View source for Mediterranean diet

{{Short description|Diet inspired by the Mediterranean region}}
{{About|the dietary recommendation that became popular in the 1990s|food of the areas around the [[Mediterranean Sea]]|Mediterranean cuisine}}
{{Use dmy dates|date=March 2024}}

[[File:DIETA MEDITERRANEA ITALIA.JPG|thumb|Some ingredients that form a large part of the Mediterranean diet]]
The '''Mediterranean diet''' is a concept first proposed in 1975 by American biologist [[Ancel Keys]] and chemist Margaret Keys. It is inspired by the eating habits and [[traditional food]]s of [[Greece]], [[southern Italy|Italy]], and the Mediterranean coasts of [[Southern France|France]] and [[Spain]], as observed in the late 1950s to early 1960s.<ref>{{Cite book |last=Keys |first=Ancel Benjamin |url=http://archive.org/details/howtoeatwellstay0000keys |title=How to eat well and stay well the Mediterranean way |date=1975 |publisher=Garden City, N.Y., Doubleday |others=Internet Archive |isbn=978-0-385-00906-5 |pages=1–2}}</ref><ref>{{cite journal |vauthors=Willett WC |title=Mediterranean diet pyramid: a cultural model for healthy eating |journal=The American Journal of Clinical Nutrition |date=June 1995 |volume=61 |issue=6 |pages=1402S–1406S |doi=10.1093/ajcn/61.6.1402S |pmid=7754995 |doi-access=free}}</ref> The diet is distinct from [[Mediterranean cuisine]], which encompasses the diverse [[Culinary arts|culinary traditions]] of [[List of Mediterranean countries#List of countries in the Mediterranean Basin|Mediterranean countries]],<ref>{{Cite web |title=What is the Mediterranean Diet? |url=https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet |access-date=2025-07-10 |website=www.heart.org |language=en}}</ref> and from the [[Atlantic diet]] of northwestern Spain and Portugal, albeit with some shared characteristics.<ref>{{Cite web |last=LaMotte |first=Sandee |date=2024-02-13 |title=A cousin to the Mediterranean diet: The Atlantic diet explained |url=https://www.cnn.com/2024/02/13/health/atlantic-diet-explainer-wellness |access-date=2025-07-10 |website=CNN |language=en}}</ref> The Mediterranean diet is the most well-known and researched dietary pattern in the world.<ref>{{Cite journal |last1=Kiani |first1=Aysha Karim |last2=Medori |first2=Maria Chiara |last3=Bonetti |first3=Gabriele |last4=Aquilanti |first4=Barbara |last5=Velluti |first5=Valeria |last6=Matera |first6=Giuseppina |last7=Iaconelli |first7=Amerigo |last8=Stuppia |first8=Liborio |last9=Connelly |first9=Stephen Thaddeus |last10=Herbst |first10=Karen L. |last11=Bertelli |first11=Matteo |date=June 2022 |title=Modern vision of the Mediterranean diet |journal=Journal of Preventive Medicine and Hygiene |volume=63 |issue=2 Suppl 3 |pages=E36–E43 |doi=10.15167/2421-4248/jpmh2022.63.2S3.2745 |issn=2421-4248 |pmc=9710405 |pmid=36479477}}</ref> 

While based on a specific time and place, the "Mediterranean diet" generically describes an eating pattern that has been refined based on the results of multiple scientific studies.<ref>{{Cite web |title=What is the Mediterranean Diet? |url=https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet |access-date=2025-07-10 |website=www.heart.org |language=en}}</ref> It emphasizes [[plant-based diet|plant-based foods]], particularly [[cereal|unprocessed cereals]], [[legume]]s, [[vegetable]]s, and [[fruit]]s;<ref name="cc">{{cite web|url=https://my.clevelandclinic.org/health/articles/16037-mediterranean-diet|title=Mediterranean Diet|publisher=Cleveland Clinic|date=20 November 2022|access-date=26 November 2023}}</ref> moderate consumption of [[fish as food|fish]] and [[dairy product]]s (mostly [[cheese]] and [[yogurt]]); and low amounts of [[red meat]], [[refined grains]], and [[sugar]].<ref name=cc/><ref>{{cite web|url=https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/mediterranean-diet/ |title=Diet Review: Mediterranean Diet|publisher=The Nutrition Source, Harvard University School of Public Health|date=1 April 2023|access-date=26 November 2023}}</ref> Alcohol intake is limited to [[wine]] (typically the [[Red wine|red variety]]) consumed in low to moderate amounts, usually with meals.<ref>{{Cite web |vauthors=McManus KD |date=2019-03-21 |title=A practical guide to the Mediterranean diet |url=https://www.health.harvard.edu/blog/a-practical-guide-to-the-mediterranean-diet-2019032116194 |access-date=2025-07-10 |website=Harvard Health |language=en}}</ref><ref>{{Cite web |title=Mediterranean diet for heart health |url=https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801 |access-date=2025-07-10 |website=Mayo Clinic |language=en}}</ref> [[Olive oil]] is the principal source of [[fat]] and has been studied as a potential health factor for reducing [[mortality rate|all-cause mortality]] and the risk of [[chronic disease]]s.<ref>{{Cite journal|last=Larsson, S|date=2022|title=Can Small Amounts of Olive Oil Keep the Death Away?|journal=Journal of the American College of Cardiology|volume=79 |issue=2 |pages=113–115 |doi=10.1016/j.jacc.2021.11.006 |pmid=35027107 |s2cid=245933012 |doi-access=free }}</ref> 

