8 Scientific Health Benefits of the Mediterranean Diet

8 Scientific Health Benefits of the Mediterranean Diet

The Mediterranean diet has a host of benefits including weight loss, heart, and brain health.
8 Scientific Health Benefits of the Mediterranean Diet

If there’s one so-called diet that is widely acclaimed for its health benefits, it’s the Mediterranean diet. U.S. News & World Report ranked the Mediterranean diet No. 1 on its 40 Best Diets Overall list for 2022, citing a “host of health benefits, including weight loss, heart and brain health, cancer prevention, and diabetes prevention and control.”

More of an eating pattern than a calorie-restricted diet, the Mediterranean regimen emphasizes lots of vegetables, fruits, nuts, legumes, seeds, and fish, with liberal use of olive oil, a moderate amount of dairy foods, and a low amount of red meat — a way of eating common in Mediterranean countries such as Spain, Italy, and Greece.

Followers avoid processed foods that are high in sugar, refined carbohydrates, and unhealthy fats (think: chips, cookies, cake, white bread, white rice, and the like). But they do drink a little red wine socially during meals. The Mediterranean pattern focuses on enjoying food and drink with loved ones, along with being physically active and always keeping moderation in mind. Notably, though, there’s no counting — be it calories, fat grams, or glycemic load — to gauge that moderation.

“I look at it as a Mediterranean lifestyle. It’s not so much what they eat, which is beneficial and anti-inflammatory; it’s in how they eat it,” says Robert E. Graham, MD, MPH, a cofounder of the integrative medicine practice FRESH Medicine in New York City. “They eat it with gusto — flavor. They eat it with family members.”

There’s no one uniform Mediterranean lifestyle or eating pattern because its followers don’t all live in the same place. That complicates the effort to assess the potential health benefits of the diet. “Did you live in Italy? Did you live in Greece? Did you live in Spain? So then, when you do research studies, the diet might be a little different in each,” says Jo Ann Carson, PhD, a former professor of clinical nutrition at UT Southwestern Medical Center in Dallas and a former chair of the nutrition committee for the American Heart Association.

Dr. Carson adds that eating and drinking in moderation may be harder for those living on this side of the Atlantic — particularly because the Mediterranean diet does not set calorie intake guidelines. "I get concerned that someone from the United States will try to add ¼ cup of olive oil to their diet, but they’re not going to cut out some of the sweets … and then they’re going to be getting too many calories,” she says.

With those caveats in mind, here is a look at eight of the touted health benefits of the Mediterranean diet — and the science behind them.

1. The Mediterranean Diet May Reduce Your Risk of Heart Disease

Numerous studies suggest the Mediterranean diet is good for your ticker.

Perhaps the most convincing evidence comes from a randomized clinical trial known as the PREDIMED study. For about five years, authors followed 7,000 women and men in Spain who had type 2 diabetes or were at high risk of cardiovascular disease.

Participants were randomly assigned to three groups; all of them received guidance on the Mediterranean diet and were not advised to restrict calories. One group was given free extra-virgin olive oil with instructions to consume a minimum amount; another group was given free mixed nuts and guidance on a minimum to consume; and the third group was given nonfood gifts. Those who ate the calorie-unrestricted Mediterranean diet with supplemented olive oil or nuts had about a 30 percent lower risk of heart events at the end of the follow-up period than the control group. Researchers didn’t advise participants on exercise.

The study authors reanalyzed the data at a later point to address a widely criticized flaw in the randomization protocol, and still reported similar results in a trial.

“That is probably the biggest scientific evidence to say that a Mediterranean diet is healthful, in terms of reducing the risk of cardiovascular disease,” Carson says.

It also appears to have an edge over other diets. An analysis found the Mediterranean diet beat out a low-fat diet when it came to endothelial function in the heart, which can determine risk of cardiovascular issues.

2. A Mediterranean Diet May Reduce Women’s Risk of Stroke

We already know from the PREDIMED study that eating in a Mediterranean fashion lowers the risk of cardiovascular disease in some people. Well, the diet may also reduce stroke risk in women, though researchers didn’t observe the same results in men, according to a cohort study.

Researchers looked at a predominantly white group of 23,232 men and women ages 40 to 77 who lived in the United Kingdom. The more closely a woman followed a Mediterranean diet, the lower her risk of stroke. Yet researchers didn’t see statistically significant results in men. Most notably, in women who were at high risk of stroke, the diet reduced their chances of this health event by 20 percent.

Study authors don’t know why, but they hypothesize that different types of strokes in men and women may play a role. A good next step toward understanding the reasons behind the differences would be a clinical trial, Carson says.

