Eating style
Mediterranean diet
Vegetables, beans, whole grains, fish and olive oil as the everyday base. What the pattern is, what the trials found, and the recipes here cooked in that style.
What it is
The Mediterranean diet is a pattern rather than a set of rules. Most of the plate is plants: vegetables, fruit, beans and lentils, whole grains, nuts, herbs and olive oil as the main added fat. Fish and seafood appear at least twice a week, with smaller amounts of poultry, eggs, cheese and yoghurt. Red meat is kept to a few times a month.
There are no calorie or macro targets. In the largest trial, fat supplied around 40% of calories, much of it from olive oil or nuts, so this is not a low-fat way of eating. Wine with meals is traditional in the region, but descriptions of the diet treat it as optional.
What the research shows
The key trial, PREDIMED, followed 7,447 adults in Spain aged 55 to 80 who were at high cardiovascular risk. After a median of 4.8 years, heart attack, stroke or cardiovascular death had occurred in 3.4–3.8% of those assigned to a Mediterranean diet with added extra-virgin olive oil or nuts, against 4.4% of those advised to cut fat: roughly a 30% lower rate. The results were republished in 2018 after randomisation problems at some sites.
A 2019 Cochrane review of 30 trials was more cautious. It found low to moderate quality evidence of modest improvements in cardiovascular risk factors in people without heart disease, and concluded that some uncertainty remains about the effect on heart attacks and strokes. Much of the wider evidence is observational.
Cooking this way
Start with the swaps that change the most meals: olive oil for butter, beans or lentils in place of some of the meat, wholegrain bread and pasta, fruit and nuts as snacks, and fish twice a week. The benefit appears to come from the whole pattern, so adding olive oil to an otherwise unchanged diet is unlikely to do much.
Worth knowing
- Olive oil and nuts are high in calories and the pattern sets no portion sizes, so it is possible to gain weight on it. The numbers on each recipe still count.
- If you have heart disease, diabetes or another condition, or take medication, talk to your clinician before changing how you eat. A way of eating is not a replacement for treatment.
Common questions
Do I need to drink wine?
No. Wine with meals is traditional in the region, but it is optional. You can follow the pattern without alcohol.
Is the Mediterranean diet good for weight loss?
Only if it leaves you in a calorie deficit. It is not low in calories by design, so portions of oil, nuts, bread and pasta still need watching.
Sources
General information, not medical or dietary advice. Speak to a doctor or registered dietitian about your own situation.
