The Mediterranean Diet Has Ranked #1 For Seven Years In a Row—What Makes It So Effective?

In its annual Best Diets ranking, U.S. News and World Report has awarded the top spot to the Mediterranean diet for the seventh year in a row. According to the publication, this style of eating—inspired by the eating habits of people living in the Mediterranean region—has such serious staying power because it’s easy to follow long-term and has been shown to support heart health, bone, and joint health, and help prevent certain diseases, such as diabetes.

But “diet” is really a misnomer, says Maya Feller, MS, RD, CDN, author of Eating From Our Roots and a member of U.S. News and World Report’s Best Diets expert panel. “It’s less of a diet, more of a lifestyle, an eating pattern,” she says. “[It] can be customized based on the individual’s likes, dislikes, personal preference, religious needs, and access.”

“The Mediterranean diet is really a long-term dietary lifestyle…versus another kind of restrictive time-period diet,” agrees Maggie Berghoff, a functional medicine nurse practitioner and author of Eat to Treat. Rather than cutting out certain food groups or counting calories, “it focuses on [eating] a lot of healthy fats, healthy oils, and plant-based foods,” she says.

What Is the Mediterranean Diet?

The Mediterranean diet started to gain attention as a healthy way of eating in the 1950s, when scientist Ancel Keys, PhD, of the the University of Minnesota School of Power discovered a correlation between eating habits, lifestyles, and cardiovascular health.

“What the research found was that people who followed Mediterranean patterns of eating actually tended to have better cardiovascular profiles, so lower cholesterol, better lipid markers, good cholesterol,” says Feller.

Dr. Keys didn’t invent the Mediterranean diet, of course; he simply began to popularize a way of eating and enjoying food that people in the Mediterranean had been following for centuries. “The biggest tenets of that are seafood; lean proteins in the form of beans, nuts, and seeds; whole grains; ancient grains; fermented dairy; fruits,” says Feller. “And then alcohol is consumed in moderation.”

When looking for inspiration for your Mediterranean menu, Feller says it’s important to consider all 22 countries that surround the Mediterranean Sea—not just Greece, Italy, and France.

“The countries of North Africa and the Middle East are not often highlighted [when talking about the Mediterranean diet], when in fact, their patterns of eating are credible and really centered on legumes, grains, seeds, fermented dairy, and really interesting types of fruits,” she says. “We often are told: cucumber, feta, olives, tomato, and red onion—that’s the Mediterranean diet. Yes, that’s wonderful, but it could also be couscous and chickpeas in a curry with berbere. There’s so many different ways that it can show up.”

Mediterranean Diet Foods

Great news, folks: With the Mediterranean diet, it’s a very “you do you” approach to healthy eating. That being said, the Mediterranean lifestyle does encourage you to load your plate with particular foods and food groups.

• Fresh fruits and vegetables: According to Cleveland Clinic, you should have at least one serving of veg per meal.
• Seafood: The Mediterranean diet emphasizes seafood and poultry protein sources; fish in particular, is a great source of heart-healthy omega-3s.
• Healthy fats and oils: Extra-virgin olive oil is touted as the Med diet’s hero, but Berghoff says that other oils, such as walnut and pecan oil, are also rich in healthy polyphenols.
• Legumes: Pulses and legumes like lentils, beans, chickpeas, and peas are great sources of protein, fiber, and healthy fatty acids—and the Med diet encourages you to eat them multiple times a week.
• Nuts, seeds, and grains: Whether you’re eating ‘em as a snack, sprinkling them on your salads, or making a bowl of whole-grain cereal, add in nuts.
• Fermented dairy: While the Med diet recommends reducing your overall dairy intake to once a day, Feller says that folks in the Mediterranean reap the gut-healthy benefits of fermented dairy like yogurt and goat cheese.

Foods to Avoid When Following the Mediterranean Diet

Alcohol should be consumed in moderation, if at all, on the Mediterranean diet, says Feller.