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The Mediterranean Diet

What You Need to Know About Eating the Mediterranean Way

Mediterranean dish

When you think about Mediterranean food, your mind may go to pizza and pasta from Italy, or lamb chops from Greece, but these dishes don’t fit into the healthy dietary plans advertised as “Mediterranean.” A true Mediterranean diet consists mainly of fruits and vegetables, seafood, olive oil, hearty grains, and other foods that help fight against heart disease, certain cancers, diabetes, and cognitive decline. It’s a diet worth chasing; making the switch from pepperoni and pasta to fish and avocados may take some effort, but you could soon be on a path to a healthier and longer life.

What is a “Mediterranean diet”?

Over the past 50 years, what we think of as Mediterranean fare has changed. Many of us picture huge, three-hour feasts with multiple courses of pizza, lasagna, racks of lamb, long loaves of white bread, and endless bottles of wine. But the true Mediterranean Diet is based on the region’s traditional fruits, vegetables, beans, nuts, seafood, olive oil, and dairy—with perhaps a glass or two of red wine. That’s how the inhabitants of Crete, Greece, and southern Italy ate circa 1960, when their rates of chronic disease were among the lowest in the world and their life expectancy among the highest, despite having only limited medical services.

And the real Mediterranean diet is about more than just eating fresh, wholesome food. Daily physical activity and sharing meals with others are vital elements of the Mediterranean Diet Pyramid. Together, they can have a profound effect on your mood and mental health and help you foster a deep appreciation for the pleasures of eating healthy and delicious foods.

Of course, making changes to your diet is rarely easy, especially if you’re trying to move away from the convenience of processed and takeout foods. But the Mediterranean diet can be an inexpensive as well as a satisfying and very healthy way to eat.

Health benefits of a Mediterranean diet

A traditional Mediterranean diet consisting of large quantities of fresh fruits and vegetables, nuts, fish and olive oil—coupled with physical activity—can reduce your risk of serious mental and physical health problems by:

Protecting against type 2 diabetes. A Mediterranean diet is rich in fiber which digests slowly, prevents huge swings in blood sugar, and can help you maintain a healthy weight.

Preventing heart disease and strokes. Following a Mediterranean diet limits your intake of refined breads, processed foods, and red meat, and encourages drinking red wine instead of hard liquor—all factors that can help prevent heart disease and stroke.

Keeping you agile. If you’re an older adult, the nutrients gained with a Mediterranean diet may reduce your risk of developing muscle weakness and other signs of frailty by about 70 percent.

Reducing the risk of Alzheimer’s. Research suggests that the Mediterranean diet may improve cholesterol, blood sugar levels, and overall blood vessel health, which in turn may reduce your risk of Alzheimer’s disease or dementia.

Halving the risk of Parkinson’s disease. The high levels of antioxidants in the Mediterranean diet can prevent cells from undergoing a damaging process called oxidative stress, thereby cutting the risk of Parkinson’s disease in half.

Increasing longevity. By reducing your risk of developing heart disease or cancer with the Mediterranean diet, you’re reducing your risk of death at any age by 20%.

Myths and facts about the Mediterranean diet

Following a Mediterranean diet has many benefits, but there are still a lot of misconceptions on exactly how to take advantage of the lifestyle to lead a healthier, longer life. The following are some myths and facts about the Mediterranean diet.

Myths and facts of a Mediterranean diet

Myth 1: It costs a lot to eat this way.

Fact: If you're creating meals out of beans or lentils as your main source of protein, and sticking with mostly plants and whole grains, then the Mediterranean diet is less expensive than serving dishes of packaged or processed foods.

Myth 2: If one glass of wine is good for your heart, then three glasses is three times as healthy.

Fact: Moderate amounts of red wine (one drink a day for women; two for men) certainly has unique health benefits for your heart, but drinking too much has the opposite effect. Anything more than two glasses of wine can actually be bad for your heart.

Myth 3: Eating large bowls of pasta and bread is the Mediterranean way.

Fact: Typically, Mediterraneans don't eat a huge plate of pasta the way Americans do. Instead, pasta is usually a side dish with about a 1/2-cup to 1-cup serving size. The rest of their plate consists of salads, vegetables, fish or a small portion of organic, grass-fed meat, and perhaps one slice of bread.

Myth 4: The Mediterranean diet is only about the food.

Fact: The food is a huge part of the diet, yes, but don't overlook the other ways the Mediterraneans live their lives. When they sit down for a meal, they don't sit in front of a television or eat in a rush; they sit down for a relaxed, leisurely meal with others, which may be just as important for your health as what's on your plate. Mediterraneans also enjoy plenty of physical activity.

How to make the change

If you’re feeling daunted by the thought of changing your eating habits to a Mediterranean diet, here are some suggestions to get you started:

Eat lots of vegetables. Try a simple plate of sliced tomatoes drizzled with olive oil and crumbled feta cheese, or load your thin crust pizza with peppers and mushrooms instead of sausage and pepperoni. Salads, soups, and crudité platters are also great ways to load up on vegetables.

