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What Is the Mediterranean Diet? Your Ultimate Guide to the Heart-Healthy Eating Philosophy

November 14, 2019

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The way we think about the word “diet” today is as something borne of restriction that helps you lose weight. The Mediterranean diet couldn’t be further from that. Rather, it’s a heart-healthy eating pattern that includes the food staples of people who live in the countries around the Mediterranean Sea, such as Greece, Croatia, and Italy.

You’ll find that in their meals, they emphasize a plant-based eating approach loaded with vegetables and healthy fats, including olive oil and omega-3 fatty acids from fish. It’s a diet known for being heart-healthy."This diet is rich in fruits and vegetables, whole grains, seafood, nuts and legumes, and olive oil," says Nancy L. Cohen, PhD, RD, a professor of nutrition at the University of Massachusetts in Amherst. On this plan, you’ll limit or avoid red meat, sugary foods, and dairy (though small amounts like yogurt and cheese are included).

Eating this way means you also have little room for processed fare. When you look at a plate, it should be bursting with color; traditional proteins like chicken may be more of a side dish compared with produce, which becomes the main event.

How Does the Mediterranean Diet Work Exactly?

The Mediterranean diet wasn’t built as a weight loss plan — in fact, because it wasn’t developed at all but is a style of eating in a region of people that evolved naturally over centuries, there’s no official way to follow it. But it’s popular because it’s a well-rounded approach to eating that isn’t restrictive. Also worth noting is two of the five so-called blue zones — areas where people live longer and have lower rates of disease — are located in Mediterranean cities (Ikaria in Greece and Sardinia in Italy).

What Are the Potential and Known Health Benefits of the Mediterranean Diet?

The Mediterranean diet is most famous for its benefit to heart health, decreasing the risk of heart disease by, in part, lowering levels of LDL (“bad”) cholesterol and reducing mortality from cardiovascular conditions. It’s also been credited with a lower likelihood of certain cancers, like breast cancer, as well as conditions like Parkinson’s disease and Alzheimer’s disease.

Can the MIND Diet Prevent Dementia?

Emerging evidence suggests that eating this way may offer protective effects for those with or at risk for type 2 diabetes. For one, Mediterranean eating improves blood sugar control in those already diagnosed with the condition, suggesting it can be a good way to manage the disease. What’s more, given that those with diabetes are at increased odds for cardiovascular disease, adopting this diet can help improve their heart health, according to a paper published in April 2014 in the journal Nutrients.

Finally, people eat about nine servings of fruit and vegetables a day on a Mediterranean diet. Produce packs an array of disease-fighting antioxidants, and people who fill their diet with these foods have lower risk of disease. Yet as the National Institutes of Health (NIH) points out, scientists don’t know if it’s the antioxidants or other compounds (or general healthy eating patterns) that are responsible for these advantages.

Can Following the Mediterranean Diet Help With Weight Loss?

As a traditional way of eating for many cultures worldwide, the Mediterranean diet wasn’t designed for weight loss. It just so happens that one of the healthiest diets around the globe is also good for keeping your weight down.

One review, published in April 2016 in The American Journal of Medicine, looked at five trials on overweight and obese people and found that after one year those who followed a Mediterranean diet lost as much as 11 pounds (lb) more than low-fat eaters.(They dropped between 9 and 22 lb total and kept them off for a year.) But that same study found similar weight loss in other diets, like low-carb diets and the American Diabetes Association diet. The results suggest, the researchers say, that “there is no ideal diet for achieving sustained weight loss in overweight or obese individuals.”

Yet following a Mediterranean diet can be an incredibly well-rounded way to lose weight that ditches gimmicks and doesn’t require calorie or macronutrient counting as other diets (looking at you, ketogenic diet) do. And with the emphasis on healthy fat, it’s satisfying, too. That said, the 2020 U.S. News & World Report Best Diets ranked the Mediterranean diet as No. 1 for Best Diets Overall and it ranks 15 in its list of Best Weight-Loss Diets.The reviewers note that it’s not a slam dunk, and all depends on how you eat. Even healthy diets like the Mediterranean aren’t free-for-all eating plans.

Learn More About the Health and Weight Loss Benefits of the Mediterranean Diet

A Detailed Mediterranean Diet Food List to Follow: What to Eat and Avoid

When you’re looking to start to follow the Mediterranean diet, you’ll rely heavily on the following foods. While this is not a calorie-counting plan, we’ve included nutrition stats for your reference:

Olive Oil

Per Tablespoon Serving 120 calories, 0 grams (g) protein, 13g fat, 2g saturated fat, 10g monounsaturated fat, 0g carbohydrate, 0g fiber, 0g sugar

Benefits Replacing foods high in saturated fats (like butter) with plant sources high in monounsaturated fatty acids, like olive oil, may help lower the risk of heart disease by 19 percent, according to research — including an article published in March 2018 in the Journal of Clinical Nutrition.

