Why Following a Mediterranean Diet Lowers All-Cause Mortality Risks

Family with wine

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Although the Mediterranean diet is often ranked the top overall diet by multiple news outlets, few studies have relied on biomarkers to determine the impact of the Mediterranean diet on longevity. But research shows that greater adherence to the Mediterranean diet is associate with a lower risk of mortality in older adults.

In fact, according to the InCHIANTI study, which followed more than 600 participants over the course of 20 years, adherence to the diet may be help people live a longer life and is an especially useful diet plan for mature adults. Here is what you need to know.

What the Research Says

The InCHIANTI Study followed 642 participants—56% of whom identified as female—age 65 or older for 20 years. At the baseline, researchers measured serum concentration of biomarkers that are associated with intake of vegetables, legumes, fruits, nuts, cereals, fish, and olive oil. Serum resveratrol was also measured.

The study revealed a statistically significant correlation between adherence to a Mediterranean diet and lower all-cause mortality. It also demonstrated a relationship between how much Mediterranean food people consumed and their overall mortality.

Where the Mediterranean Diet Originates

While Italy, Greece, and Spain may come to mind at the mention of the Mediterranean diet, it is important to note the diversity of the countries bordering the actual body of water in question. Abbie Gellman, MS, RD, CDN, a chef and author of "The Mediterranean DASH Diet Cookbook," notes the similarities in cuisine.

Abbie Gellman, MS, RD, CDN and Chef

The Mediterranean diet focuses on a region made up of 21 countries—all of which border the Mediterranean sea.

— Abbie Gellman, MS, RD, CDN and Chef

"The Mediterranean diet focuses on a region made up of 21 countries—all of which border the Mediterranean sea," says Gellman. "While the exact flavor profiles and cuisines may differ, they all generally emphasize eating fruits, vegetables, whole grains, beans and legumes, and seafood." 

What's more, when you adopt the Mediterranean diet, you have the opportunity for exposure to a wider variety of flavors and eating experiences says Michelle Dudash, RDN, Cordon Bleu-certified chef, author of "The Low-Carb Mediterranean Cookbook," and creator of Spicekick meal spice kits notes

"Glance at a map and you'll see there are more regions on the Mediterranean, including the Middle East and North Africa," says Dudash. "This is wonderful because you can discover new foods and enjoy even more food options while expanding your palate."

Patterns Over Perfection

While all three experts agree that, regardless of ethnic region, the Mediterranean diet relies heavily on produce, legumes, olive oil, seafood, whole grains, herbs, and spices, making it your own does not have to be a process of elimination. Think of making additions to your diet in these categories, and do not wait until your so-called golden years to get on board.

Michelle Dudash, RDN, Cordon Bleu-Certified Chef,

Starting healthy habits earlier in life is important for keeping health risks low and biomarkers in check.

— Michelle Dudash, RDN, Cordon Bleu-Certified Chef,

"Starting healthy habits earlier in life is important for keeping health risks low and biomarkers in check," says Dudash. "For example, arteries don't become clogged and blood sugars don't go out of balance overnight from our lifestyle, but rather over a long period of time."

She notes that prioritizing high-fiber fruits and vegetables, grains, healthy fats (from olive oil, seafood, nuts, and seeds), and lean meats can aid in living a disease-preventative Mediterranean lifestyle. 

Amy Myrdal Miller, MS, RDN, culinary nutrition expert and president of Farmer’s Daughter Consulting in Carmichael, California, echoes the importance of prioritizing patterns over specific food groups.

"It’s important to look at dietary patterns over time versus the impact of single foods or individual nutrients," Mydral Miller says.

She suggests patterns that include abundant fruits, vegetables, legumes, nuts, and other plant-based foods alongside animal-based foods like lean beef and low-fat dairy to promote health as well as enjoyment.

"Enjoyment is key to following an eating pattern that will last versus following a short-term diet," Myrdal Miller says.

How to Start Eating the Mediterranean Way

Reaping the potential longevity benefits of the Mediterranean diet doesn't have to mean you're eating like a Greek fisherman—although, wouldn't that be nice if it were that easy. Dudash notes that small, sustainable changes to your overall meal plan are best in the long run.

She recommends that you make small changes like adding beans to salads and stirring them into stews and soups. You also can try to have a vegetable on your plate at most meals—even a handful of greens on your sandwich helps. And, while a moderate portion of steak is fine, fill most of your plate with your favorite vegetables.

Another option is to enjoy easy-to-grab fruit, nuts, and seeds for snacks and to get in the habit of using extra-virgin olive more often in place of butter and margarine. For dessert, do as the Italians do by ending with a fresh fruit plate and saving sugary sweets for special occasions.

Overall, Dudash says keeping your kitchen stocked with the Mediterranean diet essentials will help you get meals on the table easier. And don't forget that canned, frozen, and dried fruits, vegetables, and seafood all count, too.

A Word From Verywell

It is never too early to incorporate tenets of the Mediterranean diet into your current eating habits, especially because research indicates that it may add years to your life. Start with small additions to your diet as opposed to eliminations, and keep your own flavor preferences in mind.

Remember that this region is inclusive of many different flavors that can actually expand your palate. You also should talk with a healthcare provider or a registered dietitian before making changes to your eating plan. They can help you determine what is right for you.


2 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hidalgo-Liberona N, Meroño T, Zamora-Ros R, et al. Adherence to the Mediterranean diet assessed by a novel dietary biomarker score and mortality in older adults: The InCHIANTI Cohort StudyBMC Med. 2021;19(1):280. doi:10.1186/s12916-021-02154-7

  2. Fleming JA, Kris-Etherton PM, Petersen KS, Baer DJ. Effect of varying quantities of lean beef as part of a Mediterranean-style dietary pattern on lipids and lipoproteins: A randomized crossover controlled feeding trial. Am J Clin Nutr. 2021;113(5):1126-1136. doi:10.1093/ajcn/nqaa375

By Nicole Rodriguez, RDN, NASM-CPT
Nicole Rodriguez, registered dietitian and certified personal trainer, resides in the metro New York area, where she offers nutrition counseling and fitness coaching to a diverse clientele.