Mediterranean Diet: A Detailed Beginner’s Guide

The Mediterranean Diet (MedDiet) should not be considered a diet in the traditional sense of the word.

It’s a healthy eating pattern that is well researched and often recommended by registered dietitians, doctors, and other health care professionals as a way of reducing the risk of many chronic diseases.

If you are curious about the Mediterranean diet and the benefits of this eating pattern, here’s a beginner’s guide to getting started.

What Is the Mediterranean Diet?

The recognition of the Mediterranean Diet’s health benefits was sparked in the 1970s by American scientist Ancel Keys, who wrote a book titled, How to Eat and Stay Well, the Mediterranean Way.

Back in a time when Mediterranean communities hadn’t been spoiled by modern conveniences, Keys was fascinated by the surprisingly superior health of poor Italians compared to their wealthier American relatives who had emigrated to New York.

Keys observed a correlation between diet and heart disease.

He followed up on his book by conducting the Seven Countries Study, published in 1980, which further shed light on the health benefits obtained by living a Mediterranean lifestyle.

There is no one exact way to achieve the MedDiet. The plan simply mimics the plant-strong meals and a physically active lifestyle of people in countries surrounding the Mediterranean Sea.

It incorporates some of the local foods traditionally found in the area because of their known health benefits.

MedDiet emphasizes nutrient-dense plant foods, including whole grains, fresh vegetables and fruits, nuts, unsaturated oils, and even a little red wine.

It emphasizes fatty fish and moderate amounts of eggs, poultry, and dairy products.

The MedDiet does not exclude sweet treats or red meat but warns people to eat these sparingly. Finally, the plan encourages daily physical activity.

In collaboration with Harvard Medical and the World Health Organization, the non-profit organization Oldways created a visual representation of the Mediterranean Diet with this pyramid. (1)

This is similar to the former USDA food pyramid, which encourages greater consumption of the foods towards the bottom and lower consumption of those at the top.

Potential Disease-Fighting Benefits

Since Keys’ initial research, hundreds of studies have strengthened the evidence of MedDiet’s outstanding health benefits, particularly related to chronic diseases caused by Western lifestyle. (2)

MedDiet has also been shown to promote weight loss and weight maintenance while evading these diseases.

Cardiovascular Disease

The evidence for using the MedDiet to fight cardiovascular disease is robust and consistent.

Time and again, international, repeated, and comprehensive studies point to the power of nutrients in this plan to thwart factors that contribute to heart disease, so much so that it is becoming the standard for dietary advice. (3)

Weight Loss

While the MedDiet was not designed to achieve weight loss, many people do lose weight, especially if:

• Food choices are improved by starting the MedDiet.
• Followers choose to reduce the portion sizes and calories they eat.
• Followers exercise an hour each day while following the MedDiet plan.

This review discussed the successes of MedDiet for weight loss, especially when calories were planned and reduced. (4)

Cancer

A 2019 review of studies concluded that the MedDiet had anti-cancer properties, likely due to the anti-inflammatory and antioxidant effects of olive oil, fruits, and vegetables. (5)

The diet seemed effective against several types of cancers, especially when prescribed during the earliest stages.

Type 2 Diabetes and Metabolic Syndrome

Adhering to a MedDiet pattern appears to be an effective way to fight existing Type 2 Diabetes and metabolic syndrome in patients, as well as being protective against developing problems in the first place.

According to one study, the benefits are the result of the combination of nutrients built into the diet. (6)

Brain Health

The results from this 2017 review demonstrated repeated evidence that the Mediterranean Diet wards off diseases of cognitive function, including dementia and possibly Alzheimer’s disease. (7)

The review concluded that important nutrients, which are rich in this plant-based diet, act as warriors for brain health, blocking against mental decline.

What to Eat on the Diet

Because the MedDiet plan is not restrictive, there is an abundance of healthy foods from all food groups from which to choose.

Variety and making sure plant-based foods are the stars of every meal is the primary focus. The goal is to include a large variety of nutrients.

While some may think that Mediterranean Diet means that the foods will lean toward Greek, Italian, or Spanish recipes, the plan can be adapted to suit any cultural preferences.

Fruits and Vegetables

Aim for making fruits and vegetables the bulk of every meal by eating several servings every day.

While both fruits and vegetables are high in nutrient density, remember vegetables are generally the lower-calorie choice if your goal is weight loss.

To gain a wide variety of vitamins and phytochemicals from your produce, choose a rich assortment of colors like:

• Red: tomatoes and strawberries
• Orange: carrots and pumpkin squash
• Yellow: peppers and pineapple
• Green: spinach, avocados, and broccoli
• Blue/Purple: blueberries, purple grapes, figs, and eggplant
• Brown: mushrooms and potatoes

Whole Grains

Carbohydrates have gotten a lot of negative publicity with popular low-carb diets, but not with the MedDiet.

Whole grains contribute to heart health and are a known source of nutrients like thiamin, niacin, folate, and fiber. (8)

Choose whole grains over refined grains as often as possible for nutrient density.

Some great choices are oats, whole grain bread, brown rice, bulgur, whole grain crackers, and whole wheat pasta.

Nuts and Legumes

Nuts offer protein, healthy fats, fiber, and nutrients. Each kind has a unique combination of fat and vitamins, so eating a wide variety can be beneficial.

Some are even better than others; for example, walnuts are especially high in omega-3 fatty acids. (9)

Other good choices include almonds, hazelnuts, and pecans. While these are nutrient-dense, they are also calorie-dense, and just a handful can go a long way.

