The Mediterranean Diet: Is It Right for You?

There may not be a single diet that’s best for everyone, but if the most common diets had to go head-to-head, the Mediterranean Diet would be a top contender. Year after year, the U.S. News and World Report (1) ranks it as the healthiest dietary pattern, and decades of research support that title. 

The Mediterranean Diet supports health, longevity, and performance with its abundance of nutrient-dense foods. However, there isn’t just one Mediterranean Diet. 

In fact, the Mediterranean region includes 22 countries with a population of about 480 million people! So, what is the Mediterranean Diet, exactly, and is it the best option for you?

Editor’s Note: The content on BarBend is meant to be informative in nature, but it should not be taken as medical advice. When starting a new training regimen and/or diet, it is always a good idea to consult with a trusted medical professional. We are not a medical resource. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. They are not substitutes for consulting a qualified medical professional.

What Is the Mediterranean Diet?

The Mediterranean Diet is derived from the traditional eating habits of the 21 countries bordering the Mediterranean Sea, including nations like Greece, Italy, and Turkey. An impressive amount of research shows that this dietary pattern reduces the risk of a number of chronic diseases, supports brain health, and promotes longevity. (1)

Because the region is so large and diverse, there isn’t “one” Mediterranean Diet. Rather than emphasizing specific foods or food groups, the diet encourages a variety of minimally-processed, nutrient-rich foods. It predominantly revolves around vegetables, fruits, whole grains, legumes, nuts, seafood, lean poultry, and limited amounts of low-fat dairy and plant-based oils. (1)

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The Mediterranean Diet doesn’t just include foods, though; it also recommends physical activity and social connections, both of which have a huge impact on health and longevity. It’s also easy to modify, making it suitable for vegan, kosher, and sport-specific needs, just to name a few.

How was the Mediterranean Diet developed?

The Mediterranean diet is based on findings from The Seven Countries Study, which was headed by renowned nutrition researcher Dr. Ancel Keys. From 1958 to 1999, this international study — the first of its kind — explored the connection between diet and heart disease among 13,000 men across multiple countries including Greece, Italy, Japan, and the United States. (2) 

The researchers discovered that the type of dietary fat (saturated, monounsaturated, or polyunsaturated) holds more influence over cardiovascular health than overall fat intake. They concluded that a diet can include up to 40 percent calories from fat without increasing the risk of heart disease, as long as most of the fat is unsaturated. (3)

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Regions that followed a Mediterranean-style dietary pattern (characteristic of Italy and Greece at the time) tended to have lower rates of cardiovascular disease, so Keys and his colleagues promoted that way of eating based on their findings.

Common Foods on the Mediterranean Diet

Many versions of the Mediterranean Diet exist, but studies use specific, validated lists to measure how closely dietary patterns adhere to the general Mediterranean-style diet guidelines. Though the foods eaten in the Mediterranean region vary, and have changed since the 1960s, these lists still contain the most common foods eaten on a Mediterranean Diet. (4)

Fruits and Veggies

Fresh fruits and vegetables are abundant in the Mediterranean Diet, and they’re foundational to meals. It could be considered a plant-based diet (though it isn’t necessarily plant-exclusive, because it can contain animal products.) Fruits and veggies provide complex carbs, fiber, plenty of vitamins and minerals, and immune-supporting compounds known as phytochemicals. (1)

Apples, melons, dates, figs, grapes, pomegranates, and citrus fruits have been popular in the Mediterranean region for centuries, though the Mediterranean Diet doesn’t recommend these over other fruits that might be more available or preferable. (5)

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The climate of the region also supports a huge variety of vegetable crops, all of which are encouraged on the Mediterranean Diet. Surprisingly, tomatoes didn’t reach the Mediterranean region until the 16th century, but they’ve become a main staple in the cuisine and are included in many Mediterranean Diet recipes. (1)(5)

Whole Grain Cereals and Breads

Of course, pasta and bread are included in a Mediterranean-style dietary pattern, but the portions aren’t like those found in most American restaurants. Opt for whole grain options most of the time, and include other grains such as barley, oats, and rice. Whole grains are complex carbs rich in fiber and several B vitamins. (1)

