The Mediterranean Diet: A Scientifically Proven Way of Eating for a Healthy Heart, Brain, and Longevity

On the small Greek island of Ikaria, people commonly live into their nineties, heart attacks are rare, and dementia is significantly less common than in the rest of Europe. The secret is not genetics, but what the locals eat throughout their lives—olive oil, fish, legumes, seasonal vegetables and whole-grain bread. These foods form the basis of the Mediterranean diet, a nutritional model inspired by the traditional eating habits of people in Italy, Greece, Spain and Morocco.

It is one of the best-researched eating patterns in the world. Hundreds of studies show that it reduces the risk of major cardiovascular events by about 30%, type 2 diabetes by 30%, and Alzheimer’s disease by up to 30%. In this article, you will find out exactly what the Mediterranean diet includes, why it works, and how to build a meal plan around it even outside the Mediterranean region.

Quick summary: What is the Mediterranean diet?

• What it is: A traditional, lifelong way of eating based on plant foods, extra virgin olive oil, fish, and legumes.
• Health benefits: Hundreds of studies confirm a substantial reduction in the risk of heart attack, type 2 diabetes, Alzheimer’s disease, and certain types of cancer.
• Dietary foundation: Vegetables, fruit, whole grains, and nuts are consumed daily. Fish, poultry, and legumes several times per week. In contrast, minimal red meat, processed meats, and sweets.
• Recognition by authorities: The World Health Organisation (WHO) and the American Heart Association (AHA) recommend it for disease prevention, and in 2010, UNESCO added it to the list of the Intangible Cultural Heritage of Humanity.

What is the Mediterranean diet?

The Mediterranean diet is a traditional way of eating among people living in countries along the Mediterranean Sea. It emphasises plant foods, olive oil, fish, and legumes, and limits red meat, processed meats, and sweets. It is not a short-term weight-loss diet or a temporary eating plan, but a lifelong nutrition and lifestyle approach that, in addition to diet, also includes physical activity, shared meals, and a connection to local seasonal ingredients. In 2010, UNESCO added it to the list of the Intangible Cultural Heritage of Humanity, confirming not only its health benefits but also its cultural value. ^[37]

The original geographic core of the Mediterranean diet was Greece, Italy, Spain and Morocco. After UNESCO recognition, the list of representative countries gradually expanded.

Mediterranean diet vs. modern Italian cuisine

Be careful not to confuse the two: the Mediterranean diet is not the same as modern Italian cuisine. Pizza with processed cheese filling, creamy pasta, lasagne, or large portions of red meat are not part of the traditional Mediterranean model. The scientifically proven benefits apply to the dietary model of the 1960s in countries such as Greece (especially Crete) and southern Italy—i.e., the period before the industrial transformation of food in these regions. ^[34]

How did the term Mediterranean diet originate?

The term Mediterranean diet was introduced by American physiologist Ancel Keys, who, in the 1950s, observed that people in Crete and southern Italy suffered from heart disease far less often than Americans. Keys, a professor at the University of Minnesota, noticed that the difference was not genetics, but diet. People in the Mediterranean ate more olive oil, vegetables, legumes, and whole-grain foods, and significantly less saturated fat. ^[9,24,25]

To test his hypothesis, in 1958, he launched the groundbreaking Seven Countries Study, the first large-scale epidemiological study on the relationship between diet and cardiovascular disease.

What ultimately confirmed the health benefits of the Mediterranean diet?

Although the results of the Seven Countries Study were later criticised, Ancel Keys presented the world with a hypothesis that was confirmed about 60 years later by the Spanish randomised clinical trial PREDIMED.

It followed 7,447 people at increased cardiovascular risk and found that a Mediterranean diet enriched with extra virgin olive oil or nuts reduced the incidence of major cardiovascular events (myocardial infarction, stroke, death from cardiovascular causes) by about 30% compared with a control diet that recommended reducing fat intake. Keys’s intuition was therefore correct, and modern science confirmed it with hard data from a randomised controlled trial. ^[19,49]

UNESCO 2010: the Mediterranean diet as cultural heritage

On November 16, 2010, UNESCO added the Mediterranean diet to the Representative List of the Intangible Cultural Heritage of Humanity. The decision was made at the 5th session of the Intergovernmental Committee in Nairobi, Kenya, and in 2013, the list of representative countries was expanded to include Cyprus, Croatia, and Portugal. ^[31,37,38]

With this step, UNESCO sent an important message. It positioned the Mediterranean diet as a comprehensive cultural system, not merely a healthy meal plan. The organisation’s official definition describes it as a set of skills, knowledge, practices, and traditions extending from the landscape to the table—from growing ingredients and fishing, through food preparation, to sharing meals within the family and community. ^[37]

Thanks to UNESCO’s cultural recognition and hundreds of studies in databases such as PubMed, the Mediterranean diet is among the best-supported nutrition models in the world. ^[10]

• The WHO recognises it as a healthy dietary pattern. ^[51]
• The American Heart Association and the American Diabetes Association include it among recommended dietary approaches for preventing cardiovascular disease and type 2 diabetes. ^[2,16,20]

Which foods are eaten in the Mediterranean diet, and which are limited?

