The Mediterranean diet is based on the traditional cuisines of countries bordering the Mediterranean Sea. It emphasizes plant-based foods, eating fish and poultry rather than red meat, and using olive oil as a primary fat source. People who follow the Mediterranean diet consume wine in moderation and often substitute fruits for sugary desserts.
The Mediterranean diet follows the current dietary guidelines of the American Heart Association. It has been found to reduce the risk of heart disease and some cancer types, improve blood sugar and blood pressure, and support weight loss.
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1. Reduces Heart Disease Risk
Research has consistently shown the Mediterranean diet effectively reduces the risk of cardiovascular disease. One 2019 Circulation Research review of studies on the effect of the Mediterranean diet on cardiovascular disease found the evidence for this diet was solid and consistent.
The report’s authors note conformity with the Mediterranean diet could improve cardiovascular health and reduce the risk of stroke and total cardiovascular disease.
2. Improves Blood Pressure
The Mediterranean diet includes vegetables, fruits, legumes, nuts, seeds, and healthy fats. It discourages foods high in salt and saturated fats, which could lead to lower blood pressure in the long term.
One study reported in 2017 aimed to determine how strict adherence to the Mediterranean diet would affect blood pressure and endothelial (linings of the blood vessels and lymph vessels) function. Researchers found adults who consumed the diet had significantly lower systolic blood pressure and improved endothelial function over six months.
3. Reduces LDL Cholesterol
The Mediterranean diet is a healthy way to lower low-density lipoprotein (LDL) cholesterol (considered “bad” cholesterol) and triglyceride levels, while increasing high-density lipoprotein (HDL) cholesterol (considered “good” cholesterol).
One 2017 randomized control study found that strict adherence to a Mediterranean diet that included extra virgin olive oil could decrease LDL levels in people at high risk for cardiovascular disease.
4. Prevents or Manages Type 2 Diabetes
Healthy eating is vital to preventing and managing type 2 diabetes, and the Mediterranean diet may help to achieve this.
In a PREDIMED (Prevención con Dieta Mediterránea, or Prevention with Mediterranean Diet) trial reported in 2014, study participants without diabetes followed either a Mediterranean diet supplemented with extra virgin olive oil, a Mediterranean diet supplemented with nuts, or a low-fat diet.
Compared to the low-fat diet, those on the Mediterranean diet with olive oil supplementation for four years had a 40% risk reduction for diabetes. Those on the Mediterranean diet with nut supplementation had an 18% risk reduction for diabetes.
5. Slows Cognitive Decline
A systematic review and meta-analysis explored the association between the Mediterranean diet and cognitive health among healthy adults. It concluded people who adhered to the Mediterranean diet may reduce the risk of mild cognitive impairment and Alzheimer’s disease.
The study also found positive associations with global cognition (thinking and memory in general), working memory, and episodic memory. It is recommended as a therapeutic diet to prevent or delay cognitive disorders and improve cognitive functions.
6. Supports Weight Loss
If you are looking for a diet that can help you to lose weight, the Mediterranean diet is a healthy choice. One large study found following this diet could reduce your risk for abdominal obesity and help you keep weight off.
The Mediterranean diet can work for weight loss because it is based on shifting your relationship with food for the long term, and many of the foods on the diet are healthful and beneficial for weight loss or preventing weight gain.
The Mediterranean diet emphasizes plant-based foods and healthy fats, promoting not only whole grains, fruits, and vegetables, but also beans and nuts with drizzles of extra virgin olive oil. The meal plan and eating patterns align with the Dietary Guidelines for Americans, 2020–2025.
For example, fruits, vegetables, and whole grain foods are filling and can help you stay fuller, and they are loaded with fiber, which aids in weight loss. The diet also encourages limited sugars and processed foods since they are linked to weight gain. People on the diet are advised to make wise choices and watch portion sizes.
