The Mediterranean diet has been ranked number one for six years in the “U.S. News Diet Rankings.” These results are released on January 1, and many health experts agree it will likely be at the top in 2025.
Considered more of a lifestyle approach than a strict “diet,” the Mediterranean diet lends itself well to customization and is a longtime favorite of many healthcare providers and researchers. Here’s why health experts say this diet has been ranked highly for so long.
What is the Mediterranean Diet?
The Mediterranean diet is based on traditional eating patterns of certain countries around the Mediterranean Sea in the mid-20th century. It is generally rich in fruits and vegetables, whole grains, legumes, nuts and seeds, and extra virgin olive oil.
It also includes a lot of fish, moderate amounts of poultry, and dairy products like yogurt and natural cheese. The Mediterranean diet limits red meat and processed meat and includes minimal sugar and processed foods. Traditionally, it includes a moderate amount of wine with meals, but those who don’t currently drink are advised not to start—more on that in a bit.
One element of the Mediterranean diet that makes it more of a lifestyle approach is the emphasis on being part of a community. It also focuses on preparing and enjoying meals with loved ones, eating local and seasonal foods, and being physically active.
What Exactly Makes the Mediterranean Diet So Healthy?
This approach to eating may offer several health benefits, says Rachel Berman, RD, CDN, a registered dietitian and author of the Mediterranean Diet for Dummies. “The Mediterranean diet has been linked to promoting heart health, reducing complications of diabetes, preventing and managing cancer, reducing inflammation, increasing lifespan, optimizing brain health, and more.”
According to Maggie Moon, MS, RD, a Los Angeles-based registered dietitian and author of The MIND Diet: 2nd Edition, there are specific foods that research has highlighted as beneficial. “The health benefits come from a combination of foods in the whole dietary pattern. It’s important to remember that the dietary pattern works synergistically to support human health.”
Researchers have identified certain aspects of the Mediterranean diet that make it health-promoting. Even specific foods have been called out for their benefits. Here are a few big ones you should be aware of.
It’s High in Fiber
Because of its emphasis on plant foods, the Mediterranean diet is rich in fiber. Getting the 25 to 35 grams recommended daily for most healthy adults is linked to improved cholesterol, improved blood sugar control, digestive regularity, reduced risk of certain cancers, and more.
It’s Low in Red Meat and Processed Meats
High intake of red meat and even moderate intake of processed meat have been linked to increased disease risk. But, one facet of the Mediterranean diet that makes it so health-promoting is that it involves little red meat or processed meat.
It’s Rich in Fish
Because the Mediterranean diet is focused on the eating patterns of countries around the Mediterranean Sea, says Berman, it’s no surprise that fish is a big component of the diet. “The main benefit of seafood comes from its omega-3 fatty acid content. Because your body doesn’t make it, you need to get it from your diet.”
She adds that research shows omega-3s can reduce inflammation in the body, the blood vessels, and the joints. This lowers the risk of depression, triglyceride levels, and heart disease. It also lessens the risk of Alzheimer’s disease and dementia.
Olive Oil Is a Mainstay
Olive oil is one of the more unique components of the Mediterranean diet Moon says. “It’s known for containing hundreds of polyphenols with various antioxidant and anti-inflammatory properties that protect and repair our cells from wear and tear, stress, sickness, and premature aging.”
The landmark PREDIMED trial found that a Mediterranean diet supplemented with extra virgin olive oil reduced the risk of heart attack, stroke, or cardiovascular-related death by 30%, she says.
Likewise, olive oil is rich in heart-healthy unsaturated fatty acids and contains a heavily-researched compound called oleocanthal. This compound has been noted for a wide range of health benefits, including anti-inflammatory effects, reduced risk of certain cancers, and better brain health, Berman says.
“Oleocanthal is an antioxidant that has been shown to decrease the build-up of amyloid plaques in the brain, which can lead to Alzheimer’s disease,” she says. “A recent study published in JAMA Network found that 7 grams (1/2 tablespoon) of olive oil per day can reduce your risk of dementia-related death by 28%.”
Nuts and Seeds Are Staples
The Mediterranean diet is particularly rich in nuts like almonds, hazelnuts, and walnuts, says Moon. “The PREDIMED trial found that a Mediterranean diet supplemented with nuts reduced the risk of heart attack, stroke, or cardiovascular-related death by 28% and was linked to better memory and cognition. There is a broad body of research on nuts for heart and brain health. The two are closely linked.”
Pistachios are another healthy nut choice. A recent randomized controlled trial funded by the American Pistachio Growers and the National Institutes of Health found that daily consumption of 2 ounces of pistachios (about two handfuls) significantly increased macular pigment optical density, a marker for eye health, in six weeks.
Tammy M. Scott, PhD, the lead researcher and a research assistant professor at the Friedman School and assistant professor at Tufts University School of Medicine, Department of Psychiatry, attributes this to the fact that pistachios are the only nut that provides a substantial source of lutein. This antioxidant protects the eyes from blue light damage and may reduce the risk of age-related macular degeneration.