Always eat breakfast. Fruit, whole grains, and other fiber-rich foods are a great way to start your day, keeping you pleasantly full for hours.

Eat seafood twice a week. Fish such as tuna, salmon, herring, sablefish (black cod), and sardines are rich in Omega-3 fatty acids, and shellfish like mussels, oysters, and clams have similar benefits for brain and heart health.

Cook a vegetarian meal one night a week. If it’s helpful, you can jump on the “Meatless Mondays” trend of foregoing meat on the first day of the week, or simply pick a day where you build meals around beans, whole grains, and vegetables. Once you get the hang of it, try two nights a week.

Use good fats. Extra-virgin olive oil, nuts, sunflower seeds, olives, and avocados are great sources of healthy fats for your daily meals.

Enjoy dairy products in moderation. The USDA recommends limiting saturated fat to no more than 10% of your daily calories (about 200 calories for most people). That still allows you to enjoy dairy products such as natural (unprocessed) cheese, Greek or plain yogurt.

For dessert, eat fresh fruit. Instead of ice cream, cake or other baked goods, opt for strawberries, fresh figs, grapes, or apples.

What to do about mercury in fish

Despite all the health benefits of seafood, nearly all fish and shellfish contain traces of pollutants, including the toxic metal mercury. These guidelines can help you make the safest choices.

  • The concentration of mercury and other pollutants increases in larger fish, so it’s best to avoid eating large fish like shark, swordfish, tilefish, and king mackerel.
  • Most adults can safely eat about 12 ounces (two 6-ounce servings) of other types of cooked seafood a week.
  • Pay attention to local seafood advisories to learn if fish you’ve caught is safe to eat.
  • For women who are pregnant, nursing mothers, and children aged 12 and younger, choose fish and shellfish that are lower in mercury, such as shrimp, canned light tuna, salmon, pollock, or catfish. Because of its higher mercury content, eat no more than 6 ounces (one average meal) of albacore tuna per week.

Make mealtimes a social experience

The simple act of talking to a friend or loved over the dinner table can play a big role in relieving stress and boosting mood. Eating with others can also prevent overeating, making it as healthy for your waistline as it is for your outlook. Switch off the TV and computer, put away your smartphone, and connect to someone over a meal.

Gather the family together and stay up to date with each other’s daily lives. Regular family meals provide comfort to kids and are a great way to monitor their eating habits as well.

Share meals with others to expand your social network. If you live alone, cook a little extra and invite a friend, coworker, or neighbor to join you.

Cook with others. Invite a friend to share shopping and cooking responsibilities for a Mediterranean meal. Cooking with others can be a fun way to deepen relationships and splitting the costs can make it cheaper for both of you.

Quick start to a Mediterranean diet

The easiest way to make the change to a Mediterranean diet is to start with small steps. You can do this by:

  • Sautéing food in olive oil instead of butter.
  • Eating more fruits and vegetables by enjoying salad as a starter or side dish, snacking on fruit, and adding veggies to other dishes.
  • Choosing whole grains instead of refined breads, rice, and pasta.
  • Substituting fish for red meat at least twice per week.
  • Limit high-fat dairy by switching to skim or 1% milk from 2% or whole milk
Instead of this: Try this Mediterranean option:

Chips, pretzels, crackers and ranch dip

Carrots, celery, broccoli and salsa

White rice with stir-fried meat

Quinoa with stir-fried vegetables

Sandwiches with white bread or rolls

Sandwich fillings in whole-wheat tortillas

Ice cream

Pudding made with skim or 1% milk

Adapted with permission from Harvard Health Letter: July 2013, a newsletter published by Harvard Health Publications.

More help for diets

Resources and references

Health benefits of a Mediterranean diet

Study Supports Heart Benefits from Mediterranean-Style Diets – A study starting in 2003 shows the healthy results from eating a Mediterranean diet. (Harvard Health Publications)

Mediterranean diet beats low-fat diet for long-term weight loss – How the Mediterranean diet can be as good for your waistline as it is for your heart. (Harvard Health Publications)

Antioxidants: Vitamin C and E, Mediterranean Diet – A breakdown on the benefits of a diet rich with Vitamin C and E, and monounsaturated fats. (National Parkinson Foundation)

Mediterranean Diet: A heart-healthy eating plan – Learning about a heart-healthy eating plan based on typical foods and recipes of Mediterranean-style cooking. (Mayo Clinic)

Omega-3 fatty acids

Omega-3 Fatty Acids – Simple charts listing omega-3 fatty acid content of selected foods. (Tufts University School of Medicine)

Mediterranean recipes

Mediterranean diet recipes - Choose from a selection of different Mediterranean diet recipes. (Mayo Clinic)

A Mediterranean Meal Plan - Provides recipes for breakfast, lunch, dinner, and snacks that conform to the Mediterranean diet. (American Diabetes Association)

Authors: Greg Boose and Robert Segal, M.A. Last updated: May 2017.