Eat As They do in the Mediterranean

By Claire Carlton, MS, RD, LD/N

Cultures around the world have thrived consuming a variety of traditional cuisines and staple foods unique to their region. Perhaps the most well known traditional dietary pattern for promoting health is the Traditional Mediterranean Diet (TMD), first recognized in the 1950s when the people living in these areas were noted by physiologist Ancel Keys to have lower incidence of chronic disease and longer life expectancy compared with other regions of the world. The Mediterranean region includes Greece, Southern Italy, Spain and other olive-growing countries of the Mediterranean basin. Through collaborative efforts, Oldways (a nonprofit food and nutrition education organization), the Harvard School of Public Health and the World Health Organization created the first Mediterranean Diet Pyramid in 1993. Since then, numerous studies have demonstrated the health promoting effects of the TMD.

The TMD could be considered more of a lifestyle than your standard diet, as this eating pattern acknowledges the importance of physical activity, connection with others during meals and savoring the flavors of food. The lifestyle embraces the use of seasonal foods and ingredients in cooking. Staples of the Mediterranean eating pattern include the following.

  • Food that is minimally processed
  • A diet high in plant-based foods including vegetables, fruits, nuts/seeds, beans/legumes and whole grains
  • Olive oil as the primary cooking fat
  • A diet liberal in total fat, but lower in saturated fat (the kind that increases cholesterol)
  • Limited dairy with small amounts of cheese and yogurt daily
  • Fish/seafood, poultry and eggs as the preferred protein sources
  • Red meat about once per week, with leaner cuts favored
  • Daily exercise
  • Limited refined sweets

Of important note is that most meals are structured around plant foods like vegetables, beans and whole grains with meat and dairy added to provide adequate calories (energy) and offer additional flavor, healthy fats and proteins. So what is it about these foods that make this diet so great for health?

Phytochemicals and antioxidants

As mentioned above, this diet is high in plant foods, specifically colorful fruits and vegetables, beans and whole grains. Different colors in fruits and vegetables represent various phytochemicals and antioxidants. Phytochemicals (or phytonutrients) are plant compounds that offer benefits to the human body to prevent cancer and other chronic disease, boost immunity and promote detoxification. A 2004 Harvard study looked at 100,000 individuals, and researchers found that consuming at least eight servings of fruits and vegetables daily was linked with a 30 percent lower risk of heart attack and stroke compared with eating fewer than two servings. The TMD emphasizes these foods at meals, and they work in a synergistic way to promote health. This means that no single food is the magic answer to optimal health; rather, regular consumption of a variety of nutrients and foods is best to reap the benefits.


The TMD is high in whole grains, beans and legumes, which introduce a rich source of dietary fiber to the diet. Fruits and vegetables are also high in fiber. Fiber plays a significant role in weight loss by promoting satiety (aka keeping us full between meals so we don’t munch mindlessly). In addition, insoluble fiber from foods keeps the digestive system healthy by regulating bowels.

The high level of fiber consumed by the Mediterranean people is also one of the reasons the diet is touted to have cardiovascular benefits. Soluble fiber helps to remove cholesterol from the blood and helps us to maintain healthy blood levels.

Healthy fats

The TMD uses liberal amounts of olive oil in cooking. Olive oil is rich in monounsaturated fatty acids, which are beneficial for cardiovascular health. The PREDIMED Study, published in the New England Journal of Medicine, tested the benefits of the TMD using a randomized clinical trial of 7,500 subjects diabetes or at high risk for cardiovascular disease were assigned to three different diets. The diets included a TMD with 4 tablespoons of olive oil daily, a TMD with 1 ounce of nuts daily and finally a low fat diet. After five years, those on the low fat diet had difficulty sticking to the diet while those following either variation of the TMD saw significant reduction of risk for heart attack and stroke.

Adherence to a TMD has also been associated with decreased risk of neurodegenerative diseases. A 2015 review article in the journal Molecules looked at several studies exploring the role of olive oil in disease prevention. Specifically, the polyphenols in olive oil have been studied for their neuroprotective and anti-inflammatory properties. According to current research, cognitive decline in diseases like Alzheimer’s is linked to increased oxidative stress, and consuming a diet high in antioxidants, like the TMD, may help to protect against these conditions.

Finally, the fish and seafood consumed in the Mediterranean eating pattern contains omega 3 fats — a type of polyunsaturated fat, which not only boosts heart health, but also is also beneficial for mood and cognition.

What about red wine?

Wine can be included as part of a healthy Mediterranean diet in moderation. This means no more than a 5-ounce glass per day for women and no more than 10 ounces per day for men. This amount has been shown to increase HDL cholesterol levels (the good kind), which is cardioprotective.

Tips to incorporate Mediterranean-inspired foods to your diet!

  1. Swap the canola and vegetable oil in your cupboard for extra virgin olive oil. Use the olive oil to make salad dressings or drizzle over freshly made hummus. Cook with olive oil at low to medium heat to roast or sauté meats, fish and veggies.
  2. Make a healthy Mediterranean style dessert with ½ cup grass-fed organic yogurt, a handful of blueberries, 1 teaspoon of lemon zest and a drizzle of raw honey.
  3. Instead of snacking on chips and salsa, make a Mediterranean-style snack platter to share with friends and family. Fill your platter with assorted olives, artichokes, grape tomatoes, cheese, nuts, whole grain bread and grapes.
  4. Incorporate fish such as wild salmon, tuna and sardines at least twice a week. When fresh wild salmon is not in the budget, keep cans of wild salmon in the pantry. Use canned salmon to make salmon burgers and place atop a bed of greens.


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