Observance of a Mediterranean diet can also impact the severity of a stroke, should it occur. One analysis of 368 stroke patients found that those on a Mediterranean diet had a lower severity of stroke.

3. A Mediterranean Diet May Prevent Cognitive Decline and Alzheimer’s Disease

As a heart-healthy diet, the Mediterranean eating pattern may also fight the decline in your memory and thinking skills with age. “There is growing evidence that what we eat can impact our brains as we age,” says Claire Sexton, DPhil, the Chicago-based director of scientific programs and outreach at the Alzheimer’s Association. Dr. Sexton adds that the Mediterranean diet is one diet that may reduce the risk of dementia. “Generally speaking, it is best to eat a heart-healthy diet low in saturated fats and high in vegetables and fruits,” she says. “Such a diet may have vascular and anti-inflammatory properties.”

A review looked at the effect of the Mediterranean diet on cognitive function and concluded “there is encouraging evidence that a higher adherence to a Mediterranean diet is associated with improving cognition, slowing cognitive decline, or reducing the conversion to Alzheimer’s disease.”

What’s more, a small study looked at brain scans of 70 people who had no signs of dementia at the outset, and scored them for how closely their eating patterns hewed to a Mediterranean diet. Those who scored low tended to have more beta-amyloid deposits (protein plaques in the brain associated with Alzheimer’s disease) and lower energy use in the brain at the end of the study. At least two years later, these individuals also showed a greater increase of deposits and reduction of energy use — potentially signaling an increased risk for Alzheimer’s — than those who more closely followed the Mediterranean diet.

All that said, more research is needed before recommending this eating approach to lower Alzheimer’s risk. The authors called for additional research in a larger participant group and for a longer study period.

For now, Sexton notes that nutrition is one aspect of helping to stave off cognitive decline, but it’s not the only one. “It is important to also realize that, for maximal benefits, a healthy diet would likely need to be combined with other healthy lifestyle practices to help protect an aging brain,” she says. “Adopting one lifestyle factor, like a healthier diet, may reduce the risk of cognitive decline — but the more healthy lifestyle behaviors you can incorporate, the more cognitive benefit you’re likely to see.” This is an area of research the Alzheimer’s Association is exploring with its U.S. Study to Protect Brain Health Through Lifestyle.

Sexton says the Mediterranean diet isn’t the only one that may offer brain protection. The blood-pressure lowering DASH diet and MIND diet (MIND stands for Mediterranean–DASH Diet Intervention for Neurodegenerative Delay), which is a hybrid of the Mediterranean pattern and the DASH diet, are two others she mentions.

“The jury is still out on any one specific diet being the most beneficial for our brains, and there likely won't be a one-size-fits-all diet that can prevent dementia or cognitive decline in all individuals,” she says.

4. The Mediterranean Diet May Help With Weight Loss and Maintenance

Likely because of its focus on whole, fresh foods, the Mediterranean diet may help you lose weight in a safe, healthy, and sustainable way; on the other hand, it probably won’t lead to fast weight loss. As mentioned, in its 2022 rankings, U.S. News & World Report rated the Mediterranean diet as No. 1 in its overall category, yet the diet is tied with several other plans for 12th placein the website’s Best Weight Loss category.

According to a randomized crossover trial, it may be because the Mediterranean diet encourages fish and other animal products, oil, and nuts, which can work against weight loss efforts if consumed in large quantities compared with a low-fat vegan diet.

But you probably will lose weight if you restrict calories too. According to previous research322 moderately obese middle-aged participants in Israel, who were mostly men, followed one of three diets: a calorie-restricted low-fat diet, a calorie-restricted Mediterranean diet, and a calorie-unrestricted low-carb diet.

 Among the Mediterranean diet followers, women ate a maximum of 1,500 calories per day and men’s calorie count was restricted to 1,800 calories per day, with the goal of having no more than 35 percent of their calories from fat. The calorie restrictions were the same for those on the low-fat diet. The mean weight loss was 4.4 kilograms (kg) (9.7 pounds [lb]) for the Mediterranean diet group, 2.9 kg (6.4 lb) for the low-fat group, and 4.7 kg (10.3 lb) for the low-carbohydrate group.
And the diet may help you keep the pounds off. A study found that those who followed a Mediterranean diet were twice as likely to maintain weight loss.

5. A Mediterranean Diet May Stave Off Type 2 Diabetes

For type 2 diabetes management and the possible prevention of the disease, a Mediterranean diet may be the way to go.

Using participants from PREDIMED, scientists randomized a subgroup of 418 people ages 55 to 80 without diabetes and followed up with them after four years to see if they had developed the disease. Participants who followed the Mediterranean diet, whether they were provided with free olive oil or nuts, had a 52 percent lower risk of type 2 diabetes during the four-year follow-up, and they didn’t necessarily lose weight or exercise more.

