How to get the health benefits of a Mediterranean diet

The health benefits of the Med diet are well documented. So how do you follow it at home?  Healthy Food Guide nutrition experts break it down.

The Med diet is one of the healthiest in the world – but no, it isn’t all about slugging down copious amounts of red wine with creamy cheese sauces on your pasta… Instead, the emphasis is on eating vegetables, pulses, fish, fruit, unsaturated fats, nuts and fibre-rich grains.

This way of eating is based on the dietary staples of people living in the countries bordering the Mediterranean Sea, including France, Spain, Italy and Greece. Although the exact ingredients vary between regions, the basic principles are the same in each country.

According to the British Nutrition Foundation, the Med diet includes a higher consumption of vegetables, fruit, whole grains, low-fat dairy foods, seafood, nuts, seeds and legumes. It also means switching to unsaturated fats and having lower intakes of fatty/ processed meat, refined grains, sugar-sweetened foods and beverages, as well as a lower salt, lower saturated fat intake than the typical Western diet.

“Experts agree that there isn’t any one ‘magic’ ingredient to the Med diet, but rather the synergy of all the ingredients working together to have a protective effect on health – including a lower risk of heart disease,” Healthy Food Guide nutrition editor Amanda Ursell says.

“You won’t get these effects from just drinking red wine and adding garlic to your dinner. It’s about eating a largely plant-based diet, as outlined above, but also copying the Med lifestyle, such as spending more time cooking from scratch and eating/socialising together around the table, as well as getting the right balance between activity and rest.”

What to eat on the Mediterranean diet

The Mediterranean Diet Foundation (an international organisation based in Greece) advises following the Med diet pyramid, an eating plan supported by the Federation of European Nutrition Societies and the Forum on Mediterranean Food Cultures. This places foods of plant-based origin at the base of the pyramid, which, it advises, should be consumed in greater proportion and frequency than foods at the central and upper levels. The red meat and sugary foods at the top of the pyramid should be eaten least frequently of all.

The Foundation recommends including the following ingredients…

Every day

Cereals

One or two servings per meal (such as bread, rice, pasta and couscous). Preferably whole grain, as they contain valuable minerals such as magnesium or phosphorus and fibre that can be lost during processing.

Vegetables

Eat two or more servings at lunch and dinner – at least one serving should be raw. Choose a variety of colours and textures to provide a diversity of antioxidants and protective compounds.

Fruits

Include one or two servings per meal to replace desserts or snacks.

Water

Make sure you have a daily intake of 1.5–2 litres.

Dairy products

Needed for bone health, but choose low-fat versions.

Olive oils

They should be the main source of dietary fat for cooking and dressings (but stick to 1tbsp per person per meal as even healthy oil is high in calories).

Spices, herbs, garlic and onions

Use to add flavour to your food, which will help you cut down on salt.

Olives, nuts and seeds

Good sources of healthy fats, proteins, vitamins, minerals and fibre – a small handful makes a healthy snack.

Wine

While wine is part of the Med diet when drunk with meals, it’s recommended to stick to healthy guidelines – that is, no more than 14 units a week, with at least two days alcohol-free.

Weekly

A variety of plant and animal protein should be eaten – but remember most Mediterranean dishes don’t have meat protein as the main ingredient.

Fish and shellfish

Two or more servings a week.

Eggs

Two to four servings a week will provide a good source of protein.

Red meat

Less than two servings per week, preferably lean cuts. Processed meats (eg ham and bacon) less than once a week.

Plant-based proteins

A combination of legumes (more than two servings per week) and cereals to provide fibre.

Foods to limit

Less healthy treat foods, such as sugar, pastries, sweets and chocolates and sweetened fruit juices and soft drinks can be consumed only in small amounts.

Lifestyle pointers

Other elements of the Med diet include keeping portion sizes moderate, spending time preparing food and cooking, eating seasonal foods where possible and avoiding over-processed foods. It’s also about socialising around a table while eating and taking at least 30 minutes a day of moderate activity.

