Mediterranean Diet Basics: What You Need to Know

Buongiorno! Do you feel like taking a relaxing European vacation, but cannot afford to travel right now? I have an idea that you may enjoy, and it won’t break the bank.

Even if you cannot afford to travel abroad, you can still reap the nutritional benefits of some of the delicious cuisines in southern Europe. Take your taste buds on a trip across the globe without leaving home by adopting a Mediterranean diet. Food is one of the least expensive ways to “get a taste” of various parts of the world.

Many different dietary patterns can help to promote wellness. However, the Mediterranean diet is a way of eating that has one of the most substantial evidence bases for health behind it. The Dietary Guidelines even includes it in its recommendations.

As a registered dietitian, I have learned a lot about the health benefits of this delicious and varied diet. After reading today’s article, you will be similarly well-acquainted with the basics of the Mediterranean way of eating.

Here are the topics we’ll cover:

• What is the Mediterranean diet?
• Which foods are included?
• Which foods are limited?
• Should I start drinking red wine on my Mediterranean diet plan?
• What are the health benefits associated with this way of eating?
• Can I lose weight with the Mediterranean diet?

Are you ready to learn more about the diet that took first place in the 2019 U.S. News & World Report rankings? Keep reading to learn more about this diet and why it is how I choose to feed my family.

What is the Mediterranean diet?

The Mediterranean diet has no one standardized definition and is not a structured meal plan. Instead, this term reflects the generalized dietary pattern common to parts of Italy and Greece in the early 1960s.

Oldways is a non-profit organization that promotes nutritious cultural food traditions from around the globe. In 1993, they joined forces with the World Health Organization and Harvard School of Public Health to create a Mediterranean Diet Food Pyramid.

This visual representation of the Mediterranean diet features whole plant foods at its base. Seafood is recommended twice per week, as well as moderate portions of dairy, eggs, and poultry. Sweets and red meat should be eaten infrequently according to this plan.

The Mediterranean pattern is also one of the three ways of eating recommended in the Dietary Guidelines for Americans. The three patterns are:

• Vegetarian Pattern
• Healthy U.S.-Style Pattern
• Mediterranean Pattern

The main differences cited between the Healthy U.S.-Style pattern and the Mediterranean pattern are that “the Mediterranean-Style Pattern contains more fruits and seafood and less dairy than does the Healthy U.S.-Style Pattern.” The Mediterranean pattern may be slightly higher in fat if a person consumes more fatty fish and less fat-free dairy.

Which foods are included?

Traditional Mediterranean diets focus on minimally processed and nutrient-dense whole foods. Some mainstays of this diet which are common to both the Oldways food pyramid and the Dietary Guidelines include:

• Fruits
• Vegetables (both starchy and non-starchy vegetables)
• Whole grains
• Nuts
• Seeds
• Legumes (i.e., beans)
• Dairy products, fish, eggs, and poultry (consumed in moderate amounts)
• Olive oil as a primary fat source
• Red meat (consumed in low amounts)
• Herbs and spices for flavor

The Dietary Guidelines lists the recommended daily amounts for each of these foods based on individual calorie needs. If you are following their Mediterranean pattern, you can find specific food quantity information on the health.gov website.

The Dietary Guidelines also recommend that at least half of your grain intake should be whole grains. Whole grains contain fiber as well as an array of nutrients that may not be added back to refined grains after processing.

Besides, fat-free and low-fat dairy products are prioritized over whole milk to help reduce saturated fat intake. If you do not consume dairy products, calcium-fortified milk alternatives should be substituted. Some of these products have not undergone fortification; be sure to check the nutrition facts label if you use milk alternatives.

Which foods are limited?

Here is some excellent news. Unlike several other popular diet patterns, you don’t have to eliminate any foods on the Mediterranean diet. You can have a slice of cake on your birthday and still be considered compliant with this plan.

That doesn’t mean that the Mediterranean diet is a free-for-all, however. This way of eating does emphasize diet quality, and nutrient-poor foods should be limited. The Dietary Guidelines makes the following recommendations to improve the nutritional quality of the diet (adapted from the Executive Summary of the Dietary Guidelines):

• Limit added sugars to less than 10% of your total calories per day.
• Limit saturated fat to less than 10% of your total calories per day.
• Adults should limit sodium to less than 2,300 mg per day.
• If you do not currently drink alcohol, don’t start. If you do drink alcohol, do not drink more.

Should I start drinking red wine on my Mediterranean diet plan?

This one may come as a surprise. The recommendation above to skip the alcohol (if you were not previously drinking) even applies to red wine. Don’t use the Mediterranean diet as an excuse to start imbibing.

Red wine indeed contains a polyphenol called resveratrol, which is believed to be beneficial to long-term health. However, as a review from 2016 pointed out, you would need to drink over 500 liters of red wine per day to reach the therapeutic dose!

As the authors of this paper quip, wine drinking may not explain the French paradox. If you want resveratrol in your diet, red grapes and peanuts also offer small amounts without the alcohol.

Do you need a better reason not to pick up that wine glass? The American Institute for Cancer Research classifies alcohol, including red wine, as a group 1 carcinogen.