The Mediterranean diet is associated with a reduction in [[Mortality rate|all-cause mortality]] in [[observational study|observational studies]].<ref name="AACAHA2019">{{cite journal|display-authors=3|last1=Arnett|first1=Donna K.|last2=Blumenthal|first2=Roger S.|last3=Albert|first3=Michelle A.|author-link3=Michelle Albert|last4=Buroker|first4=Andrew B.|last5=Goldberger|first5=Zachary D.|last6=Hahn|first6=Ellen J.|last7=Himmelfarb|first7=Cheryl D.|last8=Khera|first8=Amit|last9=Lloyd-Jones|first9=Donald|last10=McEvoy|first10=J. William|last11=Michos|first11=Erin D.|date=17 March 2019|title=2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease|journal=Circulation|volume=140|issue=11|pages=e596–e646|doi=10.1161/CIR.0000000000000678|pmc=7734661|pmid=30879355|doi-access=free|first18=Boback|first14=Sidney C.|last18=Ziaeian|first17=Joseph|last17=Yeboah|first16=Kim A.|last16=Williams|first15=Salim S.|last15=Virani|last14=Smith|first13=Daniel|last13=Muñoz|last12=Miedema|first12=Michael D.}}</ref><ref>{{cite journal |last1=Guasch-Ferré |first1=M |last2=Willett |first2=WC |title=The Mediterranean diet and health: a comprehensive overview |journal=[[Journal of Internal Medicine]] |date=2021 |volume=290 |issue=3 |pages=549–566 |doi=10.1111/joim.13333 |doi-access=free|pmid=34423871 }}</ref> A 2017 review provided evidence that the Mediterranean diet lowers the risk of [[heart disease]] and early death;<ref name=Dinu2017>{{cite journal|last1=Dinu|first1=M|last2=Pagliai|first2=G|last3=Casini|first3=A|last4=Sofi|first4=F|title=Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials.|journal=European Journal of Clinical Nutrition|date=10 May 2017|doi=10.1038/ejcn.2017.58|pmid=28488692|volume=72|issue=1|pages=30–43|hdl=2158/1081996|s2cid=7702206|hdl-access=free}}</ref> it may also help with weight loss in [[obesity|obese people]].<ref name="pallaz">{{cite journal|display-authors=3 | last1=Pallazola | first1=Vincent A. | last2=Davis | first2=Dorothy M. | last3=Whelton | first3=Seamus P. | last4=Cardoso | first4=Rhanderson | last5=Latina | first5=Jacqueline M. | last6=Michos | first6=Erin D. | last7=Sarkar | first7=Sudipa | last8=Blumenthal | first8=Roger S. | last9=Arnett | first9=Donna K. | last10=Stone | first10=Neil J. | last11=Welty | first11=Francine K. | title=A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention | journal=Mayo Clinic Proceedings: Innovations, Quality & Outcomes | volume=3 | issue=3 | year=2019 | issn=2542-4548 | doi=10.1016/j.mayocpiqo.2019.05.001 | pages=251–267|pmid=31485563|pmc=6713921}}</ref> The Mediterranean diet is one of three [[healthy diet]]s recommended in the 2015–2020 [[Dietary Guidelines for Americans]], along with the [[DASH diet]] and [[vegetarianism|vegetarian diet]].<ref name="USDietaryGuidelines2015">{{cite web |title=2015–2020 Dietary Guidelines for Americans |url=https://health.gov/dietaryguidelines/2015/ |publisher=Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services |access-date=7 November 2019 |date=7 November 2019 |type=National guidelines |archive-date=6 November 2019 |archive-url=https://web.archive.org/web/20191106200014/https://health.gov/dietaryguidelines/2015/ |url-status=dead }}</ref> It is also recognized by the [[World Health Organization]] as a healthy eating pattern.<ref name=":0">{{Cite web |title=Mediterranean diet for heart health |url=https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801 |access-date=2025-07-10 |website=Mayo Clinic |language=en}}</ref>

Mediterranean cuisine and its associated traditions and practices were recognized as an [[Intangible cultural heritage|Intangible Cultural Heritage of Humanity]] by [[UNESCO]] in 2010 under the name "Mediterranean Diet".{{efn|In Cyprus, Croatia, Greece, Italy, Morocco, Spain, and Portugal}}<ref>{{Cite web |title=Intangible Cultural Heritage |url=https://mediterraneandietunesco.org/about/unesco-nomination/ |access-date=2025-06-21 |website=UNESCO Med Diet |language=en-US}}</ref> The Mediterranean diet is sometimes broadened to include particular [[lifestyle]] habits, social behaviors, and cultural values closely associated with certain Mediterranean countries,<ref>{{Cite journal |last1=Godos |first1=Justyna |last2=Scazzina |first2=Francesca |last3=Paternò Castello |first3=Corrado |last4=Giampieri |first4=Francesca |last5=Quiles |first5=José L. |last6=Briones Urbano |first6=Mercedes |last7=Battino |first7=Maurizio |last8=Galvano |first8=Fabio |last9=Iacoviello |first9=Licia |last10=de Gaetano |first10=Giovanni |last11=Bonaccio |first11=Marialaura |last12=Grosso |first12=Giuseppe |date=2024-03-21 |title=Underrated aspects of a true Mediterranean diet: understanding traditional features for worldwide application of a "Planeterranean" diet |journal=Journal of Translational Medicine |volume=22 |issue=1 |page=294 |doi=10.1186/s12967-024-05095-w |doi-access=free |issn=1479-5876 |pmc=10956348 |pmid=38515140}}</ref> such as simple but varied [[cooking methods]],<ref>{{Cite journal |last1=Godos |first1=Justyna |last2=Scazzina |first2=Francesca |last3=Paternò Castello |first3=Corrado |last4=Giampieri |first4=Francesca |last5=Quiles |first5=José L. |last6=Briones Urbano |first6=Mercedes |last7=Battino |first7=Maurizio |last8=Galvano |first8=Fabio |last9=Iacoviello |first9=Licia |last10=de Gaetano |first10=Giovanni |last11=Bonaccio |first11=Marialaura |last12=Grosso |first12=Giuseppe |date=2024-03-21 |title=Underrated aspects of a true Mediterranean diet: understanding traditional features for worldwide application of a "Planeterranean" diet |journal=Journal of Translational Medicine |volume=22 |issue=1 |page=294 |doi=10.1186/s12967-024-05095-w |doi-access=free |issn=1479-5876 |pmc=10956348 |pmid=38515140}}</ref> [[Communal meal|communal meals]], [[Siesta|post-lunch naps]], and regular physical activity.<ref name=":0" /><ref>{{Cite web |title=Fostering healthier and more sustainable diets – learning from the Mediterranean and New Nordic experience |url=https://www.who.int/europe/news/item/07-05-2018-fostering-healthier-and-more-sustainable-diets-learning-from-the-mediterranean-and-new-nordic-experience |access-date=2025-07-10 |website=www.who.int |language=en}}</ref>

==Health effects==
A 2017 review found evidence that practice of a Mediterranean diet could lead to reduced risk of [[cardiovascular diseases]], overall [[cancer]] incidence, [[neurodegenerative diseases]], [[diabetes]], and [[mortality rate|early death]].<ref name=Dinu2017/> A 2018 review showed that practice of the Mediterranean diet may improve overall health status, such as reduced risk of non-infectious diseases, reduced total [[cost of living|costs of living]], and reduced costs for national [[healthcare]].<ref name="martinez-lacoba2018">{{cite journal|last1=Martinez-Lacoba|first1=R|last2=Pardo-Garcia|first2=I|last3=Amo-Saus|first3=E|last4=Escribano-Sotos|first4=F|title=Mediterranean diet and health outcomes: a systematic meta-review.|journal=European Journal of Public Health|date= 2018|doi=10.1093/eurpub/cky113|pmid=29992229|volume=Advance articles|issue=5|pages=955–961|doi-access=free}}</ref> A 2016 review found similar weight loss as other diets.<ref>{{cite journal|last1=Mancini|first1=JG|last2=Filion|first2=KB|last3=Atallah|first3=R|last4=Eisenberg|first4=MJ|title=Systematic Review of the Mediterranean Diet for Long-Term Weight Loss|journal=American J Med|date=April 2016|volume=129|issue=4|pages=407–415.e4|pmid=26721635|doi=10.1016/j.amjmed.2015.11.028|doi-access=free}}</ref> A 2019 [[Cochrane review]] found that there is still uncertainty regarding the effects of Mediterranean‐style diet advice on cardiovascular disease occurrence and risk factors in people both with and without existing cardiovascular disease.<ref name="ReferenceA">{{cite journal | last1=Rees | first1=K | last2=Takeda | first2=A | last3=Martin | first3=N | last4=Ellis | first4=L | last5=Wijesekara | first5=D | last6=Vepa | first6=A | last7=Das | first7=A | last8=Hartley | first8=L | last9=Stranges | first9=S | title=Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease. | journal=The Cochrane Database of Systematic Reviews | volume=2019 | date=2019-03-13 | issue=3 | issn=1469-493X | pmid=30864165 | pmc=6414510 | doi=10.1002/14651858.CD009825.pub3 | article-number=CD009825}}</ref>

