Pros and Cons of the Mediterranean Diet

Salmon meal

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If you’re looking for a diet that’s backed by science, the Mediterranean diet is clearly a winner. This eating pattern, embraced by countries surrounding the Mediterranean Sea, has been linked to a lower risk of heart disease, cancer, diabetes, and other chronic diseases. Not only is it nutritious, but it emphasizes flavorful meals over restriction.

Of course, there are bound to be a few challenges on any new eating plan. For example, some worry about the cost of following a meal plan packed with produce and seafood, and others may struggle with the limits on red meat and added sugar.

Pros

  • Balanced diet

  • Promotes heart health

  • Better blood sugar control

  • Mental health benefits

  • Weight management

  • Reduced inflammatory markers

  • Cancer prevention

Cons

  • Some foods are costly

  • Additional guidance may be necessary for certain conditions

  • Some dietary restrictions may be challenging

  • Concerns with alcohol intake

Pros

General Nutrition

The Mediterranean diet does not eliminate any food groups and encourages a variety of nutrient-dense foods, making it easy to meet your nutritional needs.

Heart Health

Scientists have conducted a robust amount of research on the Mediteranean diet and heart health, both in observational studies as well as controlled trials. A review study in the European Journal of Clinical Nutrition concluded that following a Mediterranean diet is associated with reduced risk of coronary heart disease, heart attack, and overall mortality.

Better Blood Sugar Control

A systematic review found that the Mediterranean diet, as compared with control diets, was able to lower Hemoglobin A1C levels by up to 0.47 percent. Hemoglobin A1C reflects your body's blood sugar control over the last three months. Though it sounds small, any reduction may be helpful for people with diabetes who are trying to manage blood sugar levels.

Mental Health

One surprising benefit may be a connection between the Mediterranean diet and better mental health, according to Kelly Toups, MLA, RD, LDN, Director of Nutrition for Oldways.

"A 2018 study in Molecular Psychiatry found that those most closely following a Mediterranean diet were 33% less likely to develop incident depression than those not following a Mediterranean diet," she says.

In addition, consider the emphasis on social connections in the Mediterranean lifestyle. This is paramount for mental health, particularly among older adults. Maintaining friendships and regular social interaction can reduce loneliness, which is known to be positive for overall health.

Weight Management

It seems counterintuitive that a diet which emphasizes calorically-dense olive oil and nuts could help with weight management. However, these satiating fats–in conjunction with the many fiber-rich vegetables and fruits recommended—can help you feel full longer.

Indeed, research has found that people do not gain weight when following a Mediterranean diet. In fact, some studies have suggested the Mediterranean diet and low-carbohydrate diets lead to similar rates of weight loss after one year.

Reduces Inflammatory Markers

Inflammation is a hot topic these days, as doctors and researchers establish connections between certain inflammatory markers and chronic disease. For example, higher levels of two inflammatory markers (interleukin 6 and C reactive protein) are thought to be associated with increased risk of diabetes. Research shows the Mediterranean diet is associated with lower levels of these inflammatory markers.

Cancer Prevention

Most cases of cancer are not caused by a singular factor, but rather a combination of many genetic and environmental factors. Diet can play a role in this complex disease, and certain dietary patterns—including the Mediterranean diet—are associated with a reduced risk of cancer.

For example, a meta-analysis found that those who adhered most closely to the Mediterranean diet had a lower risk of developing colorectal cancer, breast cancer, gastric cancer, liver cancer, head and neck cancer, and prostate cancer.

Cons

There are very few cons to the Mediterranean diet, as it’s quite balanced and well-researched. However, there may be a few challenges to overcome.

Cost

Though there are not pricey branded foods or special supplements, some consumers do worry about the cost of including fish regularly. Seafood tends to be more expensive than other proteins. However, there are several ways to shop on a budget—even for seafood.

Cost-Saving Tip

To keep costs down, Toups recommends shopping sales at the grocery store. For example, many recipes that call for a specific variety of fish like cod or seabass can often be made with a local catch that may be a bit cheaper or on sale. Don’t discount frozen seafood either. It is often less expensive than fresh, and when thawed, cooks up beautifully. Lastly, canned fish is another cost-effective option.

Additional Guidance May Be Necessary for Diabetes

Even though studies suggest that a Mediterranean diet may reduce diabetes risk and better control blood sugar—some people with diabetes may need additional guidance on this diet.

Because there is an emphasis on grains, fruits, and vegetables (including starchy vegetables), meals may be high in carbohydrates. It’s important for people with diabetes to eat a consistent, controlled amount of carbohydrates throughout the day to avoid blood sugar spikes.

This does not mean people with diabetes shouldn’t eat this diet; on the contrary it can be a great choice. If you have diabetes, though, try working with a dietitian to help you plan the right carbohydrate counts for your meals within the greater framework of the Mediterranean diet.

Restrictions May Feel Challenging

This diet recommends reducing red meat and added sugar consumption, which can prove difficult for some people. While the American Heart Association gives an added sugar “allowance” to stay below each day, the Mediterranean diet recommends saving added sugar specifically for special occasions.

Keep in mind any added sugar reduction is beneficial, so don’t let this scare you off. Following a Mediterranean style diet that contains a little added sugar is still more beneficial than following a Western style diet that’s high in added sugar.

Similarly, if you’re struggling with eating red meat less often, try following this diet while incorporating red meat, but in smaller portions. Research suggests you'll still reap heart-health benefits.

Concerns About Alcohol Intake

Some experts raise concerns about the regular alcohol intake (particularly wine) in the Mediterranean diet, and whether this is truly beneficial to recommend.

The experts at Oldways give insight into this:

"When alcohol is consumed as part of a balanced meal, and coupled with daily movement and social connections, studies find a net health benefit," says Toups. "The Mediterranean diet and other traditional diets present examples of how to safely enjoy alcohol in moderation (up to one 5-ounce glass of wine per day for women, or up to two 5-ounce glasses daily for men), in a way that may support cardiometabolic health and help to foster positive social connections."

But what about when alcohol is consumed in other scenarios?

"When alcohol intake is accompanied by unhealthy habits, like smoking or poor diet, or unsafe habits, like driving, obvious health risks present themselves," she says.

The bottom line: If you and your doctor conclude it's safe to drink alcohol—in combination with your healthy diet and regular physical activity—this may support heart health. However, you don't have to start drinking to see benefits from this diet, and importantly, don't start drinking if you have a family history of alcohol addiction or are currently pregnant.

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