Despite its name, the Mediterranean "diet" is actually a longterm way of eating rather than a gimmicky quick fix promising unrealistic results. It’s based on the traditional dietary patterns of people living in countries bordering the Mediterranean Sea (think: Spain, Greece, and Italy). The Mediterranean diet has its own food pyramid, based on a foundation of fruits, vegetables, whole grains, legumes, nuts, seeds, olive oil, and a variety of herbs and spices. These foods make up the majority of the diet, supplemented with regular consumption of seafood and moderate amounts of poultry, eggs, dairy, and alcohol. Red meat, added sugars, and processed foods are rarely consumed.
Because of its many health benefits and the fact that it’s considered by many to be one of the easiest diets to follow, this style of eating has become very popular in the United States. In 2018, researchers surveyed over 20,000 Americans and found that approximately 50 percent — especially those on the West Coast and in the Northeast — try to follow a Mediterranean diet (via WebMD).
But why is the Mediterranean diet so good for you, and are there any drawbacks you should look out for? Let’s take a look.
The Mediterranean diet is a great way to get your body the nutrients it needs
Because the Mediterranean diet is actually a way of eating that’s meant to be followed over an entire lifetime rather than for a few weeks before swimsuit season, it’s important that it provide the nutrients needed for good health. Luckily, this is an area in which the Mediterranean diet excels.
A study published in the journal Nutrients in 2014 concluded that "the inclusion of foods typical of the Mediterranean diet and greater adherence to this healthy pattern was related to a better nutrient profile … with a lower prevalence of individuals showing inadequate intakes of micronutrients." That’s why the USDA’s 2015–2020 Dietary Guidelines for Americans lists the Mediterranean diet among its three recommended eating plans.
Although true nutritional deficiencies are relatively uncommon in the United States, many Americans don’t meet the recommended intake levels for a number of micronutrients, according to Oregon State University. For instance, almost 40 percent of Americans don’t get enough vitamin C, 43 percent don’t get enough vitamin A, and nearly 67 percent don’t get enough vitamin K. When it comes to minerals, over 52 percent don’t consume enough magnesium and no one is meeting the estimated average requirement for potassium.
The Mediterranean diet reduces inflammation throughout the body
Inflammation can be a double-edged sword. As Harvard Medical School explained, acute inflammation occurs immediately after an injury and produces warmth, redness, swelling, and pain. This brings white blood cells, which protect the area and begin the healing process. But if the inflammatory response becomes chronic, the body becomes confused and begins attacking healthy tissue. Chronic inflammation is believed to be at the root of many conditions, including type 2 diabetes and heart disease.
According to Eating Well, the Mediterranean diet is an anti-inflammatory one, thanks to "its emphasis on including plenty of fruits and veggies, whole grains, lean protein sources, herbs and spices, and healthy fat sources." The vitamins, minerals, and antioxidants these foods provide help strengthen the immune system and prevent chronic inflammation in the body.
A 2018 study published in the journal Nutrients examined how adherence to this style of eating affected levels of key inflammatory markers and concluded that those who were the most lax in following the Mediterranean diet had the highest levels of these inflammatory markers.
If you want to improve your heart health, eat a Mediterranean diet
U.S. News & World Report ranked the Mediterranean diet the second best heart-healthy diet (behind the Ornish diet), and there’s plenty of evidence to support this high rating. For example, one review published in Current Opinion in Lipidology concluded that adherence to a Mediterranean diet reduced the risk for cardiovascular disease and events such as heart attack by approximately 38 percent.
What about the Mediterranean diet makes it so good for our hearts? According to a 2017 study published in Critical Reviews in Food Science and Nutrition, "the protective effects of the diet appear to be most attributable to olive oil, fruits, vegetables, and legumes."
A heart-healthy diet can be especially beneficial for Americans, considering approximately 655,000 Americans die each year from heart disease, per the Centers for Disease Control and Prevention. As of this writing, it is the number one killer in the United States.
The Mediterranean diet lowers diabetes risk
According to the American Diabetes Association, 34.2 million Americans have type 2 diabetes, and 1.5 million are diagnosed with the condition each year. In addition to being the seventh leading cause of death in the United States, diabetes can lead to a number of serious health problems, including damage to the kidneys, eyes, and nerves.
Following a Mediterranean diet appears to reduce the risk for developing type 2 diabetes, based on the results of a 2011 study published in the journal Diabetes Care. Participants were assigned to either a low-fat diet control group or one of two Mediterranean diet groups (emphasizing either olive oil or nuts). At the four-year mark, the incidence of diabetes was 17.9 percent for the control group but only 10.1 percent for the olive oil group and 11 percent for the nuts group. When the two Mediterranean diet groups were combined, together they offered a 52 percent lower risk of developing diabetes than the control group.
If you currently have type 2 diabetes, a Mediterranean diet can still be worth following. One 2009 study concluded that "greater adherence to a Mediterranean-type diet is associated with lower HbA(1c) and postprandial glucose levels," which are both markers of better blood sugar control.