Tomatoes

Per 1 cup, Chopped Serving 32 calories, 1.5g protein, 0g fat, 7g carbohydrates, 2g fiber, 5g sugar

Benefits They pack lycopene, a powerful antioxidant that is associated with a reduced risk of some cancers, like prostate and breast. Other components in tomatoes may help reduce the risk of blood clots, thereby protecting against cardiovascular disease, according to a review in the journal Annual Review of Food Science and Technology.

Salmon

Per 1 Small Fillet 272 calories, 44g protein, 9g fat, 0g carbohydrates, 0g fiber

Benefits The fatty fish is a major source of omega-3 fatty acids. For good heart health, the American Heart Association recommends eating at least two fish meals per week, particularly fatty fish like salmon.

Walnuts

Per 1 oz (14 Halves) Serving 185 calories, 4g protein, 18g fat, 2g saturated fat, 3g monounsaturated fat, 13g polyunsaturated fat, 4g carbohydrate, 2g fiber, 1g sugar

Benefits Rich in heart-healthy polyunsaturated fats, these nuts may also favorably impact your gut microbiome (and thus improve digestive health), as well as lower LDL cholesterol, according to a study published in May 2018 in the Journal of Nutrition.

Chickpeas

Per ½ Cup Serving 160 calories, 10g protein, 2g fat, 26g carbohydrate, 5g fiber

Benefits The main ingredient in hummus, chickpeas are a good source of fiber, which carries digestive health and weight loss benefits, as well as iron, zinc, folate, and magnesium.

Arugula

Per 1 Cup Serving 5 calories, 0.5g protein, 0g fat, 1g carbohydrate, 0g fiber, 0g sugar

Benefits Leafy greens, like arugula, are eaten in abundance under this eating approach. Mediterranean-like diets that include frequent (more than six times a week) consumption of leafy greens have been shown to reduce the risk of Alzheimer’s disease, according to a study published in September 2015 in the journal Alzheimer's and Dementia.

Pomegranate

Per ½ Cup Serving (Arils) 72 calories, 1.5g protein, 1g fat, 16g carbohydrates, 4g fiber, 12g sugar

Benefits: This fruit, in all its bright red glory, packs powerful polyphenols that act as an antioxidant and anti-inflammatory. It’s also been suggested that pomegranates may have anti-cancer properties, too, according to a paper published in March 2014 in the journal Advanced Biomedical Research.

Lentils

Per ½ Cup Serving 115 calories, 9g protein, 0g fat, 20g carbohydrate, 8g fiber, 2g sugar

Benefits One small study, published in April 2018 in the Journal of Nutrition, suggested that swapping one-half of your serving of a high-glycemic starch (like rice) with lentils helps lower blood glucose by 20 percent.

Farro

Per ¼ Cup (Uncooked) Serving 200 calories, 7g protein. 1.5g fat, 37g carbs, 7g fiber, 0g sugar

Benefits Whole grains like farro are a staple of this diet. This grain offers a stellar source of satiating fiber and protein. Eating whole grains is associated with a reduced risk of a host of diseases, like stroke, type 2 diabetes, heart disease, and colorectal cancer.

Greek Yogurt

Per 7 oz Container (Low-Fat Plain) 146 calories, 20g protein, 4g fat, 2g saturated fat, 1g monounsaturated fat, 0g polyunsaturated fat, 8g carbs, 0g fiber, 7g sugar

Benefits Dairy is eaten in limited amounts, but these foods serve to supply an excellent source of calcium. Opting for low- or nonfat versions decreases the amount of saturated fat you’re consuming.

A 7-Day Sample Mediterranean Diet Meal Plan

To get an idea of what eating on a Mediterranean diet looks like, check out this week’s worth of sample meals:

Day 1

Breakfast Greek yogurt topped with berries and a drizzle of honey

Snack Handful of almonds

Lunch Tuna on a bed of greens with a vinaigrette made with olive oil

Snack Small bowl of olives

Dinner Small chicken breast over a warm grain salad made with sautéed zucchini, tomato, and farro

Day 2

Breakfast Whole-grain toast with a soft-boiled egg and a piece of fruit

Snack Handful of pistachios

Lunch Lentil salad with roasted red peppers, sun-dried tomatoes, capers, and an olive oil–based vinaigrette

Snack Hummus with dipping veggies

Dinner Salmon with quinoa and sautéed garlicky greens

Day 3

Breakfast Whipped ricotta topped with walnuts and fruit

Snack Roasted chickpeas

Lunch Tabouli salad with whole grain pita and hummus

Snack Caprese skewers

Dinner Roasted chicken, gnocchi, and a large salad with vinaigrette

Day 4

Breakfast Fruit with a couple of slices of Brie

Snack Cashews and dried fruit

Lunch Lentil soup with whole-grain roll

Snack Tasting plate with olives, a couple slices of cheese, cucumbers, and cherry tomatoes

Dinner White fish cooked in olive oil and garlic, spiralized zucchini, and a sweet potato

Day 5

Breakfast Omelet made with tomatoes, fresh herbs, and olives

Snack A couple of dates stuffed with almond butter

Lunch A salad topped with white beans, veggies, olives, and a small piece of chicken

Snack A peach and plain Greek yogurt

Dinner Grilled shrimp skewers with roasted Brussels sprouts

Day 6

Breakfast Eggs scrambled with veggies and chives and topped with feta with a slice of whole-grain bread

Snack Greek yogurt

Lunch A quinoa bowl topped with sliced chicken, feta, and veggies

Snack Hummus with veggies

Dinner Grilled seafood, roasted fennel and broccoli, arugula salad, and quinoa

Day 7

Breakfast Veggie frittata

Snack Handful of berries

Lunch A plate of smoked salmon, capers, lemon, whole-grain crackers, and raw veggies

Snack Mashed avocado with lemon and salt, with cucumbers for dipping

Dinner Pasta with red sauce and mussels

What Are the Pros and Cons of a Mediterranean Diet?

