, including paleo and intermittent fasting, according to a December 2019 study in The American Journal of Clinical Nutrition. The study allowed 250 people to self-select which of the three diets they wanted to follow, then monitored their progress over a year without the help of a dietitian. Overall, the results showed that people found the Med diet to be the easiest to adhere to, and more people were still following the diet after a year. Plus, the people who stuck with it in the long run lost the most weight.
Drawbacks of the Mediterranean Diet
1. The 'Rules' Are Somewhat Vague
Since there's no one set rulebook for the Mediterranean diet, there's no exact number when it comes to servings per day of the foods included, which may be confusing for some people.
For example, the diet uses words such as" low to moderate intake," "abundance" and "often," which are fairly open to interpretation. Calorie totals and physical activity parameters are also not explicitly laid out, so those who are looking for specific parameters will likely not be happy with this diet.
2. You Still Need to Talk to Your Doctor
If you have any medical conditions that depend on your diet, you need to speak with your doctor before starting any new eating plan.
- The Mediterranean diet can be high in carbohydrates, so those with uncontrolled diabetes should be cautious about making a drastic switch.
- The diet encourages a daily glass of wine, which may not be advisable for people taking certain medications.
- People taking blood thinners should be especially careful when making diet changes. Certain blood thinners are very sensitive to vitamin K levels in the diet, and those levels can vary dramatically based on plant intake. These folks may need more frequent blood monitoring on the Med diet, at least in the short-term.
What to Eat on the Mediterranean Diet
To reap the benefits of the Mediterranean diet, it's important to stick to the foods at the core of the eating plan as much as possible.
- Fruits, such as berries, figs, pomegranates and grapes
- Vegetables, such as leafy greens, carrots and onions
- Nuts and seeds
- Extra-virgin olive oil
- Beans and lentils
Eat in moderation:
- Cheese and dairy
- Lean proteins, such as chicken, fish and eggs
- Red meat
- Processed food
A One-Day Meal Plan to Get Started
- Breakfast: Smoked salmon and a small amount of cheese on whole-grain toast with berries and coffee
- Lunch: Whole-wheat penne pasta with warm fresh tomatoes, basil, olives and olive oil with arugula
- Dinner: A bowl filled with roasted chicken, cucumbers, tomatoes, chickpeas and a tzatziki dressing
- Nutrients: "Mediterranean Diet and Cardiodiabesity: A Systematic Review through Evidence-Based Answers to Key Clinical Questions"
- Harvard Health Publishing: "Foods That Fight Inflammation"
- Diabetes Care: "The Mediterranean Diet and 2-Year Change in Cognitive Function by Status of Type 2 Diabetes and Glycemic Control"
- United Nations Educational, Scientific, and Cultural Organization: "The Mediterranean Diet"
- American Heart Association: "Mediterranean Diet"
- Mayo Clinic: "Mediterranean diet: A heart-healthy eating plan"
- Dietary Guidelines for Americans: "Appendix 4. USDA Food Patterns: Healthy Mediterranean-Style Eating Pattern"
- U.S. News: "Best Diets 2020"
- The American Journal of Clinical Nutrition: "Intermittent fasting, Paleolithic, or Mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included choice of diet and exercise"
- Gut: "Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries"