The focus of the Mediterranean diet isn't on limiting total fat consumption, but rather to make wise choices about the types of fat you eat. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease.
The Mediterranean diet features olive oil as the primary source of fat. Olive oil provides monounsaturated fat — a type of fat that can help reduce LDL cholesterol levels when used in place of saturated or trans fats.
"Extra-virgin" and "virgin" olive oils — the least processed forms — also contain the highest levels of the protective plant compounds that provide antioxidant effects.
Monounsaturated fats and polyunsaturated fats, such as canola oil and some nuts, contain the beneficial linolenic acid (a type of omega-3 fatty acid). Omega-3 fatty acids lower triglycerides, decrease blood clotting, are associated with decreased sudden heart attack, improve the health of your blood vessels, and help moderate blood pressure.
Fatty fish — such as mackerel, lake trout, herring, sardines, albacore tuna and salmon — are rich sources of omega-3 fatty acids. Fish is eaten on a regular basis in the Mediterranean diet.
The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking.
However, alcohol — in moderation — has been associated with a reduced risk of heart disease in some research studies.
The Mediterranean diet typically includes a moderate amount of wine. This means no more than 5 ounces (148 milliliters) of wine daily for women (or men over age 65), and no more than 10 ounces (296 milliliters) of wine daily for men under age 65.
If you're unable to limit your alcohol intake to the amounts defined above, if you have a personal or family history of alcohol abuse, or if you have heart or liver disease, refrain from drinking wine or any other alcohol.
Putting it all together
The Mediterranean diet is a delicious and healthy way to eat. Many people who switch to this style of eating say they'll never eat any other way. Here are some specific steps to get you started:
June 14, 2013
- Eat your veggies and fruits — and switch to whole grains. An abundance and variety of plant foods should make up the majority of your meals. Strive for seven to 10 servings a day of veggies and fruits. Switch to whole-grain bread and cereal, and begin to eat more whole-gain rice and pasta products.
- Go nuts. Keep almonds, cashews, pistachios and walnuts on hand for a quick snack. Choose natural peanut butter, rather than the kind with hydrogenated fat added. Try tahini (blended sesame seeds) as a dip or spread for bread.
- Pass on the butter. Try olive or canola oil as a healthy replacement for butter or margarine. Use it in cooking. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter. Or try tahini as a dip or spread.
- Spice it up. Herbs and spices make food tasty and are also rich in health-promoting substances. Season your meals with herbs and spices rather than salt.
- Go fish. Eat fish once or twice a week. Fresh or water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it's sauteed in a small amount of canola oil.
- Rein in the red meat. Substitute fish and poultry for red meat. When eaten, make sure it's lean and keep portions small (about the size of a deck of cards). Also avoid sausage, bacon and other high-fat meats.
- Choose low-fat dairy. Limit higher fat dairy products such as whole or 2 percent milk, cheese and ice cream. Switch to skim milk, fat-free yogurt and low-fat cheese.
- Raise a glass to healthy eating. If it's OK with your doctor, have a glass of wine at dinner. If you don't drink alcohol, you don't need to start. Drinking purple grape juice may be an alternative to wine.
See more In-depth
- Traditional Mediterranean diet. Oldways Preservation Trust. http://www.oldwayspt.org/traditional-mediterranean-diet. Accessed March 23, 2013.
- Estruch R, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine. In press. Accessed March 23, 2013.
- Sofi F, et al. Adherence to Mediterranean diet and health status: Meta-analysis. BMJ. 2008;337:a1344.
- Mitrou PN, et al. Mediterranean dietary pattern and prediction of all-cause mortality in a U.S. population. Archives of Internal Medicine. 2007;167:2461.
- AHA Scientific Statement: Diet and lifestyle recommendations revision 2006. Circulation 2006;114:82.
- Dietary Guidelines for Americans, 2010. U.S. Department of Health and Human Services. http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Accessed March 23, 2013.
- Van de Laar RJ, et al. Adherence to a Mediterranean dietary pattern in early life is associated with lower arterial stiffness in adulthood: The Amsterdam Growth and Health Longitudinal Study. Journal of Internal Medicine. 2013;273:79.
- Mediterranean diet pyramid. Oldways Preservation Trust. http://oldwayspt.org/resources/heritage-pyramids/mediterranean-pyramid/overview. Accessed March 22, 2013.
- Meet the fats. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/FatsAndOils/MeettheFats/Meet-the-Fats_UCM_304495_Article.jsp. Accessed March 23, 2013.
- AHA Scientific Advisory: Wine and your heart. Circulation 2001;103:472.
- Cicerale S, et al. Chemistry and health of olive oil phenolics. Critical Reviews in Food Science and Nutrition. 2009;49:218
- Nelson JK (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2013.
- Rethinking drinking: Alcohol and your health. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf. Accessed April 4, 2013.