Mediterranean Diet

  • Author:
    Betty Kovacs Harbolic, MS, RD

    Betty is a Registered Dietitian who earned her B.S. degree in Food and Nutrition from Marymount College of Fordham University and her M.S. degree in Clinical Nutrition from New York University. She is the Co-Director and Director of nutrition for the New York Obesity Research Center Weight Loss Program.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What is the Mediterranean diet?

Eating a Mediterranean diet is not really dieting at all, but eating a variety of fresh foods that taste good and prevent obesity and its health consequences. The Mediterranean diet has been around for over 50 years, and its benefits continue to become apparent. The health benefits of the Mediterranean diet range from a lower risk of heart disease, certain cancers, diabetes, Alzheimer's, osteoporosis, and stroke; lower blood pressure and LDL levels; improved brain function, eye health, and fertility; healthy body weight; and increased life span. The good news is that you do not need to live in this geographic area to get these benefits. All that you need to do is understand where they come from and what changes you can make to your diet to get them.

The Mediterranean means "the sea between lands." This region is defined by countries that border this sea. Take a look at the map and you will get an idea of how diverse this region actually is. The diet followed throughout this region is also diverse. There are cultural, ethnic, religious, economic, and agricultural production differences impacting the dietary differences. So, while many people like to claim that there is one Mediterranean diet, this is not accurate.

The studies done on the Mediterranean diet are not all created equal. These studies use different questionnaires, containing different foods, to measure compliance with the Mediterranean diet. This means that the results that you hear about are not all obtained using the same foods and nutrients. This is important to understand because it gives you lots of options for what you can do with your diet. There is no one Mediterranean diet that you have to follow. Instead, there are different foods, beverages, herbs, and seasonings for the Mediterranean region that you can choose from.

Picture of the Mediterranean diet food pyramid
Picture of the Mediterranean diet food pyramid

Quick Guide12 Reasons to Love the Mediterranean Diet in Pictures

12 Reasons to Love the Mediterranean Diet in Pictures

What are the benefits of omega-3 fatty acids?

Scientific evidence is mounting that fish oil (predominantly omega-3 fatty acids) can reduce the risk of sudden cardiac death. Some scientists also believe that omega-3 fatty acids can improve one's blood lipid (cholesterol and triglyceride) levels and decrease the risk of coronary heart disease.

Why is the Mediterranean diet beneficial to your health?

When trying to understand what the Mediterranean diet does for your health, just remember that "it's what inside that counts." The nutrients and phytonutrients in the foods, beverages, herbs, and seasonings are responsible for the health benefits. These nutrients have benefits ranging from anti-inflammatory, antiviral, antimutagenic, antioxidant, antithrombic, and vasodilatory effects.

There are six essential nutrients in our diet: carbohydrates, protein, fat, water, vitamins, and minerals. They are essential because they are needed for your body to function optimally. When you are deficient in any of these, there are negative health consequences. You also need the correct balance of these nutrients for ideal weight and health. The Mediterranean diet gets this right with a high amount of vitamins, minerals, essential fatty acids, and high-fiber sources of carbohydrates while it is low in processed foods.

Along with the essential nutrients are phytonutrients (also called phytochemicals). These are not considered essential because there is no deficiency if we don't have them in our diet. But they are very beneficial because having them in our diet enhances our health and helps fight diseases. Phytonutrients are found in plant foods and are there to protect the plants from germs, fungi, bugs, and other threats. There are over 25,000 phytonutrients and possibly more to be discovered. This is the reason you want to eat foods to get these instead of taking them in the form of a supplement. The Mediterranean diet is full of phytonutrients.

So, what does the Mediterranean diet have that other diets don't? Here are the sources of some of the health benefits:

Fish

There are two essential fatty acids in our diet; omega-3 (n-3) and omega-6 (n-6). Human beings' diets originally evolved with an equal ratio of n-3 to n-6. That means we consumed an equal amount of each. Over the years, the amount of n-6 in our diets went up to about 20 times the amount of n-3 that we consume. This is important to know because the benefits of n-3 are clear, and many people choose to take a supplement without realizing that not all essential fatty acids work the same or are needed from a supplement.

