A balanced diet can help prevent and manage chronic diseases, such as heart disease and type 2 diabetes. The Mediterranean diet is well researched for its ability to help promote overall health and longevity. (3) Its blend of healthy eating basics and Mediterranean lifestyle traditions make this a healthy and sustainable diet for many individuals. Thinking about eating Mediterranean style? Keep reading to find out just what it’s all about.
What is the Mediterranean diet?
The Mediterranean diet is a general term for the traditional dietary and lifestyle habits of the countries located in the Mediterranean region (e.g., Greece, Spain). (17) The Mediterranean diet has been praised for decades following research conducted in the 1960s that demonstrated a lower incidence of coronary heart disease among individuals living in the Mediterranean region. (19) Current research indicates that adopting the Mediterranean diet promotes longevity and can decrease the risk of various chronic diseases, such as Alzheimer’s disease, cancer, and type 2 diabetes. (18)
Mediterranean diet foods
The typical Western diet, also commonly known as the Standard American Diet (SAD), consists considerably of packaged and processed foods, red meat, saturated fats, and sweets. (3) Research indicates that this nutrient-poor dietary pattern may contribute to the development of chronic diseases, including obesity and type 2 diabetes. (3)
In contrast, the Mediterranean diet emphasizes a mostly plant-based dietary pattern, including an abundance of fruits, vegetables, nuts, seeds, olive oil, and whole grains. (1) The Mediterranean diet pyramid below highlights the Mediterranean diet foods to enjoy and their recommended servings while following the diet.
Other general guidelines to consider when following the Mediterranean diet include:
- Replace saturated and trans fats (e.g., animal fat, butter) with unsaturated fats (e.g., avocado, olive oil).
- Enjoy low-fat dairy products in moderation. (3)
- Reduce red meat intake by substituting meat with small portions of fatty fish (e.g., mackerel, salmon) or poultry.
- Use herbs and spices rather than sweeteners, sauces, and gravies. (12)
Mediterranean diet lifestyle recommendations
Research indicates that incorporating Mediterranean lifestyle behaviors is also an important component of the Mediterranean diet. (26) Important lifestyle habits that can complement the diet include:
- Choosing fresh, local, seasonal foods
- Cooking at home, ideally with family and friends
- Eating mindfully and slowly
- Getting adequate sleep
- Practicing moderate physical activity regularly (about 30 minutes per day) (26)
Health benefits of the Mediterranean diet
Rich in antioxidants and anti-inflammatory nutrients, the Mediterranean diet can offer many health benefits and protective effects against a variety of chronic diseases. (17)
Brain health and cognition
Brain cells naturally weaken with age, and external factors, such as poor diet, can accelerate this natural aging process, leading to cognitive decline. (4) Unlike the typical Western diet, the Mediterranean diet promotes a regular intake of essential omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are found in significant amounts in fatty fish. (2)(24) Studies suggest that including omega-3 fatty acids in the diet can improve cognitive function and may protect against neurodegenerative dementia, including Alzheimer’s disease. (22)
DHA is most abundant in the brain, and having adequate DHA levels has been shown to protect our hippocampus, the memory processing area of the brain. (2)(4) EPA is present in amounts about 300 times less than DHA, but it’s important for proper brain development. (8) As essential fatty acids, EPA and DHA must be consumed through dietary or supplement sources in order to meet recommendations. (16)
Did you know? Research indicates that routinely eating fish at least once a week can reduce cognitive decline in older individuals. (10)
Cardiovascular disease (CVD) is one of the leading causes of death worldwide. (20) The Mediterranean diet is made up of heart-healthy foods that contain antioxidants, fiber, and omega-3 fatty acids. Following this cardioprotective diet has been shown to:
- Lower CVD risk and mortality
- Promote a healthy body mass index (BMI)
- Reduce blood pressure
- Reduce cholesterol and triglyceride levels (24)
More than one-quarter of the North American population is estimated to have metabolic syndrome, a condition characterized by a combination of overweight or obesity, high blood pressure, and high blood glucose (sugar). (5)
Having metabolic syndrome can lower quality of life and increase a person’s risk of developing CVD, type 2 diabetes, and cancer. (5) Certain components of the Mediterranean diet that are typically lacking in the Western diet, such as fruits and vegetables, fish, and whole grains, can reverse or prevent metabolic syndrome and its related conditions. (5)
Research indicates that individuals with obesity are more likely to have low antioxidant levels. (6) Antioxidants act as anti-inflammatory molecules and protect cells from damage that may lead to chronic diseases. (6) Extra-virgin olive oil, seafood, and plant-based foods are sources of many protective antioxidants. (9)
The Mediterranean diet consists of many high-fiber plant-based foods such as fruits, vegetables, legumes, and whole grains. Eating fiber-rich foods improves satiety (the feeling of fullness) more than low-fiber foods, which promotes weight control. (20) Fiber-rich foods also promote glycemic (blood sugar) control and insulin sensitivity in individuals with diabetes. (11)
Did you know? Individuals with metabolic syndrome, obesity, and type 2 diabetes are more likely to experience insulin resistance, a state where glucose (sugar) remains in the bloodstream. (25) Chronic high blood sugar weakens the immune system and can cause damage to blood vessels; this damage can lead to various health complications, including eye disease and kidney disease. (23)
Dietary fat in the Mediterranean diet consists mainly of mono- and polyunsaturated fats. Replacing dietary saturated fats with primarily unsaturated fats has been shown to promote a healthy weight, increase insulin sensitivity, and reduce the risk of type 2 diabetes. (7)(20)
Potential concerns with the Mediterranean diet
The Mediterranean diet may not be for everyone and can have negative health implications for some individuals. It’s best to speak with your integrative practitioner if you have any concerns about the Mediterranean diet. Here are some possible health concerns of which to be aware.