The United States 2015–2020 national guidelines devised a "Healthy Mediterranean-Style Eating Pattern", assessed against and mirroring the Mediterranean diet patterns and its positive health outcomes. It was designed from the "Healthy U.S.-Style Eating Pattern", but it contains more fruits and seafood, and less dairy.<ref name="USDietaryGuidelines2015" /> In the 2020s, research on the Mediterranean diet indicates that it may contribute to health.<ref>{{Cite journal|last1=O'Keefe|first1=James H.|last2=Torres-Acosta|first2=Noel|last3=O'Keefe|first3=Evan L.|last4=Saeed|first4=Ibrahim M.|last5=Lavie|first5=Carl J.|last6=Smith|first6=Sarah E.|last7=Ros|first7=Emilio|date=2020-09-22|title=A Pesco-Mediterranean Diet With Intermittent Fasting: JACC Review Topic of the Week|journal=Journal of the American College of Cardiology|volume=76|issue=12|pages=1484–1493|doi=10.1016/j.jacc.2020.07.049|issn=1558-3597|pmid=32943166|doi-access=free}}</ref>

===Cardiovascular disease===
The Mediterranean diet is included among dietary patterns that may reduce the risk of cardiovascular diseases.<ref name=pallaz/> A 2013 [[Cochrane review]] found limited evidence that a Mediterranean diet favorably affects cardiovascular [[risk factor]]s.<ref name="ReferenceA"/>  A 2013 meta-analysis compared Mediterranean, [[veganism|vegan]], vegetarian, low-glycemic index, low-carbohydrate, [[High fiber diet|high-fiber]], and [[high-protein diet]]s with control diets. The research concluded that Mediterranean, [[Low-carbohydrate diet|low-carbohydrate]], [[Low-glycemic diet|low-glycemic index]], and [[high-protein diet]]s are effective in improving markers of risk for cardiovascular disease and diabetes, while there was limited evidence for an effect of vegetarian diets on glycemic control and lipid levels unrelated to weight loss.<ref>{{cite journal|author1=Ajala O. |author2=English P. |author3=Pinkney J. |title= Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes |journal= The American Journal of Clinical Nutrition|volume=97|issue=3|pages=505–516|year=2013|pmid=23364002|doi=10.3945/ajcn.112.042457 |doi-access=free}}</ref> However, more cautious reviews arose in early 2016, raising concerns about the quality of previous [[systematic review]]s examining the impact of a Mediterranean diet on cardiovascular risk factors.<ref name="Huedo2016">{{cite journal|last1=Huedo-Medina|first1=TB|last2=Garcia|first2=M|last3=Bihuniak|first3=JD|last4=Kenny|first4=A|last5=Kerstetter|first5=J|title=Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: a review|journal=American Journal of Clinical Nutrition|date=March 2016|volume=103|issue=3|pages=841–50|doi=10.3945/ajcn.115.112771|pmid=26864357|type=Review|doi-access=free}}</ref> These reviews insisted upon the need for further standardized research,<ref name="pmid26483006">{{cite journal |vauthors=Nissensohn M, Román-Viñas B, Sánchez-Villegas A, Piscopo S, Serra-Majem L |title=The Effect of the Mediterranean Diet on Hypertension: A Systematic Review and Meta-Analysis |journal=Journal of Nutrition Education and Behavior |volume=48 |issue=1 |pages=42–53.e1 |date=January 2016 |pmid=26483006 |doi=10.1016/j.jneb.2015.08.023 |type=Review}}</ref> stating that the evidence for possible prevention of cardiovascular disease by the diet was "limited and highly variable".<ref name="pmid27509006">{{cite journal |vauthors=Liyanage T, Ninomiya T, Wang A, Neal B, Jun M, Wong MG, Jardine M, Hillis GS, Perkovic V |title=Effects of the Mediterranean Diet on Cardiovascular Outcomes-A Systematic Review and Meta-Analysis |journal=PLOS ONE |volume=11 |issue=8 |article-number=e0159252 |date=2016 |pmid=27509006 |pmc=4980102 |doi=10.1371/journal.pone.0159252 |type=Review|bibcode=2016PLoSO..1159252L |doi-access=free }}</ref> Reviews in 2016-17 reached similar conclusions about the ability of a Mediterranean diet to improve cardiovascular risk factors, such as lowering the risk for [[hypertension]] and other cardiovascular diseases.<ref name=Dinu2017/><ref name="Gay2016">{{cite journal|last1=Gay|first1=HC|last2=Rao|first2=SG|last3=Vaccarino|first3=V|last4=Ali|first4=MK|title=Effects of Different Dietary Interventions on Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials|journal=Hypertension|date=April 2016|volume=67|issue=4|pages=733–9|doi=10.1161/HYPERTENSIONAHA.115.06853|pmid=26902492|s2cid=24011456|doi-access=free}}</ref> A Mediterranean diet is recommended as a means of lowering [[Apolipoprotein B]].<ref name="pmid327821191">{{cite journal | vauthors = Lamantia V, Sniderman A, Faraj M| title=Nutritional management of hyperapoB | journal= Nutrition Research Reviews | volume=29| issue=2 | pages=202–233 | year=2016 | doi= 10.1017/S0954422416000147 | pmid=27821191}}</ref>