Alcohol intake has been linked to an increased risk of the following cancers: “breast, esophagus, liver, colorectum, stomach, mouth, pharynx and larynx.” There is an increased risk for several of these cancers, even at very low levels of drinking.

Thankfully, it is not all bad news. Though consuming alcohol is linked to a heightened risk of cancer, moderate alcohol intake may reduce the risk of heart disease. If you do choose to drink, know that combining it with smoking appears to be particularly harmful.

Moderate alcohol intake is considered up to one drink per day for women and up to two drinks for men. The Dietary Guidelines explicitly state that “alcohol is not a component of the USDA Food Patterns.” The calories in these beverages need to be accounted for and should not take the place of nutritious foods.

What are the health benefits associated with this way of eating?

The Mediterranean diet has earned a spot in the Dietary Guidelines because it is one of the diets with the most evidence behind it for long-term health. This diet is linked to improvements in heart disease risk factors, including:

• Blood pressure
• Blood sugar levels
• Lipid profile (i.e., cholesterol levels)

Heart disease is the top killer in the U.S. for both women and men. It is responsible for a whopping one in every four deaths in the United States. Choosing a diet, such as the Mediterranean diet, that lowers your risk is a brilliant move.

Like other diet patterns that are part of the Dietary Guidelines, the Mediterranean diet also incorporates recommendations for physical activity. The Physical Activity Guidelines for adults suggest at least 150 minutes of moderate-intensity physical activity per week. Muscle-strengthening exercises should be incorporated into the exercise routine at least twice per week.

The Oldways Mediterranean food pyramid recommends being physically active as well. Also, the Oldways pyramid advises followers to drink water every day and to enjoy meals with others. This is more of a holistic approach to wellness that moves beyond food.

By encouraging an overall healthy lifestyle, rather than food eliminations, the Mediterranean diet can be considered a way of life. Improvements in diet are only one of the healthy behaviors that can reduce risk factors for chronic disease. Increasing physical activity, quitting smoking, and having adequate social support are important as well.

Instead of focusing on rules regarding what not to do, the Mediterranean diet is a guide for positive lifestyle changes. It can help to protect your heart, reducing your risk for the top cause of death in the United States. The lack of food restrictions makes it easy to take in a large variety of foods and prevent nutrient deficiencies.

Unlike some other popular diet plans, you can safely use the Mediterranean diet with the entire family without close medical supervision. No modified meals for individual members of the family will be needed (unless someone is on a prescribed nutrition therapy). What’s not to love about that?

Can I lose weight with the Mediterranean diet?

There is evidence that the Mediterranean diet is supportive of weight loss as long as calories are restricted. Though this dietary pattern encourages the consumption of a wide range of healthy foods, a calorie deficit is still needed to lose weight. Unfortunately, it is still possible to gain weight even on a diet of primarily healthy foods.

Some common components of the Mediterranean diet are surprisingly high in calories. Over-consumption of these foods can stymie a weight loss goal. Here are a few examples:

• Olive oil: 120 calories per 1 Tablespoon
• Nuts: 150-200 calories per ¼ cup
• Whole wheat flour: 100-110 calories per ¼ cup
• Avocado: 250-300 calories per fruit
• Red wine: 125 calories per 5-ounce serving

If your energy needs are typical 2,000 calories, it is essential to pay attention to portion control so that you do not end up in a calorie surplus. Be particularly careful with the amount of added oils you use on your foods, including heart-healthy olive oil. By going heavy on the olive oil, you can easily add a few hundred extra calories to your meal.

Nuts make a convenient snack and, like olive oil, are rich in heart-healthy monounsaturated fats. However, at 150- 200 calories per ¼ cup, it is easy to consume 1,000 calories of nuts in a sitting. Choose fresh fruits, vegetables, and lean proteins; instead, if you want a high-volume snack for fewer calories.

Those looking for weight loss should keep in mind that grain-based desserts are the top calorie source in American diets. Whole-grain muffins, bread, cookies, and cakes are often similar in calories to those made with refined flours. Choose uncrushed grains with meals (e.g., brown rice or farro) if you tend to overindulge in products made with flour.

When composing meals, make half of your plate non-starchy vegetables to help support a weight loss goal on the Mediterranean diet. Split the other half of the plate between lean protein and starchy foods. This recommendation reflects the diabetes plate method, but it can help with general weight management as well.

One more area where you may inadvertently sabotage your weight loss goal on a Mediterranean plan is beverages. At 125 calories per 5-ounce glass, a nightly glass of red wine can become a significant part of your energy intake. For healthy weight management, the Oldways food pyramid got it right in suggesting water as the beverage of choice.

Final Thoughts About The Mediterranean Diet

Much like a trip to the Mediterranean, the Mediterranean diet is relaxed and can be an enjoyable part of your lifestyle. Since there are no food restrictions, the most substantial downside of this diet is it may not support weight loss. You can easily overcome this pitfall by shifting your food choices towards the less energy-dense options.

Are you interested in this way of eating that is reminiscent of a European vacation, but doesn’t know where to start? Get some delicious meal inspiration that will delight your whole family on our recipe pages. Also, keep an eye out for a tantalizing Mediterranean meal plan in our future articles. Ciao!