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People switching to the Mediterranean diet often make common mistakes that can interfere with its effectiveness. Helen Rushbrook/Stocksy United
  • The Mediterranean diet was named the top diet in the US News & World Report for the seventh year.
  • Recent research indicates that heart health, longer lifespans, and lower dementia risk are among the many benefits of the diet.
  • However, experts share people make some common mistakes that can reduce the effectiveness of the Mediterranean diet.

Death, taxes, and the Mediterranean diet ranking as the top diet in the US News & World Report. These are life’s three big “guarantees” — or at least they have been for the last seven years.

The Mediterranean diet first topped the list developed with insights from dieticians in 2018 and hasn’t let go of its crown since, once again coming in at No. 1 in the 2024 report released in January.

The diet is often hailed as the no-diet diet.

“The Mediterranean diet is a nutritional pattern inspired by the traditional dietary habits of countries bordering the Mediterranean Sea,” says Trista Best, MPH, RD, LD of Balance Once Supplements.

Best explains that the Mediterranean diet:

  • Emphasizes a high consumption of fruits, vegetables, legumes, nuts, olive oil, and whole grains
  • Includes moderate amounts of fish and poultry, with limited red meat intake
  • Encourages the use of herbs and spices for flavoring, and regular physical activity is considered an integral part of the lifestyle.

Research suggests that the benefits of the Meditteranean diet are wide-ranging and include:

Sounds like a (meal) plan, right?

While the Mediterranean diet appears to have benefits and legions of fans, experts share that people trying to put it into practice can make some common mistakes that reduce its effectiveness.

The following are the seven most common mistakes people make when trying to adopt the Mediterranean diet and how health experts say you can avoid them.

Excessive processed food intake

Isabel Vazquez, MS, RD, LD, a registered dietician with the Memorial Hermann Health System, says the Mediterranean diet de-emphasizes ultra-processed food. However, people attempting to follow it may reach for it because of clever packaging and labeling.

“A common mistake people make is eating processed foods that claim to be aligned with the Mediterranean diet or consuming too many ultra-processed foods,” Vazquez says. “Foods like packaged snacks compromise the health benefits found in the Mediterranean diet.”

A common pain point?

Highly processed foods that are labeled vegan and healthy,” says Kimberly Gomer MS, RD/LDN.

Researchers have noted that highly processed foods can more effectively trigger reward-related neural pathways than less-processed options and have compared these foods to addictive substances.

Research from 2020 indicates that ultra-processed food consumption could increase risks for chronic conditions like:

“At the end of the day, it is not about completely avoiding all processed foods but rather about consuming fewer ultra-processed items such as chips, candy bars, frozen meals, cakes, and cookies,” Vazquez says. “I always advise focusing on nutrient-dense foods like vegetables and fruits.”

Overlooking portion sizes

Best says consuming large portions of food — even options considered part of the diet — can lead to overeating and hinder weight loss or maintenance efforts.

Gomer points to a potential Mediterranean diet pitfall at the center of this mistake.

“There is no definition for the diet, which is a problem in that its instructions are very vague,” Gomer says.

Unlike MyPlate and the food pyramid it replaced, the Mediterranean diet doesn’t include visuals or hard-and-fast numbers to guide food and portion choices.

But Best says this allows people to tune into their cues by eating mindfully. She knows this tip can be difficult for people, though.

“Use smaller plates to control portion sizes, allowing for better self-regulation,” Best says.

Making drastic changes and having unrealistic expectations

The heaping helpings of praise piled on the Mediterranean diet may make it literally and physically appealing. However, experts caution it is not a quick fix.

“The Mediterranean diet, as nutritious and health-promoting as it may be, isn’t a way to cure or treat existing conditions,” says Cara Harbstreet, MS RD LD of Street Smart Nutrition. “Keep your expectations realistic, and be prepared for the slow, steady approach that can help reduce your risk of chronic disease in the future.”

Harbstreet says managing expectations can also include carving out some grace and patience with yourself.

