What Is the Mediterranean Diet: The SilverSneakers Guide

This world-famous diet may just be the key to better health and a longer life.

You've no doubt heard of the Mediterranean diet. It's one of the most well-researched eating patterns on the planet. And for the past five years, it has topped U.S News's annual list of best diets.

So what's so great about the Mediterranean diet? We've gathered all the info you need to help you understand this eating pattern and give it a try.

What Is the Mediterranean Diet?

The Mediterranean diet is a way of eating based on the traditional foods (and drinks) of the countries surrounding the Mediterranean Sea.

“Way of eating” is the key phrase there. Unlike most diet plans, this one favors general guidelines over strict rules. “It’s more a lifestyle,” says Keri Gans, R.D.N., author of The Small Change Diet. “It’s what we should all refer to as well-balanced, healthy eating.”

People first started paying attention to the Mediterranean diet over 50 years ago, based on findings from the Seven Countries Study. This landmark study followed over 10,000 middle-aged men from the U.S., Northern Europe, Southern Europe, and Japan for decades. Researchers gathered data on their lifestyle and what they ate, plus heart health factors such as serum cholesterol and diagnosed heart disease.

Of the seven countries studied, researchers found that the men living around the Mediterranean, in Italy, Greece, and modern-day Croatia had the lowest rates of heart disease. Since then, the Mediterranean diet has been the subject of thousands of research studies, testing its association with everything from diabetes to brain health and weight loss.

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What Are the Basic Principles of the Mediterranean Diet?

The Mediterranean Sea is surrounded by many diverse countries, cultures, and cuisines. But the "Mediterranean diet" is largely based on the traditional eating patterns of people in Crete, Greece, and Southern Italy.

These cuisines were the basis of the Mediterranean Diet Food Pyramid. This was created in the 1990s by the Harvard School of Public Health, the World Health Organization, and Oldways Preservation and Exchange Trust, a public health nonprofit.

The Mediterranean diet is not what you might think of as a traditional "diet." There are no "forbidden" foods, and you don't need to count or restrict calories, carbs, or fat. It's simply a way of eating that emphasizes more plant foods and healthy fats.

The Mediterranean eating style can be broken into the following basic guidelines:

• Eat mostly: Vegetables, fruits, nuts, seeds, legumes, potatoes, whole grains, herbs, spices, fish, seafood, and extra virgin olive oil
• Eat in moderation: Poultry, eggs, cheese, and yogurt
• Eat rarely or not at all:Red meat, sugar-sweetened beverages, added sugars, processed meat, refined grains, refined oils, and other highly processed foods
• Drink: Mostly water, plus moderate amounts of red wine (one 5-ounce glass per day is encouraged)

The Mediterranean diet is not a low-fat diet. But it does focus on plant-based “good” fats over animal fats, which are high in saturated fat. Olive oil is the primary added fat. It’s made mostly of unsaturated fats, which research shows are good for heart health. The diet includes many other foods that are naturally high in healthy fats, like avocados, nuts and seeds, and fatty fish like salmon and sardines.  

Fish and seafood are the preferred protein sources in the Mediterranean diet. You'll want to eat these at least twice a week. You can include poultry, eggs, and dairy in moderation, too. Red meat is much less common, generally limited to just a few servings per month.

And the Mediterranean diet isn’t just about eating. It includes lifestyle aspects, too, such as:  

• Daily physical activity 
• Sharing meals with family and friends

Recommended reading: 6 Stealth Health Benefits of Exercise 

What Are the Health Benefits of the Mediterranean Diet?

Numerous studies have linked the Mediterranean eating style to better heart health, a sharper mind, and a longer life. And it’s never too late to reap the benefits. Here’s what the research says.

Heart health: You may know the Mediterranean Diet best for its touted heart health benefits. Numerous studies have found that a Mediterranean-style eating pattern is linked to: 

• Lower blood pressure 
• Lower cholesterol 
• Lower risk of heart disease and stroke.  

In one of the largest intervention studies, called PREDIMED, study participants who were assigned to either a Mediterranean diet or a control diet based on general advice to lower their fat intake. Those on the Mediterranean diet were 30 percent less likely to die from a cardiac event like a stroke or heart attack, compared to the control group.

