The Mediterranean diet is based on the traditional foods that people used to eat in countries like Italy and Greece. Researchers noted that the people were exceptionally healthy compared to Americans and had a risk of an increasing number of lifestyle diseases.
Numerous studies have now shown that the Mediterranean diet can cause weight loss and help prevent heart attacks, strokes, type 2 diabetes, and premature death.
There is no one right way to follow the Mediterranean diet, as there are many countries around the Mediterranean Sea and people in different areas eat different foods.
Consider these notes as a general guideline, not something written in stone. The plan can be adjusted to your individual needs and preferences.
THE BASICS
- EAT: Vegetables, fruits, nuts, seeds, legumes, potatoes, whole grains, breads, herbs, spices, fish, seafood, and extra virgin olive oil.
- EAT IN MODERATION: Poultry, eggs, cheese, and yogurt.
- EAT ONLY RARELY: Red meat.
- DON’T EAT: Sugar-sweetened beverages, added sugars, processed meat, refined grains, refined oils, and other highly processed foods.
AVOID THESE UNHEALTHY FOODS
You should avoid these unhealthy foods and ingredients:
- ADDED SUGAR: Soda, candies, ice cream, table sugar and many others.
- REFINED GRAINS: White bread, pasta made with refined wheat, etc.
- TRANS FATS: Found in margarine and various processed foods.
- REFINED OILS: Soybean oil, canola oil, cottonseed oil and others.
- PROCESSED MEAT: Processed sausages, hot dogs, etc.
- HIGHLY PROCESSED FOODS: Anything labelled “low-fat” or “diet” or which looks like it was made in a factory.
You must read food labels carefully if you want to avoid these unhealthy ingredients.
FOODS TO EAT
Exactly which foods belong to the Mediterranean diet is controversial, partly because there is such variation between different countries.
The diet examined by most studies is high in healthy plant foods and relatively low in animal foods.
However, eating fish and seafood is recommended at least twice a week. The Mediterranean lifestyle also involves regular physical activity, sharing meals with other people and enjoying life.
You should base your diet on these healthy, unprocessed Mediterranean foods:
- VEGETABLES: Tomatoes, broccoli, kale, spinach, onions, cauliflower, carrots, Brussels sprouts, cucumbers, etc.
- FRUITS: Apples, bananas, oranges, pears, strawberries, grapes, dates, figs, melons, peaches, etc.
- NUTS AND SEEDS: Almonds, walnuts, macadamia nuts, hazelnuts, cashews, sunflower seeds, pumpkin seeds, etc.
- LEGUMES: Beans, peas, lentils, pulses, peanuts, chickpeas, etc.
- TUBERS: Potatoes, sweet potatoes, turnips, yams, etc.
- WHOLE GRAINS: Whole oats, brown rice, rye, barley, corn, buckwheat, whole wheat, whole-grain bread, and pasta.
- FISH AND SEAFOOD: Salmon, sardines, trout, tuna, mackerel, shrimp, oysters, clams, crab, mussels, etc.
- POULTRY: Chicken, duck, turkey, etc.
- EGGS: Chicken, quail, and duck eggs.
- DAIRY: Cheese, yogurt, Greek yogurt, etc.
- HERBS AND SPICES: Garlic, basil, mint, rosemary, sage, nutmeg, cinnamon, pepper, etc.
- HEALTHY FATS: Extra virgin olive oil, olives, avocados, and avocado oil.
Whole, single-ingredient foods are the key to good health.
WHAT TO DRINK
Water should be your go-to beverage on a Mediterranean diet. This diet also includes moderate amounts of red wine — around 1 glass per day.
However, this is completely optional, and wine should be avoided by anyone with alcoholism or problems controlling their consumption.
Coffee and tea are also completely acceptable, but you should avoid sugar- sweetened beverages and fruit juices, which are very high in sugar.
BENEFITS AND NEGATIVES OF THE MEDITERRANEAN DIET
BENEFITS
There have been numerous studies documenting the health benefits of the Mediterranean diet.
GENERAL NUTRITION
The Mediterranean diet does not eliminate any food groups and encourages a variety of nutrient-dense foods, making it easy to meet your nutritional needs and enjoy a wide range of foods and flavours.
HEART HEALTH
Scientists have conducted a robust amount of research on the Mediterranean diet and heart health. The results show that there is clear evidence to support the Mediterranean diet for better heart health.
For example, a review study in the European Journal of Clinical Nutrition concluded that following a Mediterranean diet is associated with reduced risk of coronary heart disease, heart attack, and overall mortality.
