Benefits, heart health and weight loss

“The Med diet can include white pasta and grains on occasion, but within the pyramid, the biggest layer is for whole fruits and veg, pulses and legumes and nuts and seeds. Bread and pasta and cakes and sweets are included in the pyramid as occasional treats, but they are traditionally homemade, so there is a lot of focus on the quality of the food too,” says nutritionist Dr Federica Amati, a lecturer at Imperial College London and the author of the new book Every Body Should Know This. 

The Med diet is not only delicious and proven to be the healthiest way of eating, but its focus on vegetables, fruits and legumes is flexible and can be easily adapted to different national cuisines. 

It’s not complicated to cook, and because almost everything is included it’s not overly restrictive either. 

“You can recreate this eating pattern with any cuisine as every country has its indigenous plants and pulses so you can create the Med diet with foods that are local to you and in season. It works just as well for the south-east Asian and east African diets and with traditional British fruit and veg, for example,” says Dr Amati. 

“The important thing is that on this diet you’re getting lots of fibre, lots of different biochemicals, healthy fats and nutrients that we need to feel our best and to reduce our risk of illness later in life,” says Dr Emily Leeming, a dietitian and microbiome scientist. 

The diet is also about more than just food. When researchers studied the traditional eating patterns of people in Mediterranean countries, they observed that they were physically active most of the day and that their meals were leisurely and eaten with family and friends. At the bottom of the pyramid, then, is a recommendation to eat with others and be active. 

“It’s not just the food, it’s the whole lifestyle. It’s important to sit down and eat with family and friends and spend a reasonable amount of time to allow the feeling of satiety to kick in,” says Hoffman.

Heart health

The evidence for the protective elements of the Med diet is compelling. 

“Going back over 50 years, the Seven Countries Study found that dietary patterns in the Mediterranean were linked with lower rates of heart disease and death. The Lyon Diet Heart Study built on these findings – this clinical trial showed a striking protective effect on heart attack recurrence. Since then, large-scale trials have consistently shown compelling evidence on cardiovascular health including blood pressure and blood cholesterol,” says Dr Samantha Gill, a specialist gastroenterology dietitian. 

Weight management

The primary focus of the Med diet is health rather than weight loss but if it’s followed correctly, studies have shown that it leads to a lower body weight and that people tend to keep the weight off long-term, as they can stick to the Med diet more easily than other weight loss diets. 

Diabetes

As the Med diet is good for blood sugar control and weight management, it follows that it is also helpful for Type 2 diabetes. A review of studies in 2020 concluded that people who follow the diet are 20 per cent less likely to develop Type 2 diabetes than those who don’t follow the diet. 

Mental health and longevity

In 2017, a landmark study, the Smiles Trial, showed that the Med diet had a powerful effect on depression. 

“This study took people with moderate to severe depression – one group followed a Mediterranean-style diet and the other group did not. The diet included an impressive 50g of fibre per day. The results showed those in the Mediterranean-style group had a much greater reduction in depressive symptoms. In fact, 32 per cent in the diet group compared to 8 per cent in the control group were classified as no longer depressed,” says Dr Gill. 

Other studies have reported similar findings and the diet is also linked to a lower risk of dementia and Alzheimer’s disease. 

“At the base of the Med diet pyramid is eating socially with loved ones and a physically active lifestyle. We know that social contact and physical activity lead to better health outcomes and a longer life,” says Dr Amati. 

Pregnancy and fertility 

New research has linked the anti-inflammatory foods in the Med diet to improvements in fertility. Studies have also shown that eating the Med diet when pregnant also leads to healthier outcomes in children. 

Frailty in older people 

Studies have shown that following the Med diet can help improve and prevent frailty in older people.

Autoimmune conditions 

Several studies have shown that the Med diet is anti-inflammatory and can help ease symptoms of autoimmune diseases such as psoriasis, rheumatoid arthritis and inflammatory bowel diseases. 

Cancer 

A 2017 review of studies showed that the Med diet may help reduce the risk of several cancers, potentially because it reduces weight gain and obesity, which is linked to many cancers. 

Gut health 

Research has shown the Med diet can increase gut microbiome diversity and lead to a higher abundance of certain bacterial species. 

• Most of the diet should be made up of plants (for example fruits, vegetables, whole grains, legumes, nuts and seeds) which contain fibre and plant chemicals (such as polyphenols)
• Healthy fats such as monounsaturated fats from extra virgin olive oil and polyunsaturated fats (such as omega-3) from oily fish, nuts and seeds
• Lean proteins such as fish and to a lesser extent poultry
• Limited amounts of dairy, particularly fermented dairy such as yogurt and cheese
• Red wine, in limited amounts with food

“How you cook the food is also important. Meat is cooked mainly in stews, which reduces the production of carcinogens from high-temperature frying, and vegetables tend to be cooked in olive oil, which helps the body absorb the nutrients,” says Hoffman. 

Fruits and vegetables

Fruits and vegetables are very nutrient-dense, and consuming a wide variety means we ensure we get all the nutrients and biochemicals we need for our health. 

“With the Med diet we don’t have the traditional meat and two veg; the hero ingredients are the fruit and veg, so it’s about making sure you’re having a wide variety of fruit and vegetables and bringing them to the forefront of your diet,” says Dr Amati. 

And our choice of fruit and veg doesn’t have to be based on typically Mediterranean varieties – we can choose whatever is in season and local to us. 

Whole grains and fibre sources

The Med diet is rich in whole grains and sources of fibre such as nuts, seeds, beans and pulses. 

“We are understanding more and more what a vital role fibre plays in the health of our gut microbiome and whole grains and legumes, like rye bread and chickpeas, for example, tend to be higher in fibre than fruit and veg,” says Dr Leeming. 

Proteins: fish, poultry and plant-based options

Fish contains omega-3, which is important for our brain development. 

“Omega-3 is instrumental for our brains, mood and cognition, and in the UK and the US we have some of the lowest-circulating levels in our blood of omega-3. You can find omega-3s in plant sources too like flaxseeds, chia seeds and walnuts, but in plants it is harder to convert into the type of omega-3 DHA that we need for our brain, so if you’re not a fish eater I do tend to recommend a supplement,” says Dr Leeming.