What to Expect on the Mediterranean Diet

Based on the traditional cooking styles of countries surrounding the Mediterranean sea, the Mediterranean diet offers a heart-healthy approach to planning your meals. When following this diet, you can expect to eat a variety of plant-based foods along with moderate amounts of fish, dairy, and poultry.

What to Eat

There are not many off-limits foods on the Mediterranean diet. All food groups are encouraged, with a few additional stipulations. That said, even foods like red meat and added sugar are fine to include occasionally.

Compliant Foods

Vegetables

Vegetables are a nutritional powerhouse, offering up vitamins, minerals, fiber, and phytochemicals. They make up a large portion of the Mediterranean diet—but that doesn’t mean your meals won’t taste good! Think of the delicious flavors of fresh sliced heirloom tomatoes drizzled with olive oil and sprinkled with a pinch of sea salt, or that slightly caramelized sweetness of roasted broccoli.

Fruits

The Mediterranean diet discourages added sugar consumption, but welcomes the natural sugar found in your favorite fruits. Not only do these satisfy your sweet tooth, but they also offer many nutrients. Get creative! Snack on the tart seeds of a pomegranate, enjoy figs filled with a little goat cheese, or grill up some ripe peaches.

Whole Grains

Though they’ve become the villain in certain circles, whole grains can certainly fit in a healthy diet. On the Mediterranean diet, you can enjoy traditional favorites like wheat bread and whole-grain pasta—but you can also experiment with ancient grains like farro or freekeh.

Beans and Lentils

Beans are associated with several cultural eating styles (like Mexican cooking), but you might be surprised that they also fit into a Mediterranean diet. Beans and lentils are inexpensive, easy to prepare, and a good source of plant-based protein, making them an excellent pantry staple.

Oils, Herbs, and Spices

Olive oil is the backbone of Mediterranean food, offering up that wonderful fruity, pungent flavor. Rich in heart-healthy monounsaturated fats and antioxidants, this oil can be used for anything from salad dressings to dips to cooking.

Nuts and Seeds

From almonds to walnuts; pumpkin seeds to sesame seeds—nuts and seeds should make an appearance on your plate. Though some people are scared off because of the high calorie count, portion-controlled servings provide healthy fats and protein to keep you feeling full and satisfied.

Fish

Fish is an excellent addition to the diet. It's rich in protein and omega-3 fatty acids. While the specific amounts of fish intake vary among different countries in the Mediterranean, you’ll want to aim for at least two servings of fish each week.

Eggs

Eggs are an inexpensive source of protein, and incredibly easy to prepare. On the Mediterranean diet, you can enjoy a moderate amounts of eggs. Remember to add in produce too. Try scrambling up your eggs with peppers and onions for breakfast, or make an asparagus frittata for dinner.

Dairy

Though milk is not frequently consumed on a Mediterranean diet, low to moderate amounts of cheese and yogurt can be a part of your meals. These dairy products provide calcium, which is helpful for bone health.

Poultry (in Moderation)

Poultry, like chicken and turkey, is a great source of protein and often low in saturated fats. You’ll want to stick with smaller portions of poultry while putting more focus on the plant-based portions of your plate.

Red Wine (in Moderation)

A 2018 review of previous studies suggests that moderate consumption of red wine may have beneficial health effects. However, there are several groups that should not drink red wine, even if they’re following the Mediterranean diet—for example, those who struggle with alcohol addiction, those with liver problems, women who desire to become pregnant, pregnant women, and women who are breastfeeding. Check with your doctor to see if red wine is appropriate based on your medical history.

Non-Compliant Foods

Red Meat (in Excess)

Red meat consumption is traditionally quite low in Mediterranean eating patterns. If you’re a meat lover though, don’t worry. Try using unprocessed, lean meat as a small part of some meals, rather than the main focus of most meals.

Added Sugar (More Than Occasionally)

Eating less added sugar is a smart move for all of us. The average adult in the United States consumes 19.5 teaspoons of sugary daily or about 66 pounds of added sugars, annually. This is far more than is recommended by major health organizations. The recommended intake should be equal to or less than 6 teaspoons for women and equal to or less than 9 teaspoons for men.

