The Mediterranean Diet pros and Cons title. a lady, sitting at a table, about to eat.

Mediterranean Diet Pros and Cons

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Introduction:

If you could eat delicious tasting foods while socializing with family and friends and partake in a fun and active physical lifestyle and improve the quality of your health, would you adopt this sustainable habit?

This blog will review the Mediterranean Diet pros and cons. There are so many health benefits to this type of lifestyle. I will show you how you can tweak the cons to make it work for you!

Mediterranean Diet History:

The Mediterranean Diet has been researched for over 60 years. Studies continue to result in favorable health outcomes. Today, the Mediterranean diet is considered one of the healthier dietary models worldwide.1

Dr. Ancel Keys first studied the Mediterranean Diet in 1945, but his work failed to garner attention until the fall of 1958 when he started his Seven Countries Study. The results of this study indicated that deaths from coronary heart disease and stroke in the United States and Northern Europe greatly exceeded those in Southern Europe. Further research indicated that there was a clear difference in the diet and lifestyle of these regions.1

What is the Mediterranean Diet?

Before looking at the Mediterranean Diet pros and cons we should first review what this eating pattern looks like. First, it is not just a diet, but a culinary tradition. This lifestyle includes eating fresh, simply prepared, delicious tasting foods with seasonal ingredients.

The lifestyle encourages daily physical activity, adequate rest, and focuses on enjoying meals commonly around a table shared with family and friends in a social and leisurely way.2

The Mediterranean Diet is a generic name for the traditional dietary patterns of individuals living along the 22 countries bordering the Mediterranean Sea. This culinary tradition is simple and straightforward. Eat more fresh, whole foods, in season. Focus on fresh fruits, vegetables, whole grains, nuts, seafood, and olive oil.

The Mediterranean diet pros and cons:

The Mediterranean diet pros:

Mediterranean Diet pros and cons. Foods from the Mediterranean Diet on a table.
  1. Following it can Improve your overall health and quality of life.
  2. It is environmentally friendly and sustainable.
  3. It is a sustainable habit/lifestyle. Not a quick or temporary diet.
  4. Tastes delicious and full of nutrient dense foods.
  5. It is not a restrictive diet. No calorie counting.

The Mediterranean Diet characteristics:

  • Moderation. Portions sizes should be based on frugality, adapting energy needs to the physical active lifestyles.
  • Socialization: Social support and connections, gratitude for the meal, enjoying a meal with family or friends around a table, improved sense of community.
  • Cooking. Make cooking an important activity.
  • Seasonality: Emphasis on seasonal, fresh, minimally processed foods (sustainable diet model)3,4
  • Activity: Regular practice of moderate physical activity (at least 30 minutes total). This could include walking, taking the stairs, household chores, lawn work, gardening, hiking, etc.
  • Rest. Getting adequate rest is part of a healthy lifestyle.

Food Choices:

Mediterranean diet pros and cons. Pyramid of foods to consume.

Every meal: A variety of minimally processed whole grains and legumes:1-2 servings a meal (whole grain bread, whole grain pasta, brown and wild rice, quinoa, couscous, millet, amaranth, oatmeal, barley, bulgur, cornmeal, chickpeas, black beans, green peas, lima beans, kidney beans, black-eyed peas, navy beans, great northern beans, pinto beans, soybeans, lentils).  1 slice of bread, ½ cup cooked whole grain is one serving, 1-ounce cooked pasta.

Vegetables: 2 or more a meal: a variety of colors and texture.

Fruits: 1-2 a meal: a variety of colors and texture.

Fat: Olive oil (the main source of fat), extra virgin is best, nuts and seeds avocado.

Water: 6-8 glasses. May include non-sugar herbal tea, low salt/low fat broths.

Spices, herbs, garlic, and onions for flavoring.

Twice a day:

Dairy: 2 servings. Low fat is preferred. Low fat yogurt, cheese or other fermented dairy products.

A reasonable amount of (about a handful) Olives, nuts, and seeds for snacking.

Up to once a day with one meal.

Respecting religious and social beliefs, a moderate amount of wine or other fermented beverages during one meal sitting (up to one 5-ounce glass for woman, and up to two 5-ounce glass for men). * See the section below Should I really be drinking wine?

Weekly:

Traditional Mediterranean dishes do not have animal-origin protein foods as the main ingredient but rather as a condiment or a source of flavor in the dish.