Furthermore, previous research found that the Mediterranean diet improved blood sugar control more than low-carbohydrate, low-glycemic index, and high-protein diets in people with type 2 diabetes. This finding suggests that a Mediterranean diet may be an effective way to help ward off type 2 diabetes–related health complications.

6. People With Rheumatoid Arthritis May Benefit From the Mediterranean Diet

Rheumatoid arthritis (RA) is an autoimmune disease in which the body’s immune system mistakenly attacks the joints, creating pain and swelling in and around them. Certain properties of the Mediterranean diet, including its richness in anti-inflammatory omega-3 fatty acids, may help relieve RA symptoms.

Research thus far suggests that long-chain omega-3 fatty acids (found in fatty fish) may be helpful in relieving RA symptoms on top of medication, though more research is needed.

A systematic review and meta-analysis found that anti-inflammatory diets such as the Mediterranean diet reduced pain associated with rheumatoid arthritis more than other diets.

7. Are Foods in the Mediterranean Diet Protective Against Cancer?

Indeed, a Mediterranean diet meal plan may help prevent certain types of cancer.

A systematic review and meta-analysis suggested that the Mediterranean diet reduced the risk of cancers such as breast cancer, colorectal cancer, and head and neck cancers, and helped prevent death among cancer survivors.

A separate study based on PREDIMED data found that women who ate a Mediterranean diet focused on extra-virgin olive oil had a 62 percent lower risk of breast cancer than those in the control group who ate a low-fat diet.

8. Some Foods in the Mediterranean Diet May Ease Depression

The Mediterranean way of eating is linked to lower incidence of depression, according to an analysis of 41 observational studies.

Analysis of pooled data from four longitudinal studies revealed that the diet was associated with a 33 percent reduced risk of depression, compared with participants who followed a “pro-inflammatory diet” (richer in processed meats, sugar, and trans fats) that is more typical of a standard American diet.

The study didn’t reveal why a Mediterranean diet lowered depression risk. The study authors wrote that their results may be a launching point to develop and study diet-based interventions for depression.

The Importance of Moderation When Following a Mediterranean Diet

The evidence is clear and abundant that a Mediterranean way of eating can be healthful, but Carson warns it’s still important to watch your portions and avoid unhealthy foods if you want to reap all the benefits. Keep in mind that the U.S. Department of Health and Human Services recommends a daily calorie intake range of 1,600 to 3,200 for an adult, depending on age, gender, and level of physical activity.

“Whether you’re thinking of diabetes or cancer or heart disease, we want people to be at a healthy weight and not to be gaining weight unnecessarily. As you’re following the Mediterranean pattern, make sure that you’re doing it in a way that helps you control calories, which is very doable,” she says.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

  1. Mediterranean Diet. U.S. News & World Report.
  2. Implementing a Mediterranean-Style Diet Outside the Mediterranean Region. Current Atherosclerosis Reports.
  3. A Comprehensive Meta-Analysis on Evidence of Mediterranean Diet and Cardiovascular Disease: Are Individual Components Equal? Critical Reviews in Food Science and Nutrition.
  4. Primary Prevention of Cardiovascular Disease With a Mediterranean Diet. New England Journal of Medicine.
  5. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. New England Journal of Medicine.
  6. Mediterranean Diet and Endothelial Function in Patients With Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial. PLoS Medicine.
  7. Mediterranean Diet Reduces Risk of Incident Stroke in a Population With Varying Cardiovascular Disease Risk Profiles. Stroke.
  8. Pre-Stroke Adherence to a Mediterranean Diet Pattern Is Associated With Lower Acute Ischemic Stroke Severity: A Cross-Sectional Analysis of a Prospective Hospital Register Study. BMC Neurology.
  9. Adherence to a Mediterranean-Style Diet and Effects on Cognition in Adults: A Qualitative Evaluation and Systematic Review of Longitudinal and Prospective Trials. Frontiers in Nutrition.
  10. Mediterranean Diet and 3-Year Alzheimer Brain Biomarker Changes in Middle-Aged Adults. Neurology.
  11. A Mediterranean Diet and Low-Fat Vegan Diet to Improve Body Weight and Cardiometabolic Risk Factors: A Randomized, Cross-Over Trial. Journal of the American Nutrition Association.
  12. Weight Loss With a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. New England Journal of Medicine.
  13. Exploring the Relationship Between the Mediterranean Diet and Weight Loss Maintenance: The MedWeight Study. British Journal of Nutrition.
  14. Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet. Diabetes Care.
  15. Systematic Review and Meta-Analysis of Different Dietary Approaches to the Management of Type 2 Diabetes. American Journal of Clinical Nutrition.
  16. Rheumatoid Arthritis: Causes, Symptoms, Treatments, and More. Arthritis Foundation.
  17. Omega-3 Fatty Acids. National Institutes of Health.
  18. Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Nutrients.
  19. An Updated Systematic Review and Meta-Analysis on Adherence to Mediterranean Diet and Risk of Cancer. European Journal of Nutrition.
  20. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial. JAMA Internal Medicine.
  21. Healthy Dietary Indices and Risk of Depressive Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Molecular Psychiatry.
  22. 2015–2020 Dietary Guidelines. U.S. Department of Health and Human Services.