The Mediterranean diet is low in [[saturated fat]] with high amounts of [[monounsaturated fat]] and [[dietary fiber]]. One possible factor is the [[Olive oil#Potential health effects|potential health effects of olive oil]] in the Mediterranean diet. Olive oil contains monounsaturated fats, most notably [[oleic acid]], which is under clinical research for its potential health benefits.<ref name=BucklandGonzalez2015>{{cite journal|vauthors=Buckland G, González CA|title=The role of olive oil in disease prevention: a focus on the recent epidemiological evidence from cohort studies and dietary intervention trials|journal=Br J Nutr|volume=113|pages=S94–101|date=April 2015|issue=Suppl 2 |pmid=26148926|doi=10.1017/S0007114514003936|type=Review|doi-access=free}}</ref> The [[European Food Safety Authority]] Panel on Dietetic Products, Nutrition and Allergies approved health claims on olive oil, for protection by its [[polyphenol]]s against oxidation of blood lipids<ref name=EFSApolyphenols2011>{{cite journal|author=European Food Safety Authority|title=Scientific Opinion on the substantiation of health claims related to polyphenols in olive|journal=EFSA Journal|volume=9|issue=4|page=2033|date=2011|doi=10.2903/j.efsa.2011.2033|doi-access=free}}</ref> and for the contribution to the maintenance of normal blood [[LDL-cholesterol]] levels by replacing saturated fats in the diet with oleic acid<ref name=EFSAoleicacid2011>{{cite journal|author=European Food Safety Authority|title=Scientific Opinion on the substantiation of health claims related to oleic acid intended to replace saturated fatty acids (SFAs) in foods or diets |journal=EFSA Journal|volume=9|issue=4|page=2043|date=2011|doi=10.2903/j.efsa.2011.2043|doi-access=free}}</ref> (Commission Regulation (EU) 432/2012 of 16 May 2012).<ref name=OfficialJournalEuropeanUnion2012>{{cite web|url=http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32012R0432|title=COMMISSION REGULATION (EU) No 432/2012 of 16 May 2012 establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children's development and health. Text with EEA relevance.|website=Official Journal of the European Union|access-date=31 August 2016}}</ref> A 2014 meta-analysis concluded that an elevated consumption of olive oil is associated with reduced risk of all-cause mortality, cardiovascular events and stroke, while monounsaturated fatty acids of mixed animal and plant origin showed no significant effects.<ref name=SchwingshacklHoffmann2014>{{cite journal|vauthors=Schwingshackl L, Hoffmann G|title=Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies|journal=Lipids Health Dis|volume=13|article-number=154|date=1 October 2014|pmid=25274026|doi=10.1186/1476-511X-13-154|pmc=4198773|type=Review |doi-access=free }}</ref> The [[American Heart Association]] discussed the Mediterranean diet as a healthy dietary pattern that may reduce the risk of [[cardiovascular disease]]s.<ref name="AHA2016">{{cite journal|display-authors=3|last1=Van Horn |first1=L |last2=Carson |first2=JA |last3=Appel |first3=LJ |last4=Burke |first4=LE |last5=Economos |first5=C |last6=Karmally |first6=W |last7=Lancaster |first7=K |last8=Lichtenstein |first8=AH |last9=Johnson |first9=RK |last10=Thomas |first10=RJ |last11=Vos |first11=M |last12=Wylie-Rosett |first12=J |last13=Kris-Etherton |first13=P |name-list-style=vanc |date=29 November 2016 |title=Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association. |journal=Circulation |volume=134 |issue=22 |pages=e505–e529 |doi=10.1161/CIR.0000000000000462 |pmid=27789558 |s2cid=37889352 |doi-access=free}}</ref>

A 2023 review found evidence for a reduction of mortality and cardiovascular disease risk in women on a Mediterranean-type diet.<ref name="HRT-20230314">{{cite journal |author=Pant, Anushriya |display-authors=et al. |date=March 14, 2023 |title=Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis |url=https://heart.bmj.com/content/early/2023/02/14/heartjnl-2022-321930 |journal=[[Heart (journal)|Heart]] |volume=109 |issue=16 |pages=1208–1215 |doi=10.1136/heartjnl-2022-321930 |pmid=36918266 |s2cid=257533347 |access-date=March 16, 2023}}</ref>

===Diabetes===
In 2014, two meta-analyses found that the Mediterranean diet was associated with a decreased risk of [[type 2 diabetes]],<ref>{{cite journal|last1=Schwingshackl|first1=L|last2=Missbach|first2=B|last3=König|first3=J|last4=Hoffmann|first4=G|title=Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis.|journal=Public Health Nutrition|date=22 August 2014|pages=1292–9|pmid=25145972|doi=10.1017/S1368980014001542|volume=18|issue=7|pmc=10273006|doi-access=free}}</ref><ref>{{cite journal|last1=Koloverou|first1=E|last2=Esposito|first2=K|last3=Giugliano|first3=D|last4=Panagiotakos|first4=D|title=The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants.|journal=Metabolism: Clinical and Experimental|date=July 2014|volume=63|issue=7|pages=903–11|pmid=24931280|doi=10.1016/j.metabol.2014.04.010}}</ref> findings similar to those of a 2017 review.<ref name=Dinu2017/> The American Diabetes Association and a 2019 review indicated that the Mediterranean diet is a healthy dietary pattern that may reduce the risk of diabetes.<ref name="ADA2019">{{cite journal |author=American Diabetes Association |date=January 2019 |title=5. Lifestyle Management: Standards of Medical Care in Diabetes-2019 |journal=Diabetes Care |volume=42 |issue=Suppl 1 |pages=S46–S60 |doi=10.2337/dc19-S005 |pmid=30559231 |doi-access=free}}</ref><ref>{{cite web|title=8 eating plans for patients with prediabetes
|date=25 December 2019 |publisher=American Medical Association|url = https://www.ama-assn.org/delivering-care/diabetes/8-eating-plans-patients-prediabetes|access-date=4 October 2020}}</ref>

===Cancer===
A [[meta-analysis]] in 2008 found that strictly following the Mediterranean diet was correlated with a decreased risk of dying from cancer by 6%.<ref name="pmid18786971">{{cite journal |vauthors=Sofi F, Cesari F, Abbate R, Gensini GF, Casini A |title=Adherence to Mediterranean diet and health status: meta-analysis|journal=BMJ (Clinical Research Ed.)|volume=337|issue=sep11 2 |article-number=a1344 |year=2008 |pmid=18786971 |pmc=2533524 |doi=10.1136/bmj.a1344}}</ref> Another 2014 review found that adherence to the Mediterranean diet was associated with a decreased risk of death from cancer.<ref>{{cite journal|last1=Schwingshackl|first1=L|last2=Hoffmann|first2=G|date=15 October 2014|title=Adherence to Mediterranean diet and risk of cancer: a systematic review and meta-analysis of observational studies.|journal=International Journal of Cancer|volume=135|issue=8|pages=1884–97|doi=10.1002/ijc.28824|pmid=24599882|s2cid=10389033|doi-access=free}}</ref> A 2017 review found a decreased rate of cancer, although evidence was weak.<ref name="Dinu2017"/> An updated review in 2021 found that the Mediterranean diet is associated with a 13% lower risk of cancer mortality in the general population.<ref>{{cite journal|vauthors=Morze J, Danielewicz A, Przybyłowicz K |date=2021|title=An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer|journal=European Journal of Nutrition|volume=60|issue=3|pages=1561–1586|doi=10.1007/s00394-020-02346-6|pmid=32770356|pmc=7987633}}</ref>