Research review published in 2019, study authors wrote that the available evidence is “large, strong, and consistent” supporting this diet for reduced rates of coronary heart disease, ischemic stroke, and total cardiovascular disease.
BETTER DIABETES PREVENTION AND MANAGEMENT
Following the Mediterranean diet may help those with type 2 diabetes achieve better blood sugar control.
A systematic review of 56 trials between 1978 to 2016 and including 4,937 patients with type 2 diabetes found that the Mediterranean diet, as compared with control diets, was able to lower haemoglobin A1c levels by up to 0.32% on average.
Haemoglobin A1c reflects the body’s blood sugar control over the last three months. Though it sounds small, any reduction may be helpful for people with diabetes who are trying to manage blood sugar levels.
IMPROVED MENTAL HEALTH
One surprising benefit may be a connection between the Mediterranean diet and better mental health, according to the Director of Nutrition for Oldways, a non-profit organization that promotes healthy food and nutrition.
In fact, a 2018 study in Molecular Psychiatry found that following a Mediterranean diet is associated with reduced risk of depressive symptoms or clinical depression.
In addition, consider the emphasis on social connections in the Mediterranean lifestyle. This is paramount for mental health, particularly among older adults.
Maintaining friendships and regular social interaction can reduce loneliness, which is known to be positive for overall health.
WEIGHT MANAGEMENT
It seems counterintuitive that a diet which emphasizes calorically-dense olive oil and nuts could help with weight management. However, these satiating fats–in conjunction with the many fibre-rich vegetables and fruits recommended—can help you feel fuller for longer.
Indeed, research has found that people do not gain weight when following a Mediterranean diet. In fact, some studies have suggested the Mediterranean diet and low-carbohydrate diets lead to similar rates of weight loss after one year.
REDUCES INFLAMMATORY MARKERS
Researchers have been conducting trials establishing connections between certain inflammatory markers and chronic disease.
For example, higher levels of two inflammatory markers (interleukin 6 and C-reactive protein) are thought to be associated with an increased risk of diabetes. Research shows the Mediterranean diet is associated with lower levels of these inflammatory markers.
CANCER PREVENTION
Most cases of cancer are not caused by a singular factor, but rather a combination of many genetic and environmental factors. Diet can play a role in this complex disease, and certain dietary patterns—including the Mediterranean diet—are associated with a reduced risk of cancer.
A meta-analysis found that those who adhered most closely to the Mediterranean diet had a lower risk of developing colorectal cancer, breast cancer, gastric cancer, liver cancer, head and neck cancer, and prostate cancer.
BETTER FOR THE ENVIRONMENT
Diets that rely less on beef and more on grains and other plant-based foods have been shown to be healthier for the planet as a Mediterranean diet saves water, conserves land, and cuts fertilizer use.
NEGATIVES
For some people, there may be a few drawbacks to the Mediterranean diet. However, many of these negatives are minimal.
COST
There are no expensive branded foods or special supplements that you are required to buy on the Mediterranean diet. But some consumers express concern about the cost of some foods, including fish, seeds, nuts, and olive oil. For example, fresh seafood tends to be more expensive than other proteins.
ADDITIONAL GUIDANCE MAY BE NEEDED
Even though studies suggest that a Mediterranean diet may reduce diabetes risk and support better blood sugar control, some people with diabetes may need additional guidance while on this diet.
Because there is an emphasis on grains, fruits, and vegetables (including starchy vegetables), meals may be high in carbohydrates. It’s important for people with diabetes to eat a consistent, controlled amount of carbohydrates throughout the day to avoid blood sugar spikes or dangerously low sugars (if you’re using insulin or certain oral medications).
This does not mean people with diabetes shouldn’t follow this plan. On the contrary, it can be a great choice. If you have diabetes, though, try working with a dietitian to help you plan the right carbohydrate counts for your meals within the greater framework of the Mediterranean diet.
RESTRICTIONS MAY FEEL CHALLENGING
This diet recommends reducing red meat and added sugar consumption, which may be difficult for some people. Those who are used to a more standard diet may consume added sugar in processed foods on a regular basis. Those following the Mediterranean diet are advised to save added sugar specifically for special occasions.
Keep in mind any added sugar reduction is beneficial, so don’t let this deter you. Following a Mediterranean style diet that contains a little added sugar is still more beneficial than following a diet that’s high in added sugar.
Similarly, if you’re struggling with eating red meat less often, try following this diet while incorporating lean and unprocessed red meats like flank, top round, and brisket half flat, but in smaller portions. Research suggests you’ll still reap heart-health benefits.
