How You Can Get Started on the Mediterranean Diet

Advice on how to get started on this life-saving way of eating

salmon salad

Contributor: Leslie Cho, MD

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As an interventional cardiologist who specializes in prevention, I’m often asked by patients, friends and family which diet will best prevent heart disease.

There’s been much hype and fanfare surrounding various diets, but the diet that has consistently shown benefit in randomized control studies is the Mediterranean diet. It’s been shown to reduce heart attack and stroke as well as lower LDL, or bad, cholesterol.

The Mediterranean diet is based on the traditional eating habits found in southern Italy and Greece in the early 1960s. It focuses on plant-based foods – heavy on vegetables, fruits, legumes, fish, olive oil and some amount of nuts.

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But what does that really mean, and how much of these should we be eating? We can all agree that even too much of good thing is bad. So here’s some helpful advice about how to follow the Mediterranean diet as studied in clinical trials:

  • Vegetables: Three servings a day. One serving equals 1/2 cooked or 1 cup of raw vegetables.
  • Fruits: Three servings a day. One serving equals 1/2 to 1 cup.
  • Olive oil: One tablespoon a day, but no more than four tablespoons a day. This includes your cooking oil.
  • Legumes: Three servings a week of beans, peas, alfalfa, peanuts, etc.
  • Fish: Three servings a week. The smellier the fish are, the better, because smelly fish contain higher levels of omega-3 fatty acids. Smart choices include salmon, tuna, herring, sardines, mackerel and anchovies.
  • Nuts: Three servings a week. One serving equals 1/4 cup, one ounce or two tablespoons of nut butter. Ideally, go for raw, unsalted and dry-roasted walnuts, almonds or hazelnuts.
  • Starches: Three to six servings a day. One serving equals 1/2 cup cooked, one slice of bread or one ounce of dry cereal. Choose whole grains, oats, barley, brown rice, quinoa and red skin or sweet potatoes.
  • White meat: Three three-ounce servings a week. Choose skinless poultry, which includes choices such as chicken, turkey, pheasants and ostrich instead of red meat. You should have no more than one serving, meaning three ounces, of red meat a week. Choose lean cuts such as sirloin, tenderloin or flank steak if you have to have red meat.
  • Dairy/eggs: Three servings a week. Choose 1 percent or fat-free milk, yogurt or cottage cheese. There are no limits on egg whites.
  • Desserts: One three-ounce serving a week. If possible, let fruit be your dessert. If you have to eat baked goods, choose one with healthy ingredients, and eat smaller portions.
  • Wine: Four to six ounces a day. No beer or hard liquor; drinking wine is optional. Don’t start drinking if you’ve never drank before. There is no good data that taking up alcohol will prevent heart disease.

The first thing people notice about this diet is the limit on fish, nuts, meat and dairy to only three servings a week – not every day. Also, notice the lack of animal fat. In this diet, meat is an accent and not a centerpiece, of your meal.

Finally, eating is one of the greatest pleasures in life. Enjoy your food, eat what’s good for you in moderation and remember the words of Hippocrates: “Let food be thy medicine, and medicine be thy food.”

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This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.