What Is the Mediterranean Diet? Foods, Servings and How to Start

The Mediterranean diet is an eating pattern based on the traditional food habits of countries around the Mediterranean Sea, such as Greece, southern Italy and Spain. Most of each meal comes from plants: vegetables, fruit, whole grains, beans, nuts and olive oil. Fish and seafood show up often, dairy and poultry in moderate amounts, and red meat and sweets only now and then. It is a flexible pattern rather than a branded plan, and few eating styles have been studied as much.

Evidence grade: Strong. This rests on a large multi-year randomized trial, umbrella reviews that pooled dozens of meta-analyses of observational studies and trials, and the pattern's place as a reference pattern in U.S. federal dietary guidance.

What Is the Mediterranean Diet?

There is no single official Mediterranean diet. The term covers the shared way of eating found across many Mediterranean regions: mostly plant foods cooked with olive oil, plus fish, some dairy, little red meat, and fruit as the usual dessert. In 2011 the Mediterranean Diet Foundation Expert Group published an updated version of the Mediterranean diet pyramid. In it, the main meals are built mostly on plant foods, and "frugality and moderation" are stressed [3].

The same group points out that the pattern was never only about food. The base of the updated pyramid holds lifestyle habits: shared meals, cooking, regular physical activity, enough rest, and seasonal, local foods. UNESCO recognized the Mediterranean diet as an Intangible Cultural Heritage of Humanity in 2010 [3].

The Mediterranean Diet Pyramid: Servings at a Glance

The pyramid sets guidelines for each day, each week and occasional foods. The serving counts below come from the 2011 pyramid paper [3]. Treat them as a guide to proportions, not a prescription. The right amounts depend on your energy needs.

The pyramid also includes wine or other fermented drinks in moderation with meals, "respecting religious and social beliefs" [3]. U.S. guidance is more cautious. The Dietary Guidelines say adults can choose not to drink. Those who do drink should keep to 2 drinks or fewer a day for men and 1 or fewer for women, because drinking less is better for health than drinking more [2]. If you don't drink now, you don't need to start in order to eat this way.

The U.S. Version: A Healthy Mediterranean-Style Pattern

The 2020-2025 Dietary Guidelines for Americans listed three USDA eating patterns. They were the Healthy U.S.-Style pattern and two variations of it, Healthy Vegetarian and Healthy Mediterranean-Style. All three share the same core elements [2]. The newer 2025-2030 edition reorganizes federal advice around whole, minimally processed foods. The 2020 patterns remain available on DietaryGuidelines.gov as a previous edition [2].

At 2,000 calories a day, the two patterns compare like this [2]:

In short, the Mediterranean-style version swaps some dairy for more fruit and nearly doubles the seafood.

Why Olive Oil Is Central

The pyramid places olive oil at its center as the main source of fat. It is used for cooking, for dressings and for cooking vegetables and other plant foods [3]. USDA food composition data show that olive oil is about 73% monounsaturated fat, 11% polyunsaturated fat and 14% saturated fat by weight [6]. Extra-virgin olive oil is the least processed grade, and the 2011 pyramid authors describe it as rich in antioxidant compounds [3].

Olive oil is still calorie-dense, like every oil. In the U.S. pattern, a whole day's oil budget at 2,000 calories is 27 grams, about 2 tablespoons [2]. Use olive oil in place of butter or other fats rather than adding it on top of them.

What the Research Measured

The PREDIMED trial

PREDIMED is the largest randomized trial of the pattern. Researchers in Spain assigned 7,447 adults aged 55 to 80, all at high cardiovascular risk but without cardiovascular disease, to one of three diets. Two groups ate a Mediterranean diet and were given either free extra-virgin olive oil or free mixed nuts. The third group was advised to cut back on dietary fat [1]. After a median of 4.8 years, a major cardiovascular event (heart attack, stroke or cardiovascular death) occurred in 3.8% of the olive-oil group, 3.4% of the nut group and 4.4% of the control group [1].

The original 2013 report was withdrawn. The authors found protocol problems, including household members enrolled without randomization at some sites. The corrected 2018 report used analyses that did not rely on every participant having been randomized, and the results were similar [1]. All participants were older Spanish adults at high risk, so the findings may not apply to everyone.

Reviews of many studies

A 2018 umbrella review pooled 13 meta-analyses of observational studies and 16 meta-analyses of randomized trials, covering more than 12.8 million people and 37 health outcomes. It found robust evidence linking closer adherence to the pattern with lower overall mortality and with several major chronic-disease outcomes [4]. For other outcomes, including inflammatory and metabolic markers, the evidence was only suggestive or weak [4]. Most of these studies are observational, which means they show associations, not cause and effect.

Trials have also measured blood markers. A 2014 meta-analysis of 17 trials (about 2,300 adults, each lasting at least 12 weeks) found greater drops in C-reactive protein and interleukin-6 on Mediterranean diets than on comparison diets. The studies varied widely, though [5]. Our anti-inflammatory eating guide explains what those markers do and don't tell you.

