Mediterranean Diet

Last Updated: December 18, 2023

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.

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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?

Due to its high fat content — which can be 40% or more of total energy in the more traditional versions — the Mediterranean diet could cause weight gain in normal-weight individuals or stall weight loss in individuals with overweight or obesity. However, this may have more to do with the caloric content of a high-fat diet per se than with the fat content of the Mediterranean diet — plenty of evidence suggests that a calorie-restricted Mediterranean diet can benefit weight loss.[11][12] Nevertheless, olive oil, nuts, and fatty fish — while nutritious — are calorie-dense foods that should be consumed in moderation for weight-conscious individuals.

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.[13] 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.[14] 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