You don’t have to live in the Mediterranean to enjoy the health boosting benefits of this delicious food and lifestyle.  There is no one right way to follow the diet, as there are many countries around the Mediterranean Sea and these many regions broaden the possibilities of the flavors that you will encounter.  This article describes the foods/lifestyle from the Italian perspective. Consider this as a general guideline, not something written in stone. It should be adjusted to your individual needs. 

The Basics


  • Vegetables (range of colors), fruits, nuts, seeds, legumes, whole grains, herbs and spices, fish and seafood (wild and not farmed), olives and olive oil

Eat in Moderation:

  • Poultry (organic), eggs (organic and cage-free), cheese (probiotic rich, raw, unpasteurized), yogurt (plain, organic), dark chocolate

Eat only Rarely:

  • Red meat (pastured, organically raised), butter, sweets and pastries, processed white flour products (crackers, cookies, bagels, pretzels)

Don’t Eat:

  • Added sugar, sugar-sweetened beverages, processed meat, refined grains (bread and pasta made from refined wheat), refined oils (corn, soybean, canola, cottonseed and other vegetable oils)and trans fats, highly processed foods (anything labeled “diet” or “low-fat” which looks like it was made in a factory.
  • you must read food labels carefully

What to Drink:

  • Water should be your go-to beverage. Drinking mineral water (flat or sparkling), with meals is a very common tradition in the Mediterranean.  Home drinking water should be clean and chemical free.
  • Red wine to compliment your food is a traditional part of the Mediterranean meal. White and rosé wines are also consumed but the polyphenols in red wine make it the healthiest pick.  Consider organic and dry farm wines  – wines that don’t use irrigation – have less sugar and less alcohol than wines produced with irrigation. Of course this is optional, and wine should not be consumed by anyone with alcoholism or problems controlling their consumption.
  • Coffee and tea in moderation and preferably black without sugar or sweeteners.
  • Herbal infusions and tisanes enjoyed hot or cold are very popular in the Mediterranean.

Wait, What about Pasta and Bread?

Most Italians eat pasta everyday, but it is generally only one of several courses in a typical Italian meal. And above all, portion sizes in Italy are undoubtedly much smaller than they are in America. In the southern and more Mediterranean regions of Italy, dry (durum wheat and water) pasta is preferred over fresh egg enriched pasta.  Durum wheat pasta is also higher in protein content than typical American pasta, that is often made with soft wheat and is therefore higher in carbohydrates. Italians cook their pasta al dente (to the tooth) while Americans tend to eat soft overcooked pasta, which has a higher glycemic index, meaning that it can raise your blood glucose. Pasta sauce is also considered a condiment and there should be just enough to coat each strand of pasta and no more. Oh, and the rich Alfredo sauce in unknown to most Italians.

Italians do not automatically put a large bowl of bread (or garlic knots) on their table. And there is no such thing as dipping bread in olive oil (don’t ask for it). Although exceptions abound, bread is to be eaten with food (but not with pasta) and not as a pre-dinner snack.  If there happens to be sauce left at the bottom of your pasta plate, you can then use a bit of bread to soak it up.


Mediterranean cuisine is very simple and pays more attention to the source, quality and selection of ingredients.  The quality of fruits and vegetables is influenced by how it is cultivated, when it is picked and its treatment afterwards.  When choosing protein such as poultry, meat, fish and eggs, look to see how the animals were raised and how the meat was processed. Organic, free-range, and pasture raised will insure that you do not also ingest growth hormones, chemicals and toxins.

These factors greatly influence both the taste and the nutrition of the product. When possible it is always preferable to buy seasonal products, locally produced and simply prepared. Ingredients important to the Italian food culture will be discussed in subsequent blogs.

Mediterranean Lifestyle

Obviously it’s not just the pattern of eating or the freshness of the food…there’s more to this lifestyle that we could learn from Italians and try to adopt. Throughout the centuries, Italy has weathered the hardships of many foreign occupations, national disasters, starvation, domination, destruction of war, and terrorism. Her people’s survival became the key to their wellbeing. It gave them the ability to survive, adapt, and live serenely no matter what life had in store. Strong family (or extended family) ties, solid friendships, love and romance, spirituality, a positive attitude and putting your best foot forward are core principles.

It’s not only what you eat, but also how you eat. A meal is also an excuse for a social occasion with family and friends, to talk about their days, argue about politics, and talk about the latest news or gossip. Meals are never rushed. Your digestion will be easier because you are spreading your food over time. Also when everyone is sharing, it’s unlikely that you will overindulge, so moderation will become the norm. Many businesses still close in the middle of the day for three hours to allow for a leisurely lunch. In the summer or during particularly hot weather, lunch is followed with quiet time, the siesta.

A lifestyle based on the Mediterranean diet also includes plenty of physical activity and social interaction. Italians tend to lead less sedentary lives. Walking is a necessity not just in cities but also in many towns where cars may be banned from the center of town. Most old buildings are walkups, and elevators are usually found only in high-rises. In small towns and rural areas the number of hills and steps the average Italian has to negotiate in their daily lives is much more that in the United States.  It’s not unusual to see Italians, even octogenarians, shopping everyday for fresh in-season foods, also allowing them some time to socialize. Adding to one’s wellbeing is also the evening passeggiata when families will take a long leisure stroll after dinner, commuting with neighbors and relatives with no particular destination in mind.  It’s also very common in small towns to see folks, young and old, bringing their chairs outside to sit all evening, chatting, gossiping and being part of a community.

How to Make Some simple changes to promote your Mediterranean Lifestyle:

  • You don’t have to be a top chef or nutrition expert, just get started by getting more of the preferred foods into your diet and avoid those that are not recommended. Start slow and build from there.
  • Structure mealtimes – dinner should be a time for family to come together.
  • Switch from whatever fats you now use to olive oil.
  • Don’t fuss with dessert – fruit gives sweet, vitamins and fiber. Snacks are fruit and nuts.
  • Think about the quality of food you buy and seek out the best.
  • Make sure that you have a few social connections each week. Even if it’s just a cheerful phone encounter.
  • Preserve the extended family structure – remember when families were close and when the kitchen was the living room and meals the entertainment.
  • Schedule in some down time – a weekend siesta, a stop at the coffee shop, a walk with friends, a break from technology/computer.
  • Get outside. Start a garden, even if it’s just herbs on a windowsill or a tomato plant on a balcony.
Mediterranean Diet Pyramid – 1993 – created in partnership with the Harvard School of Public Health and the WHO – as a healthier alternative to the USDA’s original food pyramid

Get inspired:

For more nutritional information and the science behind it: Masley, Steven, MD. The Mediterranean Method, 2019, Harmon Books.

In depth information including more information on the Mediterranean Diet Pyramid and a Diet Menu Plan Book: Oldways –