===Weight loss in obesity===
Overweight adults who adopt Mediterranean diets may lose weight by consuming fewer calories.<ref>{{cite journal |last1=Estruch |first1=Ramon |last2=Ros |first2=Emilio |title=The role of the Mediterranean diet on weight loss and obesity-related diseases |journal=Reviews in Endocrine and Metabolic Disorders |date=1 September 2020 |volume=21 |issue=3 |pages=315–327 |doi=10.1007/s11154-020-09579-0 |pmid=32829455 |s2cid=221235205 |url=https://link.springer.com/article/10.1007/s11154-020-09579-0 |access-date=23 March 2021 |language=en |issn=1573-2606|url-access=subscription }}</ref><ref>{{cite journal |last1=Esposito |first1=Katherine |last2=Kastorini |first2=Christina-Maria |last3=Panagiotakos |first3=Demosthenes B. |last4=Giugliano |first4=Dario |name-list-style=vanc |title=Mediterranean diet and weight loss: meta-analysis of randomized controlled trials |journal=Metabolic Syndrome and Related Disorders |date=February 2011 |volume=9 |issue=1 |pages=1–12 |doi=10.1089/met.2010.0031 |pmid=20973675 |issn=1557-8518}}</ref><ref>{{cite journal |last1=Mancini |first1=Joseph G. |last2=Filion |first2=Kristian B. |last3=Atallah |first3=Renée |last4=Eisenberg |first4=Mark J. |title=Systematic Review of the Mediterranean Diet for Long-Term Weight Loss |pmid=26721635|journal=The American Journal of Medicine|pages=407–415.e4 |doi=10.1016/j.amjmed.2015.11.028|url=https://www.amjmed.com/article/S0002-9343(15)30027-9/fulltext |date=April 2016|volume=129 |issue=4 |doi-access=free }}</ref> A 2019 review found that the Mediterranean diet may help obese people lower the quantity and improve the nutritional quality of food intake, with an overall effect of possibly losing body weight.<ref name=pallaz/>

===Cognitive ability===
A 2016 systematic review found a relation between greater adherence to a Mediterranean diet and better cognitive performance; it is unclear if the relationship is causal.<ref>{{cite journal|last1=Petersson|first1=SD|last2=Philippou|first2=E|title=Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence.|journal=Advances in Nutrition|date=September 2016|volume=7|issue=5|pages=889–904|doi=10.3945/an.116.012138|pmid=27633105|pmc=5015034}}</ref>

According to a 2013 systematic review, greater adherence to a Mediterranean diet is correlated with a lower risk of [[Alzheimer's disease]] and slower cognitive decline.<ref>{{cite journal|last1=Lourida|first1=Ilianna|last2=Soni|first2=Maya|last3=Thompson-Coon|first3=Joanna|last4=Purandare|first4=Nitin|last5=Lang|first5=Iain A.|last6=Ukoumunne|first6=Obioha C.|last7=Llewellyn|first7=David J.|title=Mediterranean Diet, Cognitive Function, and Dementia|journal=Epidemiology|date=July 2013|volume=24|issue=4|pages=479–489|doi=10.1097/EDE.0b013e3182944410|pmid=23680940|s2cid=19602773|doi-access=free}}</ref> Another 2013 systematic review reached similar conclusions, and also found a negative association with the risk of progressing from [[mild cognitive impairment]] to Alzheimer's, but acknowledged that only a small number of studies had been done on the topic.<ref>{{cite journal|last1=Singh|first1=B|last2=Parsaik|first2=AK|last3=Mielke|first3=MM|last4=Erwin|first4=PJ|last5=Knopman|first5=DS|last6=Petersen|first6=RC|last7=Roberts|first7=RO|title=Association of mediterranean diet with mild cognitive impairment and Alzheimer's disease: a systematic review and meta-analysis.|journal=Journal of Alzheimer's Disease|date=2014|volume=39|issue=2|pages=271–82|pmid=24164735|doi=10.3233/JAD-130830|pmc=3946820}}</ref>

===Major depressive disorder===
[[observational study|Observational]] studies have found a correlation between adherence to the Mediterranean diet and a lower risk of depression but have not proven that a Mediterranean diet lowers the risk of depression.<ref>{{cite journal |last1=Lassale |first1=C |last2=Batty |first2=GD |last3=Baghdadli |first3=A |last4=Jacka |first4=F |last5=Sánchez-Villegas |first5=A |last6=Kivimäki |first6=M |last7=Akbaraly |first7=T |title=Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. |journal=Molecular Psychiatry |date=July 2019 |volume=24 |issue=7 |pages=965–986 |doi=10.1038/s41380-018-0237-8 |pmid=30254236|pmc=6755986 }}</ref><ref>{{cite journal |last1=Psaltopoulou |first1=T |last2=Sergentanis |first2=TN |last3=Panagiotakos |first3=DB |last4=Sergentanis |first4=IN |last5=Kosti |first5=R |last6=Scarmeas |first6=N |title=Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. |journal=Annals of Neurology |date=October 2013 |volume=74 |issue=4 |pages=580–91 |doi=10.1002/ana.23944 |pmid=23720230|s2cid=5995461 }}</ref>

===Gluten===
As the Mediterranean diet usually includes products containing [[gluten]], such as pasta and bread, increasing use of the diet may have contributed to the growing rate of [[gluten-related disorders]].<ref name="VoltaCaioQuestionsQuotation">{{cite journal|vauthors=Volta U, Caio G, Tovoli F, De Giorgio R|year=2013|title=Non-celiac gluten sensitivity: questions still to be answered despite increasing awareness|journal=Cellular and Molecular Immunology|type=Review|volume=10|issue=5|pages=383–392|doi=10.1038/cmi.2013.28|issn=1672-7681|pmc=4003198|pmid=23934026|quote=Many factors have contributed to the development of gluten-related pathology, starting with the worldwide spread of the Mediterranean diet, which is based on a high intake of gluten-containing foods.}}</ref>

==Dietary components==
{{Further|Mediterranean cuisine}}
[[File:Harvard food pyramid.png|thumb|The Mediterranean diet [[Food pyramid (nutrition)|food pyramid]], summarizing the pattern of eating associated with this diet]]

There are variations of the "Mediterranean diets" in different countries and among the individual populations of the Mediterranean basin, due to ethnic, cultural, economic and religious diversities.<ref name="bmc">{{cite journal |last1=Trichopoulou |first1=A |last2=Martínez-González |first2=MA |last3=Tong |first3=TY |last4=Forouhi |first4=NG |last5=Khandelwal |first5=S |last6=Prabhakaran |first6=D |last7=Mozaffarian |first7=D |last8=de Lorgeril |first8=M |title=Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. |journal=BMC Medicine |date=24 July 2014 |volume=12 |article-number=112 |doi=10.1186/1741-7015-12-112 |pmid=25055810|pmc=4222885 |doi-access=free }}</ref> The "Mediterranean diet" as defined by dietitians generally includes the following components,<ref name=pallaz/> which are not typical of diets in the [[Mediterranean Basin]]:<ref name=LinAronson2015>{{cite journal|vauthors=Lin PH, Aronson W, Freedland SJ|title=Nutrition, dietary interventions and prostate cancer: the latest evidence|journal=BMC Medicine |volume=13|article-number=3|date= 8 January 2015|pmid=25573005|pmc=4823849|doi=10.1186/s12916-014-0234-y|type=Review |doi-access=free }}</ref><ref name="Willett_Defines_Med_Diet">{{cite journal |author=Willett WC |title=Mediterranean diet pyramid: a cultural model for healthy eating|journal=American Journal of Clinical Nutrition |volume=61 |pages=1402S–6S |pmid=7754995 |issue=6 |date= 1 June 1995 |last2=Sacks |first2=F |last3=Trichopoulou |first3=A |last4=Drescher |first4=G |last5=Ferro-Luzzi |first5=A |last6=Helsing |first6=E |last7=Trichopoulos |first7=D |doi=10.1093/ajcn/61.6.1402s|doi-access=free }}</ref>
* High intakes of [[olive oil]] (as the principal source of fat), and a [[plant-based diet]]: vegetables (including leafy green vegetables, onions, garlic, tomatoes, and peppers), fresh fruits (consumed as desserts or snacks), cereals (mostly [[whole grain]]s), nuts, and legumes.
* Moderate intakes of fish and other [[seafood]], poultry, eggs, [[dairy product]]s (primarily cheese and yogurt), and red wine.
* Low intakes of red meat, [[processed meat]], refined carbohydrates, and sweets.

