The Mediterranean Diet

Author: Caroline Deen 
(Accredited Practicing Dietitian) 

Eating responsibly is not only good for the planet it’s good for you too! While no food is inherently good or bad, it is important to enjoy a wide variety of foods in proper quantities; avoiding eating too much or too little.

The Mediterranean diet is one example of a plant based diet that is both sustainable and widely recognized to have extraordinary health benefits. It is a diet rich in vitamins, minerals, antioxidants, fibre and unsaturated fat, while also being low in processed foods, refined sugar and saturated fat. Not only is it exceptionally nutritious but it is also highly palatable and easier to follow than a low fat diet [1]. The Mediterranean diet consists of a wide variety of all foods but particularly fruit and vegetables.

The diet gained popularity and recognition in the 1960s from a big population study looking at the lifestyle and cardiovascular health of 7 countries. The results showed that populations in the US and Northern Europe had significantly larger numbers of deaths from heart disease than the population in Southern Europe [2]. Since that first finding the link between the traditional diet of countries around the Mediterranean Sea and its positive effect on health has become well established. 

Studies have shown the Mediterranean diet to reduce the risk of developing type 2 Diabetes by as much as 50% [3, 4].

The diet has been strongly associated with more weight loss, lower blood pressure, an improved cholesterol and lipid profile and better blood sugar control when compared to a low fat diet [3, 4, 5].

It also has a strong protective effect against:

  • obesity,
  • diabetes,
  • heart disease,
  • cancer,
  • Parkinson’s,
  • Alzheimer’s,
  • liver disease [3,4,6]

 People following a traditional Mediterranean diet live longer!

Ikaria (Greece) and Sardinia (Italia) are two places that follow a traditional Mediterranean diet and are among the five identified ‘Blue Zones”, which have the greatest population living beyond 100 years. The other three; Lima Loma (California), Nicoya (Costa Rica) and Okinawa (Japan) also follow a highly plant based diet [7].

The diet has been simplified into 10 Commandments which are as follows [1]:

  1. Use olive oil as the main added fat. (3 Tbsp/day)
  2. Eat a wide variety of vegetables with every meal: include tomatoes and leafy greens such as spinach and rucola.
  3. Include at least two legume meals per week. Legumes include beans, lentils and chickpeas. They can be bought dried or precooked in cans.
  4. Eat at least two serves of fish per week; include oily fish.
  5. Eat smaller portions of meat (beef, lamb, pork, chicken) and rarely.
  6. Eat fresh fruit every day. Great between meals as a snack or as dessert.
  7. Eat cheese less often.
  8. Choose wholegrain breads and cereals in moderate portions.
  9. If you enjoy wine consume it in moderation and always with meals.
  10. 10. Sweets for special occasions only and in small portions.

These key features of the diet are also in line with the principles of sustainable eating.

Below is an image of ‘The Double Pyramid’ produced by the Barilla Center for Food and Nutrition (BCFN) [8]. On the left the Mediterranean diet is outlined, with foods to be enjoyed most often at the bottom and those to be eaten occasionally at the top. On the right is a pyramid displaying foods with the greatest ecological footprint at the top in red and those that have the smallest ecological footprint at the bottom in green. The foods that are recommended to be consumed in large quantities have a lower environmental impact than those at the top of the pyramid which cause the greatest environmental damage.

References and further reading:
  1. Itsiopoulos C, Brazionis L, Kaimakamis M, Cameron M, Best JD, O'Dea K & Rowley K. Can the Mediterranean diet lower HbA1c in type 2 diabetes? Results from a randomized cross-over study. Nutr Metab Cardiovasc Dis 2010.
  2. Keys A, Kromhout D, Buzina R et al. Food Consumption patterns in the 1960s in seven countries. Am Soc Clin Nutr 1989; 49(5): 889-94.
  3. Estruch, R. Anti-inflammatory effects of the Mediterranean diet: the experience of the PREDIMED study. Proceedings Nutr Soc 2010; 69:333-340.
  4. Salas-Slavado J et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet. Diabetes Care. 2011; 34(1):14-9.
  5. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB.The effect of mediterranean diet on metabolic syndrome and its components a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011 Mar 15;57(11):1299-313
  6. Sofi et al, Adherence to Mediterranean diet and health status: meta-analysis. BMJ 2008:337:1344.
  7. Blue Zones 2014, About blue zones, Blue Zones, viewed 12 Sept 2015,
  8. Ciati R, Ruini L etal. Double Pyramid 2015; Recommendations for a sustainable diet. Italy; 2015. 78p.