The traditional Mediterranean diet

The traditional Mediterranean diet by itself is not designed for weight loss. But couple it with mild caloric restriction and regular physical activity, and it will indeed lead to weight loss and improved health.

Let's assume you’ve heard good things about the Mediterranean diet and want to try it for weight loss.  I will also assume you have excessive body fat or a body mass index over 25.  Maybe you have just 10 or 20 pounds to lose.  Perhaps you are much heavier and are concerned about the adverse health effects of obesity.

Body mass index (BMI) is used to define overweight and obesity.  Your BMI is your weight in kilograms divided by your height in meters squared.  A BMI between 18.5 and 25 is considered healthy.  BMIs between 25 and 30 are overweight.  Here’s an online BMI calculator.  For example, a 5-foot, 4-inch person enters obesity territory - BMI over 30 - when weight reaches 174 pounds (79 kilograms).  A 5-foot, 10-incher is obese starting at 208 pounds (94.5 kilograms).  Numerous adverse health effects are associated with obesity.

Why the Mediterranean Diet?

Observational and clinical studies have clearly shown that the traditional Mediterranean diet is associated with overall greater health and longevity, lower incidence of dementia and cancer (of the colon, breast, prostate, and uterus), and lower incidence of cardiovascular disease, including coronary heart disease that causes heart attacks. Furthermore, recent studies indicate that such a diet may improve asthma and prevent type 2 diabetes mellitus andchronic obstructive pulmonary disease.

What is the Traditional Mediterranean Diet?

I use the word “diet” in this section not as a weight-loss program, but “the usual food and drink of a person.” Twenty-one countries have a coastline on the Mediterranean Sea, and additional countries are in the Mediterranean region. “Traditional” refers to the mid-20th century. Observational studies around that time associated the Mediterranean diet with longer life spans, reduced rates of chronic disease (less cardiovascular disease and dementia), and fewer cancers of the colon, breast, prostate, and uterus. There is no monolithic, immutable, traditional Mediterranean diet. But there are similarities among many of the regional countries that tend to unite them, gastronomically speaking. Greece and southern Italy are particularly influential in this context.

Here are the general characteristcs of the traditional, healthy Mediterranean diet:

•      It maximizes natural whole foods and minimizes highly processed ones

•      Small amounts of red meat. Meat is used more as a garnish than as the

centerpiece of the meal

•      Less than four eggs per week

•      Low to moderate amounts of poultry and fish

•      Daily fresh fruit

•      Seasonal locally grown foods with minimal processing

•      Concentrated sugars only a few times per week

Wine in low to moderate amounts, and usually taken at mealtimes

•      Milk products - mainly cheese and yogurt - in low to moderate amounts

•      Olive oil as the predominant fat

•      Abundance of foods from plants: vegetables, fruits, beans, potatoes, nuts,

seeds, breads and other whole grain products

•      Naturally low in saturated fat, trans fats, and cholesterol

•      Naturally high in fiber, phytonutrients, vitamins (e.g., folate),

antioxidants, and minerals (especially when compared with concentrated,

refined starches and sugars in a modern Western diet)

•      Naturally high in monounsaturated and polyunsaturated fats, particularly as a

replacement for saturated fats

Oldways Preservation and Exchange Trust, in Boston, MA, has done great work promoting the traditional Mediterranean diet.  Oldways produced a traditional Mediterranean diet pyramid in 2000.

Can the Traditional Mediterranean Diet of the Mid-20th Century be Improved?

Scientific breakthroughs, mostly over the last decade, should allow us to fine-tune the traditional Mediterranean diet, leading to greater improvements in health and longevity.  Specific modifications to the traditional Mediterranean diet will ensure that you get the optimal amount of various foods that have been clearly associated with lower rates of disease and longer lifespan.  

Please consider the following modifications - which we’ll call the Advanced Mediterranean Diet - as you eat Mediterranean-style:

•      How much fish?  Two servings per week, to prevent sudden death and heart attacks.

•      What kind of fish? Cold-water fatty fish (albacore tuna, salmon, mackerel, sardines, trout, sea bass, swordfish, herring, anchovies, halibut, pampano).  Many of these fish were not available to the Mediterraneans of the mid-20th century.

•      How many nuts?  Three to five 1-ounce servings per week.

•      How much olive oil?  Aim for a minimum of seven to 14 tablespoons weekly.

•      How much fruits and vegetables?  At least 5 servings daily, to reduce risk of cancer, heart attacks, and stroke.

•      How much legumes?  Four servings per week, to prevent coronary artery disease.

How much wine, for those who choose to drink?  No more than one glass (4-5 ounces) daily for women and two glasses for men, to prolong lifespan and reduce coronary artery disease and dementia.  Before taking up the wine habit, carefully consider the pros and cons.

•      How much whole grain?  Three servings daily, to reduce risk of premature death, coronary artery disease, diabetes mellitus, and cancer.

•      The traditional Mediterranean diet was generally high-fiber but how much fiber do we need?  Twenty-five to 30 grams daily, to prevent diverticulosis, constipation, irritable bowel syndrome, and hemorrhoids.