These proportions are sometimes represented in the [[Mediterranean Diet Pyramid]]. In a diet with roughly this composition, the fat content accounts for 25% to 35% of the total intake of [[calorie]]s, while the amount of saturated fat is, at most, 8% of the calorie content.<ref name="Willett_Defines_Med_Diet" />

Some [[Mediterranean cuisine|cuisines of the Mediterranean region]] are not fully consistent with Mediterranean diet guidelines. For instance, olive oil is not the staple fat in the cuisines of all countries which border the Mediterranean: in [[Northern Italy|northern]] and [[Central Italy|central]] Italy, [[lard]] and [[butter]] are commonly used in cooking, and olive oil is reserved for dressing salads and cooked vegetables;<ref name="Alberini">Massimo Alberini, Giorgio Mistretta, ''Guida all'Italia gastronomica'', Touring Club Italiano, 1984</ref> in both [[North Africa]] and the [[Middle Eastern cuisine|Middle East]], sheep's [[tail fat]] and rendered butter ([[ghee|''samna'']]) are traditional staple fats.<ref name="Tapper">{{cite book |author1=Tapper, Richard |author2=Zubaida, Sami |title=A Taste of Thyme: Culinary Cultures of the Middle East |publisher=Tauris Parke Paperbacks |year=2001 |isbn=978-1-86064-603-4 |page=43}}</ref>

{| class="wikitable"
	|+ Comparison of dietary recommendations for three Mediterranean diet plans
|-
	! Foods
	! Oldway's Preservation<br />and Trust (2009)<ref>{{cite web | title = Mediterranean Diet Pyramid | url = http://oldwayspt.org/resources/heritage-pyramids/mediterranean-pyramid/overview | access-date = 27 February 2013 }}</ref> 
	! Mediterranean Diet<br />Foundation (2001)<ref>{{Cite journal | pmid = 22166184| year = 2011| last1 = Bach-Faig| first1 = A.| title = Mediterranean diet pyramid today. Science and cultural updates| journal = Public Health Nutrition| volume = 14| issue = 12A| pages = 2274–84| last2 = Berry| first2 = E. M.| last3 = Lairon| first3 = D.| last4 = Reguant| first4 = J.| last5 = Trichopoulou| first5 = A.| last6 = Dernini| first6 = S.| last7 = Medina| first7 = F. X.| last8 = Battino| first8 = M.| last9 = Belahsen| first9 = R.| last10 = Miranda| first10 = G.| last11 = Serra-Majem| first11 = L.| author12 = Mediterranean Diet Foundation Expert Group| doi = 10.1017/S1368980011002515| doi-access = free| hdl = 10609/92329| hdl-access = free}}</ref>
	! Greek Dietary<br />Guidelines (1999)<ref>Food and Agriculture Organization of the United Nations, "Food-based dietary guidelines—Greece" [https://www.fao.org/nutrition/education/food-dietary-guidelines/regions/greece/previous-versions-gre/en/]</ref><ref>{{Cite journal | pmid = 15012018 | year = 2004 | last1 = Martínez-González | first1 = M. A. | title = The emerging role of Mediterranean diets in cardiovascular epidemiology: Monounsaturated fats, olive oil, red wine or the whole pattern? | journal = European Journal of Epidemiology | volume = 19 | issue = 1 | pages = 9–13 | last2 = Sánchez-Villegas | first2 = A. | doi=10.1023/b:ejep.0000013351.60227.7b| s2cid = 8863511 }}</ref>
|-
	| [[Olive oil]] || Every meal || Every meal || Main added lipid
|-
	| [[Vegetables]] || Every meal || ≥2 servings every meal  || 6 serv./day
|-
	| [[Fruits]] || Every meal || 1–2 serv. every meal || 3 serv./day
|-
	| [[Bread]]/[[cereals]] || Every meal || 1–2 serv. every meal || 8 serv./day
|-
	| [[Legumes]] || Every meal || ≥2 serv./week || 3-4 serv./week
|-
	| [[Nut (fruit)|Nuts]] || Every meal || 1–2 serv./day || 3–4 serv./week
|-
	| [[Fish]]/[[seafood]] ||  ≥2 serv./week || ≥2 serv./week  || 5–6 serv./week
|-
	| [[Egg as food|Eggs]] || Moderate portions, daily to weekly || 2–4 serv./week || 3 serv./week
|-
	| [[Poultry]] || Moderate portions, daily to weekly || 2 serv./week || 4 serv./week
|-
	| [[Dairy product]]s || Moderate portions, daily to weekly || 2 serv./day || 2 serv./day
|-
	| [[Red meat]] || Less often || <2 serv./week || 4 serv./month
|-
	| [[Confectionery|Sweets]] || Less often || <2 serv./week || 3 serv./week
|-
	| [[Red wine]] || In moderation || In moderation || Daily, in moderation
|-
	| colspan=4 | {{small| Servings are defined as: {{nowrap|bread 25 g.}}, {{nowrap|[[potato]] 100 g.}}, {{nowrap|cooked [[pasta]] 50–60 g.}}, {{nowrap|vegetables 100 g.}}, {{nowrap|[[apple]] 80 g.}}, {{nowrap|[[banana]] 60 g.}}, {{nowrap|[[orange (fruit)|orange]] 100 g.}}, {{nowrap|[[melon]] 200 g.}}, {{nowrap|[[grapes]] 30 g.}}, {{nowrap|[[milk]] or [[yogurt]] 1 cup}}, {{nowrap|1 egg}}, {{nowrap|meat 60 g.}}, {{nowrap|cooked dry beans 100 g.}}}}
|}