When you’re following the Mediterranean diet, it’s OK to enjoy sweet treats occasionally (think birthdays, holidays, or other celebrations), but do your best to steer clear of daily indulgences.

Refined Grains (More Than Occasionally)

Refined grains are stripped of their fiber-rich outer layer, making them less healthy than their whole grain counterparts. Stick with whole grains on this diet.

Other Refined Oils

Olive oil is an essential element of the Mediterranean diet. Since it's thought that the diet's benefits stem from the total combination of key foods and lifestyle, you'll want to avoid changing this to another oil as much as possible.

Recommended Timing

There’s no “official” timing for meals on the Mediterranean diet, though most cultures have a similar three meal structure to that which you've experienced in the United States. If you decide to start embracing this meal plan, you'll probably eat three meals a day and snack in-between if you are hungry.

Interestingly, there are differences in the sizes and traditions surrounding these meals when you examine traditional Mediterranean cultures.

"Mediterranean breakfasts tend to be on the smaller side," says Kelly Toups, MLA, RD, LDN, Director of Nutrition for Oldways. "However, lunch was traditionally an important meal that people returned home for and leisurely enjoyed with their families, rather than quickly eating in a cubicle by themselves."

Toups says lunch is often followed by a mid-day nap, or siesta, which researchers think may be linked with lower blood pressure.

"Dinner was not quite as big as lunch, and in places like Italy, is often followed by an evening walk, or passeggiata," she says. "Coming from the U.S., with such a rigid bedtime schedule and nighttime routine, is quite a sight to see entire villages, children included, strolling around the main plazas at 9:00pm or later."

Resources and Tips

Following the Mediterranean diet is not necessarily difficult, but does take a little planning. Here are a few tips:

Use High-Quality Olive Oil

This should be your primary source of oil for food preparation and most cooking. Sometimes people express concern about cooking with olive oil because they’ve been told the smoke point is low. The smoke point of olive oil varies based on the type (i.e. extra virgin, refined, etc.) but most should hold up just fine for stovetop cooking over medium heat, or oven cooking around 400 degrees.

Experiment With Seafood

If you've never been a big seafood fan, it's time to give it another try. Toups recommends trying a variety of dishes to see which are most appealing.

"Grilled shrimp and grilled octopus have a pleasant, meaty texture, while salmon can be buttery and almost steak-like in its richness." she says. "Pan fried sardine or salmon patties are also a delicious choice, with hardly a hint of 'fishiness.'"

Pile on the Produce

If there's one common element to most nutritious meal plans, it's the emphasis on vegetables and fruits. If the entire diet seems overwhelming, a good first step is simply to focus on filling your plate with produce.

Use Visual Reminders

Print out the Oldways Mediterranean diet pyramid to hang on your fridge. When it’s time to plan your meals or grab a snack, glance at it for an easy reminder of which foods to choose.

Modifications

Because a Mediterranean diet doesn’t cut any major food groups and encourages variety in meals, it’s a diet that just about anyone can follow safely. 

If you have certain food allergies or dietary restrictions, you can make small adjustments to safely follow this diet:

• Dairy-free: You can still follow the Mediterranean diet if you have a dairy allergy or intolerance. Since milk is not widely consumed, you’ll just skip the cheese and yogurt. You can choose to include dairy-free substitutions for these, like plain coconut milk yogurt, if desired.
• Gluten-free: Whole grains are integral to the Mediterranean diet, but they don’t have to be gluten-containing grains. Swap wheat products for other gluten-free whole grains like brown rice, quinoa, buckwheat, or amaranth.

Similarly, if you have one of the medical conditions below, you may need to make a few small modifications when following this plan:

• Pregnant: If you’re pregnant, you’ll want to skip over the red wine on a Mediterranean diet. No amount of alcohol is currently considered safe during pregnancy.
• Alcohol addiction: This is another scenario where you’ll want to skip the alcohol intake, but the remainder of the diet’s recommendations are safe to follow.
• Diabetes: Meals on this diet are nutritious, but some meals can be high in carbohydrates. Luckily most of these carbohydrates are high-fiber options that affect blood sugar more slowly. You’ll still want to check with your doctor or dietitian for meal planning tips to ensure steady blood sugar levels.