- Studies of the Mediterranean diet as it is understood today started with the Seven Countries Study conducted in the 1960s
- A meta-analysis including over 1.5 million healthy adults following the Mediterranean diet found those adults had a reduced risk of both cardiovascular and overall mortality. 1
WHAT IS THE MEDITERRANEAN DIET?
The Mediterranean diet is a set of guidelines shaped and inspired by the traditional eating patterns of regions surrounding the Mediterranean, including Southern Italy and Crete. It is important to recognize that there is no official “Mediterranean diet plan” like there is for programs like the Atkins or South Beach diet. Rather, it encourages the consumption of lean proteins in small portions, fruits and vegetables, legumes, whole grains and healthy fats (specifically those high in monounsaturated fats and polyunsaturated omega-3 rich fatty acids). The most commonly used visual guide is the Oldways Mediterranean Diet Pyramid.
Major components of the Mediterranean diet include the following:
- Making plant-based foods (legumes, vegetables, fruits, grains and nuts) the foundation of every meal.
- Cooking with healthy fats such as olive oil.
- Limiting red meat.
- Eating fish/seafood twice a week.
- Eating no more than three servings a day of dairy products.
- Using spices and herbs rather than heavily salting your food to increase flavor.
- Drinking a limited amount of wine (see precautions later).
- Embracing physical activities (such as walking instead of driving when possible) and social activities (such as enjoying meals with others).
WHAT CONDITIONS DOES THE MEDITERRANEAN DIET TREAT?
The Mediterranean diet decreases risk of developing several physical and mental health conditions and can improve symptoms related to chronic health concerns including, but not limited to:
- Type 2 diabetes
- Heart disease
- Metabolic syndrome
- Excess weight and slow metabolism
- Digestive disease/distress
- Hormonal disorders
- Rheumatoid arthritis
- Nonalcoholic fatty liver disease
- Cardiovascular disease
Is there evidence that the Mediterranean diet works?
Yes. Research on the Mediterranean diet has grown. In the last 20 years, more literature is being published exploring and confirming the positive impact it has on treating and decreasing the symptoms of several conditions.
Management of Type 2 Diabetes
- A systematic review and meta-analysis comparing the Mediterranean diet to other diets in its ability to manage type 2 diabetes found that the Mediterranean diet was associated with better glycemic (blood sugar) control and a decrease in cardiovascular (heart disease) risk factors. 2
- A meta-analysis of randomized controlled trials found that adults engaged in the Mediterranean diet who restricted their calorie intake, increased their physical activity and utilized the diet more than 6 months experienced a significant reduction in weight and body mass index. Appropriately engaging in the diet did not result in any weight gain. 3
Cognitive Function and Dementia
- A systematic review of 12 studies found that participants who strictly followed the Mediterranean diet had better cognitive function, lower rates of declining cognitive functioning, and a reduced rate of Alzheimer’s disease. There was a relationship between the level that the participants followed the diet and the impacts it had on cognitive function. 4
Depression and Type 2 Diabetes
- Patients with diabetes and depression who participated in a Mediterranean diet with an increased intake of nuts
experienced a significant decrease in depressive symptoms in comparison to those who were assigned to participate in a low-fat diet. 5
Osteoarthritis and Quality of Life
- A study looking at the diets of 4,470 adults found that higher adherence to a Mediterranean diet was associated with increased quality of life and decreased pain levels, disability, and depressive symptoms. 6
If you or your health care provider are seeking more in-depth research on the effectiveness or impact of the Mediterranean diet for particular health concern, visit https://www.ncbi.nlm.nih.gov/pubmed/?term=Mediterranean+diet.
Are there precautions, side effects or safety concerns I should be aware of before I begin the Mediterranean diet?
You may experience some discomfort when beginning a new diet since you will be adjusting to new foods and decreasing your intake of others. It is possible to experience light-headedness, bloating, gas and an upset stomach. Please make sure you alert your care provider of any prolonged discomfort you are experiencing related to dietary changes.
Additionally, the Mediterranean diet does allow for the consumption of a moderate amount of wine. That amount is
one drink for women and two for men per day. But such an allowance would not apply to anyone with a condition that may be exacerbated or worsened by consuming alcohol, which would include people with liver disease, pregnant women and anyone with a history of alcoholism.
Healthy individuals can start a Mediterranean diet on their own. Several good guides are available for doing this. Some websites that contain menu and food plan options can be found at:
Who can assist me with beginning the Mediterranean diet?
If you are interested in beginning the Mediterranean diet, you may want to seek the help of a nutritional counselor. Nutritional counselors tend to be either registered dietitians or certified nutritionists.
How do I find a qualified practitioner who can assist me with beginning the Mediterranean diet?
Check to see if the nutritionist is licensed or certified to practice. The primary organization of qualified nutrition professionals is the Academy of Nutrition and Dietetics. Their website can help you find an expert with a search by ZIP Code.
Look for a registered dietitian or registered dietitian nutritionist (RDN), disciplines that typically require a four-year bachelor’s degree and 900 to 1,200 hours in a dietetic internship through an accredited program, as well as passing a dietetics registration exam and continuing professional education requirements. Some RDNs are certified in a specialized area, including pediatric nutrition, sports dietetics, nutrition support or diabetes education.
Will my insurance company cover the cost of seeing a nutritional counselor?
Most commercial and government insurances, including Medicare and Medicaid, cover medical nutrition therapy (MNT) for certain conditions including diabetes and obesity. Obesity screening and counseling is covered if it is received in a primary care setting. Medicare recipients in rural areas may receive MNT through telehealth.
Should I inform my primary care physician that I am starting the Mediterranean diet?
Yes, always inform your primary care provider of any major dietary changes or weight loss or gain, as adjustments in medications or other therapies may be needed.
- Mayo Clinic Staff. (2017, November 3). Mediterranean diet: A heart-healthy eating plan. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801.
- Esposito, K., Maiorino, M.I., Bellastella, G., Chiodini, P., Panagiotakos, D., & Giugliano, D. (2012). A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ Open, 5(8).
- Esposito K, Kastorini CM, Panagiotakos DB, Giugliano D. (2011). Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metabolic Syndrome and Related Disorders, 9(1): pp. 1-12.
- Lourida, I., Soni, M., Thompson-Coon, J., Purandare, N., Lang, I.A., Ukoumunne, O.C., & Llewellyn, D.J. (2013). Mediterranean diet, cognitive function, and dementia: a systematic review. Epidemiology, 24(4): pp.479-89.
- Sánchez-Villegas, A., Martínez-González, M.A., Estruch, R., Salas-Salvadó, J., Corella, D, Covas, M.I., Arós, F., Romaguera, D., Gómez-Gracia, E., Lapetra, J., Pintó, X., Martínez, J.A., Lamuela-Raventós, R.M., Ros, E., Gea, A., Wärnberg, J., & Serra-Majem, L. (2013). Mediterranean dietary pattern and depression: the PREDIMED randomized trial. BMC Medicine, 11(208).
- Veronese, N., Stubbs, B., Noale, M., Solmi, M., Luchini, C., & Maggi, S. (2016). Adherence to the Mediterranean diet is associated with better quality of life: data from the Osteoarthritis Initiative. American Journal of Clinical Nutrition, 104(5): pp. 1403-1409.