Doctor's Note

This is the first of a six-part video series on the Mediterranean diet. Normally I’d split these up so it’s not day after day of the same topic, but I figure there is enough general interest in the subject that it was worth the Mediterranean marathon. The next five are:

  1. The Mediterranean Diet or a Whole Food Plant-Based Diet?
  2. PREDIMED: Does Eating Nuts Prevent Strokes?
  3. Which Parts of the Mediterranean Diet Extended Life?
  4. Do Flexitarians Live Longer?
  5. Improving on the Mediterranean Diet

I’ve mentioned the Mediterranean diet before, but never in this depth:

More information on heme iron: Risk Associated With Iron Supplements.

More information on magnesium in How Do Nuts Prevent Sudden Cardiac Death? and Mineral of the Year—Magnesium.

And more on polyphenols in videos like How to Slow Brain Aging by Two Years and Juicing Removes More Than Just Fiber.

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  • Brian Humphrey

    Despite all the fad diets and misinformation flooding every media outlet, the only proven method for extraordinary health and longevity is a whole foods plant-based diet! Thanks again Dr.Greger and crew. ;)

  • I’ve always avoided the Mediterranean diet fad because I thought it was just an excuse to eat tons of olive oil and cheese and claim thats somehow healthy. So many people fry everything in olive oil or drown their salads in the stuff because they read some pro-fat article about eating your “heart healthy oils”…No thanks, I’ll stick to cooking with water in the frying pan and skip the oil.

    • Julie

      Veggie Eric, Note that at 2:19 the chart the researchers used to determine a healthy diet gave the most points to those eating olive oil regularly.

      • Joe Caner

        With 1.52 grams of palmitic acid and 120 empty calories per tablespoon, olive oil is tasty, but it is not your friend. You are much better off getting your fats from nuts and seeds, and water sautéing your food like Veggie Eric.

        • Julie

          Hey, don’t shoot the messenger! I just pointed out the criterion used in the study discussed by Dr. Greger in the video. Yes, I totally agree with you that whole nuts and seeds are a better choice than olive oil as they are a whole food retaining all their nutrients.

          • rob

            But no salt and not fried in oil.

          • Mark G

            I worry when I see people say “no salt”, instead of low salt. I was using no salt until recently, and twice in the past few years I developed horrible pain in my shoulders 24/7, fatigue and a general feeling of un-wellness and misery that was just ongoing. My doctor noted each time that my sodium seemed low. This last time I went straight home and ate some food and added salt. Within an hour I felt better. This last time it took me 3 or 4 weeks to fully recover. Even my tears didn’t taste salty. I now make sure I get a little salt every day. So, for me, it’s low salt, not no salt. I’ve learned the hard way that my body needs some, and mine can’t get all of it through whole food alone. I mention this so that if others develop similar symptoms they can consider this as a possible reason. I don’t want others to suffer what I suffered.

          • Besides, no oil or salt! Just got a cardboard taste in my mouth.

          • Alan

            I eat a lot of food with no salt and hardly ever use added oils and my taste buds are used to it and i enjoy my food.

          • Alan

            Mark, I took it that Rob was talking about how to prepare and eat the nuts and not saying that he was advocating a low salt diet.

          • Charlie Michael Morrison

            You can get plenty of sodium from plant sources like celery and we don’t need salt. Even the iodine can be found in some plants depending on the soil they grew in. Here in the Northwest U.S. We have lots of iodine in our soil.

        • UCBAlum

          While we would both agree that mainlining olive oil would not be advisable for most people, I think we could also agree that olive oil is not “empty calories”. Fat is a nutrient. Polyphenols and antioxidants affect the body.

          I don’t find “all or nothing”, “good or bad”, “empty or full”, or myriad other binaries helpful. In fact, I think they are at the root of humanity’s confusion about diet.

          People eating traditional diets are not confused. People looking for “good” food ingredients and avoiding “bad” foods or ingredients are the ones that are confused. Fat is not “bad” and its calories are not “empty”.

          That said, I avoid saturated fat altogether and use very little oils in my cooking because I think eating fewer processed oils is healthier than more. I can’t even imagine what I would do if I bought into the notion that oil like olive oil is “empty calories”. I just don’t see how that’s useful and It’s not true.

          • Thea

            UCBAlum: re: “I think we could also agree that olive oil is not “empty calories”. Fat is a nutrient.” By your reasoning, sugar is not a junk food. Sugar has carbohydrates and carbs are a (macro) nutrient.

