Mediterranean Diet

The Mediterranean Diet emphasizes plant-based foods and healthy fats. You eat mostly veggies, fruits and whole grains. Extra virgin olive oil is the main source of fat. The Mediterranean Diet can lower your risk of cardiovascular disease and many other chronic conditions. A dietitian can help you customize the diet to suit your needs.

Overview

What is the Mediterranean Diet?

The Mediterranean Diet is a way of eating that emphasizes plant-based foods and healthy fats. You focus on overall eating patterns rather than following strict formulas or calculations.

In general, you’ll eat:

• Lots of vegetables, fruit, beans, lentils and nuts.
• A good amount of whole grains, like whole-wheat bread and brown rice.
• Plenty of extra virgin olive oil (EVOO) as a source of healthy fat.
• A good amount of fish, especially fish rich in omega-3 fatty acids.
• A moderate amount of natural cheese and yogurt.
• Little or no red meat, choosing poultry, fish or beans instead of red meat.
• Little or no sweets, sugary drinks or butter.
• A moderate amount of wine with meals (but if you don’t already drink, don’t start).

This is how people ate in certain Mediterranean countries in the mid-20th century. Researchers have linked these eating patterns with a reduced risk of coronary artery disease (CAD). Today, healthcare providers recommend this eating plan if you have risk factors for heart disease or to support other aspects of your health.

A dietitian can help you modify your approach as needed based on your medical history, underlying conditions, allergies and preferences.

What are the benefits of the Mediterranean Diet?

The Mediterranean Diet has many benefits, including:

• Lowering your risk of cardiovascular disease, including a heart attack or stroke.
• Supporting a body weight that’s healthy for you.
• Supporting healthy blood sugar levels, blood pressure and cholesterol.
• Lowering your risk of metabolic syndrome.
• Supporting a healthy balance of gut microbiota (bacteria and other microorganisms) in your digestive system.
• Lowering your risk for certain types of cancer.
• Slowing the decline of brain function as you age.
• Helping you live longer.

The Mediterranean Diet has these benefits because it:

• Limits saturated fat and trans fat. You need some saturated fat, but only in small amounts. Eating too much saturated fat can raise your LDL (bad) cholesterol. A high LDL raises your risk of plaque buildup in your arteries (atherosclerosis). Trans fat has no health benefits. Both of these “unhealthy fats” can cause inflammation.
• Encourages healthy unsaturated fats, including omega-3 fatty acids. Unsaturated fats promote healthy cholesterol levels, support brain health and combat inflammation. Plus, a diet high in unsaturated fats and low in saturated fat promotes healthy blood sugar levels.
• Limits sodium. Eating foods high in sodium can raise your blood pressure, putting you at a greater risk for a heart attack or stroke.
• Limits refined carbohydrates, including sugar. Foods high in refined carbs can cause your blood sugar to spike. Refined carbs also give you excess calories without much nutritional benefit. For example, such foods often have little or no fiber.
• Favors foods high in fiber and antioxidants. These nutrients help reduce inflammation throughout your body. Fiber also helps keep waste moving through your large intestine and helps maintain healthy blood sugar levels. Antioxidants protect you against cancer by warding off free radicals.

The Mediterranean Diet includes many different nutrients that work together to help your body. There’s no single food or ingredient responsible for the Mediterranean Diet’s benefits. Instead, the diet is healthy for you because of the combination of nutrients it provides.

Think of a choir with many people singing. One voice alone might carry part of the tune, but you need all the voices to come together to achieve the full effect. Similarly, the Mediterranean Diet works by giving you an ideal blend of nutrients that harmonize to support your health.

Mediterranean Diet food list

The Mediterranean Diet encourages you to eat plenty of some foods (like whole grains and vegetables) while limiting others. If you’re planning a grocery store trip, you might wonder which foods to buy. Here are some examples of foods to eat often with the Mediterranean Diet.

Mediterranean Diet serving goals and sizes

A fridge and pantry full of nutritious foods are great for starters. But where do you go from there? How much of each food do you need? It’s always best to talk to a dietitian to get advice tailored to your needs as you get started. The chart below offers some general guidance on serving goals and serving sizes, according to the type of food.

