Mediterranean Diet
A Mediterranean diet is high in vegetables, fruits, whole grains, and olive oil and low in meat, sweets, and saturated fat. It is linked to lower risks of cancer and relief of some symptoms and imbalances common among people with cancer.
Mediterranean diet at a glance
The Mediterranean diet has become recognized as a beneficial diet for people around the world to follow for its health benefits, ease of implementation, and eating pleasure. It focuses on these foods:
In abundance:
- Fruits
- Vegetables
- Whole grains
- Legumes
- Nuts and seeds
- Olive oil
- Herbs and seasonings
In moderate amounts:
- Fish (once or twice a week)
- Poultry
- Eggs
- Yogurt
- Cheese
- Salt
- Red wine with meals, also see: recommendations against alcohol for people with cancer ›
Only sparingly:
- Meat and meat products
- Sweets
- Butter or margarine
Most of the benefits from eating a Mediterranean diet are seen in lower risk of cancer, both as a whole and for many specific cancer types. Some evidence also links a Mediterranean diet to lower risks of depression, anxiety, and cognitive symptoms.
The Mediterranean diet was initially based on the dietary habits of people living in Mediterranean regions, especially traditional Greek diets. The foods and ingredients used in the Mediterranean diet are commonly available in grocery stores throughout the USA and Canada. Many substitutions of foods with a similar nutritional value are possible. Some examples:
- Oats, rye, or brown rice for whole wheat
- Cilantro, cumin, cinnamon, ginger, and other seasonings for rosemary and basil
- Berries or melons for stone fruits
With substitutions, a “Mediterranean” diet can conform to many tastes and cultural preferences from around the world.
CancerChoices ratings for Mediterranean diet
We rate the Mediterranean diet on seven attributes, with 0 the lowest rating and 5 the highest. We rate the strength of the evidence supporting the use of the Mediterranean diet for a medical benefit, such as improving treatment outcomes or managing side effects.
See how we evaluate and rate complementary therapies ›
Improving treatment outcomes
See More- Insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of increased survival among people with cancer with the highest adherence to a Mediterranean diet
- Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of Gleason grade group progression among men with prostate cancer with each 1-unit increase in adherence to a Mediterranean diet
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on prostate cancer mortality among people with prostate cancer with the highest adherence to a Mediterranean diet in a large study
See How can a Mediterranean diet help you? What the research says ›
Optimizing your body terrain
See More- Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of better markers of glycemic control among people with type 2 diabetes or other diagnoses eating a Mediterranean diet
- Good evidence of lower fasting insulin and homeostatic model assessment of insulin resistance (HOMA-IR) but not HbA1C among people eating a Mediterranean diet
- Insufficientpreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) and inconsistent evidence of an effect on fasting glucose among people eating a Mediterranean diet
- Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of higher immune activation among people eating a Mediterranean diet for several years
- Good evidence of lower markers of inflammation such as C-reactive protein (CRP), high sensitivity CRP (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) among people eating a Mediterranean diet
- Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of an alteration of gut microbiota to a status associated with less inflammation, reduced risks of diseased states, and a balanced state (eubiosis) in general among people eating a Mediterranean diet
See How can a Mediterranean diet help you? What the research says ›
Managing side effects and promoting wellness
See More- Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less cancer-related fatigue and better quality of life during androgen deprivation therapy (ADT) among people with prostate cancer eating a Mediterranean diet
See How can a Mediterranean diet help you? What the research says ›
Reducing cancer risk
See More- Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of cancer as a whole or mortality among people without cancer at baseline with higher adherence to a Mediterranean diet
- Good evidence of lower risk of breast cancer among people with the highest adherence to a Mediterranean diet, although the effect may vary with the specific types of breast cancer
- Good evidence of lower risk of lung cancer, stronger among people who smoke heavily and perhaps stronger among men, among people with the highest adherence to a Mediterranean diet
- Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of bladder cancer among people with the highest adherence to the Mediterranean diet
- Modest evidence of lower risk of colorectal cancer among people with the highest adherence to a Mediterranean diet
- Modest evidence of lower risk of upper gastrointestinal cancers as a whole
- Modest evidence of lower risk of liver cancer among people with the highest adherence to a Mediterranean diet
- Modest evidence of lower risk of head and neck cancers among people with the highest adherence to a Mediterranean diet
See How can a Mediterranean diet help you? What the research says ›
Use by integrative oncology experts
See More- Widely used by integrative practitioners
- Recommended in integrative cancer clinical practice guidelines
Safety
See More- Generally safe, with only minor side effects
- People with special nutritional needs should consult a dietician before changing their diet
- Some ingredients and foods are not appropriate for children
Affordability and access
See More- Widely available without restriction
- Generally inexpensive (less than $500 US/year extra cost compared to other diets)
The Mediterranean diet is part of a lifestyle that also includes generous amounts of physical activity,1Mayo Clinic staff. Nutrition and healthy eating: Mediterranean diet: a heart-healthy eating plan. Mayo Clinic. July 23, 2021. Viewed May 10, 2022. and so it relates closely to two of our 7 Healing Practices: Eating Well and Moving More. However, virtually none of the studies we evaluated in this review measured or even mentioned physical activity, reporting only on diet. We cannot assume that people asked to follow a Mediterranean diet increased their physical activity in these studies. We review and assess studies that combine changes in diet with changes in physical activity in a separate section on both our Eating Well and Moving More pages at the bottom of the pages describing the evidence.
Keep reading about a Mediterranean diet
Authors
Andrew Jackson, ND, serves as a CancerChoices research associate. As a naturopathic physician practicing in Kirkland, Washington, he teaches critical evaluation of the medical literture at Bastyr University in Kenmore, Washington. His great appreciation of scientific inquiry and the scientific process has led him to view research with a critical eye.
Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.
Curator and reviewer
Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.
For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.
Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.
Last update: December 12, 2023
Last full literature review: November 2021
CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.
Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.
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References[+]
| 1 | Mayo Clinic staff. Nutrition and healthy eating: Mediterranean diet: a heart-healthy eating plan. Mayo Clinic. July 23, 2021. Viewed May 10, 2022. |
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