            Everyone I know defines sugar as the ultimate junk food. Sugar is a highly process single-macro nutrient food with little else–hence “empty calorie”. Olive oil is the same thing, but with fat instead of carbs. When you compare olive oil to sugar, as Jeff Novick does in this very helpful clip, the olive oil looks worse than the sugar. Check it out:

            It’s true that appropriate amounts of the *right types of* “fat” are not bad for us. Just as it is true that appropriate amounts of the right types of carbs and protein are not bad for us. But when it comes to oils, including olive oil, we are not talking about fat that comes naturally in a whole food. We are talking about a modern, highly processed ingredient that gets put into our food. It’s helpful for people to understand where oils fall on the health spectrum.

            re: “I don’t find..binaries helpful.” misses the opportunity to talk about reality when something really is good or bad. Do you really mean to say that say Twinkies are not bad for us? That you can’t say that anything is good or bad?

          • UCBAlum

            You’re interested in my argument? Really? Hmmm. I’m not feeling it.

          • I think making healthy choices is actually quite simple: It’s a _Whole_ food plant based diet. Whole food fats like nuts, seeds, and avocado are packed full of nutrients, fiber. Oils, even cold pressed, are a different story. They are 100% extracted fat with relatively little to no nutritional content. It takes over 400 olives to make 1 jar of olive oil — we should call it what it is…olive juice. Cold pressed, virgin, organic or whatever…it’s definitely not a health food. I think that’s what we mean when we say olive oil is empty calories. To quote Dean Ornish: “It’s 100% fat and 14% of it is saturated. At 120 calories a tablespoon it’s very easy to eat too much of “a bad thing”. It won’t raise your LDL as much as butter or other saturated fats will, so it might look like it’s reducing your cholesterol, but it’s still raising it. It’s just not raising it as much other fats would! It’s the omega-3’s that reduce inflammation and are “heart healthy”, and olive oil has very little omega-3, maybe 1%. It’s mostly omega-9, which has been shown to impair blood vessel function. “

          • UCBAlum

            I agree with you completely.

            For me, problems arise when someone takes that information and says “olive oil is bad”…or empty or whatever. Eating olives is certainly the healthier choice, but olive oil is arguably healthier than palm oil or butterfat or beef tallow.

            Olive oil has more nutrients than many foods Americans consume, and when someone substitutes olive oil for one of them their health will likely benefit. So, “bad” is an absolute that only makes sense in context, which means it’s relative, which means it’s not helpful for most people. Besides, olive oil has polyphenols and phytosterols and vitamin E & K, and that’s not “empty”.

            Say we should cut down on processed oils in order to limit our saturated fat and overall fat intake and replace those fats with whole, unprocessed foods for greater health, and I’m all in.

          • paul

            Someone with some common sense, I love it! Cheers.

          • paul

            Wrong Wrong and again Wrong. But then again you are quoting Ornish and he and Essylstein only had it part right. If you use it as intended, in salads and not heated up so it does not oxidize, your are fine! There are is high and low density LDL, and the dense LDL is the bad guy that comes from heated or oxidized oils and transfats etc, the large fluffy LDL is NOT an issue and is helpful and needed by the body. So cook with organic hard pressed olive oil, no way. Put it in your salad or as a marinate, all day long! It has a higher ration of Omega 3 to Omega 6 ration true, but Omega 6 is only bad in fast food or heated forms!! If you are eating right, and all organic you will have a hard time even getting Omega 6 in your diet!! Hope this helps.

          • UCBAlum

            So sugar is “bad” and its calories “empty”? How about for the ultramarathon runner at mile 85 who needs to replace glycogen stores quickly?

            “everyone knows” is not an argument. in fact, it’s a caution sign that there probably is no real argument.

            Life is complicated and binaries can be destructive…as I said in the post that you glossed over in favor of defending a binary.

        • paul

          Wrong Wrong Wrong…. uncooked organic pressed virgin olive oil is ‘outstanding’ for you, do not let anyone tell you otherwise. Of course, moderation with everything, two tsp in your salad with balsamic vinaigrette, no problem. All the salt talk is over rated, if you have no issues with salt use it sparingly and make sure it is pink Himalayan salt only, that salt is not contaminated like basin salts. Enjoy your good quality oils not heated up, and a little Himalayan salt is A OK>

      • I hear ya… Olive oil is a confusing issue. I can’t help but think about the good Dr.
        Caldwell Esselstyn yelling at his audience “NO OIL!!!”. =) Effective I must say because to this day whenever I think about using olive oil I hear Dr. E in the back of my mind saying… “don’t you dare drown your food in that muck!” hahahaha.