“In reality, drastic changes done all at once make it less likely you’ll be able to stick to new habits in the long-term,” Harbstreet says.

Starting with one tweak, like adding fruit to breakfast daily, lays a steadier foundation.

Going light on vegetables

The Mediterranean diet includes many types of food, including legumes, lean animal proteins, and some types of fats. But Vazquez has noticed people aren’t consuming enough vegetables.

“Many of us fall short in consuming an adequate amount of vegetables, even though the Mediterranean diet emphasizes their importance,” Vazquez says. “Vegetables are rich in antioxidants and play a crucial role in maintaining a balanced diet.”

Vegetable consumption was a problem before the Mediterranean diet’s reign atop the US News & World Report began.

A CDC analysis published in 2017 indicated that less than 10% of U.S. adults were eating the recommended amount of vegetables. People living in lower-income areas were disproportionately affected.

What is “enough?”

“Ideally, half of our plate should consist of non-starchy vegetables,” Vazquez says. “It is recommended to eat 2 to 3 cups of vegetables daily. Remember, the more colorful the vegetable, the greater the health benefits.”

Not drinking enough water

Experts share overlooking hydration while following the Mediterranean diet is an issue for a couple of reasons. First, the Mediterranean diet is full of fiber-rich foods like fruits and vegetables, as mentioned above.

“Overall, that’s something we should all strive for, but if you suddenly increase your fiber intake without being mindful of hydration, you might be in for some discomfort in the bathroom,” Harbstreet says. “Focus on gradually increasing how many grams of fiber you eat daily while also incorporating more opportunities to sip on water or other clear liquids.”

Additionally, dehydration can affect hunger and energy levels, Best says.

The CDC doesn’t have an official water intake recommendation and says it can depend on climate, whether a person is pregnant or nursing, and activity level, among other factors.

“Drink an adequate amount of water throughout the day,” Best says. “Water supports digestion, helps control appetite, and is essential for overall health. Carry a reusable water bottle to encourage regular intake.”

Drinking too much alcohol

While the Mediterranean diet does not entirely rule out alcohol, specifically red wine, experts share it’s essential to practice moderation.

“Don’t take the inclusion of red wine to an extreme,” Harbstreet says. “Yes, there are compounds in red wine that may be beneficial. But at the end of the day, alcohol is one of the few things I recommend limiting.”

Forgetting food is more than fuel

Yes, people may be interested in the Mediterranean diet for its health benefits. However, Best says it’s essential to take a holistic approach to eating.

“Overlooking the social and cultural aspects of the Mediterranean diet diminishes its potential impact on mental well-being and overall satisfaction,” Best says.

Vazquez agrees.

“The Mediterranean diet is more than just about food,” Vazquez says. “It also encompasses the social and cultural aspects of eating. Neglecting to enjoy meals with others or rushing through them can diminish the overall experience and health benefits of the diet.”

Vazquez’s recommendation?

“Taking time to savor and appreciate meals with family and friends is an integral part of the Mediterranean lifestyle,” she says. “Viewing it merely as a diet is a misconception. It is more than that; it’s a long-term lifestyle.”

The Mediterranean diet is lauded by dieticians and other healthcare professionals for its reported benefits.

Research suggests it can lower risks for chronic diseases and conditions.

The diet emphasizes vegetables, whole grains, plant-based proteins like legumes, lean animal proteins, and healthy fats.

However, dieticians notice common mistakes, including overconsumption of ultra-processed foods labeled as “vegan” or “healthy,” drinking too much alcohol, lack of adequate water intake, and too few vegetables.

While no food is entirely off the table, experts share that it is best to limit ultra-processed foods and prioritize whole ones, particularly vegetables.

Drinking adequate water will aid digestion, which is helpful given the fiber-rich foods the Mediterranean diet entails.

Finally, dieticians share it’s best to have fun with it. Share meals with families, try new recipes, and remember food is more than fuel — it’s cultural and social.