The research on the benefits of n-3 fatty acids has shown that it can help protect against inflammation, cardiovascular disease, hypertension, cancer, arthritis, depression, insulin resistance, obesity, and aging. The Mediterranean diet is high in n-3 food sources. These include salmon, anchovy, sardines, bluefish, herring, mackerel, mullet, sturgeon, and tuna.

Olives and olive oil

The phytonutrients found in olives and olive oil, known as phenolic antioxidants, are linked to neuroprotective effects against cerebral ischemia, spinal cord injury, Huntington's disease, Alzheimer's disease, multiple sclerosis, Parkinson's disease, aging, and peripheral neuropathy. Black olives and extra virgin olive oil have the highest content and need to be used in moderation to control the calories that you are getting from them.

Legumes

Well-known legumes include green beans, peas, peanuts, soybeans, dry beans, chickpeas, lentils, alfalfa, clover, and broad beans. The majority of legumes contain phytonutrients that are linked to health benefits protecting against numerous diseases or disorders, including coronary heart disease, diabetes, high blood pressure, and inflammation.

Garlic

Many people know how good garlic tastes but don't realize how good it is for you. The phytonutrient found in garlic, allicin, has turned out be helpful in acting as an antioxidant, an antimicrobial, for anticancer properties, and as a protectant against cardiovascular disease.

Capers

These flower buds from a shrub are used in the popular dishes chicken piccata, spaghetti puttanesca, and eggplant caponata. Few people realize the numerous health benefits of these little buds. Research has linked them to having antimicrobial, anti-oxidative, anti-inflammatory, immunomodulatory, anti-diabetic, anti-atherosclerosis, and antiviral properties.

This list goes on and on with all of the herbs, spices, and fresh foods that are consumed in the Mediterranean region. Getting to know the cuisine from the region can give you more ideas on what you can change in your diet.

What is a meal plan for the Mediterranean diet?

The best part of the Mediterranean diet is that you have options. There is not one food that does everything. Instead, it's all of the foods, herbs, and spices that give you the health benefits. You don't have to consume it all at once or take any magic pill. You can make choices throughout your day in what you eat, how you season your foods, and how you prepare things. Everything that you do will count.

The Mediterranean food pyramid gives you a guideline for developing your own meal plan:

Your calorie needs will determine how much of each of these you will consume. On average, their intake is:

Daily intake is an average of the following:

  • Fruits: 4 to 6 servings
  • Vegetables: 2 to 3 servings
  • Unrefined cereal, and cereal and bread products: all these are consumed daily
  • Nonfat or low-fat dairy: 1 to 2 servings
  • Olive oil: main added fat
  • Wine: 1 to 2 glasses
  • Garlic, onions, herbs, and spices: much use

Weekly intake is an average of the following:

  • Fish: 4 or 5 servings
  • Olives, pulses, and nuts: more than 4 servings
  • Potatoes: 4 or 5 servings
  • Cheese and yogurt: in moderation
  • Eggs: 1 to 4 servings
  • Sweets: 1 to 3 servings monthly
  • Red meat and meat products: 4 to 5 servings

You can set your goals to slowly make these changes. Using garlic when you cook, changing over to a couple of fish-based meals per week, using legumes in your meals a couple of times a week, limiting processed foods, and adding capers to your salads, meats, and sauces are great ways to begin. This goes beyond any "diet" that you go on and then go off when you are done. It's about being aware of getting more nutrients from food and feeding your health.

Medically reviewed by a Board-Certified Family Practice Physician

REFERENCES:

Bektas, N., et al. "Investigation for anti-inflammatory and anti-thrombotic activities of methanol extract of Capparis ovata buds and fruits." J Ethnopharmacol 142.1 June 2012: 48-52.

Bouchenak, M. "Nutritional quality of legumes, and their role in cardiometabolic risk prevention: a review." J Med Food Feb. 2013.

Carlsen, M.H. Nutr J 22.9 Jan. 2010: 1-11.

Cavagnaro, P.F., et al. "Effect of cooking on garlic (Allium sativum L.) antiplatelet activity and thiosulfinates content." J Agric Food Chem 55.4 Feb. 2007: 1280-1288.