Potatoes

Potatoes aren’t included in every Mediterranean Diet scoring system, but the potato has been a part of Mediterranean cuisine since the 16th century. Contrary to popular belief, both white potatoes and sweet potatoes are nutritious options. They’re rich in vitamin C, vitamin B6, and potassium. Beta carotene gives sweet potatoes their orange hue. (1)(5)

Legumes, Nuts, and Seeds

Legumes include lentils, beans, peas, and peanuts. (You might recognize them in other forms as part of the Mediterranean Diet — like hummus, which is made from chickpeas.) They’re all good sources of complex carbs and fiber while providing a bit of protein as well. 

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Most legumes are very low in fat, with the exception of peanuts, which are rich in unsaturated fats. Almonds, walnuts, pistachios, and pine nuts are some of the most common nuts and seeds in the Mediterranean Diet, and like peanuts, they’re rich in unsaturated fats. (1)

Fish

The Mediterranean Diet includes a wide variety of fish, like cod, bass, mackerel, and salmon. Fish is high in protein, and fatty fish like mackerel, sardines, or salmon, are also high in vitamin D and polyunsaturated fats. (1)

Olive Oil

Rich in polyunsaturated fats, olive oil has long been a staple of Mediterranean cuisine. It’s the most commonly-used oil in the Mediterranean Diet, but sesame, sunflower, avocado, and canola oil are also high in polyunsaturated fats and may work better for certain cooking methods. (1)(6)

Wine

Unlike other alcoholic drinks, the small amount of red wine included in the Mediterranean Diet may play a role in supporting cardiovascular health due to its antioxidant properties. However, non-alcoholic red wine is just as effective, so it’s likely that the benefits come from the phytochemicals in the grapes that were used to make the wine. (7)

Other Foods Are Also Highly Recommended

Some foods aren’t included in the Mediterranean Diet scoring criteria, but would still fit the general guidelines as minimally-processed, nutrient-dense choices. Moderate amounts of poultry, low-fat dairy products, and eggs can all fit into a Mediterranean-style dietary pattern. (1)

What You Can’t Eat on the Mediterranean Diet

While no foods are “off-limits,” the Mediterranean Diet limits highly-processed, packaged foods and sweets, which often include refined carbohydrates, added sugars, added sodium, and trans fats. 

Red meat, butter, and full-fat dairy — all of which are high in saturated fat — are also limited. (1)(4)

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Red wine can be consumed in moderation, but that isn’t a cue to start drinking. Rather, it’s a good idea to keep alcohol to a minimum, and opt for red wine instead of other alcoholic drinks. (1)(4)

If you were following the Mediterranean Diet to the letter, your day might look something like this:

• Breakfast: Shakshuka, a North African dish featuring eggs poached in a thick spiced tomato, pepper, and onion sauce, often served with hearty bread.
• Lunch: Whole grain pita wrap with hummus, chicken breast, tabouleh, and roasted red peppers.
• Snack: Feta cheese, sliced cucumber, and chopped cherry tomatoes tossed in balsamic vinaigrette.
• Dinner: Baked cod with olive oil, roasted vegetables and orzo.
• Dessert: Greek yogurt with fresh fruit and almonds.

Note that this doesn’t necessarily represent the only assortment of foods you could eat while following the Mediterranean diet. These foods/meals are considered common selections for those in the region.

Benefits of the Mediterranean Diet

After decades of research on the Mediterranean Diet, it’s clear that this dietary pattern provides a plethora of health benefits. It’s good for the heart, gut, brain, and bones, making it a wise (and evidence-based) choice for any health-conscious person.

