There is no exact “Mediterranean” diet. Based on how people from 16 countries bordering the Mediterranean Sea eat and drink, this dietary pattern may vary depending on culture, ethnic background, religion, economy, and agricultural production.

However, the Mediterranean diet does emphasize nutritious, single-ingredient foods that are rich in fiber and healthy fats, including vegetables, fruits, whole grains, beans, fish, nuts, seeds, and olive oil.

Science Behind the Diet

The Mediterranean diet is primarily known for its heart-healthy attributes. It blends the basics of healthy eating with traditional flavors and cooking techniques from the Mediterranean Sea region. In the 1960s, researchers observed fewer deaths related to coronary heart disease in Mediterranean countries, including Greece and Italy, when compared to the US and northern Europe.

Subsequent studies depicted a connection between the Mediterranean diet and reduced risk factors for cardiovascular disease. Healthy fats are a staple in the Mediterranean diet. Monounsaturated fats, found in olive oil, nuts, and seeds, are the principal fat source in the Mediterranean diet.

Monounsaturated fats do not raise blood cholesterol levels the way saturated fats from animal products do. Rather, they have been shown to lower LDL cholesterol, or “bad” cholesterol, levels, thus reducing the risk of cardiovascular events, like stroke and heart attack.

Those who follow the Mediterranean diet tend to eat much less saturated fats than those who follow the average American diet. Fatty fish, a main protein source of the Mediterranean diet, are rich in omega-3 fatty acids. Omega-3 fatty acids are a type of polyunsaturated fat that may help reduce inflammation in the body as well as decrease triglycerides, reduce blood clotting, and lower the risk of stroke and heart failure.

Other than heart-healthy benefits, the Mediterranean diet may also play a role in weight loss, improved rheumatoid arthritis symptoms, and reduced risk of Alzheimer’s disease, type 2 diabetes, and various types of cancer.

Foods to Eat

Daily, Without Restrictions

• Fruits & Vegetables – aim for 7-10 servings per day
• Legumes – beans, peas, lentils, pulses, peanuts, chickpeas
• Nuts & Seeds – walnuts, almonds, hazelnuts, macadamia nuts, cashews, and sunflower & pumpkin seeds
• Whole Grains – oats, barley, rye, quinoa, brown rice, couscous, bulgur, farro, and whole-grain breads, cereals & pasta
• Herbs & Spices – basil, chili powder, cinnamon, cloves, cumin, dill, garlic, ginger, fennel seed, marjoram, mint, oregano; boost flavor & lessen salt
• Healthy Oils – canola, extra-virgin olive, safflower, sesame, flaxseed, grapeseed, avocado
• Fish & Seafood – salmon, sardines, herring, tuna, trout, mackerel, mussels, oysters, shrimp, and clams; at least twice per week
• Water – primary hydration source
  
  

Throughout the Week, In Moderation

• Poultry – skinless, white meat; baked, broiled, or grilled
• Eggs – no limit on egg whites; eat egg yolks in moderation
• Dairy – low-fat milk, cheese, yogurt, & cottage cheese
• Wine – enjoy a serving of red wine with a meal (1 serving for women, up to 2 servings for men); if you do not drink, the American Heart Association does not recommend starting
  
  

Once or Twice a Month, In Small Portions

• Red Meat – limit to lean cuts like tenderloin, sirloin & flank steak; limit to no more than 1 serving per week
• Sweets – avoid commercial baked goods & desserts; limit homemade baked goods to less than 3 times per week

Mediterranean Diet Meal Examples

• Greek yogurt with strawberries and oats
• Oatmeal with raisins and nuts
• Vegetable & feta omelet and a side of fruit
• Smashed avocado on whole-grain pita, topped with eggs fried in olive oil
• Whole grain toast with nut butter & sliced banana
• Hard-boiled egg with a homemade fruit smoothie

• Lentil soup Tuna salad
• Vegetable & hummus wrap with fruit
• Farro salad with shrimp
• Pasta with basil tapenade
• Quinoa salad with bell peppers, olives, cucumber, tomatoes & feta

• Grilled fish, pasta with marinara sauce & eggplant sautéed in olive oil
• Baked chicken with green beans and potatoes, topped with oregano, garlic & lemon
• Salad with chickpeas, tomatoes, olives & feta cheese
• Broiled salmon with brown rice & vegetables
• Cauliflower crust pizza with Greek yogurt pesto & grilled veggies
• Quesadilla with sautéed spinach, sun-dried tomatoes, olives & feta cheese.