Food	Serving Goal	Serving Size	Tips
Fresh fruits and vegetables.	Fruit: 3 servings per day; Veggies: At least 3 servings per day.	Fruit: ½ cup to 1 cup; Veggies: ½ cup cooked or 1 cup raw.	Have at least 1 serving of veggies at each meal; Choose fruit as a snack.
Whole grains and starchy vegetables (potatoes, peas and corn).	3 to 6 servings per day.	½ cup cooked grains, pasta or cereal; 1 slice of bread; 1 cup dry cereal.	Choose oats, barley, quinoa or brown rice; Bake or roast red skin potatoes or sweet potatoes; Choose whole grain bread, cereal, couscous and pasta; Limit or avoid refined carbohydrates.
Extra virgin olive oil (EVOO).	1 to 4 servings per day.	1 tablespoon.	Use instead of vegetable oil and animal fats (butter, sour cream, mayo); Drizzle on salads, cooked veggies or pasta; Use as dip for bread.
Legumes (beans and lentils).	3 servings per week.	½ cup.	Add to salads, soups and pasta dishes; Try hummus or bean dip with raw veggies; Opt for a veggie or bean burger.
Fish.	3 servings per week.	3 to 4 ounces.	Choose fish rich in omega-3s, like salmon, sardines, herring, tuna and mackerel.
Nuts.	At least 3 servings per week.	¼ cup nuts or 2 tablespoons nut butter.	Ideally, choose walnuts, almonds and hazelnuts; Add to cereal, salad and yogurt; Choose raw, unsalted and dry roasted varieties; Eat alone or with dried fruit as a snack.
Poultry.	No more than once daily (fewer may be better).	3 ounces.	Choose white meat instead of dark meat; Eat in place of red meat; Choose skinless poultry or remove the skin before cooking; Bake, broil or grill it.
Dairy.	No more than once daily (fewer may be better).	1 cup milk or yogurt; 1 ½ ounces natural cheese.	Choose naturally low-fat cheese; Choose fat-free or 1% milk, yogurt and cottage cheese; Avoid whole-fat milk, cream, and cream-based sauces and dressings.
Eggs.	Up to 1 yolk per day.	1 egg (yolk + white).	Limit egg yolks; No limit on egg whites; If you have high cholesterol, have no more than 4 yolks per week.
Red meat (beef, pork, veal and lamb).	None, or no more than 1 serving per week.	3 ounces.	Limit to lean cuts, such as tenderloin, sirloin and flank steak.
Wine (optional).	1 serving per day (people assigned female at birth); 2 servings per day (people assigned male at birth).	1 glass (3 ½ ounces).	If you don’t drink, the American Heart Association cautions you not to start drinking; Talk to your healthcare provider about the benefits and risks of consuming alcohol in moderation.
Baked goods and desserts.	Avoid commercially prepared baked goods and desserts; Limit homemade goods to no more than 3 servings per week.	Varies by type.	Instead, choose fruit and nonfat yogurt; Bake using liquid oil instead of solid fats; whole grain flour instead of bleached or enriched flour; egg whites instead of whole eggs.

How do I create a Mediterranean Diet meal plan?

It’s important to consult with a primary care physician (PCP) or dietitian before making drastic changes to your diet or trying any new eating plan. They’ll make sure your intended plan is best for you based on your individual needs. They may also share meal plans and recipes for you to try at home.

In general, when thinking about meals, you’ll want to collect some go-to options and recipes for breakfasts, lunches, dinners and snacks. The more variety, the better. You don’t want to get stuck in a rut or feel like you’re restricted in which foods you can or should eat. Luckily, there’s plenty of room for changing things up with the Mediterranean Diet. Below are some examples of meals you might enjoy.

Breakfast

Get your day going strong with breakfasts like:

• Steel-cut oats with fresh berries and ground flaxseed.
• Whole-grain toast with nut butter and a nutritious smoothie.
• Greek yogurt topped with fruit and walnuts.
• Egg white omelet with fresh, seasonal veggies.

Lunch

For midday nutrition and a powerful energy boost, consider:

• A bulgur salad like lemon and herb tabbouleh or charred broccoli tabbouleh.
• A whole-grain pasta salad with plenty of fresh veggies.
• Roasted portobello sandwich and a cup of hearty veggie soup.
• Toasted quinoa and salmon salad.

