What goes into a Mediterranean diet, and how to get started (2024)

What goes into a Mediterranean diet, and how to get started (1)

If you know anything about healthy eating, you've probably heard that the benefits of Mediterranean-style eating are as clear as the crystal sea at a Greek island getaway.

But for someone just testing the waters of heart-healthy eating, the specifics of such a diet can get a little murky. That's because its definition can vary.

Mediterranean-style eating is not necessarily about eating so many servings of a particular food at each meal, said Catherine M. Champagne, professor of nutritional epidemiology and dietary assessment and nutrition counseling at Louisiana State University's Pennington Biomedical Research Center in Baton Rouge. "It's more of a pattern."

In general, that pattern includes:

‒ Fresh fruits and vegetables.

‒ Nuts, beans and whole grains.

‒ Olive oil as the principal source of fats, as opposed to butter or margarine.

‒ Fish and other seafood.

‒ Limiting consumption of red and processed meat, sugary sweets, processed foods and some dairy.

It's an eating pattern rooted in the traditional habits of people in countries that border the Mediterranean Sea, where rates of heart disease tend to be lower and life expectancies after age 45 have been among the highest in the world.

The details of what makes a Mediterranean diet can shift from country to country, Champagne said. But repeated studies have linked it to lower cardiovascular risk. One study, published in 2018 in JAMA Network Open, found that among nearly 26,000 U.S. women followed for up to 12 years, adherence to such a diet was associated with a one-quarter lower risk of any of four cardiovascular events, including heart attack and stroke.

Mediterranean-style eating was incorporated into the recent update of an American Heart Association tool for evaluating heart health. The tool, Life's Essential 8, produces a score based on eight easily measured assessments: diet, physical activity, nicotine exposure, sleep health, body weight, blood lipids (cholesterol and other fats), blood glucose and blood pressure. easily measured assessments: diet, physical activity, nicotine exposure, sleep health, body weight, blood lipids (cholesterol and other fats), blood glucose and blood pressure.

The experts behind Life's Essential 8 supported both Mediterranean-style eating patterns and DASH, or Dietary Approaches to Stop Hypertension, which have many similar components. In individuals, Life's Essential 8 rates diet based on a screening tool for what's called the Mediterranean Eating Pattern for Americans.

Christy Tangney, a professor of clinical nutrition and preventive medicine at Rush University Medical Center in Chicago, helped create that 16-question screening tool.

One of the hallmarks of Mediterranean-style eating is its flexibility, she said. Research done in Spain on Mediterranean eating, for example, includes sofrito, a sauce made of olive oil and vegetables commonly eaten there. Tangney's "Americanized" screener leaves sofrito out, because it's rarely seen in U.S. diets, but adds berries.

Mediterranean-style eating works, Champagne said, in part because of how it affects cholesterol in the bloodstream. The Mediterranean diet lowers "bad" LDL cholesterol, and research suggests it either doesn't affect "good" HDL or slightly increases it, she said.

The bottom line, Champagne said, is simply: "We've seen lots of heart health benefits with a Mediterranean diet."

That does not mean it's perfect. People trying to lose weight will still need to cut back on calories. And Tangney said it can be a challenge for Americans to embrace whole grains, walk away from processed foods and ease up on dairy products such as cheese.

Also, access to the fresh fruits, vegetables and other foods in a Mediterranean eating pattern can be a challenge for people with low incomes, said Dr. Annabelle Santos Volgman, a professor of medicine at Rush University Medical Center and medical director of the Rush Heart Center for Women.

Understanding the role of wine can also be tricky. Moderate wine drinking – one to two drinks a day – has been considered part of the diet. But Volgman, who worked with Tangney to develop the screening tool, said the possible benefits from wine are outweighed by the potential harms. Federal guidelines recommend that people who don't drink alcohol should not start, and for those who do drink, less is better for health.

Such caveats aside, adopting aspects of Mediterranean eating can be easy.

Embracing extra virgin olive oil for cooking or in salad dressings is one place to start, Tangney said. Eat leafy greens daily. "When you look at your plate, the largest part of your plate should be vegetables," she said.

For protein, a Mediterranean eating plan would have you cut back on red meat, so try fatty fish – such as anchovies, salmon, mackerel, tuna or sardines – once or twice a week. Beans are also a good protein source; Tangney suggests having them three times a week. Eat nuts or fresh fruit instead of sweets for dessert.

Champagne said breakfast could include an olive oil spread on whole-wheat toast, and possibly an egg. A dinner of salmon with pilaf and a large portion of stir-fried vegetables could work, she said. Pastas should be whole grain. And people who don't enjoy lots of olive oil can find healthy fats in nuts or avocados instead.

Diet isn't the only part of Mediterranean living that's important for heart health. The eating pattern is historically associated with lifestyles that include exercise and social activity.

But the flexibility that makes Mediterranean-style eating hard to define can make it easy to embrace.

"People love choice," Tangney said. "Nobody wants to be dictated to."

If you have questions or comments about this American Heart Association News story, please email [emailprotected].