Reduces the Risk of Cardiovascular Disease

Various studies have reported that a Mediterranean Diet can reduce the risk of cardiovascular disease, stroke, heart attack, and heart disease-related death by about 25 to 35 percent in both men and women, even if they’re at increased risk of these diseases due to other lifestyle factors. The diet can also improve blood pressure and cholesterol levels. (8)(9)(10)(11)

Reduces the Risk of Several Cancers

The Mediterranean Diet is linked to lower chances of dying from cancer and a reduced risk of certain cancers, including head and neck, respiratory, gastric, liver, and bladder cancers. It seems especially protective against colorectal cancer, likely because of its impact on gut microbes and the immune system. (12)(13)

Supports Brain Health & Cognitive Function

The Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet — a hybrid form of the Mediterranean Diet — is associated with better cognitive function and a 20 percent lower risk of developing dementia, including Alzheimer’s disease. This form of the Mediterranean diet also slows the rate of cognitive decline that often happens after a stroke. (14)(15)

Could Help Manage Type 2 Diabetes

The Mediterranean Diet helps to regulate blood sugar, insulin levels, and body weight in people with Type-2 diabetes. It’s also linked to lower levels of certain inflammatory markers that could increase their risk of cardiovascular disease. It could play a very small role in Type-2 diabetes prevention, as well. (16)(17)(18)

Supports Bone Health

Low bone density can increase the risk of fractures in both athletes and older adults. A Mediterranean diet is linked to slightly higher bone density regardless of a person’s activity level or smoking status; in other words, it can help protect against the loss of bone density even in people at high risk of losing bone mass. 

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It’s also associated with a 20% lower risk of hip fractures, which can be life-threatening in older adults due to the long hospitalization required during their recovery. (19)(20)

Drawbacks of the Mediterranean Diet

When followed correctly, the Mediterranean Diet poses no health risks and has very few drawbacks. Still, there are some special circumstances to consider before choosing this diet. 

Requires Lots of Fresh Produce

The Mediterranean Diet is rich in fresh fruits, vegetables, and other minimally-processed foods. While fresh foods are often cheaper than processed “convenience” foods, their short shelf-life, lower availability, and cooking requirements can render them much less accessible to people living in lower socioeconomic statuses or in regions without access to grocery stores.

The United States Department of Agriculture (USDA) estimates that about 10 percent of the American population live in food deserts, which are areas with very low access to grocery stores. (24)(25) 

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Fortunately, it’s still possible to follow a Mediterranean-style dietary pattern using frozen and canned foods. Frozen fruits and vegetables are just as nutrient-dense as fresh options. (26) Choose fruit canned in juice (rather than syrup) and vegetables or beans canned in water (or rinse them thoroughly) to reduce added sugar and sodium found in many canned products.

You Might Miss Out On Certain Nutrients

The Mediterranean Diet is omnivorous, but it can be modified for vegetarian, vegan, or kosher diets as well as restrictions due to allergies. However, excluding animal products like red meat, poultry, fish, eggs, and dairy can lead to low or inadequate levels of several vitamins and minerals. 

A vegan or vegetarian version of the Mediterranean Diet could lack vitamin B12, calcium, iron, and zinc, which are all found in their most bioavailable (or absorbable) forms in animal products. In that case, supplementation can help fill in the nutritional gaps. (27)

Additionally, the Mediterranean Diet features poultry and high-protein veggie options. However, it may not be fair to call it a high-protein diet. If you require a high amount of daily protein each day for muscle growth, you may need to look outside the standard food sources found in the diet, or rely on supplementation as well.

May Cause Cause Gas and Bloating 

Common foods in the Mediterranean Diet — like nuts, olive oil, and artichokes — can be high in fat or fermentable carbs known as FODMAPs. Although these are excellent fuel for gut microbes, they can cause gas, bloating, and loose bowels in many people, especially those with irritable bowel syndrome. Some foods might need to be limited, and it can take several days for the gut to adapt more dietary fiber. (28)

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FODMAPs can also cause digestive distress for some people if they’re eaten too close to a workout, so athletes may need to choose their pre-workout meals with this in mind if they’re prone to exercise-induced indigestion. (22)

Your Takeaways

The Mediterranean Diet is an evidence-based, balanced, budget-friendly way to eat. It can help prevent disease, promote longevity, and support performance. It’s easy to modify to meet specific dietary requirements, and doesn’t needlessly restrict or enforce certain foods or supplements. 