The Mediterranean diet is built on four core pillars: vegetables, fruit, whole grains, and extra virgin olive oil. Several times per week, legumes, fish, and poultry are added; dairy products are also consumed daily in smaller amounts, while red meat, processed meats, and sweets should remain exceptions. ^[8]

Which foods are consumed daily on the Mediterranean diet?

Every day, you should eat vegetables, fruit, whole grains, extra virgin olive oil, and a small portion of nuts. These groups make up the larger share of the diet by volume and provide fibre, vitamins, antioxidants, and healthy fats. ^[3,29]

Food group	How much and how often	Examples of foods
Vegetables	≥ 2 servings with each main meal	Tomatoes, zucchini, eggplant, leafy greens, peppers, broccoli, etc.
Fruit	2–3 servings daily, seasonal, fresh (not juices)	Apples, citrus fruits, grapes, figs, melon
Whole grains	1–2 servings with each meal	Whole-grain bread, bulgur, couscous, brown rice, oats, durum wheat pasta
Extra virgin olive oil	~3–4 tablespoons daily	Cold and hot use, salads, stewing, baking
Nuts and seeds	1 handful (≈ 30 g) daily	Walnuts, almonds, pistachios, sunflower seeds
Dairy products	Daily in smaller amounts	Greek yoghurt, feta, mozzarella, sheep/goat cheese
Herbs and spices	Daily, instead of salt	Oregano, basil, rosemary, thyme, garlic, parsley
Water	1.5–2 litres daily	Water, unsweetened teas, mineral water

^[3,7,29]

Benefits of Mediterranean diet foods

• Vegetables provide fibre, potassium, folate, vitamin C and polyphenols. These nutrients help lower blood pressure, reduce vascular inflammation, and support gut health. ^[3,7]
• The WHO recommends at least 400 g of vegetables and fruit per day—five servings of 80 g. According to the WHO, insufficient plant-based food intake is among the main risk factors for noncommunicable diseases, and in 2017, it was associated with approximately 3.9 million deaths worldwide. ^[42,44,47]
• Fruit contains fibre, vitamin C and flavonoids (anthocyanins in berries and citrus fruits). It has antioxidant effects, naturally increases satiety, and replaces sweets in the Mediterranean diet. ^[3,7]
• Whole grains are a source of complex carbohydrates, fibre, B vitamins, magnesium and iron. They stabilise blood sugar levels, reduce LDL cholesterol, and provide long-lasting energy. ^[3,7]
• Olive oil is the main source of fat in the Mediterranean diet. Monounsaturated fatty acids (especially oleic acid) and polyphenols improve blood vessel function, reduce LDL cholesterol, and reduce oxidative stress. Extra virgin olive oil contains significantly more polyphenols than refined oil. ^[3,7]
• Nuts and seeds combine healthy fats, plant protein, fibre, magnesium, and vitamin E. Walnuts and flaxseeds also contain plant-based omega-3s (α-linolenic acid). They improve the lipid profile and provide long-lasting satiety. ^[3,7]
• Dairy products are a source of calcium, protein, vitamin B12, and probiotics (in fermented varieties). They are consumed daily, but in smaller amounts. ^[3]
• Water is the main beverage in the Mediterranean diet. The recommended intake is 1.5–2 litres per day (approximately 6–8 glasses), adjusted for age, physical activity, and climate. ^[3]
• Herbs and spices such as oregano, basil, rosemary, garlic, and onion provide antioxidants and serve as a natural substitute for salt. ^[3,7]

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Which foods are consumed several times per week on the Mediterranean diet?

On the Mediterranean diet, legumes, fish and seafood, poultry, and eggs are consumed several times per week. Dairy products are consumed daily in moderate amounts. These are the main sources of protein in the diet, complementing the daily plant-based foundation. This shift from red meat to fish, legumes, and poultry is what distinguishes the Mediterranean diet from a typical “Western” diet. ^[3]

Food group	How much and how often	Examples of foods
Legumes	≥ 2× per week	Chickpeas, beans, lentils, peas
Fish and seafood	2–3× per week, with an emphasis on fatty marine fish	Sardines, mackerel, salmon, herring, anchovies
Poultry	~2× per week	Chicken, turkey
Eggs	2–4 pcs per week	Whole eggs

Benefits of Mediterranean diet foods

• Legumes such as chickpeas, beans, lentils, and peas provide plant protein, fibre, iron, folate, and magnesium. Combined with whole grains, they form a complete alternative to meat; they are inexpensive, filling, and support stable blood sugar levels. ^[3,7]
• Fish and seafood are the best dietary sources of omega-3 fatty acids EPA and DHA, which reduce triglyceride levels, reduce inflammation, and protect the heart. Fatty marine fish (sardines, mackerel, salmon, herring) also provide vitamin D, iodine, selenium and vitamin B12. Consuming 2 servings per week covers approximately 500 mg EPA + DHA per day, which is the amount recommended by the American Heart Association to reduce cardiovascular risk. ^[7,35]
• Poultry serves as a lean source of high-quality protein with a low saturated fat content, and in the Mediterranean diet, it partially replaces red meat. ^[3]
• Eggs contain high-quality protein, choline (important for brain and liver function), vitamin B12, vitamin D and lutein. In the Mediterranean diet, eggs used in cooking and baking are also included. ^[3]

Which foods are limited or consumed only in moderation on the Mediterranean diet?

