Mediterranean Diet

Last Updated: March 18, 2024

The Mediterranean diet refers to a dietary pattern originating from Greece, Southern Italy, and other countries surrounding the Mediterranean Sea; it has been extensively studied for cardiovascular disease prevention. It’s a plant-based diet that’s low in saturated fat, with key food components such as olive oil, leafy green vegetables, fruit, whole grains, nuts, legumes, fish, poultry, low-fat dairy, and a moderate intake of red wine.

Mediterranean Diet is most often used for

What is the Mediterranean diet?

The concept of the Mediterranean diet was first developed by Ancel Keys in the 1960s when he observed a dietary pattern low in saturated fat and high in vegetable oils among the populations of Greece, Southern Italy, and other countries around the Mediterranean Sea.

Today, the Mediterranean diet is described by its main components, which include a high intake of extra virgin olive oil, leafy green vegetables, fruits, whole grains, nuts, and legumes; a moderate intake of fish and other lean meat, dairy products, and red wine; and a low intake of saturated fat, eggs, sweets, and red meat.[1] The diet is generally considered to be a “plant-based diet” and contains high levels of several nutrients including polyphenols, fiber, and mono- and polyunsaturated fatty acids.

What are the Mediterranean diet’s main benefits?

The most robust benefits of the Mediterranean diet have been observed for cardiovascular health. In particular, the Mediterranean diet reduces blood pressure[2][3] and improves endothelial function;[4][5] high adherence to the diet is associated with a lower risk for cardiovascular disease morbidity and mortality and longer telomere length (a recognized biomarker of aging).[6]

Evidence from randomized controlled clinical studies and observational studies also supports the benefits of the Mediterranean diet for glycemic control and diabetes risk, cancer incidence, cognitive decline, and overall lifespan/longevity.[7][8][9] Importantly, while these effects are stronger and more consistent among Mediterranean populations, benefits of the Mediterranean diet have been observed in non-Mediterranean countries as well.[10]

What are the Mediterranean diet’s main drawbacks?

One of the biggest problems with the Mediterranean diet is that it’s inconsistently defined. The modern Mediterranean diet has deviated from the traditional foods and culinary traditions that are native to the Mediterranean region, and several misconceptions have emerged about the diet due to its adoption in Western countries. This has led to the false labeling of certain foods and practices as “compatible with the Mediterranean diet.”[11]

First, the Mediterranean diet is not a purely vegetarian diet — it allows for the consumption of meat and fish. Second, certain foods — American-style pizza, for example — are sometimes mistaken as being part of a Mediterranean diet, but they’re actually substantial sources of calories, sodium, and fat. Third, the Mediterranean diet emphasizes moderate alcohol (wine) intake with meals, but the patterns of alcohol consumption in Western countries have strayed far from the concept of drinking red wine only during meals and spread out over the week. Finally, several foods are sometimes erroneously believed to be Mediterranean diet foods, including avocado, certain desserts, quinoa, margarine, potatoes, and tofu. Ultimately, there’s some confusion about what the Mediterranean diet is, making it difficult for individuals to apply this dietary approach to their lives and limiting the transferability of the Mediterranean diet to non-Mediterranean countries.

How does the Mediterranean diet work?

While all foods and nutrients comprising the Mediterranean diet likely interact to exert synergistic effects on health, some benefits may be attributed to specific dietary components.

Bioactive plant compounds like polyphenols and antioxidants are found in many common staples of the Mediterranean diet, including red wine, olive oil, coffee, tea, nuts, fruits, vegetables, herbs, and spices. Polyphenols upregulate the body’s natural antioxidant systems, reduce the production of pro-inflammatory cytokines, lower blood pressure via enhanced nitric oxide production, and decrease levels of systemic oxidative stress — all of which ameliorate recognized cardiovascular disease risk factors.[12] In support of this, a greater estimated intake of dietary polyphenols in participants consuming a Mediterranean diet has been associated with better cardiovascular outcomes, lower blood pressure, less inflammation, and a decreased risk for new-onset type 2 diabetes.[13] The high intake of “healthy” unsaturated fatty acids in the Mediterranean diet may also exert health-protective effects, as may the social and lifestyle practices associated with this diet.

Examine Database: Mediterranean Diet