Overall, it’s one of the best dietary patterns to follow, with decades of research supporting its many benefits. That said, there’s no universally-applicable “best diet.” The Mediterranean Diet can be expensive and, if you require a particularly high amount of daily protein, require you to assist with supplements to meet your marks. 

FAQs

Still wondering if the Mediterranean Diet is right for you? Here are your common questions, answered:

1. U.S. News & World Report. (2023, June 16). Mediterranean Diet. 
2. Seven Countries Study. (n.d.). About the Study: History. 
3. Seven Countries Study. (n.d.). Study Findings: Cross-Cultural Comparison. 
4. Seven Countries Study. (n.d.). Mediterranean Diet Tag. 
5. Essid, M. (2012). Chapter 2. History of Mediterranean food. Dans : CIHEAM éd., MediTERRA 2012 (english): The mediterranean diet for sustainable regional development (pp. 51-69). Paris: Presses de Sciences Po. 
6. Matthaus, B., Özcan, M. M., & Al Juhaimi, F. (2016). Some rape/canola seed oils: fatty acid composition and tocopherols. Zeitschrift fur Naturforschung. C, Journal of biosciences, 71(3-4), 73–77.
7. Castaldo, L., Narváez, A., Izzo, L., Graziani, G., Gaspari, A., Minno, G. D., & Ritieni, A. (2019). Red Wine Consumption and Cardiovascular Health. Molecules (Basel, Switzerland), 24(19), 3626.
8. Pant, A., Gribbin, S., McIntyre, D., Trivedi, R., Marschner, S., Laranjo, L., Mamas, M. A., Flood, V., Chow, C. K., & Zaman, S. (2023). Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis. Heart (British Cardiac Society), 109(16), 1208–1215. 
9. Karam, G., Agarwal, A., Sadeghirad, B., Jalink, M., Hitchcock, C. L., Ge, L., Kiflen, R., Ahmed, W., Zea, A. M., Milenkovic, J., Chedrawe, M. A., Rabassa, M., El Dib, R., Goldenberg, J. Z., Guyatt, G. H., Boyce, E., & Johnston, B. C. (2023). Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis. BMJ (Clinical research ed.), 380, e072003. 
10. Pan, B., Wu, Y., Yang, Q., Ge, L., Gao, C., Xun, Y., Tian, J., & Ding, G. (2019). The impact of major dietary patterns on glycemic control, cardiovascular risk factors, and weight loss in patients with type 2 diabetes: A network meta-analysis. Journal of evidence-based medicine, 12(1), 29–39.
11. Ge, L., Sadeghirad, B., Ball, G. D. C., da Costa, B. R., Hitchcock, C. L., Svendrovski, A., Kiflen, R., Quadri, K., Kwon, H. Y., Karamouzian, M., Adams-Webber, T., Ahmed, W., Damanhoury, S., Zeraatkar, D., Nikolakopoulou, A., Tsuyuki, R. T., Tian, J., Yang, K., Guyatt, G. H., & Johnston, B. C. (2020). Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials. BMJ (Clinical research ed.), 369, m696.
12. Morze, J., Danielewicz, A., Przybyłowicz, K., Zeng, H., Hoffmann, G., & Schwingshackl, L. (2021). An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. European journal of nutrition, 60(3), 1561–1586. 
13. Illescas, O., Rodríguez-Sosa, M., & Gariboldi, M. (2021). Mediterranean Diet to Prevent the Development of Colon Diseases: A Meta-Analysis of Gut Microbiota Studies. Nutrients, 13(7), 2234.
14. van den Brink, A. C., Brouwer-Brolsma, E. M., Berendsen, A. A. M., & van de Rest, O. (2019). The Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diets Are Associated with Less Cognitive Decline and a Lower Risk of Alzheimer’s Disease-A Review. Advances in nutrition (Bethesda, Md.), 10(6), 1040–1065. 
