Mediterranean diet 101: a complete guide and meal plans for low-carb and traditional versions – Diet Doctor


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    Tips for dining out

    Eating a low-carb Mediterranean diet in restaurants is a breeze:

    • Choose grilled or baked, unbreaded seafood or meat with vegetables or a side salad.
    • Request that your food be cooked with olive oil, and ask for olive oil to dress your salad.
    • Request a double portion of vegetables to replace potatoes, rice, or other starchy sides.
    • Order water or dry red wine to drink.

    5. What to eat on a standard Mediterranean diet

    Mediterranean diet pyramid@4x-50
    If you have little or no weight to lose and do not have type 2 diabetes, you can include more carbs at your Mediterranean meals. This means you can eat some potatoes, brown rice, unrefined grains, or whole wheat bread. You can find the level of carbs that is right for you.

    Adding carbohydrates will make your meals more typical of the standard Mediterranean diet. It will still be full of fresh, minimally processed food that is much healthier than the standard, highly-processed American diet.

    If you find that when you eat more carbs you crave more carbs, that may be a sign that you have exceeded your personal carb threshold and should cut back.

    Eat at most meals:

    • Protein: Legumes (beans, chickpeas, lentils), seafood, poultry, eggs, cheese, or yogurt; include fish or shellfish at least twice a week
    • Vegetables: All types, especially tomatoes, bell peppers, cucumbers, squash, greens, artichokes, eggplant, and broccoli
    • Whole grains and starchy vegetables, such as whole-grain pasta or cereal, brown or wild rice, quinoa, couscous, and potatoes, etc.
    • Fruits: All types
    • Olive oil, olives, nuts, or seeds
    • Herbs and spices

    Eat less frequently:

    • Red meat (twice per week)
    • Processed meat, such as ham or prosciutto (once per week)

    Foods to avoid:

    • Fruit juice
    • Foods with added sugar (candy, cookies, cakes, ice cream, and other sweets)
    • Foods made with white flour (white bread, white pasta, white rice)
    • Sweetened beverages

    What to drink

    Water is always a great beverage choice, whether still or sparkling. Coffee and tea with milk or cream are also fine.

    Again, good news for wine lovers. Red wine at meals is typical of many Mediterranean diets, and studies suggest it may reduce some heart disease risk factors, as noted above. However, it’s completely optional.

    If you do consume alcohol as part of a Mediterranean diet, limit yourself daily to two glasses of wine if you’re a man or one glass if you’re a woman.

    6. Mediterranean diet meal plan

    Mediterranean diet meal plan

    Are you ready to get started eating wholesome, filling Mediterranean food?

    Here is a one-week sample meal plan. Feel free to substitute other foods based on what you like to eat and what’s available or in season. If you want fewer carbs, just reduce the portions of bread, grains, potatoes, rice, or fruit.

    Day 1

    Breakfast: Greek yogurt, oatmeal, and berries

    Lunch: Bell-pepper salad with chickpeas and quinoa, dressed with olive oil.

    Dinner: Grilled salmon, broccoli, and wild rice with a fresh pear for dessert.

    Day 2

    Breakfast: Spinach and onion frittata; melon

    Lunch: Feta cheese and raw vegetables, whole-grain roll with olive oil

    Dinner: Grilled chicken with basil, artichoke hearts, and potatoes; berries

    Day 3

    Breakfast: Ricotta cheese with chopped apples and cinnamon

    Lunch: Chicken gyros on whole-wheat pita bread; orange

    Dinner: Clams, mushrooms, olive oil, and garlic on whole-grain linguine

    Day 4

    Breakfast: Whole-grain cereal with Greek yogurt and chopped pecans

    Lunch: Caprese salad, whole-grain breadsticks; figs

    Dinner: Roast lamb with rosemary, couscous, asparagus, and olive oil

    Day 5

    Breakfast: Avocado toast with hard-boiled eggs

    Lunch: Feta and quinoa stuffed bell peppers; apple

    Dinner: Grilled salmon, broccoli, whole-grain pasta with garlic and olive oil; melon

    Day 6

    Breakfast: Greek yogurt with chopped walnuts and berries

    Lunch: Leftover salmon, broccoli, and pasta

    Dinner: Chicken kebabs with bell peppers and onions, wild rice; melon

    Day 7

    Breakfast: Spinach and mushroom omelet, whole-grain toast

    Lunch: Tuna salad with couscous, greens, olive oil dressing

    Dinner: Steak, olive oil-roasted Brussels sprouts, baked potato; berries


    Beverage suggestions for each day are coffee, tea or water for breakfast and lunch. Feel free to have a glass of red wine at dinner, if you desire.

    Tips for dining out

    Fortunately, it’s easy to eat a typical Mediterranean style meal at many restaurants. Here are some tips for dining out:

    • Choose unbreaded, grilled or baked seafood, poultry, meat, or legumes with vegetables and a salad.
    • Request that your food be cooked with olive oil, if possible.
    • Ask for olive oil at the table to dress your salad.
    • Ask for extra vegetables or salad to replace fries, or request whole grain pasta or bread rather than refined white flour versions.
    • Order still or sparkling water, or enjoy a glass of red wine.

    7. The history of the Mediterranean diet

    The history of the Mediterranean diet

    The traditional Mediterranean diet is the way people in Greece and southern Italy ate in the late 1950s. Around that time, researchers noted that people in these areas seemed to live longer and have less chronic disease compared to those in some other countries.