How to Start Eating the Mediterranean Way

• Change your cooking fat first. Cook with olive oil and use it in dressings instead of butter or other spreads.
• Build plates around vegetables. Aim for at least two vegetable servings at lunch and dinner, and make one of them raw, such as a salad [3].
• Switch to whole grains. Try whole-grain bread, brown rice, farro, bulgur or whole-wheat pasta.
• Eat fish twice a week. Canned sardines, salmon and tuna are budget-friendly ways to get there.
• Give beans a bigger role. Use lentils, chickpeas and white beans in soups, salads and stews several times a week, sometimes in place of meat [3].
• Snack on nuts, olives and fruit instead of packaged sweets. A handful of nuts is a typical portion [3].
• Season with herbs and spices, garlic, onion and lemon, so you need less salt [3].
• Keep red meat and sweets for occasions. Treat them as extras rather than everyday foods.

For a ready-made week of meals, see our Mediterranean diet meal plan. Our Mediterranean diet recipes collect individual dishes. If weight is your main interest, our Mediterranean diet for weight loss article covers what those studies measured. If you are comparing eating patterns, the DASH diet is another pattern built on plants and whole foods.

Eating out and shopping

At restaurants, choose grilled, baked or roasted fish, poultry or vegetables. Ask for dressings on the side, and order a vegetable or bean dish as a main. When shopping, fill most of your cart with produce, canned or dried beans, whole grains, nuts, canned fish and a good bottle of extra-virgin olive oil. The Dietary Guidelines count fresh, frozen and canned vegetables and fruit, so frozen produce is an easy way to manage cost [2].

Safety and Interactions

The Mediterranean pattern uses ordinary foods and is considered suitable for most adults. A few points are worth checking:

• Alcohol is optional. Some adults should not drink at all, including people who are pregnant [2]. Ask your doctor whether alcohol is safe with your medicines.
• Fish choices during pregnancy and childhood. The Dietary Guidelines point to joint FDA/EPA advice on choosing lower-mercury seafood for people who are or may become pregnant or are breastfeeding, and for young children [2].
• Nut and seafood allergies. Swap in seeds, beans or other protein foods as needed.
• Medicines. Leafy green vegetables are rich in vitamin K. If you take warfarin (Coumadin), keep your vitamin K intake about the same from day to day, because sudden changes can affect how the medicine works, and talk to your doctor or pharmacist before you add a lot more greens [7]. If you take any prescription medicine or have a medical condition, check with your healthcare provider or a registered dietitian before changing your eating pattern substantially.

Frequently Asked Questions

What foods do you eat on a Mediterranean diet?

Mostly vegetables, fruit, whole grains, beans, nuts, seeds, herbs and spices, with olive oil as the main fat. Fish and seafood appear at least twice a week. Yogurt, cheese, eggs and poultry are eaten in moderate amounts, and red meat, processed meat and sweets are limited [3].

What foods are limited on the Mediterranean diet?

Nothing is strictly banned. The pyramid suggests fewer than two servings of red meat and no more than one serving of processed meat a week. Sweets, pastries and sugary drinks are kept to small amounts on special occasions [3].

Can you eat eggs on the Mediterranean diet?

Yes. The 2011 pyramid lists two to four servings of eggs per week, including eggs used in cooking and baking [3].

What is a typical Mediterranean breakfast?

Breakfast follows the same pattern as other meals. Typical options are plain yogurt with fruit and nuts, whole-grain bread with olive oil and tomato, or eggs with vegetables.

Do you have to drink wine on the Mediterranean diet?

No. The traditional pattern includes moderate wine with meals, but U.S. guidelines say adults can choose not to drink and that drinking less is better than drinking more [2][3].

Is the Mediterranean diet the same as the Dietary Guidelines' Mediterranean-style pattern?

They are close but not identical. The USDA version is a variation of the Healthy U.S.-Style pattern. At 2,000 calories it has more fruit and seafood and less dairy than the standard pattern, and it is set in U.S. cup and ounce equivalents [2].

Sources

1. Estruch R, Ros E, Salas-Salvado J, et al.; PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018.
2. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025 (Table 1-1 and Appendix 3, Table A3-5: Healthy Mediterranean-Style Dietary Pattern). DietaryGuidelines.gov. 2020.
3. Bach-Faig A, Berry EM, Lairon D, et al.; Mediterranean Diet Foundation Expert Group. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011.
4. Dinu M, Pagliai G, Casini A, Sofi F. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr. 2018.
5. Schwingshackl L, Hoffmann G. Mediterranean dietary pattern, inflammation and endothelial function: a systematic review and meta-analysis of intervention trials. Nutr Metab Cardiovasc Dis. 2014.
6. U.S. Department of Agriculture, Agricultural Research Service. Oil, olive, salad or cooking (SR Legacy, FDC ID 171413). FoodData Central.
7. NIH Office of Dietary Supplements. Vitamin K: Fact Sheet for Consumers. 2021.

Disclosure: OPA Nutrition sells supplements, including products mentioned in this article. This content is for education only and is not medical advice. Statements about dietary supplements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Talk to your healthcare provider before using any supplement, especially if you take medication or have a medical condition.

Written and reviewed by Michael Gonzales, Founder, OPA Nutrition · Last reviewed: October 17, 2026 · How OPA researches and writes