“This is especially good news for people who don’t regularly consume large quantities of other lutein-containing foods such as kale and spinach,” says Dr. Scott. “Beyond eye health, previous studies have shown that pistachios help support heart health and can help manage blood sugar with their healthy fats and fiber, and they’re a good plant-based source of complete protein. They contain essential vitamins and minerals, like B6, which could support overall immune system health and help your body convert food to energy throughout the day.”
The fat, fiber, and protein in nuts like pistachios also help you feel satisfied and are useful for weight management, Dr. Scott says.
It Includes Lots of Colorful Produce
Colorful fruits and vegetables, whole grains, and legumes are also great sources of antioxidant and anti-inflammatory compounds. They also help fight disease and boost well-being.
It’s a Lifestyle, Not a Diet
Berman explains that the foundation of the Mediterranean diet pyramid is being active and enjoying meals with loved ones while being mindful about what you eat. “In other diet plans, this is an afterthought, whereas in the Mediterranean diet, it is part of the core tenets. It is not very strict regarding portion sizes or limiting food groups. Instead, there is more of a spotlight on the foods you should add into your diet.”
Berman adds that the key is to focus on the traditional Mediterranean diet—not a Mediterranean diet influenced by faster-paced lifestyles and convenience foods.
What About the Red Wine Part?
While moderate wine consumption is a traditional part of the Mediterranean diet patterns, health experts emphasize that it’s not without risk.
“It’s such an individual decision,” says Moon. “Can you benefit from the Mediterranean diet without a glass of wine? Of course. I’ve also seen research showing that non-alcoholic wine may benefit cognitive health, likely due to its polyphenols, which tells me there could be a way to keep the practice of wine with meals intact and remove the alcohol component.”
She says that having a glass of red wine with meals is a cultural practice in many Mediterranean countries. However, there are mixed messages regarding the health risks. For example, the World Health Organization released a statement saying there is no safe amount, particularly regarding cancer risk.
But we also see studies showing a reduced risk of cardiovascular disease and mortality when red wine is consumed in moderation, Moon adds. “We need more randomized controlled trials to fully understand this relationship.”
Ultimately, Moon does not recommend people start drinking if they aren’t already. “Whether they need to stop will depend on a more holistic assessment of the individual’s health status and practices. For those who decide to enjoy wine with dinner, we want to keep it to no more than one 5-ounce glass daily for women and two for men.”
And though red wine contains antioxidants, you can get that from the foods you eat, Berman says. “The red wine component of the Mediterranean diet is more about relaxation and enjoying meals with friends rather than the actual nutrient benefits.”
How to Introduce the Mediterranean Diet Into Your Everyday Life
Berman recommends making small changes when you shift to a Mediterranean-style pattern. “You don’t have to overhaul your entire diet to eat in a way that is more Mediterranean and beneficial for your health.”
She encourages changing the proportions of food on your plate to include more plant-based foods like fruits, vegetables, legumes, and whole grains, plus more fish and less meat, dairy, and sweets.
“So even if you don’t change what you are eating entirely,” Berman says, “fill your plate with half fruits and veggies, another quarter to whole grains or starch, and the last quarter to meat or fish.”
She also suggests eating seafood twice a week. (If you’re concerned about mercury content, she recommends visiting EPA.gov for guidance.) Switch to whole grains for fiber and nutrients, and add nuts to salads, oatmeal, snacks, and main dishes.
“Yes, nuts are calorie dense, but they will give you energy and also contain heart-healthy fats and other antioxidants that are great for your health,” she says. If you want to learn more, check out Berman’s book, Mediterranean Diet for Dummies.
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Diets That Are Similar to the Mediterranean Diet
Some diets are based on or very similar to the Mediterranean diet, including:
The DASH Diet (Dietary Approaches to Stop Hypertension) is designed to lower blood pressure by emphasizing produce, whole grains, healthy fats, and lean protein while limiting sodium and processed foods.
The Nordic Diet originated in Scandinavia and focuses on local and seasonal foods. It includes a lot of fish, whole grains such as rye and barley, root vegetables, berries, healthy fats, and oily fish.
The MIND Diet is a combination of the Mediterranean and DASH diets. It is designed to promote brain health and includes a lot of leafy greens, nuts, berries, beans, olive oil, fish, poultry, and whole grains while limiting red meat, sugar, and processed foods.
The Anti-Inflammatory Diet reduces inflammation by basing one’s eating patterns on nutrient-dense, anti-inflammatory foods such as fruits, vegetables, fish, nuts, seeds, olive oil, and whole grains.
The Okinawan Diet is based on traditional eating patterns from Okinawa, Japan. Like the Mediterranean diet, it’s rich in vegetables, especially sweet potatoes, green leafy vegetables, and fish. Tofu is also a key component of this diet, especially since the diet focuses on plant-based foods and small to moderate amounts of animal protein.
The Mediterranean diet is a well-researched eating pattern that has been shown to have numerous health benefits. It is more of a lifestyle approach than a strict diet; it’s also appealing for its approachability and how it can be customized to suit an individual’s needs, preferences, and lifestyle. Start with small adjustments to your diet to help you eat more in line with a Mediterranean approach.