You may want to prepare some lunches the day before so they’re ready to pack or grab from the fridge as needed.

Dinner

Wrap up the day with a hearty, nutrient-packed entree like:

• Salmon with mango salsa.
• Cod with lentils.
• Lean, roasted chicken over cannellini beans.
• Savory chickpea and spinach “pancakes for dinner.”
• Black bean burger on a whole-grain bun served with roasted beets.
• A heart-healthy pizza.

For some added nutrients and color, throw together a side salad — like a sesame cucumber salad or a fennel, orange and mint salad. To keep things simple, try drizzling mixed greens with a nutritious Mediterranean dressing.

Snacks

Portion and prepare snacks ahead of time so they’re ready when you need them. Here are some ideas of what to keep at the ready:

• A handful of nuts and seeds (low salt or no salt added).
• Fresh fruit, ideally local and in-season.
• Nonfat Greek yogurt and a small piece of dark chocolate (at least 70% cacao).
• Whole-grain crackers with hummus.
• Raw veggies with a nonfat Greek yogurt dip.

What foods are not allowed on the Mediterranean Diet?

The Mediterranean Diet doesn’t set hard and fast rules for what you’re allowed or not allowed. Rather, it encourages you to eat more of certain foods and limit others. Here’s what you should try to limit as much as possible:

• Any foods with added sugar, like bakery goods, ice cream and even some granola bars.
• Any drinks with added sugar, including fruit juices and sodas.
• Beer and liquor.
• Foods high in sodium or saturated fat.
• Refined carbohydrates, like white bread and white rice.
• Highly processed foods, like some cheeses.
• Fatty or processed meats.

Additional Common Questions

What is the Mediterranean Diet pyramid?

One approach to see what foods you should consume and how often is to look at the Mediterranean Diet pyramid. This pyramid has been slightly modified by several groups. According to all Mediterranean diet pyramids, you should minimize red meat and sweets and consume more fruits, vegetables, whole grains, and extra virgin olive oil.

The Mediterranean Diet pyramid is different from the Food Guide Pyramid that the U.S. government created in the 1990s.

How does lifestyle relate to the Mediterranean Diet?

To get the most from your eating plan, try to:

• Exercise regularly, ideally with others.
• Avoid smoking or using any tobacco products.
• Prepare and enjoy meals with family and friends.
• Cook more often than you eat out.
• Eat locally sourced foods whenever possible.

Can the Mediterranean Diet be vegetarian?

Yes. If you prefer a vegetarian diet, you can easily modify the Mediterranean Diet to exclude meat and fish. In that case, you’d gain your protein solely from plant sources like nuts and beans. Talk to a dietitian to learn more.

Can the Mediterranean Diet be gluten-free?

Yes. You can modify recipes to exclude gluten-based products. Talk to a dietitian for recipe ideas and support in making necessary changes.

Can I use regular olive oil instead of extra virgin olive oil?

Regular olive oil is a good alternative to an oil that’s high in saturated fat (like palm oil). However, to get the most benefits, opt for extra virgin olive oil.

A crucial fact to know before starting the Mediterranean Diet is that not all olive oils are the same. The Mediterranean Diet calls for extra virgin olive oil (EVOO), specifically. That’s because it has a healthy fat ratio. This means EVOO contains more healthy fat (unsaturated) than unhealthy fat (saturated). Aside from its fat ratio, EVOO is healthy because it’s high in antioxidants.

Antioxidants help protect your cells from damage, therefore protecting your heart and brain and reducing inflammation throughout your body. Because it’s manufactured differently, regular olive oil doesn’t contain as many of these antioxidants.

A note from Cleveland Clinic

In a world with endless diet options, it can be hard to know which one is right for you. Research has proven the benefits of the Mediterranean Diet for many people, especially those at risk for heart disease. Beyond protecting your heart, the Mediterranean Diet can help you prevent or manage many other conditions.

As with any eating plan, it’s important to talk to a healthcare provider before getting started. They’ll make sure the plan is appropriate for you and help you modify it as needed. Also, tell your loved ones about your goals. Invite them to cook and share meals with you. It’s easier to follow an eating plan over the long term when you have a supportive community with you along the way.