An Introduction to the Mediterranean Diet

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We often stress the importance of seeking out the healthiest versions of wrongfully stigmatized nutrients (i.e., fat and carbs) instead of avoiding them, a concept that the Mediterranean diet embodies perfectly.

Born out of centuries of agricultural development throughout the often rocky, unfertile lands bordering the Mediterranean Sea, this “peasant’s diet” is rich in vegetables, fruits, nuts, legumes, fish, and olive oil.

We won’t pretend that fast food globalization hasn’t extended its greasy hand across the pond, but in its traditional form, the Mediterranean diet is the perfect antithesis to the American diet.

Before rolling out the many health benefits of this well-balanced and sustainable diet, let’s take a brief tour of the food itself. 

Your Mediterranean Diet Master List

This list isn’t exhaustive by any means, but it contains many of the Mediterranean diet staples:

Vegetables

  • Cucumbers
  • Tomatoes
  • Onions
  • Zucchini
  • Eggplant
  • Leafy greens
  • Potatoes
  • Broccoli

Fruits

  • Apricots
  • Berries
  • Peaches
  • Oranges
  • Dates
  • Figs
  • Melon

Meat

  • Seafood
  • Poultry occasionally 
  • Red meat very sparingly (lamb less sparingly)

Nuts

  • Pistachios
  • Pine nuts
  • Sesame seeds
  • Almonds

Dairy

  • Real Greek yogurt (strained)
  • Feta
  • Parmesan
  • Graviera
  • Mozzarella 

Legumes

  • Chickpeas
  • Lentils
  • Lima Beans

The Rest

  • Extra virgin olive oil – lots of it
  • Grains/seeds (quinoa, barley, whole grain bread/pasta)
  • Up to 1 glass of red wine a day
  • Basil, oregano, and other herbs > salt
  • Almond butter > regular butter

Sample Meals

Given the moderate level of flexibility in this diet, there are many variations and Americanized adaptations out there, but consider the following as a typical meal plan for a day under the Mediterranean diet.

Breakfast: Greek yogurt with honey/fruit, whole wheat toast, 1-2 eggs, grilled tomatoes. 

Lunch: Tuna salad, “village salad” (cucumber, tomato, and feta), chickpeas, quinoa, grilled chicken (sandwich, salad, or plain), fruit, hummus.

Dinner: Salmon, cod, or other fish, baked potato with olive oil, whole-grain pasta, steamed spinach, roasted chicken, vegetable soup, fruit for dessert.

Snacks: Nuts, raw vegetables and fruits, hummus, toast, sliced bell peppers with oil.

Key Differences Between Mediterranean and American Diets

It’s not to disparage the American diet, but to provide context for the health benefits of the Mediterranean diet that we make these comparisons.

Here are the five most relevant differences between the two diets in terms of health outcomes:

  • Olive oil in place of butter
  • More whole foods, very little processed foods
  • Increased fiber content
  • More vegetables, less meat
  • Sparing use of dairy, saturated, and trans fats

These five differences alone have been frequently called out in research as the main drivers of longevity and disease prevention in Mediterranean populations. 

Let’s start with the big one: heart health. 

The Mediterranean Diet and Coronary Heart Disease

One of the most comprehensive findings available on the connection between the Mediterranean diet and coronary heart disease, an article from the Hellenic Association of Gerontology and Geriatrics in Athens, Greece, brings many important correlations to light.

First, the authors reference a 605-participant study in which heart attack survivors following the Mediterranean diet were found to have a “50-70% lower risk of recurrent heart disease compared with those who followed a diet similar to the American. Heart Association (AHA) Step-I diet.”

The Hellenic Association of Gerontology and Geriatrics study also points to the results of a very large epidemiological investigation known as the Seven Countries Study, which found that Italian and Greek mortality rates were among the lowest in Europe.

As usual, different parties hold different perspectives on the heart-healthy mechanisms of the Mediterranean diet, but few would contend the importance of switching out saturated and trans fats with monounsaturated and polyunsaturated (as in olive oil) fats. 

Chronic Disease Prevention

Another review from the University of Arizona and Tucson provides a broader look at the preventive potential of the Mediterranean diet on other chronic diseases affecting Americans at epidemic or near-epidemic levels.

For example, these researchers referenced several studies in which “Higher adherence to a MD (mediterranean diet) eating pattern has been associated with reduced incidence of AD (Alzheimer’s disease) and of cognitive decline.”

Furthermore, the researchers cited a study in which the Mediterranean diet was correlated with a 35% lower breast cancer risk in Asian American women. 

The review also exposed the anti-aging capabilities of the Mediterranean diet, which was shown to improve lipid profiles, systemic inflammation, and even diabetes risk in elderly participants.

Obesity

At the root of so many of the above issues is obesity, which is why healthy dieting is considered by many as the most effective and all-encompassing disease prevention.

This study from Italy’s University of Balogna attributed the following characteristics of the Mediterranean diet to statistically evidenced reductions in obesity, type 2 diabetes, and metabolic syndrome rates:

  • Low intake of added sugar, red meat, and dairy
  • High monounsaturated intake, low saturated fat intake
  • High fiber and antioxidant content
  • Balanced omega-6/omega-3 fatty acid ratio

These four points alone are integral not just to maintaining a healthy weight, but in staving off the snowballing pathology that leads to increased risk factors of the “big ones,” e.g., heart disease, diabetes, and cancer. 

Tips for New Dieters

In terms of tolerability and craving management, the Mediterranean diet lands somewhere in the middle; you don’t have to worry about drastic carb-cutting or fasting, but those of us addicted to sugary and/or processed snacks will need plenty of willpower to make the transition.

It’s important to distance ourselves from the word “diet” in this case, or to at least clarify it, because it’s really a permanent lifestyle change.

The following tips can help you structure your new lifestyle in a way that minimizes opportunities for slip-ups while emphasizing the many tasty options that are available.

First, evaluate and modify foods you already eat to make this transition an easier one.

For example, popcorn is fine, just swap out butter for olive oil and go for lightly salted or unsalted popcorn. 

Sandwiches are fine, just make sure to use minimally refined whole grains.

Next, seek out healthier fats to stay satisfied.

The Mediterranean diet doesn’t shy from fats by any means, but it will require you to transition from processed cheese, fatty red meats, chips, etc. to nuts, fish, and of course, olive oil. After a short adjustment period, you’ll hopefully find it much easier to avoid unhealthy fats.

There’s good news and bad news in the meat department, depending on your preferences.

The bad news is that many of us will have to wean ourselves off red meat, bacon, and other beloved American staples, but the good news is that there are plenty of healthy meat options available under the Mediterranean diet, like fish and chicken.

It’s also important that dieters transition out of the mid-century mentality of serving meat with every dinner or even every meal.

Finally, remember that dieting isn’t just dieting – exercise is imperative.

The synergy between diet and exercise is so strong, many studies reporting on the Mediterranean diet have had to admit that they had a very hard time isolating diet as the sole contributor to improved health outcomes, since Mediterranean people tend to walk and exercise more. 

Don’t think of it as a diet, prioritize healthy modification/substitution of foods you already eat over a complete makeover for an easier transition, and make sure to get plenty of exercise—that’s the Mediterranean diet as it should be practiced.



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