Cavagnaro, P.F., and C.R. Galmarini. "Effect of processing and cooking conditions on onion (Allium cepa L.) induced antiplatelet activity and thiosulfinate content." J Agric Food Chem 60.35 Sept. 2012: 8731-8737.

Chan, D.S., et al. "Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies." PLoS One 6.6 (2011): e20456.

Chan, J.Y., et al. "A Review of the Cardiovascular Benefits and Antioxidant Properties of Allicin." Phytother Res Aug. 2012.

Chiva-Blanch, G., et al. "Effects of Wine, Alcohol and Polyphenols on Cardiovascular Disease Risk Factors: Evidences from Human Studies." Alcohol and Alcoholism Feb. 2013: 1-8.

Cicerale S., et al. "Antimicrobial, antioxidant and anti-inflammatory phenolic activities in extra virgin olive oil." Curr Opin Biotechnol 23.2 Apr. 2012: 129-135.

Dajas, F. "Life or death: neuroprotective and anticancer effects of quercetin." J Ethnopharmacol 143.2 Sept. 2012: 383-96.

De Lorgeril, M., and P. Salen. "Mediterranean diet and n-3 fatty acids in the prevention and treatment of cardiovascular disease." J Cardiovasc Med (Hagerstown) 8.1 Sept. 2007: S38-41.

Feskens, E.J. "Meat consumption, diabetes, and its complications." Curr Diab Rep 13.2 Apr. 2013: 298-306.

Fetterman, J., and M.M. Zdanowicz. "Therapeutic potential of n-3 polyunsaturated fatty acids in disease." Am J Health Syst Pharm 66 July 2009: 1169-1179.

García-López, M. Eur J Prev Cardio Nov 2012: 1-7.

Güttler, N. Cardiol Res Pract 2012 Dec. 2012: 1-11.

Haber, B. "The Mediterranean diet: a view from history." Am J Clin Nutr 66.4 Oct. 1997: 1053S-1057S.

Kaluza, J., et al. "Red meat consumption and risk of stroke: a meta-analysis of prospective studies." Stroke 43.10 Oct. 2012: 2556-60.

Khalatbary, A.R. Nutr Neurosci Feb. 2013.

Larsson, S.C., and A. Wolk. "Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies." Br J Cancer 106.3 Jan. 2012: 603-607.

Mariani-Costantini A, Nutrition, Jul-Aug 2000;vol 16(7-8):pp 483-6.

Martínez-González MA, J Nutr, Sept 2012;vol 142(9):pp 1672-8.

Martorana M, Fitoterapia. Mar 2013;vol 85:pp 41-8.

McKeown PP, Proc Nutr Soc, Feb 2010;vol 69(1):pp 45-60.

Owen RW, Eur J Cancer Prev, Aug 2004;vol 13(4):pp 319-26.

Pellegrini N, J Nutr, Sep 2003;vol 133(9):pp 2812-9.

Pellegrini N, Mol Nutr Food Res, Nov 2006;vol 50(11):pp 1030-8.

Ramirez-Tortosa MC, J Nutr, Dec 1999;vol 129(12):pp 2177-83.

Siriwardhana N, Adv Food Nutr Res, 2012;vol 65:pp 211-212.

Skouroliakou M, J Med Food, Oct 2009;vol 12(5):pp 1105-10.

Sofi F, BMJ, Sep 2008;vol 337(a1344):pp 1-7.

Tlili N, Fitoterapia, Mar 2011;vol 82(2):pp 93-101.

Tomaino A, Biochimie, Sep 2010;vol 92(9):pp 1115-22.

Traka MH, Plant Cell, Jul 2011;vol 23(7):pp 2483-97.

Quick Guide12 Reasons to Love the Mediterranean Diet in Pictures

12 Reasons to Love the Mediterranean Diet in Pictures

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Reviewed on 4/13/2015
References
Medically reviewed by a Board-Certified Family Practice Physician

REFERENCES:

Bektas, N., et al. "Investigation for anti-inflammatory and anti-thrombotic activities of methanol extract of Capparis ovata buds and fruits." J Ethnopharmacol 142.1 June 2012: 48-52.