What the latest studies say about the Mediterranean diet

This is probably the most studied diet in the world – and the numerous health benefits are backed by the finding of dozens of trials. Here are just a few…

Good for your heart

There are masses of studies on cardiovascular health and the Med diet. One review by the Population Health Research Institute, Hamilton, Canada, concluded it was the most likely dietary model to provide protection against coronary heart disease. A study published in the New England Journal of Medicine, in 2013, found that following a Med diet – and adding nuts or olive oil – could cut the risk of having a heart attack or stroke by 30 per cent in people at high risk of cardiovascular disease, compared with a control group.

The authors of the study said a causal role of the Mediterranean diet in cardiovascular prevention has ‘high biologic plausibility’.

“The results of our trial might explain, in part, the lower cardiovascular mortality in Mediterranean countries than in northern European countries or the United States,” said the authors.

“In conclusion, we observed that following a Mediterranean diet, supplemented with extra-virgin olive oil or nuts, resulted in a substantial reduction in the risk of major cardiovascular events among high-risk patients. The results support the benefits of the Mediterranean diet for the primary prevention of cardiovascular disease.”

Possible link to dementia prevention

The Alzheimer’s Society charity says that the traditional Mediterranean diet is associated with lower levels of stroke, type 2 diabetes and cardiovascular disease and that sticking to it strictly might be associated with slower rates of decline in memory and thinking.

In addition, high levels of antioxidants from the high intake of fruit and vegetables may help to protect against the damage to brain cells associated with Alzheimer’s.

Help in preventing type 2 diabetes

The charity Diabetes UK has recently recommended the Mediterranean diet as one of five diets helpful for losing weight and preventing type 2 diabetes.

If you’re overweight, losing 5–7 per cent of your body weight can reduce your chances of developing type 2 diabetes by 50 per cent.

“There’s not one specific element of the Med diet that helps with weight loss – it’s the combination of foods working together,” explains Melanie Hargraves, registered dietitian and spokeswoman for the British Nutrition Foundation.

“It’s often about what you’re not eating as well – if you’re filling up with fruit, vegetables and fibre-rich foods, you won’t have room for high-fat, high-sugar, processed foods.”

A Med-style diet, rich in fibre and vegetables can also help people with type 2 diabetes control their blood glucose levels.

Helping to fight against cancer

While the Mediterranean diet per se hasn’t been proved to prevent cancer, many of its elements are thought to be protective.

The World Cancer Research Fund (WCRF) says that basing your diet on plant-based foods is the first step to reducing your cancer risk. It will help you maintain a healthy weight, which can reduce your risk of developing 11 cancers.

Eating plenty of whole grains and a diet rich in fibre is known to reduce your risk of developing bowel cancer.

The phytochemicals in fruit and veg protect cells in the body that lead to cancer and probably reduce your risk of developing mouth, throat and lung cancer.

Furthermore, a 2017 study by the WCRF found that following a Med diet cut the risk of developing oestrogen receptor negative breast cancer – one of the deadliest forms of breast cancer – by 40 per cent

5 easy ways to make your diet more Mediterranean

Eating a Med diet doesn’t have to be about learning how to cook Spanish tapas or elaborate French dishes. Here are some tips from the British Heart Foundation for adding a touch of the Med to your daily diet.

1. Eat more fruit and salad

Serve fruit at every meal and use it to replace desserts and unhealthy snacks such as biscuits, crisps and chocolate.

2. Have meat-free days

Get your protein instead from fish, beans and pulses.

3. Swap saturated fats for unsaturated oil

Cook with olive oils instead of butter, lard and ghee.

4. Adapt your recipes with healthier ingredients

You can still cook spicy dishes such as curries – just ditch the creamy sauces for tomato/lentil-based recipes and use olive oil to cook instead of ghee.

5. Drink moderately

Don’t go overboard on drinking red wine – one small glass a day with a meal can be fine as part of a healthy Mediterranean diet. A five-glass binge isn’t.