==Environmental effects==
{{See also|Sustainable diet|Environmental impact of agriculture}}
Consuming a Mediterranean diet or plant-based diet may contribute to improving [[Environmentalism|environmental]] and [[Sustainable agriculture|agricultural sustainability]],<ref>{{Cite journal |last=Willett |first=Walter |date=2021-04-26 |title=Mediterranean Dietary Pyramid |journal=International Journal of Environmental Research and Public Health |volume=18 |issue=9 |page=4568 |doi=10.3390/ijerph18094568 |doi-access=free |issn=1660-4601 |pmc=8123460 |pmid=33925778 |quote=The fundamental innovation in the updated MDP is a dimension representing environmental sustainability}}</ref><ref>{{Cite journal |last1=Tucci |first1=Massimiliano |last2=Martini |first2=Daniela |last3=Vinelli |first3=Valentina |last4=Biscotti |first4=Paola |last5=Porrini |first5=Marisa |last6=Del Bo' |first6=Cristian |last7=Riso |first7=Patrizia |date=2024 |title=The MED_EAT-IT approach: A modelling study to develop feasible, sustainable and nutritionally targeted dietary patterns based on the Planetary health diet |journal=Current Research in Food Science |volume=8 |article-number=100765 |doi=10.1016/j.crfs.2024.100765 |issn=2665-9271 |pmc=11109324 |pmid=38779344 |quote=This study reports on strategies to improve the previous pattern and align it more closely with the Mediterranean Diet, resulting in the MED_EAT-IT pattern.}}</ref> possibly due to lower use of dairy products, [[Ruminants#Ruminants and climate change|ruminant meat]], and [[ultra-processed foods]].<ref name="nbcnews.com">{{cite web |title=How our diets impact climate change — and what we can do about it |url=https://www.nbcnews.com/better/lifestyle/how-our-diets-impact-climate-change-what-we-can-do-ncna1041301 |website=NBC News |date=12 August 2019 |access-date=23 March 2021 |language=en}}</ref>{{better source|date=August 2025}} The environmental impact and amount of energy needed to feed livestock exceeds its nutritional value.<ref>{{cite news| title=U.S. could feed 800 million people with grain that livestock eat, Cornell ecologist advises animal scientists| url=https://news.cornell.edu/stories/1997/08/us-could-feed-800-million-people-grain-livestock-eat| newspaper=Cornell Chronicle |date=7 August 1997|access-date=26 April 2019}}</ref><ref>{{Cite web | title= Tackling climate change through livestock| url=https://www.fao.org/ag/againfo/resources/en/publications/tackling_climate_change/index.htm|date=21 October 2014 | publisher=United Nations}}</ref> In a 2014 lifecycle analysis of [[greenhouse gas emissions]], researchers found that a Mediterranean-like diet may reduce food production emissions below those of an omnivorous diet for 2050, with a [[per capita]] reduction of 30%.<ref>{{Cite journal|display-authors=3 |last1=Magkos |first1=Faidon |last2=Tetens |first2=Inge |last3=Bügel|first3=Susanne Gjedsted|last4=Felby|first4=Claus|last5=Schacht|first5=Simon Rønnow|last6=Hill|first6=James O|last7=Ravussin|first7=Eric|last8=Astrup|first8=Arne|date=2020-01-01|title=A Perspective on the Transition to Plant-Based Diets: a Diet Change May Attenuate Climate Change, but Can It Also Attenuate Obesity and Chronic Disease Risk?|journal=Advances in Nutrition|volume=11|issue=1|pages=1–9|doi=10.1093/advances/nmz090|issn=2161-8313|pmc=7442415|pmid=31504086}}</ref><ref>{{Cite journal| last1=Tilman |first1=David |last2=Clark |first2=Michael|date=2014-11-01|title=Global diets link environmental sustainability and human health|url=https://www.nature.com/articles/nature13959|journal=Nature|language=en|volume=515|issue=7528|pages=518–522 |doi=10.1038/nature13959 |pmid=25383533 |bibcode=2014Natur.515..518T |s2cid=4453972 |issn=1476-4687|url-access=subscription}}</ref>

==History and research==
Elements of the Mediterranean diet have been traced to several ancient cultures in the region, particularly the Greeks and Romans, using olive oil, seafood, bread, and wine.<ref name=keys/> The Mediterranean diet as a concept was first publicized in 1975 by American biologist [[Ancel Keys]] and chemist Margaret Keys, a husband-and-wife team.<ref name="keys">{{cite book |title=How to eat well and stay well the Mediterranean way |author1=Ancel Keys |author2=Margaret Keys |date=December 1975 |publisher=[[Doubleday (publisher)|Doubleday]] |isbn=978-0-385-00906-5|author1-link=Ancel Keys }}</ref> The Keys were the first to draw a correlation between cardiovascular disease and diet, based on studies in the 1950s in southern Italy.<ref name=keys/>

Objective data showing possible benefits of the Mediterranean diet originated from [[epidemiology|epidemiological studies]] in southern Italy and [[Crete]]; these were confirmed later by the [[Seven Countries Study]] directed by Keys and published in 1970,<ref>{{cite journal |editor=Ancel Keys |title=Coronary heart disease in seven countries |journal=Circulation |volume=41 |issue=4 Suppl |pages=I1–211 |date=April 1970 |pmid=5442782 | doi = 10.1161/01.CIR.41.4S1.I-1 |s2cid=80146863 }}</ref><ref name="guard">{{cite news|url=https://www.theguardian.com/society/2016/sep/02/mediterranean-diet-obesity-health-way-of-eating|author=Sarah Boseley|newspaper=[[The Guardian]]|title=What actually is the Mediterranean diet – and does it work?|date=2 September 2016|access-date=14 September 2021}}</ref> which was followed by a book-length report in 1980.<ref>{{cite book |title=Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease |url=https://archive.org/details/sevencountriesmu0000keys |url-access=registration |author=Ancel Keys |date=February 1980 |publisher=[[Harvard University Press]] |isbn=978-0-674-80237-7|author-link=Ancel Keys }}</ref> A 25-year follow up study published in 1996 determined that populations that had adopted a "Mediterranean diet"—defined as incorporating olive oil, bread, pasta, vegetables, herbs and seafood, with moderate consumption of meat—presented low levels of blood cholesterol and reduced incidence of coronary heart disease.<ref name=guard/><ref name="7cs">{{cite journal |vauthors=Menotti A, Keys A, Blackburn H, Kromhout D, Karvonen M, Nissinen A, Pekkanen J, Punsar S, Fidanza F, Giampaoli S, Seccareccia F, Buzina R, Mohacek I, Nedeljkovic S, Aravanis C, Dontas A, Toshima H, Lanti M |title=Comparison of multivariate predictive power of major risk factors for coronary heart diseases in different countries: results from eight nations of the Seven Countries Study, 25-year follow-up |journal=Journal of Cardiovascular Risk |volume=3 |issue=1 |pages=69–75 |date=February 1996 |doi=10.1097/00043798-199602000-00010 |pmid=8783033}}</ref>

