A Guide to Starting the Mediterranean Diet
What we eat directly influences our physical and mental health and our longevity. By following the Mediterranean diet, you can significantly improve your health and reduce your risk for chronic conditions.
Here, we look at the many health benefits of the Mediterranean diet, the types of foods included and avoided with it and how to begin to implement Mediterranean diet-based meals in your daily routine.
What is the Mediterranean diet?
The Mediterranean diet is a dietary pattern and style of eating and living that has been studied since the 1960s as a means to promote optimal health.
Widely considered as one of the healthiest dietary models in the world, studies on the Mediterranean diet began in the 1950s, when researchers noticed that the instances of death caused by cardiovascular disease were lower in countries that border the Mediterranean Sea than they were in Northern European countries and in the United States.
Since then, the Mediterranean diet has been studied as a powerful tool for the prevention of many diseases and conditions including cardiovascular disease, anxiety and depression, cancer, type 2 diabetes, Alzheimer’s, Parkinson’s, and dementia.
The Mediterranean diet promotes:
- Daily consumption of vegetables and fruit, legumes, whole grains, extra virgin olive oil, nuts, herbs, and spices
- Moderate consumption of fish, poultry, eggs, and fermented dairy products.
- Moderate alcohol consumption; typically a glass of red wine on occasion.
- Limiting red meat.
- Avoiding refined grains, refined sugars, and processed meats.
Benefits of a Mediterranean diet
Carolyn Williams, PhD, RD, is an advocate of the Mediterranean diet, and her cookbook, Meals that Heal, is largely patterned after this dietary approach.
Williams explains, “We’ve known for years that populations near the Mediterranean Sea are some of the healthiest in the world. And the data suggests that this is due, in large part, to the foods included in a Mediterranean-style diet. Additionally, the research indicates that there is a significant association between the Mediterranean diet and a reduced risk for cardiovascular disease, type-2 diabetes, autoimmune diseases, and neurological degenerative disorders like Alzheimer’s.”
Further, an analysis of studies done on the Mediterranean diet shows that the greater an individual’s adherence to this dietary pattern, the more significant the benefit to their overall health. Those who closely followed a Mediterranean diet showed a significant reduction in: overall mortality by 9%, reduction of mortality from cardiovascular diseases by 9%, the incidence of or mortality from cancer by 6%, and the incidence of Parkinson’s and Alzheimer’s diseases by 13%.
This body of research, compiled over decades, indicates that the Mediterranean Diet should be considered clinically relevant for public health as a means to prevent major chronic diseases.
For many, the word “diet” invokes a sense of exclusion, feelings of restriction, and even fear that they’ll be eating flavorless food. But with so many colorful, flavorful food options available, the Mediterranean diet is the opposite of restrictive, boring, and flavorless, making it easier to incorporate as part of a healthy lifestyle.
Additionally, research indicates that those who consume a healthier diet rank higher in their dietary satisfaction — healthier does equal happier!
Two of the five global “Blue Zones” follow the Mediterranean diet pattern of eating. Populations in Sardinia, Italy and Ikaria, Greece have been studied as part of the Blue Zones research initiative for their collective longevity, health and happiness.
In addition to their healthy dietary patterns and practices, populations in the Blue Zones include movement throughout their day, have a deep sense of purpose, family, community and belonging and include daily habits to reduce stress.
Foods to eat on a Mediterranean diet
Studies on the Mediterranean diet indicate that the vast health benefits come not from the individual foods included, but from the dietary eating pattern as a whole. Therefore, it is important to include each of the components for optimal health.
The Mediterranean diet is the original plant-based diet — and vegetables should be included at every meal, with some models suggesting a minimum six servings daily. As the primary staple of this eating pattern, those adopting the Mediterranean Diet should eat a variety of colorful veggies.
Vegetables contain a plethora of vitamins, minerals, fiber, and antioxidant phytochemicals that help reduce inflammation and provide a nutrient and disease-fighting boost.
Vegetables commonly found in the traditional Mediterranean diet include: artichokes, arugula, beets, broccoli, Brussels sprouts, cabbage, carrots, celery, celeriac, chicory, collard greens, cucumbers, dandelion greens, eggplant, fennel, kale, leeks, lemons, lettuce, mache, mushrooms, mustard greens, nettles, okra, onions (red, sweet, white), peas, peppers, potatoes, pumpkin, purslane, radishes, rutabaga, scallions, shallots, spinach, sweet potatoes, turnips, and zucchini.
Whole, fresh fruit
Whole, fresh fruit is another Mediterranean diet staple, with some models encouraging at least three servings daily. Like vegetables, fruit offers antioxidants, fiber, and a wide variety of vitamins and minerals.
