What is the Mediterranean diet?

If you’re hoping to eat healthier meals, you might be part of the target audience for the Mediterranean diet. It’s been celebrated as a healthy diet that increases your life expectancy and dramatically reduces your risk of cardiovascular disease, breast cancer, and other severe chronic illnesses.
A healthy Mediterranean diet focuses on eating minimally-processed non-starchy vegetables, nuts, whole grain cereals, and legumes. The diet includes very little in the way of meat and dairy as this used to be seen as a luxury.
However, the grocery list for the Mediterranean diet isn’t the only factor to consider. Characteristics of the Mediterranean diet include:
- Eating a wide variety of fresh vegetables daily
- Fresh fruits as desserts (with honey reserved for special occasions)
- Consuming oil, nuts, and seeds as the primary fat sources
Meanwhile, the fish in the Mediterranean diet is meant to be consumed in moderation, and dairy products, red meat, sweets, and wine are to be consumed sparingly.
What are the limitations of the Mediterranean diet?
Is the Mediterranean diet inclusive?
There are limits to the Seven Countries Study — only working men were studied by Keys, so the data isn’t representative of entire populations.
Critics of the Mediterranean diet have pointed out that the diet focuses on foods from the Mediterranean region that are palatable to predominately-white European tastes, such as Italian and southern French cuisine. It is not necessarily representative of the diverse range of cuisines from this area of the world. Of the chosen countries, 22 touch the Mediterranean, including Tunisia, Croatia, Egypt, and Morocco.
There were also oversights in the study about local cultures. For example, when Keys conducted the Seven Countries Study, he collected data from Greek participants while they were fasting for Lent, skewing preferences toward the Italian diet over the Greek diet.
Is the Mediterranean diet affordable?
A study by the International Epidemiological Association determined that lower cardiovascular risk is associated with the Mediterranean diet. Still, this association is entirely confined to higher income groups.
Disparities were found in the diets of individuals with lower incomes who did not have access to the same intake of organic foods, fatty acids, whole grains, antioxidants, and micronutrients. They often did not have the overall diversity in their diet that higher income groups had.
If you’re trying to eat the Mediterranean diet on a budget, consider:
- Shopping at farmer’s markets at the end of the market day
- Using frozen or canned fruits or vegetables without added sugar, salt, or sauces
- Using dried beans and lentils as a protein source
- Buying seafood in cans, pouches, or plain frozen portions.
Are there any Mediterranean diet health concerns?
While the Mediterranean diet is generally healthy, there are a few health concerns to consider:
- You may gain excess weight if you don’t watch portion sizes. While olive oil and nuts are healthy fat sources, they’re high in calories.
- The Mediterranean diet can be low in iron. Monitor your iron and vitamin C intake on the Mediterranean diet. Vitamin C helps your body absorb iron.
- You may have calcium loss from consuming limited dairy. Talk to your doctor to decide if you should take a calcium supplement.
- Wine should be avoided if you’re pregnant, at risk for alcohol abuse, at risk for breast cancer, or take medications that shouldn’t be mixed with alcohol.

Who Is the Mediterranean diet for?
While the target audience for the Mediterranean diet seems to be predominantly white Americans and Europeans of a higher income bracket, we could potentially learn much if we include the diets and dietary habits of underrepresented areas of the Mediterranean.
Gearing your diet away from dairy, processed meats, and excessive alcohol consumption will do more good than harm, whatever the quality of the product you buy.

QUESTION
According to the USDA, there is no difference between a “portion” and a “serving.” See AnswerHealth Solutions From Our Sponsors
Harvard T.H. Chan School of Public Health: "Diet Review: Mediterranean Diet."
Journal of Critical Dietetics: "The whiteness of the Mediterranean Diet: A historical, sociopolitical, and dietary analysis using Critical Race Theory."
MedlinePlus: "Mediterranean diet."
National Library of Medicine: "Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms," "High adherence to the Mediterranean diet is associated with cardiovascular protection in higher but not in lower socioeconomic groups: prospective findings from the Moli-sani study."
Nutrients: "Health Benefits of Mediterranean Diet."
Oxford Academic—American Journal of Epidemiology: "Invited Commentary: 30-Year Perspective on the Seven Countries Study."
PennState Extension: "Mediterranean Eating on a Budget."
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