Mediterranean Diet

Mediterranean Diet: Beginner’s Guide to a Healthy Heart

The Mediterranean diet is the No. 1 Best Diet Overall. It’s also a top-rated diet for those looking for a heart-healthy diet, a diabetes-friendly diet or to promote bone and joint health. But don’t confuse Americanized Mediterranean menus – which often feature too much refined pasta, beef and cheese – with healthy eating. Learn more about what the Mediterranean diet is, how effective it is for losing weight and what foods to eat in our Mediterranean diet review.

What Is the Mediterranean Diet?

Who hasn’t dreamed of escaping to the Mediterranean? The sea, the culture, the history and the food! Visions of tomatoes, olive oil and wine likely dance in your head. But is it too good to be true? Yes and no.

The food and eating habits of the Mediterranean region, which encompasses not only Greece and Italy but also Croatia, TurkeySpain and Morocco, are undoubtedly both delicious and healthful. However, the “Americanized” version of Mediterranean food, deep-fried cheese and falafel, heavy pasta dishes and a lot of beef and pork is anything but healthy.

Though people living in the diverse Mediterranean region eat different types of food, their diet primarily consists of plant-based foods – whole grains, beans, nuts and unsaturated fat from extra-virgin olive oil. A small amount of lean poultry and plenty of seafood is also allowed.

The Mediterranean diet focuses on diet quality rather than a single nutrient or food group. Numerous studies have shown that it reduces the risk of chronic health conditions, including heart disease and Type 2 diabetes, while promoting longevity and improving quality of life.

The nutritional value and health benefits of the Mediterranean diet were first documented in the Seven Countries Study, which investigated the relationship between diet and heart diseases among roughly 13,000 men from 1958 to 1999. The seven countries that the participants hailed from included:

  • Greece.
  • Italy.
  • Japan.
  • Finland.
  • Croatia and Serbia (Former Yugoslavia).
  • The Netherlands.
  • U.S.

The study demonstrated that the type of fat – saturated, monounsaturated or polyunsaturated – affects cardiovascular health more than total fat intake does. Although standard nutrition advice calls for a 30% limit on total calories from fat, up to 40% may be heart-friendly, if most of the fats consumed are unsaturated.

How Does the Mediterranean Diet Work?

  • Fill your plate with a wide range of foods.
  • Eat fruits, vegetables, whole grains, beans, nuts, legumes, olive oil, herbs and spices daily.
  • Eat seafood and fish at least twice a week.
  • Poultry, eggs, cheese and yogurt are OK in moderation.
  • Red meat and sweets are best reserved as occasional treats.
  • The occasional glass of red wine is acceptable.

There isn’t a single Mediterranean diet. Greeks eat differently than Italians, and Turks eat differently from the French and Spanish. There’s even a Costa Rican version of the Mediterranean diet. But they share many of the same principles. Working with the Harvard School of Public Health and the World Health Organization, Oldways, a nonprofit food think tank in Boston, developed a consumer-friendly Mediterranean diet pyramid that offers guidelines on how to fill your plate – and maybe wineglass – the Mediterranean way.

Because the Mediterranean diet focuses on nutrient-dense fruits, vegetables, whole grains, nuts, seeds and healthy fats, it leaves little room for the saturated fat, added sugars and sodium that inundate the standard American diet. As a result, people who eat a Mediterranean-style diet have longer life spans, report a higher quality of life and are less likely to suffer from chronic diseases, such as cancer and heart disease.

There are a lot of misconceptions about the Mediterranean diet – namely that eating piles of refined pasta covered in cheese sauce and sausage meets the requirements of a Mediterranean diet plan. While you can eat whole-wheat pasta (or even regular pasta) on the Mediterranean eating plan, it would be topped with plenty of fresh vegetables and beans, dressed with olive oil and perhaps sprinkled with a small amount of natural cheese.

Can I Lose Weight on the Mediterranean Diet?

Yes, it’s possible to lose weight on the Mediterranean diet, especially if you’re switching from a standard American diet. But you must make wise choices, pay attention to portion sizes and don’t overdo the olive oil, cheese, nuts and other high-calorie foods. For example, overdoing olive oil, cheese and nuts will hinder your weight loss just as ice cream and cookies will.

There are many studies that show a Mediterranean way of eating can be an effective diet for weight loss and weight maintenance, says Elena Paravantes-Hargitt, a registered dietitian nutritionist specializing in the Mediterranean diet and author of “The Mediterranean Diet Cookbook for Beginners.”

“One of the most important aspects of the Mediterranean diet in regards to weight loss is that it is easy to follow for long periods of time,” says Paravantes-Hargitt, who is also the founder of olivetomato.com, a website dedicated to the Greek-Mediterranean diet. She adds that “a traditional Mediterranean diet is 40% carbohydrates, 40% fat and about 20% protein. This combination has been shown to not only be ideal for long-term weight loss but is associated with lower mortality rates. As the diet is rich in vegetables, beans and olive oil, it provides good satiety.” Satiety is a feeling of fullness and satisfaction after eating.