•      The Advanced Diet encourages usage of heart-protective omega-3 polyunsaturated fatty acids in vegetable oils, especially flaxseed, canola, and soybean oils.  These were not significant contributors to the traditional diet.

•      Full-fat versions of dairy products were the norm in the traditional diet.  We now believe that the saturated fats in them contribute to hardening of the arteries (atherosclerosis), so the Advanced Diet favors the low-fat versions.  For the same reason, the Advanced Diet favors leaner (lower fat) cuts of meat, poultry, and game.

What’s Next?

First, review the disclaimer at the end of this document.  It’s a good idea to get medical clearance from your personal physician before you begin any diet or exercise program.  You may have an underlying illness causing your excess weight, or medical conditions that dangerously complicate the weight-loss process.

Unfortunately, the Mediterranean diet does not magically lead to weight loss.  Make no mistake about it: you can become massively obese eating Mediterranean-style.  To lose weight, you need to determine the level of calorie intake that will allow you to convert your excess fat into weightless energy.  It really does come down to calories in versus calories out.  “Calories in” is the food you put in your body.  “Calories out” is the energy you need to move about, and the energy needed to run basic metabolic processes in your body.  Mild caloric restriction coupled with a mild-to-moderate exercise program usually is the best route to successful weight loss.  Let’s assume you have been sedentary but will start a walking program (eventully walking at 3-4 miles per hour) for 30 minutes on most days of the week.  To lose weight, your appropriate calorie intake level is based on your sex and weight:

•      Overweight women between 130 and 210 pounds should reduce calories to about 1,500 calories per day.

•      Women 210 to 300 pounds reduce to 1,900 calories.

•      Overweight men between 150 and 220 pounds reduce to 1,900 calories daily.

•      Men 220 to 350 pounds reduce to 2,300 calories.

Women over 300 and men over 350 pounds who have tried and failed many different diets should consider bariatric surgery, or reduce caloric intake to 1,900 (women) or 2,300 (men).

If you just won’t exercise regularly, reduce the above suggested daily calorie intake levels by 200-300.  If you exercise but fail to lose one to one-and-a-half pounds per week, reduce daily calorie intake by 200-300 and see what happens over the next week.  Many people lose two to four pounds in the first week.  If that happens the second week, you aren’t eating enough, so increase your calories!  You can adjust your daily caloric intake on a weekly basis until it’s clear how much you can eat but still lose one to one-and-a-half pounds per week.  One pound per week is more realistic and sustainable over the long run.

While actively losing weight, take a multivitamin daily and consider a calcium supplement, “just in case.” 

For physical activity instruction and information, visit Shape Up America!, Physical Activity for Everyone, or Growing Stronger: Strength Training for Older Adults. 

If you like to be part of a supportive online community while dealing with weight issues, visit SparkPeople, 3 Fat Chicks on a Diet, or Calorie Count Plus.  All are free.  

Now the fun begins!  You start eating Mediterranean-style, following the aforementioned food guidelines and keeping track of daily caloric intake and exercise in a journal or Daily Log.  You can find caloric value of most foods atNutritionData or Calorie Count Plus.  When you go to the grocery store, take a shopping list of Mediterranean-style foods with you.  

After you reach your weight goal, add 200-300 calories back into your eating program.  For example, if you lost a pound a week on 1500 calories daily, increase to 1700 or 1800 calories.  You don’t need additional milk products or meat, so add back fruits, vegetables, nuts, whole grains, and healthy oils such as olive oil.  Keep exercising.

Remember: aim for at least 7-14 tablespoons of olive oil weekly, at least two servings of fish per week, and 3 to 5 1-ounce servings of nuts per week.  Favor fish and poultry over red meat.  Cold-water fatty fish - e.g., trout, salmon, albacore tuna, sardines, herring - are probably healthier than fried catfish.  The rest is up to you.

Help! This is Getting Complicated!

You can simplify the weight-loss process and enhance your weight-loss success by reading books such as The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer,  The Sonoma Diet: Trimmer Waist, Better Health in Just 10 Days!, and You: On a Diet: The Owner's Manual for Waist Management.  These books are based on the Mediterranean diet and provide recipes using readily available foods.  My formal reviews of You: On a Diet and Sonoma Diet are here.  You: On a Diet does not suppy enough calories for most men, but works fairly well for women under 210 pounds.  The Sonoma Diet is customizable, offering two levels of caloric intake and is a better overall program than You: On a Diet.  The Advanced Mediterranean Diet, written by me, is highly customizable - with four different calorie intake levels - and updated with the latest scientific breakthroughs.

You can also get excellent Mediterranean dieting instruction from dietitians and nutritionists.


Don’t be discouraged by admonitions that “diets don’t work.” They require discipline and willpower, but many diets do indeed work. Losing excess weight and adopting a Mediterranean diet will be well worth the effort over the long run.


The content is in no way intented to present medical advice.  It is a compilation of information to be used as part of the quest for a painfree back and a productive yoga practice.  No one can diagnose or advise you over the internet, anyway.  If you have doubts, questions, pains you don't understand, or you want more information, please speak with your health care provider.  As this information is general in nature, I guarantee nothing, but I do thank you for reading my words, and  I hope they help you


Mediterranean diet