Legumes also offer nutrients, protein, and fiber but are not high in fat. They can be eaten in greater amounts without the hefty calorie increase.

Healthy Oil

Extra virgin olive oil is known for its health benefits and is traditional to the Mediterranean area. (10)

It has a low smoking point, so it’s best used for gentle sautéing and uncooked in dressings or dips.

For higher temperature cooking, try avocado, walnut, or canola oils. Oil is packed with calories, so remember that small amounts can go a long way. (11, 12)

Seafood

The MedDiet plan recommends eating fish as a healthy protein source at least twice per week.

Fish high in omega-3 fatty acid is especially beneficial for heart health. (13)

Great choices include anchovies, sardines, salmon, trout, Atlantic mackerel, and herring.

Dairy and Poultry

As great sources of protein, vitamins, and minerals, small servings of dairy and poultry are recommended daily to weekly on the MedDiet.

Choose lower saturated fat options like fat-free Greek yogurt and chicken breast.

Red Wine

While the MedDiet is quite popular for its inclusion of red wine, this component is optional.

The health benefits of phytochemical resveratrol versus the health risks of alcohol, in general, are somewhat inconclusive. (14)

If you choose to include wine, be sure that it’s in moderation of up to one glass each day.

If you are not already drinking alcohol before beginning the MedDiet, there is no clear evidence that you should start.

Sweets and Red Meats

There’s no official recommendation for how many sweets or red meats you should consume on the MedDiet, only that you should choose them infrequently.

Consider them as treats for special occasions or only indulging in small portions.

Mediterranean Diet and Exercise

You don’t have to have a gym membership or run marathons to meet the recommendations for the Mediterranean Diet.

Walking and biking are especially traditional in the Mediterranean area, where people rely more on their feet to get them to work and to the local market.

The general recommendation for exercise on MedDiet is at least 2.5 hours weekly or about 30 minutes, 5 days per week.

If weight loss is your goal, increase the exercise to at least one hour per day.

Tips for Getting Started

Increasing the amount of vegetables you eat is important, but how you accomplish this is your choice. Decide which vegetables you enjoy as you create your weekly menu.

Think along the lines of mixed green salads, veggie soups, egg scrambles, tomato-based pasta sauces, lightly steamed cruciferous veggies, and mixed vegetables that are roasted or grilled with garlic and olive oil.

Consider using fruit for dessert instead of having less nutritious sweet treats. This can be a way to both increase fruit and cut back on sweets.

If you’re having trouble switching to whole grains, find brand new tasty recipes that appeal to you.

For example, many people have a hard time substituting white for brown rice as a stir-fry base, but they may absolutely love brown rice in a nutty pilaf recipe.

Many people enjoy fish but forget to plan for it. Schedule fish Fridays and switch out beef for fish taco Tuesdays to eat seafood twice weekly.

If you don’t want to cut out red meat, consider greatly reducing it. For example, if your spaghetti sauce recipe calls for a pound of hamburger, consider only using 1/4 pound next time.

Better yet, you can replace the meat with sauteed onions, peppers, or other veggies.

Replace saturated fats with healthy oils. Try avocado toast as an alternative to butter and use olive oil vinaigrettes in place of your cream-based dressings.

Shopping and Cooking Tips

Save money by making your weekly menu and grocery list based on the current sales flyer from your local grocery store.

Buy expensive items like nuts, produce, and fish in bulk from warehouse club stores. You will save money, and the top quality these stores provide means you’ll be more tempted by their top-quality flavors.

Only buy the amount of fresh produce that you can consume quickly. You can still do this at warehouse stores by teaming up with friends to split the bounty and the bill.

Frozen produce is less expensive and can be even more nutrient-rich than fresh produce since vitamins are locked in on the day they’re picked.

Store bulk nuts in the freezer to keep them fresher longer.

Try to double-batch recipes that freeze well to save time.

Sample One Day Meal Plan

Counting calories is not part of the Mediterranean Diet. The amounts of recommended foods followers eat should depend on satiety cues.

As the Oldways pyramid suggests, plant foods should make up the majority of the meal.

Here is a one-day sample menu of typical foods recommended on the plan.

Breakfast: Veggie Scramble and Oatmeal

Scrambled egg mixed with sautéed mushrooms, spinach, and onions.

Cooked oatmeal mixed with blueberries and walnuts.

Lunch: Greek Salad

Mixed salad greens with chopped tomatoes, marinated artichoke hearts, and Greek olives. Top with sardines, feta cheese, and olive oil-vinegar dressing. Serve with a whole grain roll.

Snack: Yogurt Parfait

Low-fat Greek yogurt mixed with toasted oats and pomegranate arils.

Dinner: Grilled Chicken Skewers

Chicken breast, red bell pepper, zucchini squash, and red onion chunks marinated in olive oil, minced garlic red wine vinegar, salt, and pepper. Served with brown rice.

The Bottom Line

The Mediterranean Diet values the power of whole plant foods while recognizing that nutrient-dense animal foods can also benefit human health.

It is a way of eating that has been tested since the beginning of humankind.

MedDiet is not a restrictive plan and can be adjusted for people with special health conditions, dietary and cultural preferences, and budget restrictions.

Simply put, the Mediterranean Diet should not be seen as a diet but as a way anyone can eat to maximize their health potential.

As a nutrition expert, I’ve recommended the MedDiet to many clients and do not doubt that future studies will unveil even more proof of its benefits.