Bouchenak, M. "Nutritional quality of legumes, and their role in cardiometabolic risk prevention: a review." J Med Food Feb. 2013.

Carlsen, M.H. Nutr J 22.9 Jan. 2010: 1-11.

Cavagnaro, P.F., et al. "Effect of cooking on garlic (Allium sativum L.) antiplatelet activity and thiosulfinates content." J Agric Food Chem 55.4 Feb. 2007: 1280-1288.

Cavagnaro, P.F., and C.R. Galmarini. "Effect of processing and cooking conditions on onion (Allium cepa L.) induced antiplatelet activity and thiosulfinate content." J Agric Food Chem 60.35 Sept. 2012: 8731-8737.

Chan, D.S., et al. "Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies." PLoS One 6.6 (2011): e20456.

Chan, J.Y., et al. "A Review of the Cardiovascular Benefits and Antioxidant Properties of Allicin." Phytother Res Aug. 2012.

Chiva-Blanch, G., et al. "Effects of Wine, Alcohol and Polyphenols on Cardiovascular Disease Risk Factors: Evidences from Human Studies." Alcohol and Alcoholism Feb. 2013: 1-8.

Cicerale S., et al. "Antimicrobial, antioxidant and anti-inflammatory phenolic activities in extra virgin olive oil." Curr Opin Biotechnol 23.2 Apr. 2012: 129-135.

Dajas, F. "Life or death: neuroprotective and anticancer effects of quercetin." J Ethnopharmacol 143.2 Sept. 2012: 383-96.

De Lorgeril, M., and P. Salen. "Mediterranean diet and n-3 fatty acids in the prevention and treatment of cardiovascular disease." J Cardiovasc Med (Hagerstown) 8.1 Sept. 2007: S38-41.

Feskens, E.J. "Meat consumption, diabetes, and its complications." Curr Diab Rep 13.2 Apr. 2013: 298-306.

Fetterman, J., and M.M. Zdanowicz. "Therapeutic potential of n-3 polyunsaturated fatty acids in disease." Am J Health Syst Pharm 66 July 2009: 1169-1179.

García-López, M. Eur J Prev Cardio Nov 2012: 1-7.

Güttler, N. Cardiol Res Pract 2012 Dec. 2012: 1-11.

Haber, B. "The Mediterranean diet: a view from history." Am J Clin Nutr 66.4 Oct. 1997: 1053S-1057S.

Kaluza, J., et al. "Red meat consumption and risk of stroke: a meta-analysis of prospective studies." Stroke 43.10 Oct. 2012: 2556-60.

Khalatbary, A.R. Nutr Neurosci Feb. 2013.

Larsson, S.C., and A. Wolk. "Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies." Br J Cancer 106.3 Jan. 2012: 603-607.

Mariani-Costantini A, Nutrition, Jul-Aug 2000;vol 16(7-8):pp 483-6.

Martínez-González MA, J Nutr, Sept 2012;vol 142(9):pp 1672-8.

Martorana M, Fitoterapia. Mar 2013;vol 85:pp 41-8.

McKeown PP, Proc Nutr Soc, Feb 2010;vol 69(1):pp 45-60.

Owen RW, Eur J Cancer Prev, Aug 2004;vol 13(4):pp 319-26.

Pellegrini N, J Nutr, Sep 2003;vol 133(9):pp 2812-9.

Pellegrini N, Mol Nutr Food Res, Nov 2006;vol 50(11):pp 1030-8.

Ramirez-Tortosa MC, J Nutr, Dec 1999;vol 129(12):pp 2177-83.

Siriwardhana N, Adv Food Nutr Res, 2012;vol 65:pp 211-212.

Skouroliakou M, J Med Food, Oct 2009;vol 12(5):pp 1105-10.

Sofi F, BMJ, Sep 2008;vol 337(a1344):pp 1-7.

Tlili N, Fitoterapia, Mar 2011;vol 82(2):pp 93-101.

Tomaino A, Biochimie, Sep 2010;vol 92(9):pp 1115-22.

Traka MH, Plant Cell, Jul 2011;vol 23(7):pp 2483-97.

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