Eggs: 2-4 week

Fish/seafood: A varied consumption of salmon, tuna, sardines, anchovies, mackerel, and herring (oily fish), shellfish, shrimp, lobster, clams, and scallops.

2 or more servings a week. 2-3 ounces per serving.

White meat poultry: 2 servings a week.

Red meat: less than 2 servings. Preferably lean cuts.

Processed meat: No more than one serving a week.

Occasionally:Food’s rich in sugar and unhealthy fats (sweets). Sugar, candies, pastries, and sweet beverages consumed in small amounts and set aside for special occasions. 6

So, in addition to the nutritional components and consumption of eco-friendly local seasonal food products of the Mediterranean Diet pattern, there is also an emphasis on exercise, conviviality, biodiversity, and culinary activities.

The Mediterranean Diet pros and cons for your health:

The Mediterranean Diet promotes overall health including improved function of many organs, decreased depressive symptoms, lower incidence of many cancers, and improved body weight. The benefits include Improved Metabolic, Cardiovascular, Reproductive, Neurodegenerative, and Mental health, Autoimmune disease, Bone health, Gut health and reduce risk of many cancers.

In a nutshell: The Mediterranean Diet is a sustainable eating pattern that has been extensively researched for over 60 years. Overall, the Mediterranean Diet has been linked to increased lifespan and longevity. Some of the Mediterranean Diet pros from the research are outlined below.

To change your life you must first change your habits.

Research studies have found the following benefits from following the Mediterranean Diet:

Overall improved longevity. 5,7

Reduction in cardiovascular risk: including lower triglycerides, blood pressure, increasing good cholesterol (HDL).8,9,10,11,12,13.

Reduction in Cancer risk. 1,8,14

Reduction in diabetes and diabetes complications, such as retinopathy.  1,10,12,15,16,18.

Lower incidence of gestational diabetes. Improvement in several neonatal and maternal outcomes.1

Modifies the risk of neurodegenerative diseases 16: Improved cognition, decreased depressive symptopms1,19, Reduced Alzheimer’s disease onset, 8.

Improvement in Gut health: decreased dysbiosis, decreased gastroesophageal reflux disease (GERD), Diverticulitis, decreased inflammatory bowel disease and colorectal cancer.8,16.

Reduction in gastric ulcers. 8

Positive effects on metabolic syndrome. 10,12

Improved body weight: Improved BMI (body mass index) and WC (Waist Circumference). 1,12,20,21.

Bone health: Improved BMD (bone mass density) and lower fracture risk. 1,17

The Mediterranean Diet pros for your health summary:

The Mediterranean Diet protects against many chronic diseases. The diet is rich in nutrient dense foods that are good sources of antioxidants, carotenoids, and polyphenols. The Mediterranean Diet is also a good source of dietary fiber and healthy fats. This powerful combination helps improve our body’s defense mechanisms to fight many diseases.

The Mediterranean Diet pros: Environmental Protection:

The Mediterranean Diet is considered one of the most environmentally friendly sustainable diets. Results in lower ecological footprint. Mediterranean foods.

The Mediterranean Diet is considered one of the most environmentally sustainable diets. Heathy for the environment as well as the consumer.  It has a lower environmental impact than other dietary patterns mainly due to the larger consumption of plant foods. The lower consumption of animal foods leaves a lower water footprint and lower greenhouse gas emissions compared to other diet patterns.

The Mediterranean Diet is considered to have a low environmental impact, and therefore more sustainable due to its emphasis on plant- based foods, focusing on seasonable local products.

Results in better ecological footprint.

Increase local and in-season plant-derived food intake.

Attenuates the environmental pressure of food production.

Mitigates climate change2, lowered demands soil, water, and energy resources. 3,6

The Mediterranean diet is rich in disease fighting nutrients:

The Mediterranean Diet is rich in functional nutrients that promote health, including:

Polyphenols have anti-oxidative, anti-bacterial or anti-inflammatory effects, anti-proliferative actions that help keep blood vessels healthy, flexible, promote circulation and decrease chronic inflammation): Food sources include berries, black currants, plums ,sweet cherries, apples, black beans, white beans, hazelnuts, walnuts, almonds, pecans, artichokes, chicory, red onions, spinach, soy tempeh, tofu, black and green teas, and red wine. (*Risks associated with polyphenols is most heavily connected to taking polyphenol in supplement form.)