Brain health: One study published in the Journal of the American Geriatrics Society found that older adults who followed a Mediterranean-style diet were 35 percent less likely to score poorly on memory and attention tests compared with those who didn’t follow the diet. They were also more likely to be active, have lower blood pressure, and feel happier.

Why the brain boost? The Mediterranean diet packs in beneficial nutrients, such as antioxidants and omega-3 fatty acids, which may help fight inflammation and improve the way your brain cells communicate, the study authors say.

Longer life: Overall, the Mediterranean can lead to a longer, healthier life. One study that looked at 5,200 adults over 65 found that a Mediterranean diet lowered their risk of early death by about 25 percent.

Another analysis in the same journal found that a Mediterranean diet was associated with a reduced risk of frailty in older adults. Frailty is a catch-all term for various age-related health problems, including increased risk of falls, fractures, muscle weakness, and dementia. Preventing frailty can add years to your life, and life to years by maintaining mobility and independence.

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Are There Any Risks to the Mediterranean Diet?

The Mediterranean diet can be a safe diet for anyone to try. You don't have to cut out certain foods or food groups. And you don't have to restrict calories or other nutrients.

You can also adapt the diet based on your food preferences and needs. For example, if you are allergic to nuts, you can focus on other sources of healthy fats like seeds, avocados, and vegetable oils.

The biggest thing to watch out for is that daily glass of red wine, Gans says. This is true for two reasons:

1. As you get older, your body can't process booze like it used to. This means you'll feel the effects a lot quicker. This can increase your risk of falling and getting hurt.
2. You might be taking medications that don’t mix well with alcohol. In fact, a study from the National Institutes of Health found that nearly 80 percent of older adults who drink alcohol use medications that don’t mix well with it. Those medications include blood thinners, blood pressure drugs, pain relievers, and antibiotics.

Talk with your doctor before you start enjoying a nightly glass of wine. Your doctor knows your medical history and can recommend a limit that's best for you.

Also worth noting: If you suffer from digestive conditions, such as celiac disease or lactose intolerance, a traditional Mediterranean eating style may set you up for stomach problems. Gans warns that since the diet includes dairy and whole grains, it can cause gas, bloating, and diarrhea.

That doesn't mean you can't adjust the diet to fit your needs. If you need to nix dairy or whole grains, simply make an effort to eat the other good-for-you foods included in the diet, Gans says. "This will still serve as a foundation for an overall healthy plate."

Recommended reading: Should You Ditch Low-Fat Foods for Good?

How Can I Plan Healthy Meals Following the Mediterranean Diet?

You don’t have to overhaul your diet all at once. You can start with some simple swaps following some of the basic guidelines of the Mediterranean Diet. Here’s what Gans suggests:

• If you don't already eat fish, try swapping some into one meal per week in place of meat. Even canned salmon or sardines will do, she says. Eventually work up to at least two 4-ounce servings of fish per week. A 4-ounce serving is about the size of a checkbook.
• If red meat is your go-to protein, start swapping in chicken or turkey one or two times a week.
• Gradually shift to a more-plant-based diet. Start with one meatless dinner a week, and experiment with vegetarian recipes. Or, you can simply cut back on your meat portion sizes, and bulk up meals with vegetables. Add in beans with your meatless meals. They’re a good plant-based source of protein. And they’re packed with fiber, which has many health benefits.  

Recommended reading: 6 Meatless Meals Even Carnivores Will Love 

• If you typically cook with butter or lard, swap some or all of that fat for olive oil or another plant-based oil like canola oil.
• Instead of white rice and bread, opt for whole grains. Try whole wheat bread, brown rice, oats, and barley.
• Start each dinner with a salad drizzled in a bit of extra virgin olive oil. It's an easy way to bump up your daily dose of vegetables and healthy fats, Gans says.
• Rethink your snacks. Keep fresh fruit on hand to snack on. Or have a small handful of a trail mix with nuts, seeds, and dried fruit. The healthy fats and protein in nuts and seeds are filling and will tide you over between meals.

Small changes like this add up to make a big difference. Plus, they're more sustainable.

"Never try to revamp your diet in 24 hours, or even a week," Gans says. "Habits that you've developed over years are hard to change."

See our sources:
Mediterranean Diet Review: Harvard School of Public Health
PREDIMED intervention study: The New England Journal of Medicine
Mediterranean Diet and longevity: British Journal of Nutrition 

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