Short-Term Weight Loss

If your goal is to fit into a 10-year-old pair of jeans in two weeks, the Mediterranean diet isn’t a great fit for you. However, health experts recommend losing no more than one or two pounds a week for a sustained length of time, and it isn’t uncommon to lose faster at the beginning of your diet, especially if you have a lot of weight to lose.

According to some research, your best bet might be to combine a Mediterranean diet with a reduction in carbs. We aren’t talking about the keto or paleo diet here. In one study, 194 overweight individuals with Type 2 diabetes were divided into three diet groups for one year (1). The three groups followed one of three diets. All three groups also cut calorie intake and exercised regularly. After 12 months, the average weight loss was:

  • 22 pounds for the low-carbohydrate Mediterranean diet group.
  • 17 pounds for the American Diabetes Association diet group.
  • 16 pounds for the traditional Mediterranean diet.

People who eat about 40% of their total calories in the form of carbohydrates and emphasize plant-based sources of protein and fat also have the lowest risk of developing Type 2 diabetes, according to an American Heart Association review of three studies involving nearly 204,000 adults. This is especially impressive given that adults in some studies were monitored for up to 30 years.

If you really want to seal the deal and lose weight, add exercise to your Mediterranean lifestyle. An often-cited study by medical professionals showed that people enrolled in a program combining a low-calorie Mediterranean diet, an exercise program and counseling fared much better than the participants who were told to adhere to a Mediterranean diet but weren’t given any information about exercise or weight loss (2).

Long-Term Weight Loss

Although few studies have been completed to demonstrate effectiveness of the Mediterranean diet for long-term weight loss, the research is promising.

Weight Maintenance and Management

According to a study of 32,119 participants, following the Mediterranean diet can minimize both weight gain and an expanding waistline (3).

How to Get Started on the Mediterranean Diet

  • Think of meat as the side dish and whole grains or vegetables as the main dish.
  • Learn to enjoy fruit as a sweet finish to your meal – grilling, broiling or baking fruit with a squeeze of citrus juice before serving it with a dollop of vanilla yogurt and a sprinkle of cinnamon is a satisfying and healthful dessert.
  • Look at recipes online and explore outside the borders of Greece and Italy. Be creative and have fun with it.
  • Plan some meals and snacks in advance so you don’t have to think about what to prepare when you’re tired and hungry.

What Does the Mediterranean Diet Cost?

Besides the cost of food, the Mediterranean diet shouldn’t cost you anything unless you want to purchase a new cookbook.

You can follow a budget-friendly Mediterranean diet. While some ingredients – olive oil, nuts, fish and fresh produce – can be expensive, you can find ways to keep the tab reasonable, especially if you’re replacing red meats and meals with plant-based home cooking.

“The Mediterranean diet recommends many low-cost, whole foods, such as fruits, veggies, whole grains and legumes. People may think they can’t afford seafood, but there are a number of budget-friendly options such as canned tuna, salmon and sardines,” says Lindsey Pine, a culinary dietitian in Los Angeles and author of the “Mediterranean Diet Meal Prep Cookbook” and “Quick & Easy Mediterranean Diet for Beginners.”

Is the Mediterranean Diet Easy to Follow?

Because the Mediterranean diet doesn’t ban entire food groups, it’s easy to follow and adopt long term.

The Mediterranean diet can be convenient. You can combine seafood, beans, whole-wheat pasta and whole grains – like farro or quinoa – with an infinite combination of fruit, vegetables, herbs and spices to create easy meals. Purchasing precooked quinoa, brown rice, lentils and beans will make meal prep easy even on the busiest days.

Mediterranean recipes are plentiful. A simple online search will turn up hundreds of healthy Mediterranean meal ideas. Want more inspiration? Oldways, the nonprofit food think tank in Boston that helped develop a Mediterranean food pyramid, recommends the “4-Week Mediterranean Diet Menu Plan.” And America’s Test Kitchen offers many Mediterranean diet recipes – even recipes specifically for an Instant Pot – from their selection of cookbooks, including “The Complete Mediterranean Cookbook: 500 Vibrant, Kitchen-Tested Recipes for Living and Eating Well Every Day.”

If you eat out while following the Mediterranean diet, share an entree with a friend. Start with a house salad or order extra veggies a la carte so that you aren’t as hungry when the main course arrives. Grilled salmon or tuna, grain bowls and pizza made with a cauliflower or whole-grain crust are good choices.

You’ll find lots of free Mediterranean diet resources on the Oldways website, including an easy-to-understand food pyramid; a printable grocery list; gender- and age-specific tips on making the Mediterranean switch; a quick-read brochure; a recipe newsletter; and a glossary of Mediterranean staples, from bruschetta to tapenade.