Mono-unsaturated fatty acids, omega-3-polyunsaturated fatty acid: Olive oil, nuts, fatty fish (Salmon, sardine, Atlantic mackerel, cod, herring, lake trout, canned light tuna)

Flavonoid’s: known for antioxidant properties. Found in onions, kale, red and purple grapes, red wine, berries, tomatoes ,lettuce, scallions, broccoli, white tea, black tea, apples, blueberries, strawberries, cocoa, chocolate, parsley, red peppers, celery, lemons, limes, oranges, grapefruit.

Fiber (prebiotics):  High fiber intake (complex and insoluble). Found in Fruits, vegetables, legumes, whole grains.

These super nutrients work on our body and cause increased resistance to stress, increased insulin sensitivity, increased immune function, increased microbiome diversity. Decreased inflammation, decreased oxidative stress, decreased metabolic syndrome, decreased obesity and type 2 diabetes, decreased LDL, decreased cardiovascular diseases, decreased colorectal cancer, decreased neurogenerative disorders. 5,8

Many properties in these powerful foods have not been identified. These food properties have shown to prevent or improve the management of chronic diseases.

Mediterranean diet pros and cons. Mediterranean Diet is rich in disease fighting nutrients. List of nutrients and a lady with a cap on.

Mediterranean Diet potential cons:

With all the decades of research and health benefits with the Mediterranean diet, what could possibly go wrong? Would there be any disadvantages following this type of lifestyle?

Will I gain weight on a Mediterranean diet?

The Mediterranean Diet lifestyle incorporates daily physical activity and employs moderation in food portions. It also encourages a higher volume of nutrient but not calorically dense vegetables, fruits, and whole grains daily, while avoiding processed foods. For more information on how to easily incorporate daily activity into your daily life see HAES Life-Enhancing Movement – Waistline Dietitian

Eating more fresh fruits, vegetables, unprocessed wholegrains, and healthy fats will help register your hunger and fullness sensations. These foods help our internal hunger and fullness mechanisms work more efficiently. You will likely feel more satisfied with the higher fiber food intake with less overall food. We typically eat more processed foods before we have the same level of contentment.

Research studies have shown that people following a Mediterranean diet had improved body weight, improved BMI (body mass index) and WC (Waist Circumference). The Mediterranean Diet can help you attain your health weight by balancing healthy food choices and using your own internal hunger and fullness cues. 1,12,20,21.

Is the Mediterranean Diet too high in carbohydrates?

The Mediterranean Diet limits sugar and sweets to special occasions. The type of carbohydrates allowed on the Mediterranean Diet are fresh fruits, vegetables, minimally processed whole grains and legumes. These carbohydrates are also a good source of fiber. Pairing a moderate portion of these higher fiber carbohydrates with healthy fat and lean proteins at meals is generally recommended.

The Mediterranean Diet positively affects microbiome diversity. This means that it improves the resilience and strength of your gut. This lowers oxidative stress and inflammation, while improving insulin sensitivity and immune function. Consequently, this reduces Type 2 Diabetes Mellitus as well as many other diseases.25 For more information on the benefits of prebiotics and probiotics see my fellow dietitians blog article The Difference Between Prebiotics and Probiotics: The Basics – The Mental Wellness Dietitian (angelalagonutrition.com)

Studies have shown that people following the Mediterranean Diet had a reduction in developing diabetes as well as improved glucose control for people with diabetes.1,10,12,15,16,18.  If you have poorly controlled diabetes work closely with your doctor and registered dietitian to help you find the best balance of foods and medication to help you manage your blood sugar.

Arthur Ashe quote " Start where you are, use what you have, do what you can."

Should I really be drinking wine?

If you don’t already drink alcohol, don’t start. There are many other ways to get in the antioxidants from red wine. The polyphenol called resveratrol can also be found in grapes, grape juice, peanuts, pistachios, blueberries, cranberries, and dark chocolate.

The Mediterranean Diet allows up to one 5-ounce glass of Wine for women and two 5-ounce glasses of wine for men with one main meal a day. I have measured this out several times. This is not a lot of wine, and it would not be healthy to have more than this amount (studies show a negative effect on health with higher intakes.)

