The diet industry is riddled with fads — from gluten-free to intermittent fasting to juice cleanses. But one popular healthy eating plan has been above the trends for decades, eschewing extremes for a moderate, doable approach: the Mediterranean diet.
Last month, US News and World Report named the diet one of the easiest to follow, and the second-best diet overall. It’s no wonder. Over the past several years, research has attributed a variety of heart-healthy, brain-boosting benefits to the eating plan. And three of the seven buzzy “Blue Zones” — communities around the world where residents live particularly long and healthy lives — are in the Mediterranean region.
The version of the diet familiar to most Americans first appeared as a set of guidelines presented by the World Health Organization, Harvard School of Public Health and nutrition nonprofit Oldways in 1993. It was based on the diets of Greece — particularly its largest island, Crete — and Southern Italy in the early 1960s, because of the populations’ high life expectancy and low rates of heart disease and certain cancers at the time.
The diet has since morphed to fit different needs — there’s a Mediterranean diet for diabetes and another to fight cancer, for example, and many clinics have their own versions — as well as Americans’ diversifying palates.
“There is not one Mediterranean diet,” says Dr. Donald Hensrud, director of the Mayo Clinic Healthy Living Program. “There are almost 20 countries that border the Mediterranean and each one has a [slightly] different version of the specific foods they serve — but there are features they all have in common.”
Those common factors include a core diet of vegetables, fruits, legumes, whole grains and nuts, as well as olive oil as a replacement for all other fat sources. Followers consume animal protein — with an emphasis on fish and, to a lesser extent, poultry — as well as red wine in moderation with meals, and dairy products such as low-fat yogurt and low-fat cheese. Fresh herbs and spices replace salt, and sweets and red meat are limited to a few times per month.
There have never been strict rules when it comes to how much of each healthy food to eat, though some versions of the diet offer more structure. The current iteration of the diet followed by many dietitians suggests seven to 10 servings of fruits and vegetables each day, and fish once or twice per week, but both amounts are adjustable based on lifestyle and taste.
Many experts approve of the diet in part because of its flexibility.
“The Mediterranean diet is easy to continue when you’re eating out,” says Lisa Dierks, a wellness dietitian at the Mayo Clinic Healthy Living Program. This is particularly true in New York, where Mediterranean restaurants abound. And it’s a breeze to switch it up when your go-to meals get old. Tired of Greek food? Try Tunisian cuisine, or Turkish — both of which feature vegetable- and olive-oil-rich foods. “The region provides a lot of diversity,” says Dierks.
And then there are the diet’s visible results. Several studies have shown that a Mediterranean diet can lead to weight loss. Research published in the journal the Lancet last June found that participants who ate Mediterranean diets with high levels of olive oil and nuts lost more weight than those on a low-fat control diet.
Another study, published in the British Journal of Nutrition in 2012, suggests that the diet can lower the risk of heart disease by decreasing LDL, the so-called “bad” cholesterol. Other research has suggested a link between the Mediterranean diet and a lower risk of certain types of cancer, likely due to the high levels of antioxidants in the plant-packed diet. Olive oil, for example, contains high levels of phenols, an antioxidant that’s been shown to fight inflammation.
Additionally, a study published in the journal Neurology in January found that those who consumed a Mediterranean-style diet lost less brain volume (which can affect memory) as they aged than those who ate a standard modern diet. The results have reinforced the belief that the diet is linked to a reduced risk of Alzheimer’s and other brain diseases.
But while the upsides seem to be clear, the diet is not without its challenges — including eating enough fruits, veggies and whole grains every day to satisfy the guidelines.
“If you look at the US dietary guidelines, the typical recommendation is about five to seven servings of fruits and vegetables per day,” says Dierks. “It’s a very small percentage of Americans who are able to eat that . . . amping [it] up is a stretch for some people.”
And those hoping to lose weight may need more structure, such as calorie counting. “For our patients who are doing weight management, we always recommend tracking” says Dierks. “Some track calories, others track fruits and vegetables.”
Other aspects of the diet, such as switching from butter and other fat sources to olive oil, are easier, says Dierks. While there’s no ruling on how much olive oil to consume on the diet, suggestions range from 1 to 4 tablespoons per day.
There are so many fad diets out there, and this is really on solid ground.
- Certified nutritionist Conner Middelmann-Whitney
Still, author of “Zest for Life” and certified nutritionist Conner Middelmann-Whitney says she recommends the diet wholeheartedly. “More than 3,000 research articles have been published about it, and to my knowledge none have found that it has any adverse effects,” she says. “There are so many fad diets out there, and this is really on solid ground.”
Middelmann-Whitney, who practices at a doctors’ office in Denver, says her patients love that the diet is based on whole, tasty foods. And the pleasure that comes from eating them means that results stick.
“The weight loss isn’t as dramatic as on a fad diet — it’s usually slower,” says Middelmann-Whitney. “But people realize that it’s permanent.”
Through Thursday, The Post is a publishing a special series on the Mediterranean Diet. On Wednesday, look out for mouth-watering recipes and tips from one of the country’s top Greek chefs, while Thursday will highlight dining-out strategies on the diet.