On the Mediterranean diet, red meat, processed meats and cured meats, sweets, white bread, sweetened beverages, and saturated fats such as butter and lard are limited or consumed only in moderation. These are foods that sit at the very top of the Mediterranean pyramid. They are eaten rarely, in small amounts, and on special occasions. Limiting them is associated with a proven reduction in the risk of cancer, cardiovascular disease, and type 2 diabetes. ^[3,36,43]

Food group	How much and how often	Examples of foods
Red meat	At most 1× per week, ideally lean types	Beef, pork, lamb, veal
Cured meats and processed meats	Minimal, only exceptionally	Ham, sausage, salami, hot dogs, bacon, smoked meat
Sweets, white bread, sweetened beverages	Only occasionally	Candy, cakes, white rolls, sweetened soft drinks and juices
Saturated fats (butter, lard)	Replace with olive oil	Butter, lard, palm and coconut oil
Alcohol	According to the WHO, no amount of alcohol is safe	Wine, beer, spirits

^[3,46]

What are the risks of these foods?

• Red meat – The International Agency for Research on Cancer (IARC) classified it in 2015 as “probably carcinogenic to humans” (Group 2A), particularly in relation to colorectal cancer. ^[43]
• Cured meats and processed meat – The IARC classifies them as Group 1 carcinogens, meaning they are proven to cause cancer in humans. They are associated mainly with colorectal tumours. ^[36,43]
• Sweets, white bread, and sweetened beverages are very energy-dense but low in micronutrients. Regular consumption promotes weight gain, insulin resistance, and the risk of type 2 diabetes.
• Saturated fats promote increases in LDL (bad) cholesterol and the risk of atherosclerosis. In the Mediterranean diet, they are replaced by extra virgin olive oil as the main source of fat.
• Alcohol is traditionally associated with the Mediterranean diet (in the form of a glass of red wine), but in January 2023, the WHO officially stated that no level of alcohol consumption is safe for health. Ethanol is classified by the IARC as a Group 1 carcinogen and is linked to at least seven types of cancer, including breast and colorectal cancer. ^[46]

What are the health benefits of the Mediterranean diet, and what does science say?

The Mediterranean diet is now one of the best-researched eating patterns in the world. Its health benefits have been confirmed by hundreds of studies, including large randomised clinical trials such as PREDIMED and the Lyon Diet Heart Study. ^[17,23]

1. How does the Mediterranean diet affect the heart and blood vessels?

The Mediterranean diet reduces the risk of major cardiovascular events—such as myocardial infarction, stroke, and deaths from other cardiovascular causes—by about 30% in people at high risk. This is its strongest and best-documented benefit.

• Key evidence: The Spanish randomised clinical trial PREDIMED (Prevención con Dieta Mediterránea), originally published in 2013, with a corrected version published in 2018 in The New England Journal of Medicine in 2018. Over an average of 4.8 years, the study followed 7,447 participants at increased cardiovascular risk. The groups that followed a Mediterranean diet enriched with extra virgin olive oil or nuts had a 30% lower rate of major cardiovascular events compared with the control group on a low-fat diet. ^[49]
• Mechanism of heart and vascular protection: The protective effect is not due to a single component, but to a combination of multiple active substances and mechanisms. Monounsaturated fats and polyphenols from extra virgin olive oil improve endothelial function, omega-3 fatty acids help reduce inflammation, and fibre helps stabilise blood sugar levels. These are specific measurable effects reported by randomised clinical trials: ^[5,7,23]

Indicator	Change with the Mediterranean diet
LDL cholesterol	↓ 8–10%
Systolic blood pressure	↓ ~ 6 mmHg
C-reactive protein (CRP)	↓ up to 45%
Interleukin-6 (IL-6)	↓ up to 35%

• Recommendations from leading global institutions: The American Heart Association states in its official 2023 position statement that the Mediterranean diet is among the best dietary models for cardiovascular health. Harvard T.H. Chan School of Public Health also describes it as the best-researched and most effective eating pattern for the primary prevention of heart disease. ^[16,40]

2. Does the Mediterranean diet help with type 2 diabetes?

The Mediterranean diet, combined with a moderate calorie deficit and physical activity, reduces the risk of developing type 2 diabetes by approximately 31% in people with metabolic syndrome. The effect is significantly stronger when combined with an active lifestyle than with diet alone without exercise.