Resources

  • Mediterranean Diet. U.S. News and World Report. January 2, 2019.
  • Murphy K, Parletta N. Implementing a Mediterranean-Style Diet Outside the Mediterranean Region. Current Atherosclerosis Reports. June 2018
  • Grosso G, Marventano S, Yang J, et al. A Comprehensive Meta-Analysis on Evidence of Mediterranean Diet and Cardiovascular Disease: Are Individual Components Equal? Critical Reviews in Food Science and Nutrition. November 2015.
  • Estruch R, Ros E, Salas-Salvadó J, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. New England Journal of Medicine. April 4, 2013.
  • Estruch R, Ros E, Salas-Salvadó J, et al. Primary Prevention of Cardiovascular Disease With a Mediterranean Diet Supplemented With Extra-Virgin Olive Oil or Nuts. New England Journal of Medicine. June 21, 2018.
  • Yubero-Serrano EM, Fernandez-Gandara C, Garcia-Rios A, et al. Mediterranean Diet and Endothelial Function in Patients With Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial. PLoS Medicine. September 9, 2020.
  • Paterson K, Myint P, Jennings A, et al. Mediterranean Diet Reduces Risk of Incident Stroke in a Population With Varying Cardiovascular Disease Risk Profiles. Stroke. September 20, 2018.
  • Lavados PM, Mazzon E, Rojo A, et al. Pre-Stroke Adherence to a Mediterranean Diet Pattern Is Associated With Lower Acute Ischemic Stroke Severity: A Cross-Sectional Analysis of a Prospective Hospital Register Study. BMC Neurology. June 23, 2020.
  • Hardman R, Kennedy G, Macpherson H, et al. Adherence to a Mediterranean-Style Diet and Effects on Cognition in Adults: A Qualitative Evaluation and Systematic Review of Longitudinal and Prospective Trials. Frontiers in Nutrition. July 22, 2016.
  • Berti V, Walters M, Sterling J. Mediterranean Diet and 3-Year Alzheimer Brain Biomarker Changes in Middle-Aged Adults. Neurology. May 15, 2018.
  • Barnard ND, Alwarith J, Rembert E, et al. A Mediterranean Diet and Low-Fat Vegan Diet to Improve Body Weight and Cardiometabolic Risk Factors: A Randomized, Crossover Trial. Journal of the American Nutrition Association. February 5, 2021.
  • Shai I, Schwarzfuchs D, Henkin Y, et al. Weight Loss With a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. New England Journal of Medicine. July 17, 2008.
  • Poulimeneas D, Anastasiou CA, Santos I, et al. Exploring the Relationship Between the Mediterranean Diet and Weight Loss Maintenance: The MedWeight Study. British Journal of Nutrition.May 21, 2020.
  • Salas-Salvado J, Bullo M, Babio N, et al. Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet. Diabetes Care. January 2011.
  • Ajala O, English P, Pinkney J. Systematic Review and Meta-Analysis of Different Dietary Approaches to the Management of Type 2 Diabetes. The American Journal of Clinical Nutrition. March 2013.
  • Schonenberger KA, Schupfer AC, Gloy VL, et al. Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Nutrients. November 2021.
  • Morze J, Danielewicz A, Przybylowicz K, et al. An updated systematic review and meta-analysis on adherence to Mediterranean diet and risk of cancer. European Journal of Nutrition. April 2021.
  • Toledo E, Salas-Salvadó J, Donat-Vargas C, et al. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial. JAMA Internal Medicine. November 2015.
  • Lassale C, Batty GD, Baghdadli A, et al. Healthy Dietary Indices and Risk of Depressive Outcomes: A Systematic Review and Meta-analysis of Observational Studies. Molecular Psychiatry. September 26, 2018.
  • Dietary Guidelines: 2015–2020. Appendix 2. Estimated Calorie Needs per Day, by Age, Sex, and Physical Activity Level. Health.gov.
  • What Is Rheumatoid Arthritis? Arthritis Foundation.
  • Omega-3 Fatty Acids. Office of Dietary Supplements. August 4, 2021.
Show Less