Following the Mediterranean diet could reduce your risk for certain cancers
According to the National Institutes of Health, 39.5 percent of individuals will be diagnosed with cancer during their lifetime. Breast cancer, lung cancer, prostate cancer, colorectal cancer, and melanoma are the most common cancers in the United States.
Those are sobering statistics, but the good news is that following a Mediterranean diet may reduce your risk for many of these cancers. A 2014 study published in the International Journal of Cancer concluded that "high adherence to a MD [Mediterranean diet] is associated with a significant reduction in the risk of overall cancer mortality (10%), colorectal cancer (14%), prostate cancer (4%) and aerodigestive cancer (56%)." The researchers, however, noted that following this style of eating appeared to have no significant impact on breast cancer.
When it comes to cancer risk, alcohol is the most controversial component of the Mediterranean diet. As a 2013 study published in the European Journal of Cancer Prevention noted, "Heavy alcohol drinking is associated with digestive, upper respiratory tract, liver and breast cancers." While the Mediterranean diet recommends only moderate amounts of alcohol, overindulging could raise your cancer risk.
The Mediterranean diet helps you manage your weight
For those looking to shed a few pounds, the Mediterranean diet may be an effective option. As part of a 2018 study published in the journal Nutrition & Diabetes, researchers followed a group of more than 32,000 individuals for an average of 12 years to determine how adherence to a Mediterranean diet impacted weight and waist circumference. They found that those who stuck to this style of eating gained less weight over time and were at lower risk of becoming overweight or obese.
But how does the Mediterranean diet stack up against other popular weight-loss diets? In a 2016 meta-analysis published in the American Journal of Medicine, researchers compared the Mediterranean diet, a low-fat diet, a low-carbohydrate diet, and the American Diabetes Association diet. They found that, past the one-year mark, the Mediterranean diet outperformed the low-fat diet and provided results on par with the other two.
This doesn’t mean the Mediterranean diet is a magic solution for weight loss. Despite the U.S. News & World Report rating the Mediterranean diet as the best overall diet, the easiest to follow, and the best for healthy eating, the diet ranked only 15th for weight loss and 27th for fast weight loss.
For a better complexion, choose the Mediterranean diet
We often turn to creams and serums to keep our skin glowing and youthful, but healthy skin is built from the inside out. As Dr. Saryna Young, a dermatologist at Westmed Medical Group, explained, "Oxidative damage to the skin shows up as wrinkling and pigmentary changes, the things that make us look older." The antioxidants in the foods we eat prevent and repair the damage caused by oxidative stress, keeping our skin firm, radiant, and wrinkle-free. Dr. Young noted that the Mediterranean diet, rich in colorful fruits and vegetables, is particularly rich in antioxidants.
For the approximately 8 million Americans with psoriasis, the Mediterranean diet may be especially helpful. According to a 2015 study published in the Journal of Translational Medicine, participants who adhered to a Mediterranean style of eating tended to have fewer and less severe psoriasis symptoms. Extra virgin olive oil and fish were the dietary components most strongly linked to these benefits.
The Mediterranean diet could help fight depression
While the Mediterranean diet is no substitute for medication or guidance from a trained professional, this style of eating may protect against depression and other mental health problems. In a 2019 meta-analysis published in Molecular Psychiatry, researchers reviewed 41 studies to determine if there was a link between diet and depression. They concluded that "adhering to a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet appears to confer some protection against depression."
Why the Mediterranean diet reduces risk for depression likely has to do with the nutrients it provides. As a study published in the journal Public Health Nutrition explained, "Folate intake was inversely associated with depression prevalence among men, especially smokers. Among women, B12 vitamin intake was inversely associated with depression, especially among smokers and physically active women." The researchers noted that the Mediterranean diet, with its heavy reliance on vegetables, fruits, whole grains, legumes, and seafood, provides these nutrients in abundance.
Stay mentally sharp as you age with the Mediterranean diet
When it comes to a long, healthy life, the brain is just as important as the rest of the body. While a small amount of mental fuzziness as we get older may be inevitable, Alzheimer’s disease is not a normal part of the aging process. According to the Alzheimer’s Association, 5 million Americans live with Alzheimer’s disease and the condition is the sixth leading cause of death in the United States. But the Mediterranean diet may be able to help. Not only can it enable people to live longer by lowering risk for chronic conditions like heart disease and diabetes, it can also help preserve our cognitive abilities as we age.
In a 2004 literature review published in the journal Public Health Nutrition, researchers found that "essential components of the Mediterranean diet — MUFA [monounsaturated fatty acids, such as those found in olive oil], cereals and wine — seem to be protective against cognitive decline."
A meta-analysis published in the Journal of Alzheimer’s Disease some 10 years later concluded that "a higher adherence to the MeDi [Mediterranean Diet] is associated with a reduced risk of developing MCI [mild cognitive decline] and AD [Alzheimer’s disease], and a reduced risk of progressing from MCI to AD."