7. Improves Arthritis Pain
A systematic review of studies found the Mediterranean diet results in significant decreases in subjective pain when compared to ordinary diets, although the quality of the evidence was low. Still, the study noted that the benefits from the diet were likely due to the high anti-inflammatory properties in foods typical for the diet. These foods can help lower the inflammation associated with pain in various forms of arthritis.
One study reported in 2019 of over 4,000 participants found that people with stricter adherence to a Mediterranean diet had a lower risk of pain worsening and symptomatic forms of knee osteoarthritis (considered wear-and-tear arthritis).
Studies on the diet have found some symptom improvement in rheumatoid arthritis (RA), a type of inflammatory arthritis in which the immune system attacks the synovial linings of joints. One 2018 Rheumatology International review found beneficial effects of the Mediterranean diet for reducing pain and increasing physical function in people living with RA.
8. Protects Against Cancer
The antioxidant-rich and anti-inflammatory effects of the Mediterranean diet may protect the general population against death from certain cancers and all-cause death among cancer survivors. These cancers include colorectal, head and neck, respiratory, gastric, liver, and bladder cancers.
Who Should Avoid the Mediterranean Diet?
If you have a chronic medical condition, check with your healthcare provider to ensure changes to your diet are appropriate.
It is wise to ensure you get all your nutrients while limiting red meat and dairy. For example, you may need to concentrate on other sources of iron when limiting red meat and other sources of calcium when limiting dairy.
Be mindful of your fish consumption. Some fish, such as mackerel, shark, and swordfish, may not be as safe as others because they contain the highest amounts of mercury. Some safe fish options include salmon, haddock, flounder, freshwater tuna, and shrimp.
While wine is allowed on the Mediterranean diet, alcohol should be avoided by people who are pregnant, have alcohol use disorder, or are taking medications that can interact with alcohol. People with various medical conditions or risk factors should also avoid alcohol.
Tips for Creating a Mediterranean Diet Meal Plan
The following are ways in which you can benefit from a Mediterranean diet:
Eat more legumes: According to the Harvard Medical School, you should aim for at least three servings a week of legumes. Examples are lentils, beans, peas, and chickpeas.
Don’t overconsume alcohol: Substitute red wine for beer and other liquors. Men should not drink more than two 5-ounce glasses per day, and women should not have more than one glass per day.
Focus on meat as a side: You will want to eat meat in moderation and in small portions. With this diet, you can eat lean poultry but want to limit it to 3- to 4-ounce portions. Red meat can be eaten occasionally. You will want to eat more fish and aim for two to three servings of fresh or canned fish per week.
Consume fewer sweets: If you are craving something sweet, consider fresh or poached fruit. (Poached fruit is simmered in a liquid, such as water or wine, and sweetened.) Aim for at least three servings a day of fruit.
Cook with olive oil: Olive oil is recommended as a primary added fat to this diet. It can replace other oils and fats like butter and margarine. Some foods naturally contain healthful fats and can be added to your diet. Such foods include nuts (walnuts and almonds), oily fish containing omega-3 fatty acids (salmon and sardines), and avocado.
Drink plenty of water: Try to drink plenty of water and replace sodas and juices with water.
Add whole grain bread and other whole grains: Choose whole-grain bread without added sugars or butter. You might consider experimenting with different whole-grain types, including bulgur, farro, and barley.
Summary
The Mediterranean diet is a way of eating that incorporates the cuisines of countries that border the Mediterranean Sea. There are no strict rules for following the diet. The diet primarily includes plant-based foods—fruits, vegetables, whole grains, nuts, seeds, and olive oil. It also includes fish, seafood, poultry, and dairy in moderation.
The diet offers many benefits, including reducing the risk of heart disease and certain cancers, reducing weight gain, regulating blood pressure, and improving arthritis pain. It has few risks, but it is still a good idea to check with your healthcare provider to ensure the diet is safe with any health conditions you may have or medications you take, and that you are getting all your nutrients.