The Mediterranean diet was further studied in the 1990s by [[Walter Willett]] and colleagues of the [[Harvard School of Public Health|Harvard University School of Public Health]].<ref>
{{cite news |last=Burros |first=Marian |author-link=Marian Burros |title=Eating Well |newspaper=[[The New York Times]] |date=29 March 1995 |url=https://query.nytimes.com/gst/fullpage.html?res=990CEFD81438F93AA15750C0A963958260&sec=&spon=&pagewanted=all |url-status=live |archive-url=https://web.archive.org/web/20081028210645/http://query.nytimes.com/gst/fullpage.html?res=990CEFD81438F93AA15750C0A963958260&sec=&spon=&pagewanted=all |archive-date=28 October 2008 }}
</ref><ref>{{cite journal | pmid = 7754996 | volume=61 | issue=6 Suppl | title=Health implications of Mediterranean diets in light of contemporary knowledge. 1. Plant foods and dairy products | year=1995 | journal=Am. J. Clin. Nutr. | pages=1407S–1415S |vauthors=Kushi LH, Lenart EB, Willett WC | doi=10.1093/ajcn/61.6.1407S | doi-access=free }}</ref><ref>{{cite journal | pmid = 7754997 | volume=61 | issue=6 Suppl | title=Health implications of Mediterranean diets in light of contemporary knowledge. 2. Meat, wine, fats, and oils | year=1995 | journal=Am. J. Clin. Nutr. | pages=1416S–1427S |vauthors=Kushi LH, Lenart EB, Willett WC | doi=10.1093/ajcn/61.6.1407S | doi-access=free }}</ref><ref>{{cite journal|vauthors=Willett WC | pmid = 16512956 | volume=9 | issue=1A | title=The Mediterranean diet: science and practice | year=2006 | journal=Public Health Nutr | pages=105–10 | doi=10.1079/phn2005931| doi-access=free }}</ref> The Mediterranean diet is based on a paradox: although people living in Mediterranean countries tend to consume relatively high amounts of fat, they generally have lower incidence of cardiovascular disease than those living in countries with similar levels of fat consumption, such as the United States; a parallel phenomenon is known as the [[French paradox]].<ref name="Paradoxes">{{cite journal | author = Simini Bruno | year = 2000 | title = Serge Renaud: from French paradox to Cretan miracle | journal = The Lancet | volume = 355 | issue = 9197| page = 48 | doi = 10.1016/S0140-6736(05)71990-5 | pmid = 10615898 | s2cid = 8142036 }}</ref>

Since about 2016, the [[American Heart Association]] and [[American Diabetes Association]] have recommended the Mediterranean diet as a dietary pattern that may reduce the risk of cardiovascular diseases and [[type 2 diabetes]].<ref name="AHA2016" /><ref name="ADA2019" /><ref name="ADA2018">{{cite journal|display-authors=3 |last1=Evert |first1=Alison B. |last2=Dennison |first2=Michelle |last3=Gardner |first3=Christopher D. |last4=Garvey |first4=W. Timothy |author-link4=W. Timothy Garvey |last5=Lau |first5=Ka Hei Karen |last6=MacLeod |first6=Janice |last7=Mitri |first7=Joanna |last8=Pereira |first8=Raquel F. |last9=Rawlings |first9=Kelly |last10=Robinson |first10=Shamera |last11=Saslow |first11=Laura |last12=Uelmen |first12=Sacha |last13=Urbanski |first13=Patricia B. |last14=Yancy |first14=William S. |date=May 2019 |title=Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report |journal=Diabetes Care |type=Professional society guidelines |volume=42 |issue=5 |pages=731–754 |doi=10.2337/dci19-0014 |pmc=7011201 |pmid=31000505 |doi-access=free}}</ref> The [[National Health Service]] also recommends a Mediterranean diet to reduce cardiovascular disease risk.<ref>{{cite web|url=https://www.nhs.uk/conditions/heart-attack/prevention/|title=Prevention of heart attack|publisher=UK National Health Service|access-date=22 October 2023|date=13 July 2023}}</ref>

In 2018, clinical research showed favorable outcomes for using the Mediterranean diet to lower the risk of [[metabolic syndrome]].<ref name="villani">{{cite journal |vauthors=Villani A, Sultana J, Doecke J, Mantzioris E |year=2018 |title=Differences in the interpretation of a modernized Mediterranean diet prescribed in intervention studies for the management of type 2 diabetes: how closely does this align with a traditional Mediterranean diet? |url=https://unisa.alma.exlibrisgroup.com/view/delivery/61USOUTHAUS_INST/12162755020001831 |journal=European Journal of Nutrition |volume=58 |issue=4 |pages=1369–1380 |doi=10.1007/s00394-018-1757-3 |pmid=29943276 |s2cid=49420773|url-access=subscription }}</ref>

Researchers frequently use questionnaires such as the MEDAS questionnaire (Mediterranean diet adherence screener) to monitor how closely someone is adhering to a Mediterranean-style diet, and can also be used by individuals monitoring their own diet.<ref>{{cite journal |author=Papadaki, Angeliki |display-authors=et al. |date=January 28, 2018 |title=Validation of the English Version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED Study, in People at High Cardiovascular Risk in the UK |journal=[[Nutrients]] |volume=10 |issue=2 |pages=138 |doi=10.3390/nu10020138 |doi-access=free |pmid=29382082 |pmc=5852714 }}</ref><ref>{{cite web |last=Tilt |first=Laura |title=What's Your Mediterranean Diet Score? |website=Field Doctor |date=11 September 2025 |url=https://www.fielddoctor.co.uk/health-hub/mediterranean-diet-score |access-date=15 October 2025}}</ref>

==See also==
<!-- More on Mediterranean Diet -->
{{Commons category-inline}}
{{col div|colwidth=40em}}
* [[Cretan cuisine]]
* [[Health effects of wine]]
* [[Ikaria Study]]
* [[List of diets]]
* [[Mediterranean cuisine]]
* [[Mediterranean Diet Foundation]]
* [[Sustainable diet]]
{{colend}}

==Notes==
{{notelist}}

==References==
{{Reflist|30em}}

==Further reading==
* {{cite book |last1=Hoffman |first1=Richard |last2=Gerber |first2=Mariette |title=The Mediterranean Diet: Health and Science |date=2012 |publisher=[[Wiley-Blackwell]] |location=Chichester, West Sussex |isbn=978-1-118-78502-7}}
* {{cite book |editor1-last=Preedy |editor1-first=Victor R. |editor2-last=Watson |editor2-first=Ronald Ross |title=The Mediterranean Diet: An Evidence-Based Approach |date=2020 |publisher=[[Academic Press]] |location=Cambridge, Massachusetts |isbn=978-0-12-818649-7 |edition=2nd}}
* {{cite book |editor1-last=Romagnolo |editor1-first=Donato F. |editor2-last=Selmin |editor2-first=Ornella I. |title=Mediterranean Diet: Dietary Guidelines and Impact on Health and Disease |date=2016 |publisher=Humana Cham |isbn=978-3-319-27969-5 |language=en}}

{{Plant-based diets}}
{{Diets}}
{{Authority control}}

[[Category:Diets]]
[[Category:Intangible Cultural Heritage of Humanity]]
[[Category:Plant-based diets]]
[[Category:Sustainable food system]]