Some people should not drink at all, like women who are pregnant or trying to become pregnant, people under the age of 21 and people with certain health conditions. Some religions and social beliefs abstain from any alcohol. Herbal teas, or water is used in place.

If you do drink wine, limit to the portion size recommended to get the biggest health benefit! Moderation remains the key to overall health.

Will I become nutrient deficient because I am limiting red meat and dairy?

Many studies have indicated that people following the Mediterranean Diet eating pattern have good nutrient profiles and do not typically have any nutrient deficiencies. Bone mass and fractures were lower in people adhering to Mediterranean Diet, therefore indicating that getting adequate calcium and minerals is likely with a varied Mediterranean diet. Improved BMD (bone mass density) and lower fracture risk. 1,17,22,23,24.

The Mediterranean Diet limits red meat to less than 2 servings a week. Red meat is rich in iron, vitamin B12. You can continue to consume other foods rich in these nutrients:

Iron: Enriched breads, cereals, raisins, dried fruit, Egg yolk, spinach, and other leafy greens.

B12: Chicken, Fish, Dairy, Eggs, Fortified foods in B12 including fortified cereal, non-dairy milk, soy products.

The Mediterranean Diet limits dairy to two times a day. Other good sources of calcium and vitamin D include:

Calcium: Dark green leafy vegetables, edible fish bones, fortified juices, salmon, sardines with bones, shrimp, tofu.

Vitamin D is also in fatty fish and egg yolk.

How can I afford to go on a Mediterranean Diet?

Having less red meat and smaller portions of poultry and fish will reduce your grocery bill.

Cook more and eat out less. Many foods prepared at home are cheaper and more nutritious. Go back to basics and find a few simple healthy recipes your family enjoys.

The best way to save money at the grocery store is to plan. Plan your meals ahead of time. Check to see what foods you already have in the house and plan meals around food your already have most ingredients for first.  Then plan other meals around the sales.

When you go to the store, shop with a list to cut down on any extra purchase. Check the local sale advertisements and store coupons. Stock up on non-perishable sale items.

Shop for foods that are in season. Fruits and vegetables that are in season are usually less expensive. Buy just what you need so they do not go bad before you use them. Also have frozen vegetables and fruits on hand and buy them whenever they are on sale.

Focus on the nutritious lower cost foods such as beans, peas, and lentils, eggs, peanut butter, sweet or white potatoes, canned salmon, tuna, or crabmeat. Grains such as oats, brown rice, barley, or quinoa. Frozen and canned fruits and vegetables.

Life is a voyage. Adjust your sails towards health and vitality!

What if I do not have time to cook?

I would encourage you to begin slow and start small if this is new way of eating. Keep it simple. Start with gradually adjusting the meals you have been cooking with the healthier food and seasoning options. You may not have to change a lot.

Start by seeing what ingredients you already have available. Try to plan each week’s menus in advance.

Try a new recipe weekly. You may be able to modify some of your favorite recipes you already use and just focus on using the foods to include on the Mediterranean Diet.

Remember this is not a race but a journey. Cook once and eat twice. Every meal does not have to be perfect. Try starting out with one meal a day. Gradually grow to more and more.

Where’s the beef?

What if you cannot live without the beef? You do not have to eliminate red meat. Start by cutting back and eat it less often. Choose leaner cuts and trim visible fat before cooking, and use leaner cooking methods. Moderation is the key.

If these restrictions feel too strict, start slow and adapt what you can. Gradually build up.

What if I have a sweet tooth and cannot give up sugar?

You can start by using less sugar and eating fewer desserts. Replace some of your desserts with fruit. Try figs for a sweet taste after a meal.  Try adding other spices. Adding cinnamon to oatmeal. Reducing your sugar intake will help improve your overall health.

For tips on how to cut out sugar see my fellow dietitians blog “5 Surprising Ways to Cut Sugar Cravings” 5 Surprising Ways to Cut Sugar Cravings – Menopause Better

Summary:

Adopting healthy habits takes time and patience. Adopting the Mediterranean Diet will be worth your time and will pay you back with improved health and longevity. Start where you are with what you have. You will be glad you did.

If you are interested in adopting the Mediterranean Diet lifestyle, come back soon and see my next blog ” How to adopt a Mediterranean Diet/lifestyle”.

