A dietitian's guide to the #1 ranking Mediterranean diet

Why is the mediterranean diet labelled the best diet in the world?

We are often victim to the latest diet trends that flood the media and then leave just as quickly. This is likely due to science rebutting the evidence or merely a new diet taking over with greater promise. The Mediterranean diet though has consistently been advocated as the ‘healthiest’ diet in recent years. It seems like it is here to stay. But what makes this diet so different to everything else? Why haven’t we seen this particular diet fall into obscurity like all before it? We will look at what the Mediterranean diet is and why it is touted as the epitome of diets.

Current evidence is not strong enough to decisively implement it as the ‘cure all’ diet, but we have promising results in clinical trials that not only appear to improve cardiometabolic markers, such as cholesterol, (good and bad), reduce waist circumference and body fat, lower insulin resistance and improve mental health. It has also consistent dietary patterns conducive to reducing inflammatory markers and hence it is often recommended for pain management of old injuries, arthritis and other inflammatory conditions. This is why it has been labelled the best diet, due to its relative capacity to ‘treat’ and improve a vast range of health conditions. There is not one other diet that is similar in terms of its well-studied versatility and application to all facets of health both dysfunction and overall wellbeing.

So what is the mediterranean diet

The Mediterranean diet is built upon the diet of people living in areas surrounding the Mediterranean Sea. This region due to its locality has an abundance of fresh produce with large amounts of fruit, vegetables, extra virgin olive oil and seafood. The dietary patterns reflect this and hence are associated with such significant improvements in outcomes as these patterns are consistently encouraged across most diets and are fundamentally unchallenged within the scientific communities.

So, what exactly does this diet contain and in what quantities do you eat? The Mediterranean diet has its own diet pyramid, which can be easily found by a quick google. However, the pyramid can be quite confusing as it combines multiple food groups into each level. Here is an outline the main components and serving targets below:


  1. Fruits and Vegetables
    This makes up the bottom of the pyramid and hence should contribute the MOST to the diet. The goal is eating at least 7-10 servings a day of fruit and vegetables (combined), with a focus on equal distribution of both foods.

    Fruits: Aim for fresh fruit and the serving size is approximately a tennis ball.

    Vegetables: Aim for non-starchy vegetables in this recommendation (those with a high water and micronutrient content) and a serve is ½ a cup.

    Sooooo for 3 servings of fruit and 4 servings of vegetables – at minimum this would be at least 750g of fruit and vegetable per day and >2 serves at every meal, just short of a kilo of fresh produce per day and there is not much room for too much of anything else.
  2. Wholegrains and legumes
    These are also included in the bottom of the pyramid but can the focus is on wholegrains and high fibre foods: Brown rice, pasta and other wholegrains and starchy vegetables are included here, with the goal of 1-2 servings per meal and approximately 4 servings a day.

    Wholegrains: 1 serve is ½ a cup of cooked grains or pasta or 1 slice (30g) of bread


  1. Extra Virgin Olive Oil
    The Mediterranean diet includes EVOO in up to 60ml per day and at these levels is consistent with the ideal ratio. Achieved by using this as an oil to dress salads and primarily for cooking.
  2. Olives, legumes, nuts & seeds
    The aim is to consume 2-4 servings a day. A serve of nuts is 2 Tbsp and a serve of legumes is ½ a cup. These foods should be included in meals and used as snacks.
  3. Dairy (preferably low fat)
    Consistent with 1 cup of milk, 200g of yogurt and 30g cheese.
  4. Herbs, spices, garlic and onion
    This the unique and the holy trinity of the Mediterranean diet of garlic, onion and olive oil mixed together to form the base of all meals.


  1. Starchy vegetables
    <3 serves/week (potato ½ cup per serve)
  2. Fish
    These foods should be eaten >2 times per week, forming a large source of the protein in this diet
    A serving of this food is ~100g (size of a cheque book)
  3. Poultry and Eggs
    These foods are to be eaten at a reduced amount to your typical diet. You need to aim for 1-2 serves of poultry a week and 2-4 serves per week. The saturated fat profile and the lower abundance of these foods in the Mediterranean lends itself to this frequency.

Refined carbohydrates, confectionary and Red meat

These foods are not encouraged, and should only appear individually <2 times per week. With processed meat <1 serve per week, and red meat and refined carbohydrate <3 serves. The aim is to use fruit as your alternative to sweet food and adopt a plant-wholegrain diet style with a garnish of meat, dairy and discretionary items that are high in sugar, refined carbohydrate and fats. This typical pattern is similar to our dietary guidelines and principles, but with a greater focus on one primarily oil (olive), socialization and the use of herbs, spices, garlic and onion as main-stays in this diet type.

The Mediterranean diet encourages physical activity and eating with family and is often placed on the bottom of the pyramid, which signifies the importance of having a healthy relationship with food.

Ok so why are these foods so good for you?

The health benefits of foods in the Mediterranean diet stem from the focus on wholefoods with minimal processing, home cooked meals with added herbs and spices and small amounts of animal fats and refined carbohydrates. These foods encompass a wide range of nutrients and a fat profile that stems from good fats (monounsaturated, polyunsaturated) and enriched with antioxidants, polyphenols and fibre. The 4 main components fibre, fat and bioactive substances are the combative and health promoting aspects of this diet;

  • A high fibre diet can reduce cholesterol levels, moderate appetite and stem fluxes of blood sugar levels. This is great for heart health, diabetes control and prevention and reduces the risk of developing bowel cancer. The Mediterranean diet is also extremely beneficial for longevity due to components enriched in foods with a high fibre content an irrespective of weight, a diet that is balanced in fibre and the above lowers visceral adiposity and subsequent inflammatory cascade.
  • The proportion of fats and the ratio in this diet is what dictates the versatility and ‘healthfulness’ of this diet. The advocacy of foods with a fat profile rich in monounsaturated and polyunsaturated fats compared to saturated fats, sets it apart in terms of health benefits. This has been shown to significantly decrease the risk of heart disease, diabetes and inflammatory states and other biomarkers of health.
  • The high amounts of fruit and vegetables provide a diverse subset of antioxidants, which assist in suppressing the inflammatory immune response, minimizing cell death and promoting recovery. The Mediterranean diet is characterised by its high concentration of phenol containing foods (olive oil, red wine, nuts, legumes, fruits and vegetables). Phenols are responsible for lowering blood pressure and lowering cholesterol and even linked to reducing cell turnover and impacting on cancer development.

Just as important as the good nutrients of these foods, a Mediterranean diet is very low in nutrients that contribute to poor health when consumed in excess. The low amounts of processed ‘junk’ foods that deliver a large amount of energy and saturated fat promote many health benefits just by the abstinence and lacking of these foods and hence why it is has  been platformed as one of the healthiest and most sustainable diets in the world at present.

In the next blog we will look at how to transition yourself and your family onto a Mediterranean diet. I will discuss where to find the ingredients, the cost and look at where to start.

Peta Adams, APD

Article by Peta Adams, APD

Peta is an experienced no nonsense dietitian who enjoys cutting through the media spin to deliver realistic and achievable nutrition strategies for each of her clients. She has expertise to assist a wide range of clients with chronic and acute illness, particularly those with Diabetes, Disordered eating as well as generous experience with managing client's Food Allergies and Intolerances. She is also trained in the SOS approach to feeding fussy children with sensory difficulties and has postgraduate qualifications in Paediatric/Adolescent nutrition.

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