Dairy products are some of the best sources of calcium. The Mediterranean diet guidelines suggest two servings of dairy per day, while the U.S. Department of Agriculture (USDA) advises adults to consume three servings per day in order to meet your nutritional needs. (21) Consider adding other calcium-containing foods to your diet in order to meet your daily calcium needs. Alternative sources of calcium include:
- Canned salmon or sardines
- Fortified foods and beverages (e.g., cereals, orange juice, soy milk)
- Tofu (13)
Iron is an essential mineral that is best absorbed when consumed through animal sources. (14) Red meat is a common source of iron in the SAD; however, the Mediterranean diet limits the consumption of meat. Alternative sources of iron to enjoy while following the Mediterranean diet include:
- Dark green leafy vegetables (e.g., kale, spinach)
- Dried beans
- Fortified breakfast cereals
- Whole grains (15)
Research indicates that combining lean meat, fish, or poultry with beans or dark leafy vegetables can improve the absorption of iron from vegetable sources threefold, though the exact mechanisms are not well known. (15) Iron absorption can also be improved by pairing iron-containing foods with foods rich in vitamin C, such as citrus fruit, potatoes, and tomatoes. (15)
The bottom line
The Mediterranean diet is a lifestyle and dietary pattern that promotes healthy eating in combination with social connection and physical activity. This diet, which encourages the consumption of fatty fish, fiber-rich foods, and modest servings of lean animal proteins and low-fat dairy, maximizes the intake of nutrients that the typical Western diet traditionally lacks. Following the Mediterranean diet can lower the risk for certain cancers, cognitive decline, heart disease, obesity, and type 2 diabetes. (17) If you’re a patient, consult with your integrative healthcare practitioner before making significant changes to your diet.
- American Heart Association. (2020). What is the Mediterranean diet? https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet
- Cederholm, T., Salem, N., Jr, & Palmblad, J. (2013). ω-3 fatty acids in the prevention of cognitive decline in humans. Advances in Nutrition , 4(6), 672–676.
- D’Innocenzo, S., Biagi, C., & Lanari, M. (2019). Obesity and the Mediterranean diet: A review of evidence of the role and sustainability of the Mediterranean diet. Nutrients, 11(6).
- Denis, I., Potier, B., Vancassel, S., Heberden, C., & Lavialle, M. (2013). Omega-3 fatty acids and brain resistance to ageing and stress: Body of evidence and possible mechanisms. Ageing Research Reviews, 12(2), 579–594.
- Di Daniele, N., Noce, A., Vidiri, M. F., Moriconi, E., Marrone, G., Annicchiarico-Petruzzelli, M., D’Urso, G., Tesauro, M., Rovella, V., & De Lorenzo, A. (2017). Impact of Mediterranean diet on metabolic syndrome, cancer and longevity. Oncotarget, 8(5), 8947–8979.
- Ford, E. S., Mokdad, A. H., Giles, W. H., & Brown, D. W. (2003). The metabolic syndrome and antioxidant concentrations: Findings from the Third National Health and Nutrition Examination Survey. Diabetes, 52(9), 2346–2352.
- Georgoulis, M., Kontogianni, M. D., & Yiannakouris, N. (2014). Mediterranean diet and diabetes: Prevention and treatment. Nutrients, 6(4), 1406–1423.
- Kidd, P. M. (2007). Omega-3 DHA and EPA for cognition, behavior, and mood: Clinical findings and structural-functional synergies with cell membrane phospholipids. Alternative Medicine Review: A Journal of Clinical Therapeutic, 12(3), 207–227.
- Martín-Peláez, S., Fito, M., & Castaner, O. (2020). Mediterranean diet effects on type 2 diabetes prevention, disease progression, and related mechanisms. Nutrients, 12(8).
- Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L., & Wilson, R. S. (2005). Fish consumption and cognitive decline with age in a large community study. Archives of Neurology, 62(12), 1849–1853.
- National Institutes of Health. (2020a). Glycemic index and diabetes. MedlinePlus. https://medlineplus.gov/ency/patientinstructions/000941.htm
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- National Institutes of Health. (2021a). Calcium. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
- National Institutes of Health. (2021b). Iron. https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
- National Institutes of Health. (2021c). Iron in diet. MedlinePlus. https://medlineplus.gov/ency/article/002422.htm
- National Institutes of Health. (2021d). Omega-3 fatty acids. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
- Queensland Government. (2020. The Mediterranean diet. Queensland Health. https://www.health.qld.gov.au/__data/assets/pdf_file/0032/946049/cardiac-meddiet.pdf
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- Salas-Salvadó, J., & Papandreou, C. (2020). Chapter 1 – The Mediterranean diet: History, concepts and elements. In V. R. Preedy & R. R. Watson (Eds.), The Mediterranean Diet (Second Edition) (pp. 3–11). Academic Press.
- Schröder, H. (2007). Protective mechanisms of the Mediterranean diet in obesity and type 2 diabetes. The Journal of Nutritional Biochemistry, 18(3), 149–160.
- U.S. Department of Agriculture. (2020). Dairy. USDA MyPlate. https://www.myplate.gov/eat-healthy/dairy
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- Victoria Government. (2021). Diabetes – long-term effects. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-long-term-effects
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