The Mediterranean diet could improve your sex life
It’s a topic that many people may be embarrassed to talk about, but sexual dysfunction is actually very common. According to the Cleveland Clinic, 43 percent of women and 31 percent of men experience some form of difficulty with sex. Sexual dysfunction can take many forms, including pain during sex and problems feeling desire, becoming physically aroused, or achieving orgasm. Fortunately, the Mediterranean diet appears to be helpful for at least some of these issues.
HuffPost reported on a Greek study of over 600 men with an average age of 67. It was concluded that those who replaced butter with olive oil while following the Mediterranean diet saw significant improvements in their sex lives. Olive oil helps keep blood vessels dilated and free of arterial plaques. This improves blood flow, which is critical for maintaining an erection. Olive oil also raises testosterone levels. A 2010 study published in The Journal of Sexual Medicine found that women who adhered the most to a Mediterranean diet also had significantly lower incidence of female sexual dysfunction (FSD).
Can following a Mediterranean diet lead to brittle bones?
The 2015-2020 Dietary Guidelines for Americans noted that the Mediterranean diet is lower than the "healthy U.S.-style eating pattern" in both calcium and vitamin D as a result of lower dairy consumption. Calcium and vitamin D are essential to building strong bones, so you might expect people following the Mediterranean diet to have lower bone density and be at greater risk for fracture. The research, however, is mixed.
One 2017 study found that Spanish children between the ages of six and nine who ate a Mediterranean diet were at increased risk of inadequate calcium intake. Even those who consumed dairy products in the form of yogurt and cheese did not meet the recommended calcium levels for their age group. However, a study published in the journal Nutrients in 2019 noted that adult Spanish women who followed a Mediterranean diet actually had higher bone mass compared to others. In another study published in the same journal later that year, researchers concluded that middle-aged women who adhered more closely to a Mediterranean diet were less likely to break a bone than those who followed the diet only loosely or not at all.
Eating a Mediterranean diet could lead to low iron
Iron deficiency is the most common nutritional deficiency worldwide. According to WebMD, 20 percent of women, 50 percent of pregnant women, and 3 percent of men have insufficient iron stores. Iron deficiency can lead to anemia, with symptoms like extreme fatigue, weakness, shortness of breath, and heart problems.
Iron comes in two forms known as heme and non-heme. Heme iron is found in meat, particularly red meat, and is very easy for your body to use and store. Non-heme iron comes from plant foods such as legumes and green leafy vegetables and is much harder for your body to absorb. Because the Mediterranean diet calls for eating very little red meat and moderate amounts of poultry and seafood, those following this way of eating will be getting most of their iron in non-heme form.
As the authors of The Mediterranean Diet: An Evidence-Based Approach noted, "The Mediterranean diet might be considered a low-iron available diet … . Over time, this dietary pattern leads to reduced iron stores." Many of the foods central to this diet, including nuts, legumes, and vegetables, contain polyphenols and phytates — substances that may make the non-heme iron they contain even harder to absorb.
You’ll need to weigh the pros and cons of drinking alcohol on the Mediterranean diet
The Mediterranean diet allows for moderate amounts of alcohol — one drink per day for women and two for men. The consensus is that low-to-moderate alcohol consumption can help protect your heart, reduce the risk of dementia, and relieve stress, but its effects on cancer risk — especially breast cancer — are less clear.
Alcohol consumed as part of the Mediterranean diet may lower breast cancer risk, but alcohol consumed as part of a typical Western diet seems to increase that risk. This may be because the nutrients in the Mediterranean diet counteract alcohol’s cancer-promoting effects. Or it may be the fact that those on the Mediterranean diet tend to drink red wine over other options, drink with meals, and avoid binging.
But even a small amount of alcohol can wreak havoc on your liver. According to the University of Pittsburgh Medical Center, drinking alcohol can lead to alcoholic hepatitis (liver inflammation) and cirrhosis (permanent damage to liver cells). Women appear to be more susceptible than men to alcohol-induced liver damage. And, because everyone’s sensitivity to alcohol is different, there’s no "one size fits all" recommendation when it comes to how much alcohol is safe to drink.
The Mediterranean diet could be hard to follow if you have a lot of food allergies or sensitivities
Any way of eating can be tricky to stick to if you have negative reactions to certain foods, but the Mediterranean diet can be particularly difficult because it prioritizes many of the most prevalent food allergens. According to the Food and Drug Administration, the eight most common food allergies are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans.
Although the Mediterranean diet’s food pyramid doesn’t include soy, and milk products and eggs are only eaten in moderate amounts, it recommends eating seafood and fish often. Nuts, legumes (including peanuts), and whole grains (including wheat) are part of the foundation of the pyramid and are consumed multiple times daily. If you’re one of the 10.8 percent of American adults with at least one food allergy — and especially if you’re allergic to multiple foods — your version of the pyramid may end up structurally unsound.
The Mediterranean diet is also a high-FODMAP diet. FODMAPs are a group of carbohydrates found in certain grains, vegetables, fruits, legumes, and dairy that some people have difficulty digesting. While not the same as a true food allergy, FODMAP sensitivity can cause bloating, gas, and diarrhea.