For the fifth year in a row, the Mediterranean diet won best overall diet in the US News & World Report’s annual ranking, and there’s a reason why: research has linked the popular way of eating to a longer lifespan as well as a lower risk of type 2 diabetes, heart disease, and age-related memory decline.
Unlike other popular diets, the Mediterranean diet doesn’t involve strict rules like calorie counting or macro tracking. Instead, followers consume foods that are part of the traditional diet of citizens who live in countries bordering the Mediterranean Sea — lots of vegetables, whole grains, healthy fats, and fish. If this sounds like an eating style for you, here’s an overview of the specific foods that make up the bulk of the Mediterranean diet, plus the foods you should limit.
Vegetables and fruits
Mediterranean diet adherents eat four or more servings of vegetables a day and three or more servings of fruit, making produce a key staple. For reference, only 10 percent of American adults eat the recommended two to three cups of vegetables daily and just 12.3 percent eat the advised one and a half to two cups of fruit, according to the Centers for Disease Control and Prevention (CDC). Produce consumed on a Mediterranean diet includes:
- Brussels sprouts
- Leafy greens
- Sweet potatoes
The vitamins, minerals, fibre, and antioxidants found in these fruits and veggies can help reduce your risk of heart disease and cancer, and they may also boost your mental health. A 2020 study in the journal Nutrients also found that adults who consumed at least five servings of produce per day saw improvement in general well-being, sleep quality, life satisfaction, mood, curiosity, creativity, optimism, self-esteem, and happiness—not to mention a reduction in stress, nervousness, and anxiety.
While that all sounds great, it can be overwhelming trying to eat that much produce in a 24-hour period. My tip? When deciding what to eat, start with produce first. Whip leafy greens and fruit into a breakfast smoothie. Swap a lunchtime sandwich for an entree salad, and replace half your dinner portion of pasta with spiralised zucchini. Round out the day with snacks like fruits and nuts or veggies with hummus.
People in the Mediterranean region tend to consume three to four servings of whole grains daily, with one serving equal to a half cup of cooked whole grain or slice of bread. Whole grains found in a Mediterranean diet include:
- Whole wheat
- Whole grain bread
- Whole grain pasta
- Whole grain rice
Even though Americans are eating more whole grains, less than 16 percent of total daily grain consumption comes from whole grains, per the CDC. This is concerning, given a 2018 review that found the high consumption of whole grains was associated with a lower risk of heart disease, cancer, and overall death.
Try upgrading your refined grains to their whole counterparts. For example, swap a breakfast pastry for a bowl of oatmeal; opt for brown rice over white at dinner; or replace your white bread sandwich for a lunchtime salad made with cooked quinoa.
Pulses include all varieties of beans, lentils, peas, and chickpeas. On the Mediterranean diet, three or more servings of pulses are consumed per week, and for good reason: A 2021 study published in Nutrients found that people who consumed pulses also had higher intakes of fibre, folate, and magnesium compared to those who didn’t eat pulses. Those who consumed 2.5 ounces (70 gm) —roughly a half cup of cooked chickpeas — also took in more potassium, zinc, iron, and choline, along with lower amounts of fat.
Commonly eaten pulses on the Mediterranean diet include:
- Cannellini beans
- Fava beans
- Kidney beans
- Split peas
If you’re wondering how to incorporate more pulses into your diet, simply swap them in for meat. For example, instead of beef stew, try a lentil soup. Or, snack on roasted chickpeas over beef jerky.
In the Mediterranean, people consume so much olive oil — about four tablespoons daily—that it’s practically its own food group. While fat can get a bad rep, the healthy fats found in olive oil are crucial for our health. A 2019 report published in Nutrients stated, “extra virgin olive oil (EVOO) should, indeed, be the fat of choice when it comes to human health.” Why? Because EVOO consumption is linked with lower incidences of heart disease, cancer, high blood pressure, autoimmune illnesses, and inflammatory conditions, such as ulcerative colitis.
Other healthful Mediterranean fats include avocado (technically a fruit, but still chock full of good fat) as well as nuts and seeds. In fact, you should eat nuts or seeds at least three times per week on the diet. For reference, a serving size would be a quarter cup of nuts or two tablespoons of nut or seed butter. Common nuts consumed on the diet include:
- Pine nuts
- Sesame seeds
Work these good fats into daily meals and snacks by blending nut butter or avocado into smoothies, dressing salads with EVOO balsamic vinaigrette, and sauteeing veggies in EVOO instead of butter.