• Key evidence: The Spanish study PREDIMED-Plus, whose results for type 2 diabetes prevention were published in Annals of Internal Medicine in 2025. It followed 4,746 participants with overweight or obesity and metabolic syndrome for 6 years. One group was advised to follow an energy-reduced Mediterranean diet (reducing intake by approximately 600 kcal/day), engage in regular physical activity, and receive behavioural support. The results showed a 31% lower risk of type 2 diabetes compared with the control group, which followed only the standard Mediterranean diet without calorie restriction. ^[28]
• Mechanism of protection against diabetes: The protective effect is driven by a combination of multiple substances and physiological changes. In clinical studies, the Mediterranean diet improves insulin sensitivity, lowers fasting blood glucose, as well as glycated haemoglobin (HbA1c), and helps reduce visceral fat (body fat around internal organs). ^[7,28]

Nutrient	Effect
Fibre	Slows carbohydrate absorption and stabilises blood sugar levels
Monounsaturated fats and polyphenols	Improve insulin sensitivity and help reduce chronic inflammation
Omega-3 fatty acids	Reduce inflammatory markers and improve the lipid profile

^[7]

• Recommendations from leading global institutions: The American Diabetes Association (ADA) recommends the Mediterranean diet as one of two dietary patterns for preventing type 2 diabetes. Moreover, even for people already diagnosed with metabolic syndrome or diabetes, it can bring significant improvements. ^[2,18]

3. What impact does the Mediterranean diet have on the brain and cognitive function?

The Mediterranean diet is associated with an 11–30% lower risk of cognitive decline, dementia, and Alzheimer’s disease. The effect is stronger the more strictly you adhere to the diet—this is a so-called dose–response relationship.

• Main source of evidence: The strongest evidence is a meta-analysis published in GeroScience in 2025 (Fekete et al.), which included 23 studies published between 2000 and 2024. The results showed that the Mediterranean diet reduces the risk of cognitive decline by 18%, dementia by 11%, and Alzheimer’s disease by 30%. ^[15]
• Mechanism of brain protection: The neuroprotective effect is driven by a combination of multiple components of the Mediterranean diet that act together on different pathways of brain ageing.

Nutrient	Effect
Omega-3 fatty acids EPA and DHA	They are building blocks of neuronal membranes, support signal transmission between nerve cells, and help reduce inflammation, which is now considered one of the main accelerators of Alzheimer’s disease.
Polyphenols	In laboratory and preclinical studies, they help reduce beta-amyloid aggregation, support its clearance from the brain via the blood–brain barrier, and reduce oxidative stress in neurons.
Antioxidants	They help protect neurons from oxidative damage and reduce chronic inflammation in the brain.

^[1,12,15,33]

• Recommendations from leading global institutions: In its guidelines for reducing the risk of cognitive decline and dementia, the WHO recommends the Mediterranean diet as one of the preventive strategies for maintaining cognitive health. Harvard T.H. Chan School of Public Health describes it as the only dietary pattern with sufficient evidence from clinical trials for cognitive benefits. ^[6,50]

4. Does the Mediterranean diet help reduce the risk of cancer?

The Mediterranean diet is associated with approximately a 13% lower risk of death from cancer and with a reduced risk of several specific types of cancer—especially cancers of the digestive tract, respiratory tract, and urinary tract. The strongest evidence exists for colorectal cancer and overall cancer mortality.

• Key evidence: The strongest evidence is a systematic review and meta-analysis by Morze et al., published in the European Journal of Nutrition in 2021. It summarised 117 studies with more than 3.2 million participants. The strictest adherence to the Mediterranean diet was associated with the following risk reductions. ^[26]

Cancer type	Risk reduction
Head and neck cancer	44 %
Liver cancer	36 %
Stomach cancer	30 %
Colorectal cancer	17 %
Respiratory tract cancer	16 %
Bladder cancer	13 %
Cancer mortality	13 %

^[26]

• Mechanism of protection against cancer: The Mediterranean diet helps protect against cancer in several ways at once—both through what it includes and what it leaves out.

Nutrient	Protective effect
Fibre	In the gut, it ferments into short-chain fatty acids (especially butyrate), which help maintain the health of the intestinal lining.
Antioxidants and polyphenols	They help reduce oxidative stress and chronic inflammation, which is now considered one of the main mechanisms of cancer development.
Limiting red and processed meat	Reduces the body’s exposure to known carcinogens (e.g., polycyclic aromatic hydrocarbons and heterocyclic amines) that form during smoking, curing, and heat processing of meat.

• Recommendations from leading global institutions: The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) emphasise dietary patterns based on high consumption of vegetables, fruit, legumes, and whole grains, and limiting red and processed meat—these are core principles of the Mediterranean diet. ^[48]

5. Does the Mediterranean diet support longevity?

The Mediterranean diet is associated with approximately an 8–10% lower risk of premature death from any cause. This effect results from its simultaneous impact on all major causes of death in modern society, such as cardiovascular disease, cancer, diabetes, and neurodegenerative diseases.

• Key evidence: The strongest evidence is a study by Dinu et al., published in the European Journal of Clinical Nutrition in 2018, which summarised 29 meta-analyses with a total of more than 12.8 million participants. ^[11]
• Mechanism of action: The Mediterranean diet does not extend life through one specific pathway, but through a combination of protective effects across multiple areas of health. As mentioned above, it improves cardiovascular health, reduces the risk of cognitive decline, and lowers overall cancer mortality.
• Recommendations from leading global institutions: The Dietary Guidelines for Americans include the Mediterranean diet among the eating patterns with the strongest evidence for preventing cardiovascular deaths. WHO Europe recognises it as one of the preferred models for supporting healthy ageing, and the Lancet Commission on Dementia 2024 cites it as a reference example of healthy eating for brain longevity. ^[20,39,41]

What are Blue Zones?

