The Mediterranean diet is infinitely adaptable. Here’s how to make it work for you.
Scientists are exploring how simple tweaks to this trusted diet can address specific health concerns, including hypertension, chronic pain, cardiovascular health, and more.
You’ve undoubtedly heard that the Mediterranean diet is one of the healthiest on the planet—and that’s true, given its association with various health benefits and even greater longevity. These perks and the fact that it’s been so well studied are what make it so trusted. But many people don’t realize that the Mediterranean diet isn’t a plan with strict criteria.
“The Mediterranean diet is inherently flexitarian—you can adopt the fundamental principles and apply them in a context that works for you or for any condition that has a dietary connection,” says David L. Katz, a preventive medicine specialist, past president of the American College of Lifestyle Medicine, and co-author of How to Eat. “By tweaking the basic themes, you’re taking good care of you, which means taking good care of all the parts of you.”
The core principles of the Mediterranean diet emphasize lots of vegetables, fruits, nuts, legumes (including beans), healthy fats, whole grains, and herbs and spices to add flavor. It also includes moderate amounts of fish, seafood, poultry, and eggs. By contrast, saturated fats, red meats, fried foods, ultra-processed foods, sweets, and simple carbs should be limited.
(The Mediterranean diet has stood the test of time for a reason: It works.)
Scientists are exploring how you can make simple tweaks to this core plan to address specific health concerns, including hypertension, chronic pain, cardiovascular health, and others.
What makes the Mediterranean diet so beneficial for a wide range of health conditions are the anti-inflammatory, antioxidant-rich foods it incorporates, Katz says. “Inflammation is considered the common denominator in every major disease.”
The possibilities for benefitting from the diet are limitless. Here are some science-backed hacks for how to use the core principles of the Mediterranean diet to suit your own needs.
Hypertension
The fruit-and-veggie-rich, low-sodium DASH eating plan (which is short for Dietary Approaches to Stop Hypertension) is proven for its ability to control hypertension, or high blood pressure. However, you can get similar benefits with the Mediterranean diet if you reduce your sodium intake and emphasize foods that are high in potassium, magnesium, and calcium, Katz says. These include nuts, seeds, beans, leafy greens, and dairy products.
Good strategies for reducing sodium intake include choosing low-sodium canned beans and tomatoes and rinsing them well before using them, says Sara Baer-Sinnott, president of Oldways, a nonprofit organization that promotes healthy eating based on cultural food traditions.
Brain health
The MIND diet (a.k.a., the Mediterranean-DASH Intervention for Neurodegenerative Delay) is a spin on the Mediterranean diet that was created explicitly for the purpose of protecting brain health and reducing the risk of developing Alzheimer’s. This diet emphasizes leafy greens and berries that have strong antioxidant and anti-inflammatory effects, and it has been shown to slow cognitive decline.
But it’s not the only way to go. A modified Mediterranean-ketogenic diet—consisting of 5 to 10 percent carbohydrates, 60 to 65 percent fat, and 30 percent protein—has been investigated to prevent or treat early Alzheimer’s disease. This approach is associated with beneficial changes in lipids that are linked to biomarkers of Alzheimer’s disease.
(How the MIND diet could make your brain 7 years younger.)
Chronic pain conditions
In a study in a 2024 issue of the journal Pain and Therapy, researchers had people with fibromyalgia—a disorder that affects muscles, soft tissues, and the nervous system's processing of pain—follow a general balanced diet (with a reduction in calorie intake) or a personalized form of the Mediterranean diet that eliminated dairy products and eggs. (In some instances, these foods can increase low-grade inflammation.) After eight weeks, those who adhered closely to the modified Mediterranean diet experienced reductions in pain, fatigue, depression, and anxiety.
When it comes to rheumatoid arthritis, people may benefit from modifying the Mediterranean diet to include even more fatty fish (like anchovies, salmon, herring, sardines, mackerel, and tuna) and other foods that are rich in anti-inflammatory omega-3 fatty acids (like flaxseeds, chia seeds, and walnuts), says Joan Salge Blake, a dietitian and clinical professor of nutrition at Boston University and host of the nutrition and health podcast Spot On!
Research has further found that a higher consumption of oily fish and omega-3 fatty acids is associated with a reduction in pain incidence and pain worsening among older adults over the course of five years.
Weight management
The Mediterranean diet has been shown to help with weight management. “There’s only so much real estate on the plate so if half the plate is vegetables, that will crowd out other foods, which may cut calories without cutting the volume of food,” says Salge Blake.
