How Healthy Is the Mediterranean Diet?

Any cardiologist is probably going to prescribe the Mediterranean diet, but why?

The Mediterranean diet is thought to play a role in protecting against and treating type 2 diabetes, cardiovascular disease, cancer, and cognitive-related diseases [2].

Does research support the Mediterranean diet as an answer to living a healthy life or is there more to the story? The question remains: is one way of eating the right way of eating?

History of the Mediterranean Diet

The Mediterranean diet originates from ancient civilizations which developed around the Mediterranean Sea [2].

Different cultures and countries differentiated in some food choices, cooking practices, and as with any culture diet restrictions or preferences [2].

It was seen that different countries prioritized different foods. For example, Greece traditionally had a high olive oil consumption, Croatia had a high fish intake, and Italy had a high vegetable intake [1].

Ultimately, these countries each were found to have primarily the same basic principles [2]. The components, within each culture, that were found to be beneficial to health were combined to form a diet [1].

The term “Mediterranean diet” was coined by Ancel Keys, an American scientist who was initially recognized the relationship between low cardiovascular disease and the Mediterranean communities [2].

Today the Mediterranean diet refers mainly to the way of life in Greece and Southern Italy [2].

What is the Mediterranean Diet?

The Mediterranean diet includes [2]:

• Plant-based cuisine
• Vegetables, fruits
• Legumes
• Cereals
• Nuts
• Olive oil
• Moderate incorporation of fish, seafood, or dairy
• Limited incorporation of meat and alcohol (primarily red wine)

Olive oil plays a central role when cooking and represents the main fat source [2]. Cheese is used sparingly and usually with vegetables [2]. Meat, milk, and eggs are limited to small amounts and processed meats and sweets are almost non-existent [2].

Other primary components of the Mediterranean diet include whole grains, nuts, fresh fruit, and moderate fish or seafood [2].

The Mediterranean diet reveals variety to an extent. The underlying pros and cons of the Mediterranean diet are detailed below.

Pros of the Mediterranean Diet

Research supports the Mediterranean diet’s role in preventing and treating cardiovascular disease, diabetes, cancer, and cognitive-related diseases [2].

A metanalysis of research studies related to the Mediterranean diet revealed that a higher adherence to the diet was associated with lower incidence of type 2 diabetes, cardiovascular disease, and cancer [1].

From a scientific standpoint the Mediterranean diet is chalk full of antioxidants, fiber, monounsaturated and omega-3 fatty acids, phytosterols and probiotics [5].

The benefits of this way to eating are attributed to the variety of food, maybe not a diet per se. Diet diversity is defined as the number of different foods or food groups consumed over a given time frame to lead to healthy and balanced eating [3].

Cons of the Mediterranean Diet

The Mediterranean diet is a diet and therefore has a dietary pattern featuring specific characteristics or guidelines [2]. Unfortunately, these characteristic or guidelines can often shift into food rules.

When comparing research studies, the definition of the Mediterranean diet or the foods allowed can vary slightly. That being said, some studies reveal a greater inverse relationship between the Mediterranean diet and poor health.

This is proof that a con to the Mediterranean diet is the implication that it is the healthiest way or the right way of eating.

Maybe the healthiest or right way of eating can be adjusted to meet each person’s lifestyle and needs?

What is the Takeaway?

What if the Mediterranean diet was viewed as more of a model? Would this promote the ability to be flexible and in moments spontaneous with eating patterns?

The wonderful part of the Mediterranean diet is that the incorporation of fruit, vegetables, whole grains, beans, oils, nuts, lean meats, and fish are emphasized.

The downside to the Mediterranean diet could be a production of guilt or shame if you are not able to follow the “diet” to a tee. Also, to consider that not everyone has the resources, ability, or desire to follow a strict diet.

To live a happy and healthy (physically and mentally) lifestyle does the following matter:

• Socializing
• Finances or budget
• Celebrations
• Having your favorite foods
• Listening to and honoring your body

The takeaway is a need for gentle nutrition. This is the last principle you learn in the book, Intuitive Eating by Evelyn Tribole, MS, RD and Elyse Resch, MS, RD, FADA, CEDRD.

Principle 10, Honor Your Health and Gentle Nutrition encourages making choices that not only honor health, but taste and desire [4]. This challenges the mentality that foods are merely good or bad, healthy or unhealthy.

Nourishing the body is about the choices we make most of the time, acknowledging that one snack, meal, or even a day of eating does not define you or your health [4].

Resources:

[1] Galbete, C., Schwingshackl, L., Schwedhelm, C., Boeing, H., & Schulze, M. B. (2018). Evaluating Mediterranean diet and risk of chronic disease in cohort studies: an umbrella review of meta-analyses. European Journal of Epidemiology, 33(10), 909–931. https://doi.org/10.1007/s10654-018-0427-3

[2] Lăcătușu, C. M., Grigorescu, E. D., Floria, M., Onofriescu, A., & Mihai, B. M. (2019). The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription. International Journal of Environmental Research and Public Health, 16(6), 942. https://doi.org/10.3390/ijerph16060942

[3] Mazzocchi, A., Leone, L., Agostoni, C., & Pali-Schöll, I. (2019). The Secrets of the Mediterranean Diet. Does [Only] Olive Oil Matter? Nutrients, 11(12), 2941. https://doi.org/10.3390/nu11122941

[4] Tribole, M. E. S., & Resch, M. E. S. (2020). Intuitive Eating: A Revolutionary Anti-Diet Approach (4th ed.). St. Martin’s Essentials.

[5] Ventriglio, A., Sancassiani, F., Contu, M. P., Latorre, M., di Slavatore, M., Fornaro, M., & Bhugra, D. (2020). Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review. Clinical Practice & Epidemiology in Mental Health, 16(1), 156–164. https://doi.org/10.2174/1745017902016010156

Author: Raylene Hungate, RDN, LD/N
Page Last Reviewed on April 7, 2022, and Updated By: Jacquelyn Ekern, MS, LPC