What goes into a Mediterranean diet, and how to get started (2024)

FAQs

How should I start the Mediterranean diet? ›

How Do I Transition To The Mediterranean Diet?
  1. Try adding some spinach to your morning eggs.
  2. Enjoy an apple with peanut butter for a snack instead of chips.
  3. Order the salmon vs. the steak next time you go out to eat.
  4. Try sautéing your veggies in a little olive oil instead of butter.
Jan 10, 2023

What goes into a Mediterranean diet? ›

The Mediterranean diet is a pattern of eating that focuses more on fruits, vegetables, whole grains, beans, nuts, legumes, lean proteins from fish and poultry, good fats from olive oil, and some dairy, while limiting consumption of sweets and red meats.

Can I drink coffee on the Mediterranean diet? ›

Wondering what to drink on the Mediterranean diet? Water should be the first thing you reach for. Coffee and tea are also fine, as long as you watch the added cream or sugar. Limit intake of sugar- sweetened drinks, like soda, fruit juice, or sweet tea.

What cheese is ok on a Mediterranean diet? ›

Cheese & Yogurt

Dairy products common to the traditional Mediterranean Diet include: brie, chevre, corvo, feta, haloumi, manchego, Parmigiano-Reggiano, pecorino, ricotta, yogurt (including Greek yogurt).

Do you lose belly fat on Mediterranean diet? ›

While no diet offers a 'magic pill' for weight loss or health challenges, the Mediterranean Diet, backed by the findings from the PREDIMED-Plus study, presents a scientifically supported option for those looking to reduce belly fat.

How many eggs should you eat on a Mediterranean diet? ›

Based on their high cholesterol content, the Mediterranean Diet Foundation recommends to consume up to 4 eggs per week, as a healthy alternative to fish or meat [7], and the same amount (2–4 eggs per week) was indicated in the latest Italian dietary guidelines [8].

What is a typical Mediterranean breakfast? ›

Common Mediterranean Breakfast Foods

Yogurt: We love Greek yogurt which is higher in protein, and lower in sugar. Eggs: A great source of protein and healthy fats. Oats: A healthy whole grain used in oatmeal and baked goods. Fruit: All types of fruit are encouraged on the Mediterranean diet.

What is not allowed on a Mediterranean diet? ›

The Mediterranean diet is high in plant-based foods such as vegetables, fruits, whole grains, beans, nuts, seeds, and olive oil. Foods not allowed include processed red meats, heavily processed foods, refined grains, alcohol, butter, and refined/processed/hydrogenated oils.

Is peanut butter on the Mediterranean diet? ›

And as plant-based protein sources that are high in good and unsaturated fats, peanuts and peanut butter are a natural fit within Mediterranean and Flexitarian ways of eating. Unfamiliar with the Mediterranean and Flexitarian diets?

Why is butter not allowed on Mediterranean diet? ›

The diet limits the intake of red meat, high-fat dairy products, and foods that are high in saturated fat, such as butter and cream. Avoiding processed foods can improve your overall health. It will also reduce the risk of chronic diseases, such as heart disease, type 2 diabetes, and certain cancers.

What is the fastest way to lose weight on the Mediterranean diet? ›

If you want to lose weight following a Mediterranean diet here are my 5 tips that work.
  1. Eat your main meal early in the day. ...
  2. Eat vegetables as a main course cooked in olive oil. ...
  3. You should drink water mostly and sometimes tea, coffee and wine (for adults) ...
  4. Consume the right amount of olive oil. ...
  5. Move.
Jan 17, 2024

Is mayonnaise allowed on a Mediterranean diet? ›

Avoid sauces made from cream or mayonnaise. Choose whole-grain breads, whole wheat pasta and pizza crust, brown rice, beans, and lentils. Cut back on butter or margarine on bread. Instead, you can dip your bread in a small amount of olive oil.

Is Bacon allowed on the Mediterranean diet? ›

Red meats and sweets are only eaten in small amounts. Processed meats (deli meats, bacon, ham, corned meats, salami or sausages) and packaged foods should be limited to rare occasions. Can I drink alcohol? Wine (especially red wine) is a traditional part of a Mediterranean-style diet.

Do you eat bananas on a Mediterranean diet? ›

Oats are a whole grain, which is encouraged on the Mediterranean diet. Low or moderate amounts of cheese, such as brie, feta, ricotta, and Parmigiano Reggiano (Parmesan), are also allowed. All types of fresh fruits, including bananas, are a go on the diet.

What chips are OK on Mediterranean diet? ›

Plentils Garlic and Parmesan Lentil Chips

These chips are made from lentils, a high-protein bean-like plant that is a big part of Mediterranean eating. For those avoiding gluten, this crunchy snack is gluten-free and is also free of dairy. For a heartier midday snack, try pairing them with hummus.

What happens to your body when you start the Mediterranean diet? ›

Research supports the use of the Mediterranean diet as a healthy eating pattern for the prevention of cardiovascular diseases, increasing lifespan, and healthy aging. When used in conjunction with caloric restriction, the diet may also support healthy weight loss.

How long until someone would see results with the Mediterranean diet? ›

The study found that the Mediterranean diet was more flexible and less restrictive in delivering desired weight loss results. In addition, one of the studies in the review found that participants lost an average of 8.7% of body weight on the Mediterranean diet after 12 months.

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