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How does the Mediterranean Diet work?

It depends—there isn’t “a” Mediterranean diet. Greeks eat differently from Italians, who eat differently from the French and Spanish. But they share many common understandings. Working with the Harvard School of Public Health, Oldways, a nonprofit food think tank in Boston, developed a consumer-friendly Mediterranean diet pyramid that emphasizes fruits, veggies, whole grains, beans, nuts, legumes, olive oil, and flavorful herbs and spices; eating fish and seafood at least a couple of times a week; enjoying poultry, eggs, cheese, and yogurt in moderation; and saving sweets and red meat for special occasions. Top it off with a splash of red wine (if you want), remember to stay physically active, and you’re set.

Will you lose weight?

While some research has linked the Mediterranean diet to weight loss or a lower likelihood of being overweight or obese, the jury’s still out, according to a 2008 analysis of 21 studies in Obesity Reviews. Still, if you build a “calorie deficit” into your plan—eating fewer calories than your daily recommended max, or burning off extra by exercising—you should shed some pounds. How quickly and whether you keep them off is up to you.

Here’s a look at a few studies addressing weight loss:

• One, published in 2010 in Diabetes, Obesity, and Metabolism,assigned 259 overweight diabetics to one of three diets: a low-carb Mediterranean diet, a traditional Mediterranean diet, or a diet based on recommendations from the American Diabetes Association. All groups were told to exercise 30 to 45 minutes at least three times per week. After a year, all groups lost weight; the traditional group lost an average of about 16 pounds while the ADA group dropped 17 pounds and the low-carb group lost 22 pounds.

• Another study, published in the New England Journal of Medicine in 2008, assigned 322 moderately obese adults to one of three diets: calorie-restricted low-fat; calorie-restricted Mediterranean; and non-calorie-restricted low-carb. After two years, the Mediterranean group had lost an average of 9.7 pounds, the low-fat group 6.4 pounds, and the low-carb group 10.3 pounds. Although weight loss didn’t differ greatly between the low-carb and Mediterranean groups, both lost appreciably more than the low-fat group did.

• In a third study, published in the International Journal of Obesity in 2001, researchers assigned 101 overweight men and women to either a low-fat diet or a Mediterranean-style diet. After 18 months, the Mediterranean group had lost an average of 5½ pounds, while the low-fat group had gained about 2½ pounds.

– Thank you Health section of U.S. News

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Are there health risks?

Not likely, as long as you create a sensible plan.

The approach is generally safe for everyone, from kids and adults to seniors. Still, those with health conditions should talk with their doctor before making major dietary changes.

How well does it conform to accepted dietary guidelines?

Fat. You’ll stay within the government’s recommendation that between 20 to 35 percent of daily calories come from fat.

Protein. It’s within the 10 to 35 percent of daily calories the government recommends.

Carbohydrates. At 50 percent of daily calories, you’ll align with the recommended range.

Salt. The majority of Americans eat too much salt. The recommended daily maximum is 2,300 milligrams, but if you’re 51 or older, African-American, or have hypertension, diabetes, or chronic kidney disease, that limit is 1,500 mg. The sample menu provided by Oldways is under both caps, but it’ll be up to you to choose low-sodium foods and stop reaching for the saltshaker.

Fiber. Getting the recommended daily amount of 22 to 34 grams for adults helps you feel full and promotes good digestion. You shouldn’t have any trouble meeting your goal.

Potassium. A sufficient amount of this important nutrient, according to the 2010 Dietary Guidelines, counters salt’s ability to raise blood pressure, decreases bone loss, and reduces the risk of developing kidney stones. It’s not that easy to get the recommended daily 4,700 mg. from food. (Bananas are high in potassium, yet you’d have to eat 11 a day.) The majority of Americans take in far too little. The sample Mediterranean menu fell just short of the recommendation, but because you’re almost certainly eating more fruits and veggies than you were before, you’ll likely get more potassium than most.

Calcium. It’s essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 to 1,300 mg. The sample menu didn’t provide enough, but eating more yogurt, tofu, and fortified cereals and juice should do the trick.

Vitamin B-12. Adults should shoot for 2.4 micrograms of this nutrient, which is critical for proper cell metabolism. Working in yogurt and fortified foods, like cereals, can bring you closer to that goal.

Vitamin D. Adults who don’t get enough sunlight need to meet the government’s 15 microgram recommendation with food or a supplement to lower the risk of bone fractures. Low-fat dairy and fortified cereals will help you meet the requirement.

Supplement recommended? N/A

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OK Then, Lets Recap…

• How easy is it to follow? Because Mediterranean diets don’t ban entire food groups, you shouldn’t have trouble complying long-term.
• Convenience? When you want to cook, there’s a recipe and complementary wine that’ll transport you across the Atlantic. Oldways’ consumer-friendly tips will make meal planning and prepping easier. And you can eat out, as long as you bring someone along to share the hefty entrées.
• Recipes? Oldways offers numerous recipes, including this PDF featuring meals that all cost $2 or less a serving. Otherwise, a simple Google search will turn up lots of healthy Mediterranean meal ideas. Want more inspiration? Oldways recommends The New Mediterranean Diet Cookbook: A Delicious Alternative for Lifelong Health.
• Eating out? If you do, embrace the diet’s affinity for sharing by ordering one entrée for the two of you. And be sure to start with a house salad or order extra veggies à la carte to get your fill.
• Alcohol? What’s a Mediterranean diet without wine? While certainly not required, a glass a day for women and two a day for men is fine if your doctor says so. Red wine has gotten a boost because it contains resveratrol, a compound that seems to add years to life—but you’d have to drink hundreds or thousands of glasses to get enough resveratrol to possibly make a difference (So start drinking).
• Timesavers? None, unless you hire somebody to plan your meals, shop for them, and prepare them. And you can’t pay someone to exercise for you.
• Fullness? Nutrition experts emphasize the importance of satiety, the satisfied feeling that you have had enough. Hunger shouldn’t be a problem on this diet; fiber is filling, and you’ll be eating lots of fiber-packed produce and whole grains.
• Taste? You’re making everything, so if something doesn’t taste good, you know who to blame.
• How much does it cost? It’s moderately pricey. While some ingredients (olive oil, nuts, fish, and fresh produce in particular) can be expensive, you can find ways to keep the tab reasonable. Can’t spring for the $50 bottle of wine? Grab one for $15 instead. And snag whatever veggies are on sale that day, rather than the $3-a-piece artichokes.

Does the diet allow for restrictions and preferences?

Anyone can follow the Mediterranean diet—choose your preference for more information.

Vegetarian and vegan: Yes, with a few minor tweaks you can easily replace any animal products with vegetarian- or vegan-friendly options.

Gluten-free: Yes, you can choose products that are certified gluten-free.

Low-salt: Do-able! It’s up to you to stay under your limit, but the diet’s emphasis on fruits and veggies should make it easier. Just make sure the nuts are salt-free.

Kosher: Yes, you have the freedom to use only kosher ingredients.

Halal: Yes, but it’s up to you to ensure your food conforms to halal guidelines.

***Exercise is part of the plan.