References:

1.Ventriglio, Antonio et al. “Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review.” Clinical practice and epidemiology in mental health: CP & EMH vol. 16, Suppl-1 156-164. 30 Jul. 2020, doi:10.2174/1745017902016010156

2.Dernini, Sandro, and Elliot M. Berry. “Mediterranean diet: from a healthy diet to a sustainable dietary pattern.” Frontiers in nutrition 2 (2015): 15.

3. Dernini, Sandro, et al. “Med Diet 4.0: the Mediterranean diet with four sustainable benefits.” Public health nutrition 20.7 (2017): 1322-1330.

4.Sabate, Joan, and Sam Soret. “Sustainability of plant-based diets: back to the future.” The American journal of clinical nutrition 100.suppl_1 (2014): 476S-482S.

5.Tosti, Valeria, Beatrice Bertozzi, and Luigi Fontana. “Health benefits of the Mediterranean diet: metabolic and molecular mechanisms.” The Journals of Gerontology: Series A 73.3 (2018): 318-326.

6.Bach-Faig, Anna, et al. “Mediterranean diet pyramid today. Science and cultural updates.” Public health nutrition 14.12A (2011): 2274-2284.

7.Romagnolo, Donato F., and Ornella I. Selmin. “Mediterranean diet and prevention of chronic diseases.” Nutrition today 52.5 (2017): 208.

8.Merra, Giuseppe, et al. “Influence of mediterranean diet on human gut microbiota.” Nutrients 13.1 (2021): 7.

9.Estruch, Ramón, et al. “Primary prevention of cardiovascular disease with a Mediterranean diet.” New England Journal of Medicine 368.14 (2013): 1279-1290.

10.Salas-Salvadó, Jordi, et al. “Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial.” Archives of internal medicine 168.22 (2008): 2449-2458.

11.Fitó, Montserrat, et al. “Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial.” Archives of internal medicine 167.11 (2007): 1195-1203

12.Esposito, Katherine, et al. “Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial.” Jama 292.12 (2004): 1440-1446.

13.Martínez-González, Miguel A., Alfredo Gea, and Miguel Ruiz-Canela. “The Mediterranean diet and cardiovascular health: A critical review.” Circulation research 124.5 (2019): 779-798.

14.Schwingshackl, Lukas, et al. “A network meta-analysis on the comparative efficacy of different dietary approaches on glycaemic control in patients with type 2 diabetes mellitus.” European journal of epidemiology 33.2 (2018): 157-170.

15.Salas-Salvadó, Jordi, et al. “Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial.” Diabetes care 34.1 (2011): 14-19.

16.Gantenbein, Katherina V., and Christina Kanaka-Gantenbein. “Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing.” Nutrients 13.6 (2021): 1951.

17.Palomeras-Vilches, Anna, et al. “Adherence to the mediterranean diet and bone fracture risk in middle-aged women: A case control study.” Nutrients 11.10 (2019): 2508.

18.Esposito, Katherine, et al. “A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses.” BMJ open 5.8 (2015): e008222.

19.Lassale, Camille, et al. “Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies.” Molecular psychiatry 24.7 (2019): 965-986.

20.Mancini, Joseph G., et al. “Systematic review of the Mediterranean diet for long-term weight loss.” The American journal of medicine 129.4 (2016): 407-415.

21.Pérez-Rey, Jesús, et al. “Adherence to a mediterranean diet and bone mineral density in Spanish premenopausal women.” Nutrients 11.3 (2019): 555.

22.Castro-Quezada, Itandehui, Blanca Román-Viñas, and Lluís Serra-Majem. “The Mediterranean diet and nutritional adequacy: a review.” Nutrients 6.1 (2014): 231-248.

23.Quattrini, Sara, et al. “Mediterranean diet adherence and dietary calcium intake in a group of pregnant women: Results of an Italian survey.” Food Science & Nutrition (2021).

24.Barrea, Luigi, et al. “Influence of the mediterranean diet on 25-hydroxyvitamin D levels in adults.” Nutrients 12.5 (2020): 1439.

25. Milenkovic, Tatjana, et al. “Mediterranean Diet and Type 2 Diabetes Mellitus: A Perpetual Inspiration for the Scientific World. A Review.” Nutrients 13.4 (2021): 1307.

Waistlinedietitian.com disclaimer. The purpose of this blog to to share information and not to replace medical advice. Please always follow up with your medical provider.

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