People following a traditional Mediterranean diet eat three to four ounces of fish (85 – 115 gm) about three times per week. Fish consumed include those rich in anti-inflammatory omega-3 fatty acids, like sardines, salmon, and mackerel. Other types of seafood to eat:
- Sea bass
Research indicates eating fish can prolong not only the quantity but quality of life. A 2020 analysis in Nutrients found that for every additional 20 grams of fish consumed per day the risk of dying from cardiovascular disease decreased by 4 percent.
Additionally, a 2018 study published in the American Journal of Epidemiology found that a higher fish intake was associated with decreased rates of cognitive decline in older adults. This was particularly so for episodic memory. Episodic memory is a type of long-term memory that involves recalling previous experiences with their context, in terms of time, place, and emotions.
Herbs and spices
Natural seasonings are a vital part of a Mediterranean diet because they offer not only aroma, colour, and flavour, but also added nutrients and health benefits. A 2019 review in the Journal of AOAC International found that herbs and spices possess antioxidant, anti-inflammatory, and anti-cancer properties. They also lower blood sugar and cholesterol levels as well as positively impact mood, cognition, and the gut microbiome.
Herbs and spices used liberally in a Mediterranean eating plan include:
- Bay leaf
Have fun experimenting with herbs and spices, say by adding fresh mint to a smoothie or hot tea; infusing water with fresh herbs and fruit; or whisking garlic and herbs to make a simple homemade vinaigrette.
Foods to eat in moderation on the Mediterranean diet
The food groups above make up the foundation of a Mediterranean Diet. But the eating plan also includes moderate portions of poultry, eggs, and dairy (especially fermented dairy like Greek yoghurt and kefir). So what does moderate mean? That varies depending on your personal preference. You could consume very small portions of dairy daily or eat larger amounts on a weekly basis.
Alcohol, specifically red wine, is also consumed in moderation. Although optional, red wine is traditionally enjoyed daily by Mediterranean eaters. Just stick to a small glass per day if you’re a woman and up to two glasses per day if you’re a man, per the USDA’s 2020-2025 Dietary Guidelines for Americans.
Foods to limit on a Mediterranean Diet
While the Mediterranean diet doesn’t require you to cut out one food group or food entirely, it does encourage people to limit or avoid certain items like:
- Red meat. Consumed regularly in small amounts, it can increase the risk of colorectal cancer, according to the American Institute of Cancer Research (AICR).
- Sweets. In excess, they boost the risk of obesity, type 2 diabetes, heart disease, Alzheimer’s disease, high blood pressure, and more, according to the American Heart Association.
- Highly processed foods. A 2021 study in the journal Nutrients found that each 10 percent increase in calories from highly processed food was associated with a 15 percent higher risk of death from all causes.
Specific examples of foods to limit on a Mediterranean Diet include:
- Alcohol, other than red wine in moderation
- Commercial baked goods
- Fast food
- Frozen pizza
- Lunch meat
- Processed cheese
- Refined oils
- Soda and sugary drinks
- White bread
- White pasta
- White rice
Simple swaps can help curb your intake of these foods. For example, try trading soda for sparkling water, vegetables in place of pepperoni on pizza, or eating low-sodium canned soups instead of fast food when you’re in a pinch.
People in the Mediterranean region have been enjoying this type of diet for centuries thanks to the flavours, variety, and nourishment it offers. There’s also a reason why it’s currently viewed as one of the best diets for overall health: It relies on foods known to reduce the risk of heart disease, obesity, and type 2 diabetes all while improving mood, cognition, and life expectancy.
The key to sticking to the Mediterranean diet is to view it as a lifestyle rather than a quick fix or strict meal plan. Remember that you don’t have to give up any one food entirely—instead, try adopting the principles of the diet to fit your individual needs and food preferences.
Cynthia Sass, MPH, RD, is Health‘s contributing nutrition editor, a New York Times best-selling author, and a private practice performance nutritionist who has consulted for five professional sports teams.
This story first appeared on www.health.com
(Main and Feature Image Credit: Getty Images / Brett Stevens)
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