        Here ~~~~>

        • Thea

          Veggie Eric: I so agree! That talk was so dang effective. I’ve seen lots of people mention that scene/talk, and it is something that stuck with me too. It’s not just a clear statement, “No oil”, but the passion with which it is spoken and then backed up with the science is something that goes deep into the brain.

        • Mike Quinoa

          I admire all the plant-based docs (Michael “Until Now” Greger, Caldwell “No Oil!” Esselstyn, John “Starchivore” McDougall, Neal Barnard, Joel “Nutrient Density” Fuhrman (don’t think he’s 100% PB), Michael Klaper, William Harris, etc.) and their message. They are all characters in their own right.

          • Kelly Caiazzo

            Ohh that makes me laugh so hard, Michael “Until Now” Greger. Truth! I love it. His videos are so fantastic.

          • Mike Quinoa

            Lol—My favorite part. When you hear that you know the rubber is about to hit the road.

          • Mike Quinoa

            Jeez, I forgot Dean Ornish!

        • paul

          Esselstyn, while I admire his push for plant based nutrition, is an idiot when it comes to holistic health. Him and Ornish I think got together for coffee one day and decided to use flawed study data (the china study) to prove there case, just Like Keys screwed everyone up with his 7 country study and started the ‘fat and cholesterol, meet is bad’ fad in the 50’s that has gripped america thru today. Kick him out of your mind, he is ‘old’ no pun intended, news.

    • rob

      It has been recommended that coconut oil be considered healthy even though high saturated fat.

      • It has been recommended that ppl melt a stick of butter in their morning coffee, too. But that doesn’t make it healthy.

        When I want coconut oil, I eat coconut.

        • b00mer

          “It has been recommended that ppl melt a stick of butter in their morning coffee, too.” yeesh, I can’t imagine how crappy I would feel after that! What a horrible way to start the day. It boggles the mind that people could honestly find the sensations associated with stimulant+decreased blood flow pleasant or energizing.

      • Synergy

        This is due to the high proportion of medium-chain triglycerides by comparison to other saturated fat sources. As Dr. Greger has covered elsewhere, coconut oil has still been demonstrated to raise cholesterol. When proponents tout its heart healthy qualities, they are speaking only in comparison to other sources of saturated fat, such as butter, which indeed have a more pronounced impact on cholesterol levels. Although the extra virgin form of coconut oil (as opposed to the more heavily processed forms) may impart some additional benefits via phytonutrients, overall it is not heart healthy.

      • Dominic
        • Truth! Just think about the notion of “superfoods.” How could any heavily processed extraction from a whole food be considered a superfood?? It’s pure marketing magic. Everyday superfoods are simply whole vegetables, leafy greens, berries, etc.

        • kaimana7

          it’s a misleading article!

          Studies show that MCTs are easily digested and rapidly absorbed into the blood stream from the GI tract upon consumption, and are efficiently utilized by the body for energy production, improving performance of athletes.


          Nutr Hosp. 2012 Jan-Feb;27(1):103-8. doi: 10.1590/S0212-16112012000100011. Influence of the dietary intake of medium chain triglycerides on body composition, energy expenditure and satiety: a systematic review. Rego Costa AC, Rosado EL, Soares-Mota M. Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.

          Eur J Nutr. 2013 Sep;52(6):1579-85. doi: 10.1007/s00394-012-0463-9. Epub 2012 Nov 20. Combined medium-chain triglyceride and chilli feeding increases diet-induced thermogenesis in normal-weight humans. Clegg ME, Golsorkhi M, Henry CJ. Functional Food Centre, Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, UK.

          also, coconut oil has many of the same qualities as breast milk, namely lauric acid.
          “A healthy diet contains mixtures of saturated, monounsaturated and polyunsaturated fats. The unique composition of human breast milk contains about 45 to 50 % saturated fat, about 35% unsaturated and 15-20%polyunsaturated. Lauric acid and capric acid comprise about 20% of total saturated fatty acids found in breast milk. Lauric and capric acid have potent antiviral, antibacterial, and parasiticidal (kills parasites) properties that support the immune system. These fatty acids offer the nursing infant protection from illnesses, viruses such as herpes and HIV, protozoa such as giardia lamblia, and bacteria such as chlamydia and heliocobater.

          Coconut oil is high in saturated fat (but not cholesterol since it is from a plant) containing about 50% lauric acid. Other components of coconut oil include capric acid, caprylic acid, tocopherols and tocotrienols. (Vitamin E lipids that act as potent anti-oxidants that can help maintain healthy cell structure and function). A study published in the American Journal of Clinical Nutrition has shown that lactating mothers who eat coconut oil and other coconut products, have significantly increased levels of lauric acid and capric acid in their breast milk, creating milk rich in health promoting nutrients. Coconut oil is easy for an infant’s immature digestive system to absorb and utilize. It also provides energy in the form of medium chain fatty acids to help the baby grow and develop properly.”