Blue Zones are geographically defined areas of the world where people live significantly longer and healthier than the rest of the population, and where centenarians occur up to 10 times more often than in the United States. The concept was defined in 2004 by American researcher Dan Buettner in collaboration with National Geographic and the National Institute on Ageing. ^[4]

His team identified five such areas: Sardinia (Italy), Ikaria (Greece), Okinawa (Japan), Nicoya (Costa Rica) and Loma Linda (California, USA). But why mention them? Two of these places—Sardinia and Ikaria—are located in the Mediterranean.

• Ikaria (Greece) is a small island in the Aegean Sea whose residents, according to Buettner’s research, live an average of 8 years longer than Americans, have a 20% lower incidence of cancer, half the rate of heart disease, and almost no dementia. Ikarians follow a variant of the Mediterranean diet rich in vegetables, fruit, whole grains, legumes, potatoes, and olive oil. ^[4]
• Sardinia (Italy) is home to the longest-living men in the world. The traditional diet of people in the mountainous interior of the island is based mainly on whole-grain bread, legumes, garden vegetables, fruit, and sheep’s cheese; meat is consumed only exceptionally on festive occasions. ^[4]

Blue Zones are not direct evidence that the Mediterranean diet itself causes longevity. However, Buettner identified nine shared characteristics of these long-lived populations (the so-called Power 9), among which is the Mediterranean way of eating. ^[4]

Does the Mediterranean diet help you lose weight?

Yes, it is possible to lose weight with the Mediterranean diet if it is combined with a calorie deficit and regular physical activity. Although it is not primarily designed for weight loss, it can help you lose unwanted kilograms in a healthy way and maintain your weight long term. This is confirmed, for example, by the PREDIMED-Plus study, which followed 4,746 people with overweight or obesity for 6 years. Participants who followed the Mediterranean diet and a calorie deficit lost an average of 3.3 kg of body fat. The control group, which did not undergo a calorie deficit, lost only 0.6 kg on average. ^[45]

How does the Mediterranean diet support weight loss?

The Mediterranean diet does not help you lose weight by forcing you to starve. Instead, it works through several characteristics that help you feel full for longer after meals and naturally eat less.

• High fibre content from vegetables, fruits, legumes, and whole grains prolongs the feeling of satiety and helps regulate hunger hormones.
• Healthy fats from olive oil and nuts slow gastric emptying, making you feel fuller for longer after eating.
• Limiting ultra-processed foods and sweetened beverages significantly reduces caloric intake.

What to watch out for when losing weight with the Mediterranean diet?

The main pitfall of the Mediterranean diet when trying to lose weight is the high caloric density of olive oil and nuts, although these are undoubtedly healthy foods. One tablespoon of olive oil contains approximately 120 kcal, and 100 g of nuts approximately 580–650 kcal. When losing weight, it is therefore advisable to control the quantity. An excellent compromise is a handful of nuts (approx. 30 g) and 2–3 tablespoons of olive oil daily.

How to start the Mediterranean diet in Central European conditions?

You can fully follow the Mediterranean diet outside the Mediterranean region; you just need to replace a few common foods with their Mediterranean equivalents. There is no need to buy expensive food. Frozen vegetables, canned legumes, and canned sardines are inexpensive, accessible, and nutritionally equivalent to more expensive alternatives.

1. Swap your fats

Include olive oil in your diet, which is the main carrier of polyphenols and monounsaturated fatty acids in the Mediterranean diet and one of the reasons for its proven benefits for the heart, brain, and longevity. ^[32]

The ideal choice is extra virgin olive oil (EVOO), which, thanks to cold pressing, contains the highest amount of polyphenols and antioxidants. However, it belongs exclusively to cold cuisine. Use it for salads, flavouring finished dishes, or dipping bread. At higher temperatures, it loses some of its biologically active substances. ^[14,22]

For heat treatment, refined olive oil is more suitable, as it tolerates higher temperatures without forming harmful substances. A full alternative is also rapeseed oil, which has a favorable ratio of omega-3 and omega-6 fatty acids and in some nutritional recommendations is considered equivalent to olive oil for heat treatment. ^[21]

2. Eat legumes regularly

Lentils, beans, chickpeas, and peas should be on your plate daily, or at least 4–5 times a week. Legumes are the cheapest source of quality plant protein and fibre in Europe. They do not have to be the main dish; it is enough to add a spoonful of chickpeas to a salad, beans to soup, or lentils to pasta sauce.

If you do not have time to cook dried legumes, canned ones are a full alternative; just rinse them under running water to reduce the salt content.

3. Include fish at least twice a week

The American Heart Association (AHA) recommends 2 servings of fish per week, preferably fatty marine fish. Fatty marine fish are the only reliable source of omega-3 fatty acids EPA and DHA. Choose mackerel, herring, sardines, salmon, or trout. ^[35]

You do not always need fresh fish. Canned fish are also a good solution, such as sardines, salmon, mackerel, or tuna (in their own juice or olive oil). They are nutritionally equivalent to fresh fish, available year-round, and cost a fraction of their price.

