The Mediterranean diet is most accurately defined as the dietary patterns and lifestyle traditionally followed until the 1960s by people in areas surrounding the Mediterranean Sea, such as in parts of Greece and Southern Italy. People in this region were noted to live longer and healthier lives, a fact that drew the interest of scientists from around the world in the 1950s and beyond.
The traditional Mediterranean diet is characterized by high consumption of olive oil, fruits, vegetables, nuts and legumes (such as beans, peas and lentils), as well as moderate consumption of fish and wine.1 Hallmarks also include relatively low consumption of dairy products including yogurt and specific cheeses (such as feta, brie and manchego) and low consumption of red and processed meats.2 Other historical characteristics of the Mediterranean diet include eating mainly unprocessed and fresh foods, exercising regularly, drinking in moderation and with meals and sharing meals with others.3
Here is an example of a pyramid describing the Mediterranean Diet:4
What is Unique About the Mediterranean Diet?
In contrast to other diets, the Mediterranean diet does not specifically control for calories, and it allows for a relatively high intake of healthy fats (mainly olive oil) and a moderate intake of red wine during meals (up to one serving per day for women and two servings per day for men).5
Although a high fat diet may sound “unhealthy,” the Mediterranean diet consists mainly of unsaturated fat (known as a “good” fat) from plant sources, and it discourages intake of saturated fat. This unsaturated fat comes primarily from virgin olive oil, tree nuts (such as walnuts, almonds and hazelnuts) and fatty fish (such as salmon, tuna and sardines).6
It is commonly recommended that people should decrease their intake of fat and calories in order to lose weight and improve their health. Recent studies suggest, however, that nutrition science is actually much more complex. For example, the PREDIMED study, a large study of nearly 7,500 men and women in Spain focusing on the effects of Mediterranean diet, has shown that following a Mediterranean diet long-term can lead to many health benefits, including slight weight loss and improvements in waist circumference – even without any restriction of calories.7
Thus it appears that the overall dietary pattern of the Mediterranean diet – not just the amount of calories and fat – is most important for preventing disease and disability and prolonging life.8
- Trichopoulou A, Lagiou P: Healthy traditional Mediterranean diet: an expression of culture, history, and lifestyle. Nutr Rev. 1997, 55: 383-389.
- Martínez-González MA, Bes-Rastrollo M, Serra-Majem L, Lairon D, Estruch R, Trichopoulou A: Mediterranean food pattern and the primary prevention of chronic disease: recent developments. Nutr Rev 2009;67(Suppl. 1):S111–S116
- Trichopoulou A, Costacou T, Bamia C, Trichopoulos D: Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003, 348: 2599-2608. 10.1056/NEJMoa025039.
Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, Medina FX, Battino M, Belahsen R, Miranda G, Serra-Majem L, Mediterranean Diet Foundation Expert Group: Mediterranean diet pyramid today. Public Health Nutr. 2011, 14: 2274-2284. 10.1017/S1368980011002515.
- Gea A, Bes-Rastrollo M, Toledo E, Garcia-Lopez M, Beunza JJ, Estruch R, Martinez-Gonzalez MA: Mediterranean alcohol-drinking pattern and mortality in the SUN (Seguimiento Universidad de Navarra) Project: a prospective cohort study. Br J Nutr. 2014, 111: 1871-1880. 10.1017/S0007114513004376.
- Trichopoulou A, Bamia C, Trichopoulos D: Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ. 2009, 338: b2337-10.1136/bmj.b2337.
- Estruch, Ramon, et al. "Effect of a high-fat Mediterranean diet on bodyweight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomised controlled trial." The Lancet Diabetes & Endocrinology(2016); doi: 10.1016/S2213-8587(16)30085-7
- Lim, Stephen S., et al. "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010." The lancet380.9859 (2013): 2224-2260.