How to Start the Mediterranean Diet + Meal Planning Ideas

For years, the Mediterranean diet has impressed clinicians including dietitians and nutritionists like myself, as well as cardiologists, neurologists and other medical experts who've sung the praises of a meal plan that's been validated in multiple bodies of research for its positive influence on heart health, cognitive function, bone strength and overall longevity.

And in recent years, the Mediterranean diet has started to make its way into everyday kitchen table conversations about healthy eating, with the U.S. News & World Report naming it the "best diet" five years in a row.

While the word "diet" might make you think of weight loss, the Mediterranean diet's focus is on eating nutritious foods, not necessarily losing weight. That being said, if maintaining a healthy weight is top of mind, the good news is that studies show that the Mediterranean diet can help.

So what is the Mediterranean diet, and is it hard to follow? Let's dive in.

What is the Mediterranean diet?

The term "Mediterranean diet" is used today to describe a healthy dietary pattern that mimics the traditional dietary habits of countries neighboring the Mediterranean Sea such as Greece and southern Italy.

Widely recommended by health professionals, the Mediterranean way of eating emphasizes the consumption of plant foods (fruits, vegetables, whole grains, nuts, legumes) and healthy fats such as olive oil. The general structure of the diet includes a moderate intake of poultry, fish, and dairy, and limited intakes of red meat. Good news for vino lovers – low to moderate amounts of red wine are also permitted on the plan.

Although continuing to grow in popularity in the Western world, paradoxically, adherence to the diet has been decreasing in the parts of the word where it originated. This is due to Western eating habits and globalization having influenced the Mediterranean region, coupled with changes in lifestyle and the environment specific to modern civilization.

Ironically, it was an American scientist who was the first to notice the positive impact of the dietary habits among people who lived in this region. The benefits, especially relating to heart health, were recognized as part of the "Seven Countries Study" by researcher Ancel Keys (who coined the term "Mediterranean diet"), which was first published in 1978. Although controversy is tied to this study, largely due to its influence on carbohydrate guidelines in the food pyramid introduced in 1980, it remains an important part of nutrition science history and many studies have since validated the benefits of the Mediterranean diet meal plan.

How do I start the Mediterranean diet meal plan?

When it comes to a new lifestyle change, sometimes getting started is the hardest part. If you are wondering how to start the Mediterranean diet, the first step is to familiarize yourself with which foods are included on the meal plan. Although fresh, seasonal food is what you'll be eating most, you may need to make some adjustments to your pantry to ensure you have the right non-perishable staples on hand liked canned beans and whole grain pasta. Check out these tips for a healthy pantry.

Because this eating pattern encourages the consumption of fresh, seasonal, and local foods (aka "real food")– your local farmer's market is a great place to do some of your shopping. A seasonal produce guide can also be a helpful tool.

What foods are on the Mediterranean diet meal plan?

The following guidelines are adapted from a combination of recommendations by the Mediterranean Diet Foundation and Greek Dietary Guidelines.

• Olive oil – at every meal
  
  Polyphenol rich EVOO supports healthy blood flow, already-healthy HDL cholesterol, and helps promote a healthy inflammatory response. Selecting a high quality olive oil is important! Since it is a large component of the diet, you'll want to choose a good one. Here are some criteria to look for:
  
  
  • Grown in Mediterranean-like climate needed for nutrient-rich olives while avoiding the long transit time involved in importing Mediterranean derived oil.
  • Olives are harvested early in the season.
  • Handpicked to exclude leaves and avoid the bruising caused by mechanical harvesters.
  • Crushed within hours of harvest rather than days.
  • Oil is then cold-extracted and not filtered, which preserves its raw qualities.
  • Stored in temperature-controlled stainless-steel tanks until it's poured into dark bottles to protect it from light.
• Vegetables – this is a plant-forward meal plan, so you want to eat these at every meal (~6 servings daily)
• Fruit – at every meal (~3 servings daily)
• Whole grains – at every meal (~8 servings daily)
  
  Examples: Whole-grain breads, farro, steel cut oats, wheat berries, brown rice, whole grain wheat pasta, and quinoa (technically a seed!). You can choose gluten-free grains on this meal plan if you prefer—as long as they are whole grains.
  
  Although whole grains are typically recommended at every meal, keep in mind that portion size is important, especially when it comes to weight management and maintaining already-healthy blood sugar. The traditional Mediterranean Diet is not considered one of the low-carb diets such as the ketogenic diet (which restricts the entire food group of carbohydrates), yet you can still follow a Mediterranean-style diet while paying attention to the amount of grains, fruit, legumes and starchy vegetables you eat.
  
