Simple ways to follow a Mediterranean diet

Dr Simon Poole, author of the Real Mediterranean Diet and who co-wrote the Olive Oil Diet with Judy Ridgeway, says: "If I were to pick one diet that combines nutrition, sustainability, taste and healthy lifestyles, it would be the Mediterranean diet. Many of the diets advocated nowadays focus too much on single nutrients, like fat or carbs, completely missing the point that food combinations are more important."

What is a Mediterranean diet?

The Mediterranean diet advises sticking to healthy food groups combined with lifestyle tips - like eating together at the table, taking time to savour your food, enjoying regular exercise and staying clear of junk foods.

Generally, it is based on around 5 to 7 portions of fruits and vegetables daily with wholegrain cereals, fish, eggs, dairy foods, olive oil, nuts and seeds. Meat and poultry are eaten in small amounts.

But don't worry if you struggle to get anywhere close to your 5-a-day, as frozen, tinned and dried fruits and vegetables all count just as much as fresh - but make sure the canned fruit doesn't have added sugar or syrup. The main point is eat a colourful variety of plant foods. You can also swap harder-to-buy Mediterranean options, like aubergine, for typical British foods such as cabbage or kale.

Dietician Dr Duane Mellor says: "There is some debate about whether it's best to try to mimic the Mediterranean diet in the UK, or to focus on foods that are more typical in the UK. These can provide similar nutrients to foods commonly used in Mediterranean countries."

Swaps could include having oats instead of spelt, salmon instead of shellfish, or lentils instead of chickpeas.

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What are the benefits?

Unlike many diets promoted in books, in social media or on celebrity websites, the Mediterranean diet is supported by many studies.

Poole explains: "One of the biggest studies was PREDIMED - a multi-country study of nearly 7,500 older adults - which compared two variations of the Mediterranean diet with a typical low-fat 'healthy eating' plan¹. One Med diet group was given unsalted nuts as a snack, while the other group received olive oil. Over the next five years, both Med diet groups did so well health-wise that the trial had to be stopped so that everyone could benefit."

The results showed a staggering 30% reduction in the risk of dying from a stroke, heart attack or breast cancer.

"As well as cardiovascular disease, a Mediterranean diet also appears to be beneficial for managing type 2 diabetes," adds Mellor. "A review of five clinical studies found that patients who ate a Mediterranean-type diet improved their long-term glucose control compared with patients who ate other types of diet²."

But would you expect to pile on the pounds by adding higher-fat foods like nuts, seeds and olive oil into your diet? "Not really," says Poole. "As these wholefoods help to fill us up, so we eat less at other meals."

Are there downsides?

One downside to the Mediterranean diet may be the cost. Oily fish, nuts, seeds and extra virgin olive oil can be expensive. However, you may save money by buying fewer sweets, confectionery, ready meals and savoury snacks as these are not part of the Mediterranean plan. Eating seasonal fruits and vegetables that are on offer in supermarkets will also help keep costs down.

Watch your alcohol intake too though. Although red wine is included in the diet, it's important to stick within the guidelines of 14 units a week for men and women, spread over several days and with at least a couple of alcohol-free days a week.

"The benefits of red wine are overstated," says Mellor. "Studies of the Mediterranean lifestyle often find that moderate alcohol consumption is associated with quality of life and reduced stress but that may be due more to the positive social environments than anything in the wine."

Getting started

If you are more used to pie and chips than pimiento and chickpeas, read on. Here are Poole's top ten tips to get started on the Mediterranean diet:

Vegetables: any types but ring the changes so you get lots of variety.

Extra virgin olive oil: use for cooking and salads. Dip your bread in it instead of spreading on butter or margarine.

Fruit: enjoy after meals instead of high-calorie desserts.

Snacks: choose unsalted nuts and seeds - a handful a day (around 30 g) is enough.

Herbs and spices:these contain polyphenol compounds that act as natural antioxidants in the body. Try turmeric, basil, parsley, rosemary, oregano, sage, saffron and freshly ground pepper.

Fish: each week, aim for one portion of white fish and one portion of oily fish, like mackerel, salmon, tuna (fresh but not tinned tuna counts as an oily fish) or herring.

Dairy: try Greek yoghurt or cheese made from sheep or goat milk. The full-fat versions fit better with the Mediterranean lifestyle. Try fermented dairy products, like kefir.

Drinks: An occasional glass of red wine with a meal if you wish. Water or herbal teas are recommended.

Wholegrains: try a variety of grains, like spelt, barley, buckwheat, bulgar, farro, millet, oats, polenta and rice.

Beans and pulses: high in fibre, these can be added to soups and stews to bulk out beef, lamb, pork and chicken.

Check your progress with this Mediterranean diet quiz.

Further reading

1. Martinez-Gonzalez et al: PREDIMED-PLUS TRIAL.

2. Esposito et al: Mediterranean diet and type 2 diabetes.