Tweaking the diet can amp up those perks. A study in a 2022 issue of BMC Medicine found that following a “green Mediterranean diet” with twice the dietary polyphenols (thanks to more green tea, leafy greens, walnuts, and fiber) and less red meat led to greater loss of visceral fat in people with abdominal obesity after 18 months.
Cardiovascular health
The anti-inflammatory properties of the Mediterranean diet are also helpful for your heart health because chronic inflammation is a significant contributor to heart disease. And you don’t have to stick to traditional Mediterranean foods to get those benefits. Recently, researchers created an Indian-adapted anti-inflammatory Mediterranean diet—with ingredients like split peas, basmati rice, mustard oil, and turmeric—for people with coronary artery disease, a leading cause of death in India.
You can make similar swaps in other culinary traditions, like with the Puerto Rican Optimized Mediterranean-like Diet, which aims to improve cardiometabolic health by emphasizing consumption of beans (such as the black, pinto, and kidney varieties), root vegetables, fruits (like passion fruit, mango, and pineapple), whole grains, healthy fats, and low-fat dairy foods, and limiting consumption of red meat.
Type 2 diabetes
A 2021 review of the research suggests that adhering to the Mediterranean diet can have a positive effect on people with type 2 diabetes, largely by improving blood sugar control and insulin sensitivity.
If you have diabetes, dietitians recommend a few particular tweaks: You may benefit from having smaller, more frequent meals throughout the day and having fruit with a source of protein to stabilize blood sugar, says Julia Zumpano, a registered dietitian with the Center for Human Nutrition at the Cleveland Clinic. This could mean Greek yogurt or cottage cheese with berries, an apple with a piece of cheese, or walnuts with pear slices.
Also, consuming lots of soluble fiber—including whole grains, legumes, beans, and pears—can “reduce spikes in glucose levels because it’s digested more slowly,” Salge Blake says.
Osteoporosis
Maintaining bone density is super important if you have osteoporosis but the Mediterranean diet doesn’t emphasize foods that are loaded with calcium or vitamin D. That’s why it’s important to “add low-fat or fat-free dairy foods such as milk or Greek yogurt to get enough calcium and vitamin D,” says Keith Ayoob, a dietitian in New York City and an associate professor emeritus of pediatrics at the Albert Einstein College of Medicine. “You need the calcium even if you don’t need dairy.”
If you use plant-based milks, make sure they’re fortified with calcium and vitamin D, says Salge Blake. Also, keep in mind that canned fish—such as salmon, sardines, and anchovies—are good sources of calcium because they contain soft bones.
(The scientific case for eating more bones.)
Making it even more personal
You can also adapt the Mediterranean diet for your own personal preferences. “It needs to include a few basics but there’s a lot of flexibility,” says Ayoob. If you’re vegetarian, for example, you can stick with plant-based foods and add eggs, cheese, yogurt, and milk. Pescatarians can take the same approach and add fish and seafood to their meals.
“Start incorporating facets of the Mediterranean diet that are most appealing to you as opposed to being overwhelmed by the whole picture then build upon that base,” suggests Zumpano. “Little steps make a big difference.”
Here are the core strategies to follow:
Eat more plant-based foods. That means including a wide variety of fruits, vegetables, legumes, beans, nuts, seeds, and whole grains. Try to have at least three servings each of fruits and vegetables per day and aim for produce in a variety of colors, which will bring in plenty of phytochemicals (health-promoting compounds in plants) and antioxidants, Salge Blake says.
Choose lean sources of protein. Eat more fish, seafood, poultry, and legumes and less red meat. “Try going vegetarian once a week,” suggests Baer-Sinnott. In addition to providing you with good-quality protein, these changes will reduce your intake of saturated fats.
Consume good fats. While extra virgin olive oil is a staple in the Mediterranean diet, you can use other healthy, neutral oils—such as grapeseed oil, walnut oil, peanut oil, or corn oil—in your cooking instead, Ayoob says. Also, stock up on health-promoting fats such as nuts, seeds, avocados, and fatty fish such as salmon, mackerel, and sardines.
Switch to whole grains. Trade in white bread, pasta, and rice for whole-grain options like whole-wheat bread, whole-grain pasta or bean-based pasta, brown rice, quinoa, oats, barley, and the like. Try to incorporate whole grains with every meal, Zumpano says.
Add healthy treats in moderation. These can include a small piece of dark chocolate or an occasional glass of wine. “The Mediterranean diet is easy to stay on because it’s not restrictive—it’s part of a lifestyle,” says Baer-Sinnott.
Ultimately, there isn’t a one-size-fits-all style to the Mediterranean diet. Finding ways to make it work for you, Katz says, is one of the best ways to “love foods that love you back.”