Fruit commonly found in the Mediterranean Diet includes: apples, apricots, avocados, cherries, clementines, dates, ﬁgs, grapefruits, grapes, melons, nectarines, olives, oranges, peaches, pears, pomegranates, strawberries, tangerines, and tomatoes.
Additionally, fruit is nature’s candy in the Mediterranean diet. Whereas refined, or added, sugar is inflammatory and should be avoided, fruit is anti-inflammatory. The natural sugar helps provide energy without the sugar crash of a refined sugar product's, since fruit contains fiber that slows down the metabolic process and stabilizes blood sugar.
For those looking for a better night’s rest, many of the fruit commonly found in the Mediterranean diet include compounds that are important to sleep — dried figs, avocados, and bananas provide magnesium. In addition to inflammation-busting anthocyanins, the dark pigmented skin of fruit such as cherries and berries also offers melatonin. And the serotonin provided in kiwi fruit seems to be the real winner, with one study showing that when participants ate two kiwi fruit one hour before bed, they had better sleep onset, quality, duration, and efficiency.
This group packs a big nutritional punch; some models suggest that legumes be included in every meal. Low in cost and high in B vitamins, iron, folate, calcium, potassium, phosphorous, zinc, and magnesium, legumes provide a low-to-no-fat, low-calorie plant-based source of protein.
Legumes also provide some of the best sources of dietary fiber of any food, and studies show that they help prevent and or reduce the symptoms of type 2 diabetes, reduce unhealthy (LDL) cholesterol, lower blood pressure, and help manage weight.
Where many Americans become confused is that we tend to take the term “whole grain” to mean “whole wheat flour,” or “cereal” to mean common breakfast cereals, and this could not be further from the truth.
A whole grain, or cereal — as it's often referred to in literature on the Mediterranean diet — is a grain in its whole or minimally processed form. Foods such as barley, buckwheat, bulgur, couscous, farro, millet, oats, quinoa, and brown and wild rice are examples of whole grains commonly found in the Mediterranean diet.
Like legumes, whole grains are low cost yet high in health benefits, providing an excellent source of fiber, B-vitamins, iron, copper, zinc, magnesium, and antioxidant phytochemicals. Research also indicates that dietary whole grains provide protection against type-2 diabetes, cardiovascular disease, and certain cancers.
Just remember: While whole grains are recommended, refined grains are excluded, as studies show that the intake of refined grains is associated with pro-inflammatory effects.
Fats that come from plant-based sources, such as extra virgin olive oil, avocados, nuts and seeds, provide omega-3 fatty acids and antioxidants.
Extra virgin olive oil is of particular interest and has been studied extensively for its health-promoting properties as an essential part of the Mediterranean diet. Williams also advocates for its use as a dietary means to reduce inflammation, “Extra virgin olive oil undergoes little to no chemical or heat refining, which allows it to retain more antioxidants, like vitamin E. This means it gives the body has more ammunition to fight oxidative stress and protect cells from damage.”
Due to its lower smoke point, use extra virgin olive oil at lower temperatures (Williams recommends below 325°) to ensure the oil doesn’t break down and recreate harmful chemicals in the body.
Herbs and spices
For centuries, herbs and spices have been used for their medicinal properties. Cinnamon, garlic, ginger, and turmeric have been studied for their antioxidant and anti-inflammatory properties and are often included in the Mediterranean diet.
In addition, fresh herbs like basil, bay leaf, cloves, cumin, fennel, lavender, mint, oregano, parsley, pepper, rosemary, sage, tarragon, and thyme are featured prominently in the Mediterranean diet to create fresh, flavorful meals.
Fish, eggs, and lean poultry
Protein is essential to the health of every cell in the body and plays a part in the formation, maintenance, and repair of body tissues. In addition to the plant-based proteins included in legumes, whole grains, and vegetables, the Mediterranean diet also includes low to moderate amounts of marine and animal-based protein.
Fatty fish is high in omega-3 fatty acids, which research indicates are essential to lowering inflammation, promoting a healthy brain, improving cardiovascular health, reducing cancer risk, supporting eye health, and improving sleep.
Fatty fish like salmon, trout, albacore tuna, Atlantic herring, Atlantic mackerel, anchovies, sardines and even mussels, provide an excellent dietary source of omega-3s and lean protein and included in the Mediterranean diet.
In addition to fatty fish, eggs and lean poultry, like chicken, are also included in moderate amounts in the Mediterranean diet.
Probiotic dairy products with live cultures, such as yogurt and some cheeses, help to promote a healthy gut and are included in low to moderate amounts in the Mediterranean diet. Low or no-fat, plain Greek yogurt is the perfect option as it is higher in protein than other types of yogurt. Just be sure to read labels to find any hidden added sugars that may be included in flavored yogurt.