CONCERNS ABOUT ALCOHOL INTAKE
Some experts raise concerns about the regular alcohol intake (particularly wine) in the Mediterranean diet and whether this is truly beneficial to recommend. When alcohol is consumed as part of a balanced meal, and coupled with daily movement and social connections, studies find a net health benefit.
The Mediterranean diet and other traditional diets present examples of how to safely enjoy alcohol in moderation (up to one 5-ounce glass of wine per day for women, or up to two 5-ounce glasses daily for men), in a way that may support cardiometabolic health and help to foster positive social connections.
But what about when alcohol is consumed in other scenarios? When alcohol intake is accompanied by unhealthy habits, like smoking or poor diet, or unsafe habits, like driving, obvious health risks present themselves. When adults choose to drink, its recommended one drink or less per day for women and two drinks or less for men.
A MEDITERRANEAN SAMPLE MENU FOR 1 WEEK
Below is a sample menu for one week on the Mediterranean diet. Feel free to adjust the portions and food choices based on your own needs and preferences.
MONDAY
- BREAKFAST: Greek yogurt with strawberries and oats
- LUNCH: Whole-grain sandwich with vegetables
- DINNER: A tuna salad, dressed in olive oil. A piece of fruit for dessert
TUESDAY
- BREAKFAST: Oatmeal with raisins
- LUNCH: Leftover tuna salad from the night before
- DINNER: Salad with tomatoes, olives, and feta cheese
WEDNESDAY
- BREAKFAST: Omelette with veggies, tomatoes, and onions. A piece of fruit
- LUNCH: Whole-grain sandwich, with cheese and fresh vegetables
- DINNER: Mediterranean lasagne
THURSDAY
- BREAKFAST: Yogurt with sliced fruits and nuts
- LUNCH: Leftover lasagne from the night before
- DINNER: Broiled salmon, served with brown rice and vegetables
FRIDAY
- BREAKFAST: Eggs and vegetables, fried in olive oil
- LUNCH: Greek yogurt with strawberries, oats, and nuts
- DINNER: Grilled lamb, with salad and baked potato
SATURDAY
- BREAKFAST: Oatmeal with raisins, nuts, and an apple
- LUNCH: Whole-grain sandwich with vegetables
- DINNER: Mediterranean pizza made with whole wheat, topped with cheese, vegetables, and olives
SUNDAY
- BREAKFAST: Omelette with veggies and olives
- LUNCH: Leftover pizza from the night before
- DINNER: Grilled chicken, with vegetables and a potato. Fruit for dessert
There is usually no need to count calories or track macronutrients (protein, fat, and carbs) on the Mediterranean diet.
HEALTHY MEDITERRANEAN SNACKS
You don’t need to eat more than 3 meals per day. But if you become hungry between meals, there are plenty of healthy snack options:
- A handful of nuts
- A piece of fruit
- Carrots or baby carrots
- Some berries or grapes
- Leftovers from the night before
- Greek yogurt
- Apple slices with almond butter
A SIMPLE SHOPPING LIST FOR THE DIET
It is always a good idea to shop at the perimeter of the store. That’s usually where the whole foods are. Always try to choose the least-processed option. Organic is best, but only if you can easily afford it.
- VEGETABLES: Carrots, onions, broccoli, spinach, kale, garlic, etc.
- FRUITS: Apples, bananas, oranges, grapes, etc.
- BERRIES: Strawberries, blueberries, etc.
- FROZEN VEG: Choose mixes with healthy vegetables
- GRAINS: Whole-grain bread, whole-grain pasta, etc.
- LEGUMES: Lentils, pulses, beans, etc.
- NUTS: Almonds, walnuts, cashews, etc.
- SEEDS: Sunflower seeds, pumpkin seeds, etc.
- CONDIMENTS: Sea salt, pepper, turmeric, cinnamon, etc
- FISH: Salmon, sardines, mackerel, trout, shrimp, and shellfish
- Potatoes and sweet potatoes
- Cheese
- Greek yogurt
- Chicken
- Pastured or omega-3 enriched eggs
- Olives
- Extra virgin olive oil
It’s best to clear all unhealthy temptations from your home, including fizzy drinks, ice cream, sweets, pastries, white bread, crackers, and processed foods.
If you only have healthy food in your home, you will eat healthy food.
THE BOTTOM LINE
Though there is not one defined Mediterranean diet, this way of eating is generally rich in healthy plant foods and relatively lower in animal foods, with a focus on seafood.
You can find a whole world of information about the Mediterranean diet on the internet, and many great books have been written about it.
Try googling “Mediterranean recipes” and you will find loads of great tips for delicious meals.
There is no doubt, the Mediterranean diet is incredibly healthy.