There has been a lot of talk recently about whether fat or sugar is the worst offender when it comes to our diets. However, by focusing on individual dietary components, it’s easy to miss the bigger picture. While it’s important to understand how different foods and nutrients affect our health, a whole diet approach offers a much more helpful way of looking at our eating habits and choices.

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With this thought in mind, few whole diet approaches have won as much acclaim as the Mediterranean diet (MedDiet). Victoria Taylor, senior dietitian at the British Heart Foundation, and registered nutritionist Kerry Torrens review the evidence.

What is a Mediterranean diet?

The MedDiet encourages an eating pattern that includes food staples from the countries that live around the Mediterranean, such as Spain, Greece, Italy and France. The diet is primarily a plant-based one with the contributions from animal-based products being largely comprised of fish and poultry with a limited quantity of dairy products. The diet also includes plenty of seasonal fruit and vegetables as well as beans, legumes, wholegrains and low to moderate alcohol consumption, typically red wine.

It’s thought to be the combination of all these elements that seem to bring health benefits, but one of the key aspects is the inclusion of healthy fats. Olive oil, which is a predominantly monounsaturated fat, is most commonly associated with the MedDiet, but polyunsaturated fats are also present in the form of unsalted nuts, seeds and oily fish. While the modern version of the diet utilises a higher proportion of red meat and introduces some processed foods, the diet's primary focus remains the same – plant-based with the addition of healthy fats.

Visit our ‘All you need to know about diets’ page for recipes and more expert advice on weight loss, including low-GI and the Mediterranean diet’

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How does the Mediterranean diet work?

As research into the benefits of this type of diet is ongoing, there may eventually be certain foods that are found to have greater significance for health. For now, however, it seems it is the overall diet approach and the combination of foods, rather than individual ‘superfoods’ that make this such a healthy way to eat. This makes sense, as it’s true that if you are eating an unhealthy diet full of processed foods, adding one element such as olive oil is unlikely to have noticeable health benefits if that’s the only change you make.

However, if you adjust your whole diet so you eat a little less meat and more fish, opt for healthy fats and eat more fruit and vegetables, then it could make a significant difference. Another important aspect of this diet is the sense of community, with meals taking centre stage around conversation with family and friends.

How to follow a Mediterranean diet

Although here in the UK we are some way from the warm Mediterranean climes, it’s still possible to adopt this style of eating without making massive changes. Rather than being a strict ‘diet’, the MedDiet is more a set of guiding principles that influence how you select, prepare and eat food. Typically, fast and processed foods are eliminated and replaced with whole foods including fruit, vegetables, lean proteins and wholegrains, and meals are social events, being shared with friends and family.

Two whole sea bream cooked in a pan with tomatoes

What foods to eat on a Mediterranean diet

There are no strict ‘rules,’ but foods commonly found in a Mediterranean-style diet include:

  • Olive oil, especially extra virgin oil
  • Unsalted nuts and seeds including walnuts, almonds and pine nuts
  • Oily varieties of fish such as sardines and mackerel
  • Seafood such as prawns, squid and mussels
  • Poultry
  • Chickpeas, lentils, peas and beans
  • Wholegrain wheat, rice, oats and pasta
  • Fruit including avocado, tomatoes, pomegranate and berries
  • Greek yogurt
  • Eggs
  • Green leafy vegetables as well as courgettes
  • Starchy vegetables like sweet potatoes and sweetcorn
  • Herbs such as basil, oregano, dill and rosemary

What foods to eat less of on a Mediterranean diet

  • Butter, margarine and lard
  • Biscuits, cakes and pastries
  • Confectionery
  • White refined versions of bread, pasta and rice
  • Processed meats such as sausages, burgers and bacon
  • Red meats
  • High-fat cheese, cream and milk

Can the Mediterranean diet be vegetarian?

While the MedDiet is not exclusively plant-based, it is possible to follow a balanced vegetarian version. Many of the health benefits associated with this way of eating are thanks to the diet’s emphasis on whole, fresh and seasonal foods including fruit, vegetables, wholegrains, legumes, nuts and seeds.

What drinks can I include on a Mediterranean diet

Sugary fizzy drinks, concentrated juices and cordials should be replaced with water, herbal teas and the occasional glass of red wine.

What’s the evidence for the Mediterranean diet?

Research into the traditional MedDiet has shown it may reduce our risk of developing conditions like type 2 diabetes, high blood pressure and high cholesterol, which are all risk factors for heart disease. It has also been found that people who closely follow a Mediterranean diet may live a longer life and be less likely to put on weight. While further research is still needed, early studies suggest that adherence to a Mediterranean style diet could be associated with a lower risk of dementia. With an abundance of brain healthy foods like olive oil, fresh fruits and vegetables, fish, nuts and legumes central to this way of eating, it's unsurprising to see this link come into play.

Does the Mediterranean diet work for weight loss?

The MedDiet has not been designed for weight loss, however, the evidence for weight reduction and weight management over time is impressive. Four meta-analyses of randomised controlled trials have shown a greater reduction of body weight and BMI with the MedDiet compared to other diets, while a meta-analysis of 7 prospective cohort studies found a reduced risk of becoming obese and gaining weight over time associated with a higher adherence to MedDiet.

Is the Mediterranean diet healthy? Our nutritionist’s view…

Evidence supports the use of the MedDiet as a healthy eating pattern for the prevention of heart disease, increasing lifespan and supporting healthy ageing. It also appears to reduce the risk of obesity and helps maintain a healthy weight. The MedDiet offers a balanced, non-restrictive eating plan that is, as it happens, the typical diet in two of the five so-called ‘blue zones’ - locations renowned for healthy ageing and lower rates of disease.

In conclusion, the food principles of the MedDiet offer an effective, balanced and healthy approach to eating, whilst the social aspect of the diet acknowledges the value of social connection and bonding.

Like this? Now read…

Spotlight on… heart disease
The British Heart Foundation
Vegetarian Mediterranean recipes
Healthy Mediterranean recipes

Do you have a taste for the Med? If you’ve adopted a whole-diet approach and have found it has worked for you, leave a comment below…


All health content on bbcgoodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you have any concerns about your general health, you should contact your local health care provider. See our website terms and conditions for more information.

Victoria Taylor is senior dietitian at the British Heart Foundation.

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Kerry Torrens BSc. (Hons) PgCert MBANT is a registered nutritionist with a post graduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including BBC Good Food.

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