The health benefits of the Mediterranean diet are well documented. So how do you follow it at home?
The Mediterranean diet is widely regarded as a healthy dietary pattern. It is not about consuming large amounts of red wine or rich cheese-based sauces.
Instead, the emphasis is on vegetables, pulses, fish, fruit, unsaturated fats, nuts and fibre rich grains. This way of eating reflects traditional dietary patterns of people living in countries bordering the Mediterranean Sea, including France, Spain, Italy and Greece.
Although specific foods vary between regions, the core principles are similar.
According to the British Nutrition Foundation, the Mediterranean diet includes higher consumption of vegetables, fruit, whole grains, low fat dairy foods, seafood, nuts, seeds and legumes.
It also involves choosing unsaturated fats and reducing intake of fatty and processed meats, refined grains, sugar sweetened foods and beverages, salt and saturated fats compared with a typical Western dietary pattern.
There is no single magic ingredient in the Mediterranean diet. Rather, it is the overall dietary pattern that is associated with health benefits, including a lower risk of cardiovascular disease.
These potential benefits are not achieved by consuming red wine or garlic alone.
It is based on largely plant focused eating, along with lifestyle habits such as preparing meals from basic ingredients, sharing meals socially, and maintaining a balance between activity and rest.
What to eat on the Mediterranean diet
The Mediterranean Diet Foundation advises following a Mediterranean diet pyramid, which places plant based foods at the base. These foods are recommended more frequently and in greater amounts than foods at the top of the pyramid. Red meat and sugary foods are recommended less often.
The Foundation recommends including the following:
Every day
Cereals
One or two servings per meal such as bread, rice, pasta and couscous. Whole grain options are preferred as they contain fibre and minerals including magnesium and phosphorus.
Vegetables
Two or more servings at lunch and dinner, with at least one serving raw. Choosing a variety of colours and textures can help provide a range of nutrients.
Fruits
One or two servings per meal, which can replace desserts or snacks.
Water
Approximately 1.5 to 2 litres per day, unless otherwise advised by a health professional.
Dairy products
Included regularly, with lower fat options where appropriate.
Olive oil
Used as a primary source of dietary fat for cooking and dressings. Portion awareness is important as oils are energy dense.
Spices, herbs, garlic and onions
Used to flavour foods and reduce reliance on salt.
Olives, nuts and seeds
Sources of unsaturated fats, protein, vitamins, minerals and fibre. Portion control is recommended.
Wine
If alcohol is consumed, it should be within national alcohol guidelines. In Australia, this means no more than 10 standard drinks per week and no more than 4 on any one day, with alcohol free days each week. Some individuals should avoid alcohol entirely.
Weekly
A variety of plant and animal protein foods can be included. In traditional Mediterranean style eating, meat is often not the central component of the meal.
Fish and shellfish
Two or more servings per week.
Eggs
Two to four servings per week.
Red meat
Less than two servings per week, preferably lean cuts. Processed meats such as ham and bacon should be limited.
Plant based proteins
Legumes more than two servings per week, often combined with grains to provide fibre and protein.
Foods to limit
Foods high in added sugars, pastries, sweets, chocolates, sweetened fruit juices and soft drinks should be consumed only occasionally and in small amounts.
Lifestyle considerations
Other elements include moderate portion sizes, cooking from basic ingredients, choosing seasonal foods where possible and limiting highly processed foods.
Sharing meals socially and undertaking at least 30 minutes of moderate physical activity most days are also consistent with this lifestyle pattern.
What research suggests about the Mediterranean diet
The Mediterranean diet is one of the most studied dietary patterns globally. Research suggests it is associated with several health outcomes.
Cardiovascular health
Multiple studies have found that adherence to a Mediterranean style diet is associated with a lower risk of cardiovascular disease. A 2013 study published in the New England Journal of Medicine reported that among individuals at high cardiovascular risk, a Mediterranean diet supplemented with nuts or olive oil was associated with a reduced incidence of major cardiovascular events compared with a control diet. Individual results vary and dietary changes should be discussed with a qualified health professional.
Cognitive health
Some research suggests that closer adherence to a Mediterranean dietary pattern may be associated with slower cognitive decline. Associations do not establish causation, and more research is ongoing.
Type 2 diabetes
The Mediterranean diet has been recommended by some health organisations as a dietary pattern that may assist with weight management and reducing the risk of type 2 diabetes. Weight reduction, where appropriate, may lower risk. Individualised medical advice is recommended before making dietary changes.
Cancer risk
The Mediterranean diet itself has not been proven to prevent cancer. However, elements of the diet such as higher intake of plant based foods and fibre are associated with reduced risk of certain cancers. Maintaining a healthy body weight is also associated with lower risk of several cancers. Associations reported in studies do not guarantee prevention.
5 practical ways to make your eating pattern more Mediterranean
- Eat more fruit and salad
Include fruit regularly and consider it as an alternative to discretionary snack foods. - Have meat free days
Choose protein from fish, beans and pulses more often. - Swap saturated fats for unsaturated oils
Use olive oil instead of butter, lard or ghee where suitable. - Adapt recipes
Modify recipes to include more vegetables, legumes and tomato based sauces instead of high saturated fat sauces. - Drink moderately
If you choose to drink alcohol, do so within national guidelines. Excess alcohol consumption carries health risks.
Risks and Recovery
This information is general in nature and is not a substitute for personalised medical or dietary advice. Dietary changes may not be suitable for everyone. People who are pregnant, breastfeeding, managing chronic conditions such as diabetes, kidney disease, cardiovascular disease or gastrointestinal disorders, or taking medicines affected by diet should seek advice from a qualified health professional before making significant changes.
Alcohol consumption is not recommended for some individuals and carries risks including liver disease, cancer and dependence.
Health outcomes vary between individuals. No dietary pattern can guarantee prevention of disease. If you experience concerning symptoms, seek medical assessment promptly.