Hunger shouldn’t be a problem on this diet. Fiber and healthy fats are filling, and you’ll eat lots of fiber-packed produce and whole grains on this diet.

Who Should Not Try the Mediterranean Diet?

The Mediterranean diet is safe for everyone, including older adults, children and pregnant women. If you have kidney disease or any other condition that could lead to electrolyte imbalances, please speak to your doctor before making any diet changes.

Pros

  • Nutritionally sound.

  • Diverse foods and flavors.

  • No counting carbs, points or calories.

  • Filling – it’s rich in high-fiber foods.

  • No off-limit foods or food groups.

  • Has proven health benefits.

Cons

  • Tedious portioning, meal planning or prep.

  • Lacks in-depth nutritional guidance.

Mediterranean Diet Rankings & Reviews

Mediterranean Diet ranked No. 1 in Best Diets Overall. 30 diets were evaluated with input from a panel of health experts. See how we rank diets here.

Mediterranean Diet is ranked:

U.S. News Expert Reviews:

“This diet pattern has a long background of nutrition research documenting multiple health benefits, as well as healthier weight. It is a nutritionally-balanced, sound diet that does not exclude any major food groups and can be delicious and easy to follow, though it does involve more cooking than Western diets.”
“The Mediterranean diet is always a top diet for its use of fruits, vegetables, fish and other healthy foods. It is flexible, which makes it easy to follow long term. Research has also linked it to decreases in chronic conditions.”
“Assuming a top quality variant, this dietary pattern has it all: appetizing, sustainable, backed by science and real-world experience, no gimmickry and a way of eating for life rather than a “diet” per se. Variants can be flexitarian, pescatarian, vegetarian or even vegan.”
“The Mediterranean diet may be coined a diet, but it is truly a way of life. The Mediterranean diet has abundant research to prove its superiority to other diets out there. It’s well balanced, emphasizing all of the right foods, including vegetables, fruits, whole grains, lean proteins and healthy fats, while minimizing ultra-processed foods, added sugars and saturated fats.”

Success Stories and Tips From Real People

In May 2021, Bob Rowley, an adjunct lecturer at Northwestern University’s Medill School of Journalism in Chicago, embarked on a new culinary adventure to explore the cuisine of the Mediterranean countries. As part of Oldways’ 4-week challenge, Bob and his wife Carolyn, both 69, followed a Mediterranean diet for a month. Their daily menu consisted of more fruits, vegetables and whole grains; less sugar and red meat; and no processed foods.

Although Bob Rowley, a grilling enthusiast, admits he went through “withdrawal” after two weeks without red meat, the variety of healthy and delicious Mediterranean meals kept him satisfied. The couple still enjoyed lean poultry occasionally and sprinkled their food with pecorino to satisfy cheese cravings. Their menu also included a colorful array of plant-focused meals, such as polenta and sun-dried tomatoes, whole-grain panzanella salad, pasta puttanesca and baba ganoush on whole-wheat bread.

After a month, the Rowleys saw a marked improvement in their mood and overall health. Carolyn Rowley felt more energetic and lowered her cholesterol and blood pressure levels.

“We were biking more because we had so much more energy,” she says.

While neither of them expected to lose weight on the Mediterranean diet, Carolyn Rowley dropped 5 pounds, and her husband lost 7 pounds, because they were eating healthier and being more physically active, thanks to their increased energy.

Other successful tips provided to U.S. News by followers of the Mediterranean diet include:

  • Start small by adding a few fruits or vegetables into your menu.
  • Stock up on the basics, such as whole grains and vegetables, and focus on learning different ways to prepare and incorporate them into your meals.
  • Don’t be afraid to experiment with herbs and spices.
  • Flavor your food with citrus zest or juice. Alternatively, try a new type of vinegar –perhaps blueberry or herb-infused.
  • Spend time learning appropriate portion sizes for everything from cereal to pasta to steak.

One dietitian wrote for U.S. News about her experiences following the Mediterranean diet while adapting it to her Colombian tastes and found that it helped her autoimmune issues.

 

Why Trust U.S. News

With the help of our Best Diets panel of nationally-recognized experts in nutrition, obesity, food psychology, disease management, we developed a survey in partnership with The Harris Poll. The survey asked the panel to carefully compare diets for their nutritional completeness, health risks and benefits, long-term sustainability and evidence-based effectiveness. You can see our full methodology here.

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This article is based on reporting that features expert sources.

 

SOURCES

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our editorial guidelines.

Elena Paravantes-Hargitt, RDN

Paravantes-Hargitt is a registered dietitian who specializes in the Mediterranean diet and author of The Mediterranean Diet Cookbook for Beginners. She is founder of olivetomato.com, a website dedicated to the Greek-Mediterranean Diet.

Lindsey Pine, MS, RDN, CPT

Pine is a culinary dietitian in Los Angeles and author of the “Mediterranean Diet Meal Prep Cookbook” and “Quick & Easy Mediterranean Diet for Beginners.”