15. Chen, H., Dhana, K., Huang, Y., Huang, L., Tao, Y., Liu, X., Melo van Lent, D., Zheng, Y., Ascherio, A., Willett, W., & Yuan, C. (2023). Association of the Mediterranean Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) Diet With the Risk of Dementia. JAMA psychiatry, 80(6), 630–638. 
16. Pan, B., Wu, Y., Yang, Q., Ge, L., Gao, C., Xun, Y., Tian, J., & Ding, G. (2019). The impact of major dietary patterns on glycemic control, cardiovascular risk factors, and weight loss in patients with type 2 diabetes: A network meta-analysis. Journal of evidence-based medicine, 12(1), 29–39.
17. Bonekamp, N. E., van Damme, I., Geleijnse, J. M., Winkels, R. M., Visseren, F. L. J., Morris, P. B., & Koopal, C. (2023). Effect of dietary patterns on cardiovascular risk factors in people with type 2 diabetes. A systematic review and network meta-analysis. Diabetes research and clinical practice, 195, 110207. 
18. Sarsangi, P., Salehi-Abargouei, A., Ebrahimpour-Koujan, S., & Esmaillzadeh, A. (2022). Association between Adherence to the Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Advances in nutrition (Bethesda, Md.), 13(5), 1787–1798. 
19. Noori, M., Jayedi, A., Khan, T. A., Moradi, S., & Shab-Bidar, S. (2022). Mediterranean dietary pattern and bone mineral density: a systematic review and dose-response meta-analysis of observational studies. European journal of clinical nutrition, 76(12), 1657–1664. 
20. Malmir, H., Saneei, P., Larijani, B., & Esmaillzadeh, A. (2018). Adherence to Mediterranean diet in relation to bone mineral density and risk of fracture: a systematic review and meta-analysis of observational studies. European journal of nutrition, 57(6), 2147–2160.
21. Bizzozero-Peroni, B., Brazo-Sayavera, J., Martínez-Vizcaíno, V., Fernández-Rodríguez, R., López-Gil, J. F., Díaz-Goñi, V., Cavero-Redondo, I., & Mesas, A. E. (2022). High Adherence to the Mediterranean Diet is Associated with Higher Physical Fitness in Adults: a Systematic Review and Meta-Analysis. Advances in nutrition (Bethesda, Md.), 13(6), 2195–2206.
22. Lis, D. M., Stellingwerff, T., Kitic, C. M., Fell, J. W., & Ahuja, K. D. K. (2018). Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes. Medicine and science in sports and exercise, 50(1), 116–123. 
23. Corbin, K. D., Carnero, E. A., Dirks, B., Igudesman, D., Yi, F., Marcus, A., Davis, T. L., Pratley, R. E., Rittmann, B. E., Krajmalnik-Brown, R., & Smith, S. R. (2023). Host-diet-gut microbiome interactions influence human energy balance: a randomized clinical trial. Nature communications, 14(1), 3161. 
24. US Department of Agriculture, Economic Research Service. (2011, December 1). Data Feature: Mapping Food Deserts in the U.S. Amber Waves. 
25. US Department of Agriculture, Economic Research Service. (2021). Food security and nutrition assistance. Ag and Food Statistics: Charting the Essentials. 
26. Li, L., Pegg, R. B., Eitenmiller, R. R., Chun, J. Y., & Kerrihard, A. L. (2017). Selected nutrient analyses of fresh, fresh-stored, and frozen fruits and vegetables. Journal of Food Composition and Analysis, 59, 8–17.
27. Kiani, A. K., Dhuli, K., Donato, K., Aquilanti, B., Velluti, V., Matera, G., Iaconelli, A., Connelly, S. T., Bellinato, F., Gisondi, P., & Bertelli, M. (2022). Main nutritional deficiencies. Journal of preventive medicine and hygiene, 63(2 Suppl 3), E93–E101. 
28. van Lanen, A.-S., de Bree, A., & Greyling, A. (2021). Efficacy of a low-FODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysis. European Journal of Nutrition.

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