4. Increase your intake of vegetables and fruits

The World Health Organisation (WHO) recommends at least 400 g of vegetables and fruits daily (about 5 servings). Central European seasonal and local vegetables are nutritionally equivalent to Mediterranean ones. For example, cabbage, carrots, onions, root vegetables, and tomatoes are among the very nutritionally rich foods.

You can also opt for frozen vegetables. When quickly frozen, they retain most vitamins and are often more nutritious than fresh vegetables that travel for weeks from southern Europe.

5. Switch to whole grains

Replace white bread and white rice with whole grain bread, buckwheat, oats, quinoa, barley, bulgur, or, for example, whole grain couscous. They contain more fibre, micronutrients, and have a lower glycemic index. They are thus more nutritious and will also keep you full for longer and support gut health.

6. Limit cured meats and sweets

The International Agency for Research on Cancer (IARC) classified sausages, salami, bacon, hot dogs, and smoked meat as proven human carcinogens in 2015. However, you do not need to worry that one hot dog will cause cancer, but this classification tells us that regular consumption contributes to cancer risk. Therefore, the WHO recommends limiting cured meats to a maximum of once a week. ^[36]

Sweets and white sugar should be the exception, not the rule. The best substitute is fresh fruit, a handful of nuts, or a piece of dark chocolate with at least 70% cocoa.

What does a sample meal plan according to the Mediterranean diet look like?

A sample Mediterranean day consists of three main meals and 1–2 snacks, built on vegetables, whole grains, legumes, quality plant fats, and moderate amounts of dairy products, fish, or poultry.

Meal	Main option	Variation
Breakfast	Oats with Greek yoghurt, fresh or frozen berries, a handful of nuts, and a teaspoon of honey	Whole grain toast with avocado, feta cheese, and tomato drizzled with olive oil, or a vegetable omelette (spinach, bell pepper, onion) with whole grain bread
Snack	A handful of almonds or walnuts (~30 g) and a piece of fruit	Yoghurt with a few dried figs or apricots
Lunch	Chickpea salad with cucumber, tomato, olives, and feta cheese, dressing of olive oil and lemon, accompanied by whole grain pita or bulgur	Lentil soup with carrots and celery + a slice of whole grain bread; or grilled poultry with roasted vegetables and quinoa
Snack	Sliced vegetables (carrots, bell pepper, cucumber) with hummus	A piece of fruit with a few nuts
Dinner	Baked salmon, mackerel, or trout with lemon and herbs, roasted vegetables (broccoli, carrots, zucchini), and a serving of brown rice or quinoa	Stewed beans with tomatoes and spinach, or whole grain pasta with tomato sauce, olives, and canned sardines
Beverages throughout the day	Water, unsweetened coffee, or tea	–
Dessert	Fresh fruit	A piece of dark chocolate (min. 70% cocoa)

Are there any risks or limitations associated with the Mediterranean diet?

The Mediterranean diet is among the safest ways of eating and is suitable for almost every healthy person. However, there are certain practical limitations and situations to watch out for.

• Mercury in fish: Some types of fatty marine fish (especially large tuna, shark, swordfish) may contain higher levels of mercury. Pregnant and breastfeeding women and young children should therefore avoid them and prefer safe species such as salmon, sardines, mackerel, trout, or herring. ^[30]
• High caloric density of olive oil and nuts: Although these are nutritious foods, a tablespoon of olive oil has ~120 kcal and 100 g of nuts ~580–650 kcal. For example, when trying to lose weight, it is therefore advisable to control their quantity, not eliminate them.
• Alcohol: The traditional Mediterranean diet includes a glass of red wine with meals, but it is not essential. WHO stated clearly in a 2023 position that no level of alcohol consumption is safe from a health perspective.
• Specific health conditions: People with celiac disease, lactose intolerance, or allergies to fish and nuts should adapt their meal plan. When taking blood-thinning medications (warfarin), it is advisable to consult a doctor about the intake of green leafy vegetables due to vitamin K content.

What supplements should you add to the Mediterranean diet?

The Mediterranean diet is nutritionally balanced and, when followed with variety, usually does not require special supplementation. However, there are several situations where dietary supplements make sense.

1. Vitamin D

Vitamin D is recommended for almost everyone in Europe. People in Central and Northern Europe generally have a vitamin D deficiency due to insufficient sunlight from autumn to spring.

Central European expert guidelines recommend adults supplement with 800–2,000 IU of vitamin D3 daily from October to March. For at-risk groups, such as older people, people with overweight, or darker skin, year-round. ^[27]

2. Omega-3 fatty acids

For people who do not eat fish, it is advisable to include omega-3 fatty acids (EPA and DHA) in capsules or in the form of fish oil. The European Food Safety Authority (EFSA) recommends a daily intake of 250 mg EPA + DHA for adults. ^[13]

3. Vitamin B12

Vitamin B12 is sufficient in the traditional Mediterranean diet, as dairy products, eggs, fish, and poultry are frequently consumed. However, if you follow it in a vegetarian or vegan form, B12 supplementation is essential, as this vitamin is practically absent in plant foods.

Summary: What do we know about the Mediterranean diet?

