What are the components of the Mediterranean diet?

What's on the Mediterranean Diet

The Mediterranean diet emphasizes high consumption of olive oil (especially extra virgin), vegetables, fruits, whole grains, legumes, nuts, and fish, with moderate intake of low-fat dairy and wine, while strictly limiting red meat, processed foods, refined carbohydrates, added sugars, and saturated fats. 1

Core Food Components

Primary Fat Source

• Extra virgin olive oil serves as the principal source of fat, consumed at approximately 1 liter per week or as the main cooking and dressing oil 2
• This provides monounsaturated fatty acids (12-22% of total calories) and polyphenols that contribute to cardiovascular protection 2, 3

Plant-Based Foods (Daily Consumption)

• Abundant vegetables consumed daily 1, 2, 3
• Fruits consumed daily 1, 2, 3
• Whole grains as staple carbohydrate sources, consumed daily 1, 2, 3
• Legumes (beans, lentils, chickpeas) consumed regularly 1, 2, 4
• Nuts and seeds at 30 grams daily of mixed nuts (walnuts, hazelnuts, almonds) 2, 3

Protein Sources

• Fish and seafood consumed at moderate to high levels, at least twice weekly 1, 2, 3
• Poultry and eggs in moderate portions 3
• Low-fat dairy products (primarily cheese and yogurt) in low to moderate amounts 1, 2, 3
• Red meat and meat products strictly limited to few times per month in small portions 1, 3, 5

Beverages

• Moderate wine consumption, typically red wine with meals 1, 2, 3

Foods to Limit or Avoid

• Added sugars and sweets should be minimized 1, 3
• Highly processed foods should be avoided 1
• Refined carbohydrates should be limited 1
• Saturated fats should be restricted (≤8% of total calories) 2
• Sodium intake should be limited to 1500-2300 mg/day 2

Macronutrient Composition

• Total fat: 32-43% of total energy (higher than typical low-fat diets, but quality matters more than quantity) 2
• Monounsaturated fats: 12-22% of calories 2
• Polyunsaturated fats: 7-8% of calories 2
• Saturated fats: ≤8% of calories 2
• Dietary fiber: 27-37 grams per day (double the current US average) 2, 3
• Omega-3 fatty acids emphasized from fish and plant sources 2

Key Nutritional Characteristics

• Rich in polyphenols from olive oil, fruits, vegetables, and wine 2, 6
• High antioxidant content from plant foods 6, 4
• Optimal omega-6/omega-3 fatty acid balance 4
• High fiber content promoting beneficial gut microbiota 2

Important Clinical Considerations

This dietary pattern can be consumed ad libitum (without strict caloric restriction or portion control) and still provides substantial health benefits, including a 30% reduction in myocardial infarction, stroke, and cardiovascular mortality 2

The American College of Rheumatology conditionally recommends adherence to a Mediterranean-style diet based on evidence of improvement in pain and potential long-term health benefits for cardiovascular disease and longevity 1. The recommendation emphasizes that the synergistic effects of the complete dietary pattern are more important than individual components 2.

Common pitfall to avoid: Do not focus on individual "superfoods" or nutrients in isolation—the health benefits derive from the overall dietary pattern and the combination of foods consumed together 2, 5.