    The roots of the traditional Mediterranean diet date back to the ancient Greeks and Romans, whose mainstays were bread, olive oil, and wine. They also ate many other foods, such as seasonal fruits and vegetables, legumes, cheese, fish, and meat.

    Over time, different cultures influenced what would come to be known as the traditional Mediterranean diet. Spices from the Orient and Middle East, tomatoes from America, and contributions from other lands helped shape the unique flavors and classic dishes associated with the Mediterranean diet.

    Throughout the years, Mediterranean residents tended to eat what was available to them, as many continue to do today.

    In addition to plant foods, most people who follow a traditional Mediterranean diet eat some meat, along with cheese (including sheep and goat cheese) daily or several times a week. Many also consume fish and shellfish frequently, depending how far they live from the sea.

    Although their diets are similar overall, people eat different foods depending on the Mediterranean country they live in:

    • Italian diets feature tomatoes, basil, garlic, cheese (mozzarella, Romano, and ricotta, among others), fish, meat, pasta, and cured meats like prosciutto and pancetta.
    • Greek cuisine is rich in olives, shellfish, feta, chickpeas, onions, bread, figs, and lamb.
    • Spanish diets typically include fresh shellfish, roasted meat, legumes, peppers, rice, and cured meats like ham and chorizo.

    8. The Mediterranean diet research

    Nutrigenetics concept DNA strand made with healthy fresh vegetables and fruits

    Observational studies have linked the Mediterranean diet to longer life and lower risk of heart disease and cancer.

    However, this type of evidence is considered very weak. Observational studies can only show associations between diets and health outcomes. They can’t prove that eating a certain way improves health or prevents disease.

    Instead, it’s better to rely on results from clinical trials, especially randomized controlled trials, to assess a Mediterranean diet’s potential health benefits.

    Is a Mediterranean diet effective
    for weight loss?

    If you want to lose weight, a Mediterranean diet may be a good option — but a low-carb Mediterranean diet is likely even better.

    In a review comparing different clinical trials in adults with type 2 diabetes, people who followed a Mediterranean diet for 12 months lost an average of 13.5 pounds (6.2 kilos). Other studies suggest that Mediterranean diets can help people lose weight and reduce their waist size.

    One review of five Mediterranean diet trials found this dietary pattern was more effective than low-fat diets for weight loss but not more effective than low-carb diets for weight loss. And results from a separate trial suggest that a low-carb Mediterranean diet can help people lose more weight than a classic Mediterranean diet.

    In that trial, 259 overweight people with diabetes followed a low-carb Mediterranean diet or a classic Mediterranean diet for one year. At the end of the study, people in the low-carb group lost 22 pounds (10.1 kilos), while those in the other group lost 16 pounds (7.3 kilos).

    In smaller trials, a ketogenic Mediterranean diet has shown impressive weight loss results. Although the evidence from these studies is considered weaker than randomized trials that have a control group, strong research shows that keto diets can help people lose weight.

    What does a ketogenic Mediterranean diet look like? In trials, people consumed meat, seafood, eggs, olive oil, cheese, above-ground vegetables, and in some cases red wine.

    Is a Mediterranean diet beneficial
    for heart health?

    The Mediterranean diet is often described as a “heart-healthy” diet. Does it live up to this reputation? Perhaps, although some of its benefits may have been overstated.

    Several trials have shown that eating a Mediterranean diet may reduce some heart disease risk factors.

    The PREDIMED trial followed more than 7,000 participants at high risk of heart disease for nearly five years. Those who were assigned to eat a Mediterranean diet (supplemented with either nuts or olive oil) had slightly better outcomes than those who followed a low-fat diet.

    A two-year trial in overweight people with heart disease found that losing weight on a Mediterranean diet can potentially help reduce the amount of plaque on artery walls.

    According to the authors of a 2019 study, the high intake of olive oil and nuts in Mediterranean diets seems to play a large role in reducing LDL and very low-density lipoprotein (VLDL) particles that may contribute to heart disease risk. However, despite encouraging results overall, a recent review of 30 trials concluded that it is unclear whether eating a Mediterranean diet helps prevent heart disease.

    Bottom line: Although the Mediterranean diet has been shown to help reduce some heart disease risk factors, more results from long-term trials are needed to reach definitive conclusions about its effects on heart health.

    Does the Mediterranean diet provide other health benefits?

    Following a Mediterranean diet may also improve some health conditions:

    • Diabetes and prediabetes: In 2015, researchers who conducted a review of Mediterranean diet trials in people with type 2 diabetes found that they are more effective for lowering blood sugar levels than low-fat diets.

      A low-carb or keto Mediterranean diet may be even better than a classic Mediterranean diet for lowering blood sugar. When people with type 2 diabetes eat very low-carb diets, their blood sugar often decreases to the point that they are able to reduce or discontinue their diabetes medication.

    • Fatty liver: Results from some trials suggest that a Mediterranean diet may reduce liver fat in people with nonalcoholic fatty liver disease (NAFLD) or those at high risk for the disease. Low-carb and keto Mediterranean diets have been shown to dramatically reduce liver fat.

    Take home message

    Mediterranean diets include a wide variety of fresh, flavorful foods such as seafood, meat, cheese, vegetables, olive oil, nuts, and berries. If you want to lose weight or control your blood sugar, you’ll likely get the best results by following a low-carb Mediterranean diet based on these foods.

    Feel free to add whole grains, other starches, and higher-sugar fruits if you tolerate more carbs. However, these foods are entirely optional.

    Both a low-carb and standard Mediterranean diet have been linked to potential health benefits. So if you’d like to try this way of eating, choose the one that best fits your health goals and food preferences.


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