What Is the Mediterranean Diet?

The Mediterranean diet is based on the traditional foods eaten by people living in the Mediterranean region, especially Greece. It's loaded with nutrient-dense choices, with an emphasis on vegetables, fruits, whole grains, fish, and olive oil. Research suggests following this diet may help reduce your risk of heart disease, cancer, diabetes, and other health concerns.

This eating pattern embraces whole foods, variety, and flavorful meals — rather than strict restriction — making the Mediterranean a healthy option for most people to follow long-term. It's been named the best overall diet by "U.S. News and World Report," based on feedback from a panel of nutrition experts.

Background

The Mediterranean diet is not a branded diet plan, but rather a style of eating that has evolved over thousands of years in countries surrounding the Mediterranean Sea.

The diet was first publicized in the 1970s by scientist Ancel Keys, most famously known for his Seven Countries Study. In this study, Keys examined connections between dietary fat intake and rates of heart disease.

Though many are quick to criticize Keys’ work, there were some important takeaways from his study, one of which was identifying that people in the Crete region of Greece had higher overall fat intake yet lower rates of heart disease. Keys believed their style of eating — the idea of the Mediterranean diet — was responsible for this.

However, the Mediterranean diet was not widely embraced by those in the United States at that time. In 1993, Oldways (a non-profit committed to helping people lead healthier lives through traditional diets) partnered with the Harvard School of Public Health and the World Health Organization to create the Mediterranean diet pyramid. 

This alternative to the USDA’s original food pyramid emphasizes core foods of the Mediterranean region, along with physical activity and social connections.

Criticism

There has also been some criticism of the Mediterranean diet. In 2018, one major study was retracted due to issues with the randomization process. However, a revised analysis of the study after retraction still revealed promising results, as do many other pieces of research.

Other critics of the Mediterranean diet, most notably low-carbohydrate advocates, claim that a moderate carbohydrate eating plan and the inclusion of whole grains are not nutritious. However, there is a far greater abundance of scientific evidence supporting the efficacy of the Mediterranean diet compared to that which might support these views.

How It Works

The Mediterranean diet promotes primarily unprocessed foods, with an emphasis on:

• Vegetables
• Fruits
• Whole grains
• Legumes
• Nuts
• Fish
• Olive oil

This winning combination provides vitamins, minerals, fiber, phytochemicals, and healthy fats. all of which are excellent for your health.

Dairy is also allowed on this diet, though generally in smaller amounts. In most traditional cultures, dairy servings are made up of cheese and yogurt, rather than fluid milk. Red meat is typically limited, but small amounts are OK to include occasionally. In addition, you’ll want to skip the added sugar, saving baked goods and sweet treats for more irregular indulgences.

When following this diet, you’ll want to stay hydrated by drinking plenty of water each day. You can also consume red wine in moderation — up to one 5-ounce glass per day for women, and one to two 5-ounce glasses per day for men.

Pros and Cons

Because the Mediterranean diet has been the subject of numerous research studies, there is solid data supporting its health benefits. 

There are other surprising benefits too. For example, one study connected the Mediterranean diet to better mental health. And because the diet is packed with nutrient-dense foods while not eliminating any food groups, it meets your nutritional needs in a sustainable way. 

With any diet though, there are of course potential downsides. Some feel that the Mediterranean diet is cost-prohibitive for those on lower income budgets, due to the abundance of produce, olive oil, and fish. There are certainly smart shopping tips that can be used to address this concern, though. 

In addition, any diet, including the Mediterranean diet, can become detrimental if it’s used in an overly restrictive way. If you’re worried that you’re becoming preoccupied with controlling your food intake, seek help from a medical professional.

Common Myths and Questions

When any diet is promoted to the masses, myths are bound to spread. Here are some common examples, and the facts setting them straight.

Myth: You can’t eat animal foods on the Mediterranean diet.

This diet is lower in animal foods than a Western diet, but still includes them. You’ll want to focus your animal foods on fish, moderate amounts of poultry, and portion-controlled servings of cheese and yogurt. Proponents of this diet recommend eating red meat less frequently, and saving the big steaks for a special occasion.

Myth: Any oil is fine on the Mediterranean diet.

A key ingredient to this eating pattern is olive oil, and this should not be substituted with other oils (with the exception of very high temperature cooking, where a higher smoke point oil may be used occasionally).

"There are many benefits to olive oil outside of its healthy macronutrient profile," says Toups. "For example, foods cooked in olive oil are shown to have a higher antioxidant content. Olive oil has also been studied for its potential anticancer properties."

Myth: All you need to do is follow the food recommendations to achieve all the health benefits.

The Mediterranean diet is more than just an eating plan; it’s also a lifestyle. At the base of the Mediterranean diet pyramid are two core components; social interaction and daily physical activity. Make an effort to integrate these into your life for optimal health.

Myth: You need to drink red wine to follow the Mediterranean diet.

Though red wine is a core component of this eating style in the countries of origin, you don’t have to start drinking just to follow this diet. You can still achieve certain health benefits by following the other dietary patterns without the wine. This is especially important if you’re pregnant or have a history of alcohol addiction.

Myth: The Mediterranean diet is too high in fat.

Despite the low-fat trends of the 1990’s, we now know that fat should not be feared. Healthy fats, such as those in the Mediterranean diet, help you feel satiated and full. Foods like oil and nuts also offer additional health benefits, like antioxidants.

How it Compares

If you’re comparing the Mediterranean diet to other popular diets, you’ll find some similarities. Here are a few quick comparisons to consider:

Flexitarian diet

• A semi-vegetarian meal plan with many similarities to the Mediterranean diet
• Not as well-researched but has some demonstrated health benefits.

DASH diet

• An eating pattern designed to lower blood pressure.
• Both this and the Mediterranean diet are linked to lower cardiovascular disease risk.
• May be more difficult to follow than the Mediterranean diet.

Keto diet

• An eating pattern with considerably higher fat intake compared to the Mediterranean diet.
• More restrictive as far as compliant/non-compliant foods.
• Useful in cases of epilepsy and some research suggests weight loss benefits, however long term health effects are unknown.

The Mediterranean diet is less restrictive than many other popular diets, and with a few small exceptions, very similar to the USDA’s nutrition recommendations. The diet recommends the same five food groups, but offers additional guidance within some of the of those groups. 

For example, the USDA does not specify preferences on the types of protein foods you should consume (other than emphasizing lean proteins). The Mediterranean diet, on the other hand, specifies that your protein foods should be made up of mostly legumes, nuts and seeds, fish, and moderate amounts of poultry—while limiting red meat.

Getting Started

Ready to get started? Good news! The Mediterranean diet doesn’t require any special branded foods or paid diet plans. To start eating according to this plan, just take a quick trip to the grocery store to stock up on the recommended foods. 

Fill your cart with plenty of produce, grab a few pieces of fish, and choose a good high-quality olive oil—and you’re ready to get cooking!  

A Word from Verywell

When choosing a diet, it’s important to select a plan that promotes overall health and is feasible to follow long-term. No one diet will meet every person’s needs, but the Mediterranean diet will certainly fulfill these goals for many people. 

It’s packed with nutritious choices, well-researched, and focuses on flavorful meals. Combine this diet with daily physical activity, regular social connections, and adequate sleep — and you may find yourself feeling energized and healthier.