Foods to limit or avoid on a Mediterranean diet
Refined grains, sugars, red meat, and processed foods, especially processed meats, are not commonly found in the Mediterranean diet.
Refined grains and refined sugar
The more refined a food is, the farther that food has been taken from its natural source and the less it offers in nutritional value. Studies show that diets high in refined grains and refined sugar lead to increased chronic inflammation, which is a contributing factor in most all chronic diseases, including diabetes, cardiovascular disease, depression, Alzheimer’s, obesity, and cancer.
When buying whole, fresh foods, the risk of encountering refined grains and sugars is low. The risk increases when choosing packaged and baked goods. When purchasing a packaged or processed food item, it is important to pay attention to the ingredients label and look for two words: enriched and added.
With refined grains, such as flour, the word enriched means that nutrients have been added. On the surface, that may seem like a positive. However, it actually indicates that those nutrients were initially removed and then added back during processing.
With refined sugars, the key is to reduce or avoid added sugars. Added sugars have been linked to increased inflammatory markers and to obesity, cardiovascular disease, high blood pressure, diabetes, fatty-liver disease, cancer, and cognitive decline.
Instead, opt for honey or dates for naturally added sweetness in small quantities.
Red meat and processed meat
Beef, pork, and lamb are all considered red meat. Within a traditional Mediterranean diet, these meats would only be consumed on holidays or special occasions.
High in saturated fats, red meat and processed meats (such as hot dogs, pepperoni, and some sandwich meats) have been linked to a higher instance of obesity, chronic diseases and mortality, with processed meats being especially problematic and now classified by the World Health Organization as a carcinogen.
How to build a Mediterranean meal
To build meals that follow the Mediterranean diet, registered dietitian Brierley Horton recommends that starting with vegetables as the base for every meal. Horton explains, “Because the Mediterranean diet is such a plant-heavy diet, I would start by trying to incorporate a vegetable, and if possible, both a vegetable and a fruit, at every meal.”
She also recommends building your plate based on that same premise: fill at least 75% of the plate with plant-based foods. Focus on vegetables first, then legumes, whole grains, and fruit. The remaining 25% of your plate will include your healthy fat or yogurt or lean protein, like fish, chicken, or egg.
A beginner’s tip for including a vegetable at every meal — just add spinach. This easy trick will have you eating more greens in no time. A low-calorie, nutrient-dense superfood, spinach is versatile enough to use in a sweet breakfast smoothie, be a beautiful base for your salad at lunch or the star of your main dish at dinner.
Mediterranean diet recipes for every meal
The Bottom Line
Research indicates that the benefits of adopting the Mediterranean Diet are significant, regardless of the age you begin. Start by choosing one area of the diet as your focus to create a new habit, then as you get comfortable add another, and another.
It’s never too late to make changes and adopt the Mediterranean Diet and see meaningful improvements to your health.
Experts included in this article:
Carolyn Williams, PhD, RD, is a registered dietitian and culinary nutrition expert known for her ability to simplify the concept of healthy eating. She serves as a contributing editor for Cooking Light and Real Simple and won a James Beard Award for her 2016 article “Brain Health.” She also develops content for a variety of media outlets and lifestyle brands such as Real Simple, Parents, Rally Health, Eating Well, eMeals, and Health. Other work includes nutrient analysis, recipe development, and writing, including her cookbook Meals That Heal which focuses on using the healing aspects of food with a quick, easy and practical approach. Carolyn is also a tenured faculty member at a local college teaching culinary arts and nutrition classes and co-creator and co-host of Happy Eating Podcast.
Brierley Horton, MS, RD is a dietitian nutritionist, content creator and strategist, and avid mental health advocate. She previously served as Food & Nutrition Director for Cooking Light magazine. Prior to Cooking Light, Brierley was the long-time Nutrition Editor at EatingWell magazine. She holds a master’s degree in Nutrition Communications from the Friedman School of Nutrition Science and Policy at Tufts University. Brierley’s undergraduate degrees are in Dietetics and Nutrition and Food Sciences from the University of Vermont. Her work regularly appears in EatingWell, Better Homes & Gardens, Diabetic Living, Livestrong.com, TheKitchn.com, and more. She is co-creator and co-host of Happy Eating podcast.
Julie Floyd Jones is an Atlanta, Georgia based Certified Corporate Wellness Specialist, Certified Personal Trainer and Certified Yoga Instructor. Julie is the Program Director for Excellence in Exercise where she works with corporate partners to provide wellness solutions for employees globally. She is the founder of Training & Champagning Curated Wellness Retreats and Thrive.