Strong evidence	Promising but preliminary evidence	Often exaggerated evidence
Reduces cardiovascular disease risk by ~30%	Reduces Alzheimer’s disease risk by 30%	Wine as a health benefit
Reduces type 2 diabetes risk by 31%	Reduces colorectal cancer risk by 17% and overall cancer mortality by 13%	Rapid weight loss without caloric deficit
Improvement of lipid profile (LDL, HDL) and blood pressure	Slows cognitive decline in older adults	Protection against all types of cancer
Reduction of inflammatory marker CRP and oxidative stress	Reduces overall mortality by 8–10%	Longevity solely due to diet
Helps with weight loss in combination with a caloric deficit

Frequently Asked Questions (FAQ)

What Should You Take Away from This?

The Mediterranean diet is not a diet for a few weeks. It is a long-term, sustainable way of eating with the strongest scientific support. Studies on millions of people confirm that it reduces the risk of cardiovascular diseases, type 2 diabetes, dementia, and some types of cancer.

Its strength lies in everyday food choices. It is based on whole grains, vegetables, fruits, legumes, fish, nuts, and olive oil. Meat, sweets, and alcohol are consumed moderately to minimally.

And the good news? You can follow it anywhere. You just need to gradually replace a few common foods with their Mediterranean alternatives.

Sources:

[1] ABUZNAIT, A.H. et al. Olive-oil-derived oleocanthal enhances β-amyloid clearance as a potential neuroprotective mechanism against Alzheimer’s disease: in vitro and in vivo studies. – https://pubmed.ncbi.nlm.nih.gov/23414128/

[2] AMERICAN DIABETES ASSOCIATION PROFESSIONAL PRACTICE COMMITTEE FOR DIABETES* et al. Introduction and Methodology: Standards of Care in Diabetes—2026. – https://diabetesjournals.org/care/article/49/Supplement_1/S50/163924/3-Prevention-or-Delay-of-Diabetes-and-Associated

[3] BACH-FAIG, A. et al. Mediterranean diet pyramid today. Science and cultural updates. – https://pubmed.ncbi.nlm.nih.gov/22166184/

[4] BUETTNER, D. - SKEMP, S. Blue Zones. – https://pmc.ncbi.nlm.nih.gov/articles/PMC6125071/

[5] CASAS, R. et al. The Effects of the Mediterranean Diet on Biomarkers of Vascular Wall Inflammation and Plaque Vulnerability in Subjects with High Risk for Cardiovascular Disease. A Randomized Trial. – https://pmc.ncbi.nlm.nih.gov/articles/PMC4055759/

[6] COMMUNICATIONS, M.G.B. – https://news.harvard.edu/gazette/story/2025/08/mediterranean-diet-offsets-genetic-risk-for-dementia-study-finds/

[7] DALEY, S.F. - HINSON, M.R. Mediterranean Diet. – http://www.ncbi.nlm.nih.gov/books/NBK557733/

[8] DAVIS, C. et al. Definition of the Mediterranean Diet: A Literature Review. In Nutrients . – https://pmc.ncbi.nlm.nih.gov/articles/PMC4663587/

[9] DELARUE, J. Mediterranean Diet and cardiovascular health: an historical perspective. – https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/mediterranean-diet-and-cardiovascular-health-an-historical-perspective/D257C33D41BDCE1C747D9C6A76C4AF9D

[10] DINU, M. et al. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. – https://www.nature.com/articles/ejcn201758

[11] DINU, M. et al. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. – https://www.nature.com/articles/ejcn201758

[12] DYALL, S.C. Amyloid-Beta Peptide, Oxidative Stress and Inflammation in Alzheimer’s Disease: Potential Neuroprotective Effects of Omega-3 Polyunsaturated Fatty Acids. – https://pmc.ncbi.nlm.nih.gov/articles/PMC2911611/

[13] EFSA PANEL ON DIETETIC PRODUCTS, NUTRITION AND ALLERGIES (NDA) Scientific Opinion on the Tolerable Upper Intake Level of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA). – https://onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2012.2815

[14] EFSA PANEL ON NUTRITION, NOVEL FOODS AND FOOD ALLERGENS (NDA) et al. Phenolic compounds naturally present in olive oil and lowering of blood LDL-cholesterol and systolic blood pressure, therefore reducing the risk of coronary heart disease: Evaluation of a health claim pursuant to Article 14 of Regulation (EC) No 1924/2006. – https://onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2025.9470

[15] FEKETE, M. et al. The role of the Mediterranean diet in reducing the risk of cognitive impairement, dementia, and Alzheimer’s disease: a meta-analysis. – https://pubmed.ncbi.nlm.nih.gov/39797935/

[16] GARDNER, C.D. et al. Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance: A Scientific Statement From the American Heart Association. – https://www.ahajournals.org/doi/10.1161/CIR.0000000000001146

[17] GUASCH-FERRÉ, M. - WILLETT, W.C. The Mediterranean diet and health: a comprehensive overview. – https://onlinelibrary.wiley.com/doi/abs/10.1111/joim.13333

[18] KASTORINI, C.-M. et al. The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. – https://pubmed.ncbi.nlm.nih.gov/21392646/