Snacks

• Hummus & carrots, celery or bell pepper strips
• Nut butter with apple slices
• Almonds & low-fat cheese
• Yogurt & figs
• Air-popped popcorn
• Homemade trail mix with nuts, seeds & dried fruit
• Guacamole & bean or plantain chips
• Fresh fruit
• Veggie chips
• Marinated olives

Transitioning to the Mediterranean Diet

Make transitions gradual over weeks or months so your new eating style becomes a habit rather than a phase.

• Throw out highly processed foods
• Reduce red meat, replace it with fish and poultry
• Gradually add more fruits and vegetables at mealtimes
• Use olive oil, herbs, and spices in place of salt and butter
• Drink water in place of soda or sweetened beverages a few times per day
• Start eating plant-based foods 80% of the time
• Try snacking on nuts or fruit
• Limit dairy to low-fat varieties
• Choose whole-grain products

Make sure to incorporate other lifestyle habits to optimize your health!

• Partake in at least 150 minutes of physical activity per week
• Take time to socialize and eat meals with your family and friends

Stock Your Kitchen for Success

Keep a variety of staple foods handy and in their proper places to make preparing healthy meals simple.

• Artichokes (canned)
• Beans
• Bread
• Canned Seafood
• Capers
• Cereals
• Crackers
• Garlic
• Whole Grains
• Herbs & Spices
• Honey
• Legumes
• Nuts & Seeds Oils
• Olives
• Pasta
• Potatoes
• Red Wine
• Tomatoes (Canned or Jarred)
• Vinegar
• Low-Sodium Chicken or Vegetable Stock
  

In the Fridge

• Dairy – low-fat varieties
• Eggs
• Fruits – berries & grapes
• Poultry
• Hummus & Other Mediterranean Dips
• Mustard
• Pesto
• Pickles
• Tapenade
• Vegetables
  

In the Freezer

• Frozen Fruit
• Frozen Poultry & Lean Meat
• Frozen Seafood
• Frozen Vegetables

In The Pantry

• Fresh Fruit – many fruits keep best at room temperature
• Tomatoes – store fresh tomatoes at room temperature
• Olive Oil – keep an olive oil dispenser near your stovetop and store the rest in a cool, dark place

The Bottom Line

The Mediterranean diet eating pattern is not one defined diet, but rather an overall eating style that features plant-based foods that are rich in healthy fats and fiber, rather than animal sources. This delicious way to eat blends traditional flavors and cooking methods of the Mediterranean, all while promoting health and preventing chronic disease.

References:

Cleveland Clinic. Mediterranean Diet. Cleveland Clinic Website. https://my.clevelandclinic.org/health/articles/16037-mediterranean-diet. Reviewed September 1, 2017. Accessed October 23, 2019.

Mayo Clinic Staff. Mediterranean diet: A heart-healthy eating plan. Mayo Clinic Website. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801. Published June 21, 2019. Accessed October 23, 2019. American Heart Association. Mediterranean Diet.

American Heart Association Website. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet. Reviewed April 18, 2018. Accessed October 23, 2019.

National Institutes of Health. Mediterranean diet may slow development of Alzheimer’s disease. NIH Website. https://www.nih.gov/news-events/nih-research-matters/mediterranean-diet-may-slow-development-alzheimers-disease. Published May 15, 2018. Accessed October 23, 2019.

Godman H. Adopt a Mediterranean diet now for better health later. Harvard Health Publishing Website. https://www.health.harvard.edu/blog/adopt-a-mediterranean-diet-now-for-better-health-later-201311066846. Published November 6, 2013. Accessed October 23, 2019.

Gunnars K. Mediterranean diet 101: A meal plan and beginner’s guide. Healthline Website. https://www.healthline.com/nutrition/mediterranean-diet-meal-plan#foods-to-avoid. Published July 24, 2018. Accessed October 23, 2019.

Academy of Nutrition and Dietetics. Nutrition Care Manual. General, Healthful Mediterranean Nutrition Therapy. Accessed October 23, 2019.