What Is the “Mediterranean Diet” and How to Follow It
The mediterranean diet is back on the bullshit “best diets” list , which made me wonder: has anyone ever been on a mediterranean diet? Like on purpose? There is no simple app to track it and no easy-to-read book that gives simplified rules for saying “yes” or “no” to this or that dish.
For that matter, do any of us know what the Mediterranean diet actually consists of? Olive oil, of course, and fish. But then what? “My understanding is based almost entirely on the stock images for these articles,” said a Lifehacker employee, who was not named but who was saying what we all thought.
So let’s go deeper. What do you really need to know to follow the Mediterranean diet?
Most studies are observational
First, a little background on where the definition of the Mediterranean diet came from. Scholars used the term to describe the typical diet of people in certain Mediterranean communities and then expanded the definition to include similar diets elsewhere. But it’s important to know that many of the studies on the effects of the Mediterranean diet on diabetes, cancer, heart disease, dementia, and other health conditions are observational studies.
In other words, when you see a headline about the Mediterranean diet, it’s not necessarily the result of a study in which one group of people was assigned to the Mediterranean diet and another group to another diet (although such studies exist). Most often, studies ask people – sometimes in the Mediterranean region, sometimes outside of it – about what they usually eat. Their answers are used to calculate points (for example, 2 points if you eat more than 250 grams of vegetables on average per day), and the people with the highest scores are compared to the people with the lowest scores.
Where do these points come from? Here is a document describing one of the common systems. The numbers were determined by analyzing several dozen studies, each of which gave its own definitions of diet, studying people in different regions – some in the Mediterranean, others in other parts of Europe, and sometimes on other continents.
You can read the evaluation criteria here . In short, you get two points for each of the following:
- At least 250 grams of vegetables per day (1 point for 100-250)
- At least 300 grams of fruits and nuts per day (1 point for 150-300)
- At least 140 grams of legumes (beans and lentils) per week (1 point for 70-140)
- At least 195 grams of cereals (i.e. grains) per day (1 point for 130-195)
- At least 250 grams of fish per week (1 point for 100-250)
- Less than 80 grams of meat per day (1 point if you are under 120)
- Less than 180 grams of dairy products (1 point if you are under 270)
- Alcohol between 12 and 24 grams per day (1 point if you’re under 12 grams, no points if you’re over 24)
You also get one extra point if you cook with olive oil.
As you can see, using this system as a measure of your diet is not exactly easy. Cheese and skim milk are both dairy products, but they have different weights. The same goes for fruits and nuts: are we talking about a fresh apple or a bag of pistachios? You’ll also need to convert units if you’re not used to grams: 250 grams of fish is about half a pound, but 250 grams of vegetables can look very different depending on what the vegetable is. For example, it could be 2-1/2 cups of broccoli or one large onion.
Alcohol is a little easier: 12 grams is considered a standard drink, so that’s about one to two drinks a day, depending on the alcohol content. A 12 ounce beer at 5% ABV contains 14 grams of alcohol.
I find all of this counting to be an amusing counterpoint to US News’s notion that “not counting carbs, glasses, or calories” is a benefit of the Mediterranean diet. To figure out if you’re on a Mediterranean diet, you’ll have to count a hell of a lot of things.
A Few More Cautions
Before you douse your first fish fillet with olive oil, you should know that a group of epidemiologists wrote in 2019 that while observational studies seem to support the benefits of the Mediterranean diet, the experimental evidence is from studies of people who went on a diet that didn’t follow it. used to be only “promising (though not definitive)” when it comes to reducing the risk of heart disease.
It is also important to remember that the scientific understanding of the Mediterranean diet has been made up of foods that are considered traditional in Greece, Italy and neighboring regions. Foods are included or not depending on how typical they are of this traditional eating pattern.
This means that when people say that the Mediterranean diet is scientifically sound, they are referring to studies done on people who mostly follow it. This doesn’t mean scientists built it from the ground up by listing olive oil because they thought it was healthier than other oils, or defined 250+ grams as the ideal amount of vegetables for any particular reason.
Okay, but how do you actually follow this diet?
All this to say that the Mediterranean diet seems like a great way to eat. If you want to try, go for it. The vagueness of the description of the diet is both a plus and a minus. The good news is that no food group is excluded, and nothing is officially banned. Unfortunately, without strict rules or definitions, it’s hard to know exactly what to eat at your next meal if you want to stay on a diet.
The rating chart above isn’t the only way to judge the Mediterranean diet, but it’s just as good a starting point as any. Here’s what it would look like on a daily basis:
- Vegetables : It’s still difficult to measure out 250 grams of vegetables of various sizes and shapes, but the more familiar recommendation of 3 cups of vegetables will help you get it right.
- Fruits and Nuts : Two pieces of fresh fruit like an apple and an orange will easily reach the 300 gram goal. Swap other fruits as you see fit and try to eat somewhere around a handful of nuts a day – maybe as a topping for a salad or other dish, or maybe just a handful by itself.
- Legumes : 140 grams per week is only 20 grams per day when averaged out. One can of chickpeas or black beans will cover this requirement for a week.
- Cereals (cereals) : You can meet the need for 195 grams by drinking a cup of boiled brown rice. If you think of it as two 100-gram servings, you can have one meal with half a cup of rice or farro and one meal with 2 ounce pasta. According to the scorecard, more is fine, but you need to make sure there is room for everything else.
- Fish : 250 grams per week means a quarter-pound serving twice a week, but this is the minimum. You can have more.
- Meat : An average of 80 grams per day is just under three ounces (the famous “palm-sized” or “deck of cards” serving). It’s about the size of a quarter-pound patty or half a chicken breast. Unlike fish, this is meant to be the maximum, so you can fast every week to lower your daily average.
- Dairy : 180 grams is about six ounces. Thus, a five to six ounce container of yogurt would be considered sufficient for the day. Or add feta or mozzarella to your meal.
- Alcohol : The recommended amount is one to two drinks per day. A glass of wine with dinner would be in line with the recommendation.
- Olive oil can be used as needed for cooking.
Add that together and the daily diet might include a breakfast of yogurt and fruit; lunch salad with fish and vegetables; and dinner with meat, rice and other vegetables; and some hummus and whole grain bread for starters.
For recipe inspiration, Oldways (an organization that promotes traditional eating patterns, including but not limited to the Mediterranean diet) has a database of recipes here that you can filter by diet. OliveTomato has a printable shopping list (with typical “Mediterranean” foods you might want to stock up on) and a sample 5-day meal plan. There is also a Mediterranean Diet subreddit where people post ideas and recipes.