[19] KEYS, A. Coronary heart disease in seven countries. – https://www.sciencedirect.com/science/article/pii/S0899900796004108

[20] LICHTENSTEIN, A.H. et al. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. – https://www.ahajournals.org/doi/10.1161/cir.0000000000001031

[21] LIN, L. et al. Evidence of health benefits of canola oil. – https://pmc.ncbi.nlm.nih.gov/articles/PMC3746113/

[22] LOZANO-CASTELLÓN, J. et al. Domestic Sautéing with EVOO: Change in the Phenolic Profile. – https://pmc.ncbi.nlm.nih.gov/articles/PMC7022658/

[23] MARTÍNEZ-GONZÁLEZ, M.A. et al. The Mediterranean Diet and Cardiovascular Health. – https://pubmed.ncbi.nlm.nih.gov/30817261/g

[24] MENOTTI, A. - PUDDU, P.E. Ancel Keys, the Mediterranean Diet, and the Seven Countries Study: A Review. – https://pmc.ncbi.nlm.nih.gov/articles/PMC12027923/

[25] MENOTTI, A. - PUDDU, P.E. How the Seven Countries Study contributed to the definition and development of the Mediterranean diet concept: A 50-year journey. – https://www.sciencedirect.com/science/article/pii/S0939475314003470

[26] MORZE, J. et al. An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. – https://pubmed.ncbi.nlm.nih.gov/32770356/

[27] LUDOWSKI, P. et al. Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement. – https://pmc.ncbi.nlm.nih.gov/articles/PMC9002638/

[28] RUIZ-CANELA, M. et al. Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes. – https://www.acpjournals.org/doi/10.7326/ANNALS-25-00388

[29] SERRA-MAJEM, L. et al. Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns. – https://pmc.ncbi.nlm.nih.gov/articles/PMC7728084/

[30] STAFF, M.C. Mediterranean diet for heart health. – https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801

[31] TRICHOPOULOU, A. Mediterranean diet as intangible heritage of humanity: 10 years on. – https://www.sciencedirect.com/science/article/pii/S0939475321001812

[32] USSIA, S. et al. Exploring the Benefits of Extra Virgin Olive Oil on Cardiovascular Health Enhancement and Disease Prevention: A Systematic Review. – https://pmc.ncbi.nlm.nih.gov/articles/PMC12158199/

[33] WEI, L. et al. Neuroprotective properties of extra virgin olive oil polyphenols in Alzheimer’s disease: a multi-target mechanistic review. – https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1736633/full

[34] WILLETT, W.C. et al. Mediterranean diet pyramid: a cultural model for healthy eating. – https://pubmed.ncbi.nlm.nih.gov/7754995/

[35] Are you getting enough omega-3 fatty acids? | American Heart Association. – https://www.heart.org/en/news/2023/06/30/are-you-getting-enough-omega-3-fatty-acids>

[36] Cancer: Carcinogenicity of the consumption of red meat and processed meat. – https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat

[37] Decision of the Intergovernmental Committee: 5.COM 6.41 - UNESCO Intangible Cultural Heritage. – https://ich.unesco.org/en/decisions/5.COM/6.41

[38] Decision of the Intergovernmental Committee: 8.COM 8.10 - UNESCO Intangible Cultural Heritage. – https://ich.unesco.org/en/decisions/8.COM/8.10

[39] Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission - The Lancet. – https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/abstract

[40] Diet Review: Mediterranean Diet – https://nutritionsource.hsph.harvard.edu/healthy-weight/diet-reviews/mediterranean-diet/

[41] Dietary Guidelines for Americans. – https://www.dietaryguidelines.gov/

[42] Healthy diet. – https://www.who.int/news-room/fact-sheets/detail/healthy-diet

[43] IARC Monographs evaluate consumption of red meat and processed meat. – https://www.emro.who.int/noncommunicable-diseases/highlights/red-and-processed-meats-cause-cancer.html

[44] Increasing fruit and vegetable consumption to reduce the risk of noncommunicable diseases. – https://www.who.int/tools/elena/interventions/fruit-vegetables-ncds

[45] Mediterranean diet combined with calorie reduction and exercise lowers diabetes risk by 31%. – https://erc.europa.eu/news-events/news/mediterranean-diet-combined-calorie-reduction-and-exercise-lowers-diabetes-risk-31

[46] No level of alcohol consumption is safe for our health. – https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health

[47] Nutrition – Data and statistics. – https://www.who.int/europe/news-room/photo-stories/item/data-and-statistics

[48] Our Cancer Prevention Recommendations as a package of behaviours – https://www.wcrf.org/research-policy/global-cancer-update-programme/dietary-and-lifestyle-patterns

[49] Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts | New England Journal of Medicine. – https://www.nejm.org/doi/full/10.1056/NEJMoa1800389

[50] Risk reduction of cognitive decline and dementia: WHO guidelines. – https://www.who.int/publications/i/item/9789241550543

[51] What national and subnational interventions and policies based on Mediterranean and Nordic diets are recommended or implemented in the WHO European Region, and is there evidence of effectiveness in reducing noncommunicable diseases? – https://www.who.int/europe/publications/i/item/9789289053013