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What Is the Mediterranean Diet?

It often snags a top spot on ‘best diets’ lists — here’s why


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In the 1950s, a team of researchers around the world began looking at thousands of middle-aged men (40 to 59 years old) living in seven countries — Finland, Greece, Italy, Japan, Netherlands, United States and the former Yugoslavia — to see how their diets and lifestyles affected their risk of cardiovascular disease, which had suddenly become the leading cause of death in the U.S.

The seminal Seven Countries Study, as it later became known, showed that serum cholesterol, blood pressure, diabetes and smoking are universal risk factors for coronary heart disease. But that wasn’t the only finding.

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The researchers also noticed something unusual about the people who lived in the countries surrounding the Mediterranean Sea: They were healthier than people in wealthier Western nations; specifically, they had lower rates of chronic disease and a higher-than-average life expectancy, despite their limited access to health care.

As they began investigating the potential reasons, most, if not all, arrows pointed to diet. People living in the Mediterranean countries didn’t eat exactly the same foods, but they did all eat, for the most part, a plant-based diet. And that diet seemed to have a protective effect on heart health and longevity.

In 1960, Ancel Keys, the American physiologist who launched the Seven Countries Study, coined what’s now known as the “Mediterranean diet.”

What foods are allowed on the Mediterranean diet?

The name is slightly misleading because it refers to more of a dietary pattern — of which there are slight variations — rather than a single regimented diet.

What all versions have in common, however, is an emphasis on a variety of fruits, vegetables, whole grains, beans, nuts, legumes, fish (especially those rich in omega-3 fatty acids such as salmon, sardines and mackerel) and healthy fats like olive oil. Eggs and dairy products are OK, but only in moderation. The same goes for alcohol. Up to a glass of wine at dinner is given a green light on the Mediterranean plan.

“There is no single definition for a Mediterranean diet, since it encompasses the eating pattern of all 16 countries that border the Mediterranean Sea, including parts of Europe, Asia and Africa,” explains Liz Weinandy, an outpatient dietitian and clinical instructor at the Ohio State University Wexner Medical Center. “It’s healthy for anyone of any age who’s looking to follow an overall healthy eating plan that benefits every part of the body.”

But following the Mediterranean diet involves more than simply eating a checklist of foods. Lifestyle plays an equally important role, too. Specifically, eating fresh in-season produce, sitting down to meals with family and or friends, and staying physically active by doing something you enjoy (playing pickleball, for instance, or going for a swim or a long walk outdoors) as opposed to something you don’t (like, say, logging steps on the treadmill or minutes on the elliptical machine).

What are the health benefits?

The Mediterranean diet is always turning up in the top spot on “best diets” lists — and it’s easy to see why.

For one thing, it’s easier to follow than some of the more restrictive diets. But it also has a number of health bona fides. “The Mediterranean diet has always been associated with better heart health,” says Kristin Kirkpatrick, a registered dietitian with the Cleveland Clinic. “In recent years, data also shows benefits to many other aspects, such as better mental health and better liver health.”

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In the years since the Seven Countries Study, subsequent research has shown a significantly decreased risk for cardiovascular disease among people who follow the Mediterranean diet. A review of 185 studies over the past decade, published in 2022 in the journal Nutrients, also found health benefits for lowering the risk of type 2 diabetes, obesity and cancer.

More recent research published in the journal Neurology suggests the Mediterranean diet may even help protect the brain from damage caused by Alzheimer’s disease, the most common type of dementia.

Can you lose weight on the Mediterranean diet?

Research suggests that following the Mediterranean plan is good not only for weight loss, but for weight-loss maintenance. One study found that people who followed the Mediterranean diet for a year lost as much as twice the weight as those who followed a low-carb diet.

But there are a few caveats. Although the Mediterranean plan makes specific suggestions such as “more fruits and vegetables” and “less dairy,” the actual serving sizes aren’t specified, “so it’s easier to gain weight on this plan than it is on some of the others,” Kirkpatrick says.

For instance, there’s an emphasis on healthy fats — olive oil in particular, but also nuts and avocados, all of which are heart-healthy. But they’re also high in calories, so it’s important to watch portions. Same goes for red wine, which is allowed — in moderation — on the Mediterranean plan.

The only potential downside to this plan is “not paying attention to portion sizes,” Kirkpatrick emphasizes. “You could gain weight on any dietary pattern. It really all boils down to eating until you are no longer hungry — not until you’re full.” 

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