You may have heard of the Mediterranean diet and its health effects, but the details of this diet are less well known. Here, Guts UK will explain the benefits of the Mediterranean diet, how it compares with the Western diet and how you can follow it should you wish to. 


The Mediterranean diet is inspired by the eating habits of people living in Spain, Italy and Greece. Whilst people living in these countries have a similar level of total fat consumption to people living in the UK and USA, they have a lower level of cardiovascular disease. This prompted investigation into the possible health benefits of the Mediterranean diet. 

It might help to compare this to the typical Western diet, which consists of a high intake of saturated fats, sugar and ‘processed’ or pre-packaged foods. The Western diet is typically low in fibre. 

The Mediterranean diet is made up of mostly plant foods, and also includes oily fish, nuts, seeds and olive oil, which are rich in healthy fats. This diet is typically lower in sugar and contains less meat – especially red meat. The Mediterranean diet is high in fibre. 


The health benefits of the Mediterranean diet were first widely publicised by Dr Ancel Keys. His “Seven Countries Study” analysed the diets of over 11,000 men aged 40-59, followed up over 15 years. It highlighted several points, such as the low death from heart disease in Southern Mediterranean countries. It also showed that death rates were lower in people with higher ratios of monounsaturated (compared to saturated fats) and linked this to a high intake of olive oil. It was also noted that the fibre intake in Mediterranean countries tended to be high – approximately 400 grams per day or five 80gram portions. As fibre is found in plant-based foods like fruits and vegetables, this led to the campaign for “five-a-day”. 

Gut and general health benefits

Gut health benefits – the Mediterranean diet

There is good evidence to support adopting the Mediterranean diet, to help ensure general good health. There are some additional advantages relating to gut health specifically: 

• Bowel cancer: 

Bowel cancer is the second leading cause of cancer death (after lung cancer). It shows very striking differences in incidence around the world and these differences are thought to be largely due to diet – particularly the “western” diet favoured by developed countries. The Mediterranean diet is higher in fibre, and we know there is an 11% decrease in the risk of developing bowel cancer for an extra 10g of fibre per day in the diet. 

• The Gut Microbiota: 

We know the Mediterranean diet is higher in fibre than typical Western diets. In the UK, a typical diet provides just 19g of fibre per day (compared with the advice to aim for 30g per day). 

Fibre benefits the gut microbiome by increasing the amounts of beneficial species living in our gut (such as lactobacillus and bifidobacterial). Put simply, fibre ‘feeds’ the microorganisms living in your gut. 


Evidence has shown that every additional 7g of fibre in the daily diet reduces the risk of common chronic diseases. An additional 7g of fibre in the daily diet reduces the risk of: 

  • Bowel cancer by 8% 
  • Cardiovascular disease by 9% 
  • Heart attacks by 9% 
  • Strokes by 7% 
  • Incidence of type two diabetes by 6% 

How do I follow the Mediterranean diet?

The Mediterranean diet can be followed using food groups, which allows it to be modified to reflect varying cultures and traditions. 

If you’re looking at following the Mediterranean diet, aim for the below quantities of the following food groups: 

  • Vegetables*: 4 or more portions per day (a portion is 80g). 

(e.g., broccoli, bok choy, peas, turnip, tomato, zucchini, eggplant, asparagus). 

  • Fruit*: 3 or more portions per day (a portion is 80g). 

(e.g., strawberries, kiwi, plum, grapes, fig, guava, apple, orange). 

  • Legumes: 1 portion of approximately 50g for women and 70g for men per week. 

(e.g., chickpeas, lentils, peas, beans). 

  • Nuts and seeds: 1 or more portions of 28g per week. 

(e.g., sunflower seeds, peanuts, poppy seeds, sesame seeds, walnuts, pumpkin seeds, cashew nuts). 

  • Wholegrains: 1 or more servings per day. 

(e.g., wholemeal bread, wholemeal pasta, wholemeal oats, brown rice). 

  • Fish: 4 or more servings of 100g per week 

(At least one or more should oily fish e.g., salmon, mackerel, pilchards, sardines or trout). 

  • Fats and oils: more unsaturated fats such as olive oil than saturated fats 

(e.g., olive oil 40 grams per day. Saturated fats are found in butter and the white fat surrounding animal meat, lard). 

  • Alcohol: 1/2 to 1 unit a day for women and 1 to 2 units/day for men. 

(This is different to the current UK advice for alcohol intake, with a reduced level for women. Click here to calculate your intake). 

  • Red and processed meat: Fewer than 2 servings a week for women, fewer than 3 a week for men. 

(This equates to about 120 grams per day for men and 90 grams per day for women, but in the UK, the NHS advise a lower maximum of 70 grams per day). 

* This should contain a wide a variety of different products as possible and ALL different types count – including fresh, frozen and tinned in natural juice or water. Soup is another option, but check the salt content is within healthy guidelines. 

Can I protect the environment while following the diet?

The following aspects of the diet are beneficial for the environment: 

  • Reduced intake of red meat and moderate intake of dairy foods (if you choose milk alternatives, ensure they are calcium fortified).
  • Increases in the consumption of plant-based foods and reduced intake of animal foods. This is likely to have the greatest benefit for the environment. This doesn’t mean needing to follow a vegan diet specifically, just a reduction of the overall amount of animal-based foods consumed.
  • Avoid food waste (by paying attention to portion sizes advices and not purchasing excess). 
  • You can also opt to buy fish from sustainable sources that are certified.

Frequently asked questions

Should I avoid carbohydrates altogether? 

No. Whilst a lower intake of carbohydrates may be helpful for some people with diabetes, wholegrain starchy food has been shown to have a protective effect. Every additional 7g of fibre in the daily diet reduces the risk of common chronic diseases. 

Is sugar bad for me, should I avoid it altogether? 

No, anything is moderation is okay. A diet without any sugar for example can make eating very dull and therefore almost impossible to follow. You may need to reduce the levels of sugar you consume gradually, then include it as a treat in your diet instead. 

Is fruit sugar bad? 

No. Drinking fruit juice in larger amounts can increase the calories and sugar consumed (it should be limited to one portion per day of 100mls). But fruit itself has other benefits to health, such as fibre and micronutrients. It should be included in a balanced diet. 

Does a Mediterranean diet have equal benefits for both sexes and across different ethnicities? 

From the research that has been completed to date, the results seem to show that there is no significant difference in the effect seen for both race or sex. All studies showed a reduction in mortality (death) in those adhering to the Mediterranean diet. 

How does this research relate to advice from the Government on diet (the Eatwell Guide)? 

There are small differences between the two diets, but the Eatwell Guide is based on the Mediterranean diet. It is a healthy option that has been shown to be a better way to eat for the environment than the average UK diet. 

How strict do I need to be if I want to follow this diet? 

The more you can follow the guidelines, the lower the risks of common chronic diseases will be. The best method of changing your diet is by making gradual changes to what you are eating to aim to follow the plan. If you are not including much fibre in your diet now, then your bowel will tolerate a slower increase. Increasing fibre immediately can result in more wind. Of course, this is about what you eat most of the time, so occasional deviations from this advice should not be seen as a problem. 

Can I follow the Mediterranean diet in the UK during the winter months? 

Yes. As you’re looking at food groups with the Mediterranean diet, rather than specific foods, this is possible. Tinned and frozen foods are suitable and a better option for the environment during the winter when fruit and vegetables might be out of season. Examples include tinned tomatoes, tinned ratatouille, jars of roasted peppers and frozen mixed vegetables and fruit. Choose tinned fruit in natural juice.