When you’re deciding whether a Mediterranean Diet is right for you, consider these pros and cons:

Pros

It’s easy to stick with. A diet works only if it’s doable. That means everyone in your family can eat it and you can eat in this style no matter where you go (to a restaurant for dinner, to a family event). With its flavors and variety of foods that don’t cut out any food group, this is one such eating plan. "It is an appealing diet that one can stay with for a lifetime,” Cohen says.

You can eat what you love. It’s evident that with such a variety of whole, fresh foods available to you as options, it’s easy to build meals based on the diet. And you don’t have to eliminate your favorites, either. They may require just some tweaks. For instance, rather than a sausage and pepperoni pizza, you’d choose one piled high with veggies. You can also fit in a lot of food into one meal. Filling up on fresh foods like fruit and vegetables will allow you to build volume into meals for fewer calories.

It’s low in saturated fat. You’re not going to feel hungry eating this way, because you can build in a variety of healthy fats. But by limiting large amounts of red or processed meats and relying heavily on monounsaturated fatty acids, like avocado, nuts, or olive oil, you’ll keep saturated fat levels low. These fats don't lead to high cholesterol the same way saturated fats do. Healthful sources of fat include olive oil, fish oils, and nut-based oils, Cohen explains.

It reduces risk of disease. A growing number of studies suggest that people who follow a Mediterranean diet are less likely to die of heart disease than people who follow a typical American diet. What’s more, evidence is emerging that shows people who eat this way have a lower risk of colon cancer, prostate cancer, and some head and neck cancers, according to studies published in September 2016 in the British Journal of Cancer, in February 2018 in the Journal of Urology, and in September 2017 in the European Journal of Cancer Prevention.

The Mediterranean Diet May Cut the Risk of One Type of Inflammatory Bowel Disease

Cons

Milk is limited. There are no long-term risks to eating Mediterranean, says Cohen. But you may be put off if you’re big on eating a lot of milk and rely on it to get all the calcium you need. You’ll get to eat cheese and yogurt but in smaller amounts. "To get enough calcium in the diet without milk, one would need to eat enough yogurt and cheese, or seek nondairy calcium sources," says Cohen. If needed, drink skim milk. Otherwise, nondairy calcium sources include fortified almond milk, sardines, kale, and tofu made with calcium sulfate.

You still have to cap alcohol. The hallmark of a Mediterranean diet is that drinking red wine socially is thought to be one reason why the diet is so healthy. But women should still stick to one glass and men two glasses. If you have a history of breast cancer in the family, know that any alcohol consumption raises that risk.In that case, talk to your doctor to find out what’s right for you.

Fat isn’t unlimited either. As with wine, it's possible to get too much of a good thing when it comes to healthy fats. While the Mediterranean diet meets heart-healthy diet limits for saturated fat, your total fat consumption could be greater than the daily recommended amount if you aren't careful. Plus, as Harvard Health Publishing notes, not all fats are created equal, and you’ll want to minimize your saturated fat intake in favor of healthier fats like those found in olive oil.Your total daily fat intake should provide 20 to 35 percent of your total daily caloric intake, according to the Institute of Medicine (now the National Academies of Science, Engineering, and Medicine), and saturated fats should represent less than 7 percent of your total caloric intake.

You have to find time to cook. While you don’t have to spend hours in your kitchen, you will need to cook because the diet is all about working with delicious fresh food. You may have a learning curve as you build these skills.

What Are the Potential Short- and Long-Term Effects of a Mediterranean Diet?

As has become obvious, there are numerous potential benefits from adopting a Mediterranean diet. Over the long term, these health effects may be more pronounced and can include better brain health by slowing cognitive decline and lowering risk of Alzheimer’s disease and other dementias.

It also may help stave off chronic diseases, like heart disease and type 2 diabetes, as well as act protectively against certain cancers.The diet is also a boon to mental health, as it’s associated with reduced odds of depression.There’s even some data to suggest it can be supportive in relieving symptoms of arthritis.

In the short term, you may lose a modest amount of weight over a year span and are likely to keep it off it you continue to eat following the diet. If eating in the Mediterranean style prompts you to consume more fruit and vegetables, you’ll not only feel better physically, but your mental health will get a lift, too. Research shows that people who eat more raw fruit and veggies (particularly dark leafy greens like spinach, fresh berries, and cucumber) have fewer symptoms of depression, a better mood, and more life satisfaction.