Dos and Don’ts of the Mediterranean Diet for Older Adults

This highly rated eating plan has been shown to protect your heart health and help you live longer. Here's how to make it work for you.

Following the Mediterranean diet can be a gateway to health at any age. But it's especially beneficial for older adults. Inspired by the traditional cuisine of the Mediterranean region, it emphasizes plant-based foods, healthy fats, whole grains, fruits, vegetables, and beans, while limiting red meat and sweets.

Research from Havard School of Public Health has shown that people who follow this eating pattern live longer than those who don't. They also have a reduced risk of cardiovascular disease. It's understandable why this famously tasty way of eating might appeal to the 95% of Americans ages 65 and older who have at least one chronic health condition.

If you’re thinking about trying the Mediterranean diet for yourself, consider these dos and don’ts from Jessica Sylvester, a registered dietitian based in Florida who specializes in older adult nutrition. These tips can help you make a shift that’s as sustainable as it is healthy.

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Don’t: Fall into a Diet Mindset

The first step in adopting the Mediterranean diet? Stop viewing it as a weight-loss diet, says Sylvester. It’s not a quick fix to drop a few pounds. Instead, see it as a lifelong approach to eating. “It’s a lifestyle change to embrace. There is no specified time frame,” she says. The Mediterranean diet is all about making consistent, healthy eating choices that can be maintained over time.

Do: Pay Attention to Portions

While the Mediterranean diet emphasizes healthy whole foods, portion control still matters. "Red wine, cheese, and even desserts are all allowed, but that's mostly because of how they are enjoyed in the areas where this diet originated from," says Sylvester. "These are foods that are relished, eaten slowly, and in small amounts."

It’s also important to know that many of the marquee foods of the Mediterranean diet are higher in calories and fat. Think: extra virgin olive oil, nuts, seeds, and fatty fish. These foods contain healthy unsaturated fats, but if you’re also trying to slim down, be sure to take note of the calories and serving size information on nutrition labels.

Don’t: Assume You Already Understand the Diet

The Mediterranean diet is more nuanced than it might appear. It's not just about eating more fish and using olive oil. Take time to research and understand the diet's principles, such as the importance of plant-based foods and whole grains. "Understand why there are so many health benefits," says Sylvester.

Some of the best evidence for this diet came from the PREDIMED study, a randomized clinical trial that ran for more than five years. It included 7,000 people with type 2 diabetes or elevated risk of heart disease. Study participants on the Mediterranean diet had a 30% lower risk of heart events compared to the control group. Knowing the benefits of this eating pattern can help keep you motivated to stay on track.

Recommended reading: How to Start Eating Plant-Based

Do: Read Menus in Advance

When you do eat in restaurants, it's a good idea to scope out the menu beforehand, says Sylvester. Look for dishes that align with the Mediterranean diet's principles, such as those rich in vegetables, whole grains, and lean proteins. Examples might include grilled vegetables with whole wheat cous cous, broiled salmon, or a Greek salad.

Recommended reading: Your Guide to Whole Grains — And Why They’re So Good for You

Don’t: Rely Too Much on Takeout

A big part of the Mediterranean diet is its focus on fresh, homemade food. Cooking for yourself means you control the ingredients, portions, and preparation methods of your meals. Though home cooking is rewarding, it can be a challenge, too. "Not everyone is eager or able to do this," says Sylvester. But if you can spend some time in the kitchen, you'll reap even more benefits.

Do: Personalize the Diet

The Mediterranean diet is flexible, allowing for personalization based on dietary needs, preferences, and any health conditions. "It's always best to check with a registered dietitian who will review your medical conditions and medications before implementing any dietary changes," says Sylvester. They can help you tailor the diet to suit your specific situation.

Don’t: Overdo Red Meat

Consumption of red meat is limited in the Mediterranean region. That’s a good thing — red meat is linked with heart disease and other health issues. A 2023 meta-analysis published in the European Heart Journal found that both unprocessed and processed red meat consumption are lined with an increased risk of heart disease and diabetes.

"I recommend limiting red meat consumption to once a week," says Sylvester. "A portion size of red meat is about the size of your closed palm. That's about three ounces." Focus instead on lean proteins like fish, poultry, beans, and legumes, which are central to the diet and provide a variety of health benefits.

Recommended reading: 3 Top Reasons You Should Be Eating More Pulses

Do: Create a List of Go-To Foods

Simplifying your meals and prepping them ahead of time can make it even easier to follow the Mediterranean diet. Having a few go-to meals and snacks can reduce the temptation to choose less healthy foods. Some options Sylvester recommends:

• Hummus with carrot, cucumber, or bell pepper sticks.
• Applesauce pouches without added sugar.
• A handful of mixed nuts like almonds, walnuts, or pistachios with a piece of fruit.
• Tuna pouches with whole grain crackers and veggies.
• Fill a whole-grain wrap with hummus, veggies, olives, and a source of lean protein like grilled chicken or chickpeas.

Recommended reading: 12 Tips to Make Your Meal Planning Easier

Don’t: Reintroduce Red Wine

Though red wine is technically part of the Mediterranean diet, Sylvester advises older adults to leave it out. "We know that there are health consequences of wine consumption, especially for people with diabetes," says Sylvester. If you're taking the diabetes drug Metformin, it's essential that you avoid wine and all types of alcohol. "You cannot drink while on Metformin because of the risk of lactic acidosis, which can lead to death."

Do: Experiment with New Foods

The Mediterranean diet is one of the least restrictive eating plans out there. Enjoy it by experimenting with new foods. "My patient population is mostly older adults. Oftentimes, they start trying foods they've never considered before. They're most surprised at how delectable the foods and meals on this diet are," says Sylvester.

Keeping these expert-approved dos and don'ts top of mind can help you make a successful shift to the Mediterranean way of eating. Your heart and your taste buds will thank you.

See our sources:
Mediterranean diet review: Harvard Health
Healthy aging tips: National Council on Aging
Study on link between Mediterranean diet and heart health: PREDIMED
How eating red meat affects heart health: European Heart Journal

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