  
• Legumes – frequently (~4 servings weekly)
• Nuts – frequently (~4 servings weekly)
• Fish/seafood – moderate (5-6 servings weekly)
• Dairy – moderate, opting for low-fat or reduced fat options such as feta and Greek yogurt vs. full-fat (~2 servings daily)
• Eggs – moderate (~3 servings weekly)
• Poultry – moderate (2-4 servings weekly)
• Red wine – moderate, with meals (equivalent of 1 glass daily for women or 2 glasses daily for men)
• Red meat – infrequent (~1 serving weekly or less)
• Dessert/sweets – infrequent (~2 servings weekly or less)

Don't forget about spices! Paprika, za'atar, harissa, saffron, and cumin, to name a few, make this (or any) meal plan more enjoyable. Have some fun with it and make your own spice blends. Herbs and spices support a healthy inflammatory response.

What foods are not allowed on the Mediterranean diet?

These foods should be eaten infrequently, if not entirely avoided:

• Red meat, especially processed
• Processed foods that are sugar-sweetened
• Refined grains
• Refined/processed/hydrogenated oils—avoid saturated fat

Sample Diet Meal Plan

What does a day look like on the Mediterranean diet? Check out these good-for-you menu options.

Breakfast

• Broccoli and feta frittata with whole grain toast
• Steel cut oats with fruit—top it with walnuts, one of the top heart healthy foods
• Greek yogurt parfait

Lunch

• Citrus salad with radicchio, dates, and almonds
• Asparagus and arugula salad with cannellini beans
• Greek salad

Snacks

• Fresh fruit or crudite and nuts
• Hard-boiled eggs 
• Hummus and Baba Ghanoush (eggplant dip) with whole-grain pita chips, bell peppers and other vegetables

Dinner

• Smoky Vegan Lentil Soup
• Warm spinach salad with feta cheese and pistachios and extra virgin olive oil
• Fish with lemon potatoes, sun-dried tomatoes, quinoa, and a glass of wine
• Poached snapper with stir-fried artichokes and sherry tomato vinaigrette, side of garlicky braised kale

Sorry, locavores, you won't find salmon in the Mediterranean Sea – but it's still a great option as it's high in omega 3 fatty acids and lower in mercury. Of course, almost all of these Mediterranean-inspired dishes rely on olive oil for cooking. Check out these heart healthy olive oil recipes for more ideas!

Want to upgrade your salad skills? Learn how to make a Greek Vinaigrette Dressing:

What are the top three health benefits of the Mediterranean diet?

The Mediterranean diet has been the subject of thousands of published studies that have found numerous benefits to this way of eating, most notably:

Heart health

: The Mediterranean diet is one of the best studied diets for cardiovascular health! It can help maintain already-healthy lipid levels, supports already-healthy blood pressure, inhibits inflammation to support heart health, and even help you maintain a normal weight.

Keeping cells healthy

: Eating like you are in the Mediterranean can benefit your cells too by inhibiting oxidative stress, promoting a healthy inflammatory response, maintaining normal cell growth, and helping to support DNA health.

Metabolic health

: The Mediterranean diet is good for metabolic health because the foods have antioxidant activity and help to maintain healthy insulin sensitivity and endothelial function (the endothelium is a thin membrane that lines the inside of the heart and blood vessels).

References

• Davis, Courtney et al. "Definition of the Mediterranean Diet: A Literature Review. Nutrients, November 2015, https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4663587/
• Esposito, Katherine et al. "Mediterranean diet for type 2 diabetes: cardiometabolic benefits." Endocrine, April 2017, https://pubmed.ncbi.nlm.nih.gov/27395419/
• Lăcătuşu, Cristina-Mihaela et al. "The Mediterranean Diet: From and Environment-Driven Food Culture to an Emerging Medical Prescription." Int J Environ Res Public Health, March 2019, https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6466433
• Mancini, Joseph G et al. "Systematic Review of the Mediterranean Diet for Long-Term Weight Loss." Am J Med, April 2016, https://pubmed.ncbi.nlm.nih.gov/26721635/
• Mentella, Maria Chiara et al. "Cancer and Mediterranean Diet: A Review." Nutrients, September 2019, https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6770822/
• Pérez-Rey, Jesús et al. "Adherence to a Mediterranean Diet and Bone Mineral Density in Spanish Premenopausal Women." Nutrients, March 2019, https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6470744/
• Widmer, R. Jay, MD/PhD et al. "The Mediterranean Diet, its Components, and Cardiovascular Disease." Am J Med, March 2016, https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4339461/
• "Comparison of dietary recommendations for three Mediterranean diet pyramids." National Center for Biotechnology Information, https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4663587/table/nutrients-07-05459-t001/?report=objectonly
• "Mediterranean Diet." U.S. News and World Report, https://health.usnews.com/best-diet/mediterranean-diet
• "Seasonal Produce Guide." U.S. Department of Agriculture, https://snaped.fns.usda.gov/seasonal-produce-guide