    • Not recommending this, but it’s the esteemed Walter Willett at the Harvard School of Public Health who pushes olive oil.

      Don’t have the reference handy, but in at least one of his papers, he claimed Italy had less CVD than Japan, and thus it was better to swap saturated fat for “healthy oils” instead of carbohydrate.

      Below is the Harvard food pyramid and newer healthy eating plate. I believe the pyramid had oil at 40%!!!

    • paul

      Mediterranean diet is ok Eric… you are right about cooking with oils, limit that to coconut oil only because it is a medium chain oil, most all other oils will oxidize when heated and oxidation is the enemy, not the fats. And you have to go organic with everything, the real horror not widely being published yet is the effect of Glyphosate, the active chemical in round up that is sprayed on 90% of the US GMO crops, so anything you eat that is not organic and cooked by you, well …. down yourself some poison. And sadly that is most every american daily. Get rid of Glyphosate and Statins and you could cure alot of diseases.

  • Sally

    Dr. Greger, I’d love to see an article on “natural flavors”. Even though I try not to buy much food with a long list of ingredients, it is listed in even simple items like tea bags – even Zinger tea! Thank you for your work – I hardly even have breakfast without Nutrition Facts!

    • Joevegan

      Careful about “natural flavor” it could be castoreum which extracted from the anal glands of beavers; yuck!

    • Alan

      Natural flavors can include MSG and probably does.

  • Guest

    The score card at 2:19 gives more points for eating fruits, vegetables, legumes and cereals and it lowers one’s score for consuming meat and dairy; all good so far. However, fish consumption is also awarded more points as is regular use of olive oil and frequent use of alcohol. And I see no mention of nuts and seeds. This seems to imply that fish, olive oil and some alcohol usage is healthy, which seems not to be the case from previous videos. So, on these points, I think most for Dr. Greger’s regular readers would disagree with the Mediterranean diet.

    • guest

      I wonder if there’re any studies that compare the general health and life span of those who eat a traditional Mediterranean diet to those of whole-food vegans? In other words, is there an advantage to occasional inclusion of high-quality animal products in the diet?

      • b00mer

        Why the assumption of a possible advantage? In other words, why would you not expect whole food vegans to do even better than the traditional Med diet, given everything we know about both animal products and whole plant foods at the epidemiological, clinical, and in vitro levels? Do you think occasional consumption of foods with inflammatory/carcinogenic/etc qualities would confer some benefit? If so, why?

        • guest

          b00mer: What I think doesn’t matter. What does is what people experience. I personally know people who consume animal products, in moderation, who are very healthy. The relationship between human health and nutrition is too complex to be reduced to a simple equation

          • b00mer

            I wholeheartedly agree that evidence trumps theory. I was merely commenting on the apparent assumption in your first comment that in a study of Mediterranean vs whole foods vegan, Mediterranean would be superior. My questions were trying to get at the thought process behind the assumption, not the question of wfpb vs med itself.

      • No vegan nations exist, but you may find this chart informative:

  • justme

    Thanks Dr. G for another interesting and informative report. How is that so many keep missing the mark, when so much evidence for herbetarianism (that’s my new label, because I’m not a Vegan per se) is right there? Herbetarian food tastes so much better than all the things I used to think were vital and tasty and all that. I’m so perplexed.

  • Pan

    What is your opinion and thoughts about the fact that Dr. Ancel Keys examined 22 countries for the correlation between fatcholesterol consumption and heart-disease ,but in the end excluded the 15 that did not show such corrrelation?

    • Thea

      Pan: That one is easy. Plant Positive addresses this point in detail in a couple of his videos. Here is one of them:

      If understanding cholesterol and heart disease is interesting to you, I recommend taking a look at more of Plant Positives videos, as well as more videos on this site.

      • Pan


        • Additional points on that supposed missing countries data, from a moderate low-carber committed to scientific and historical accuracy:

          Ancel Keys ~ It’s Time to Appreciate a Real Researcher …

          Spoiler alert: The missing info didn’t exist at the time Keys allegedly ignored it.

          • Alan

            As far as i am concerned the Weston Price foundation is a scam. I often wonder if they are not funded by the meat and dairy industry !!

          • Tom Goff

            There is also a very interesting post here discussing the appalling lies about Keys included in works by Taubes, Teicholz and their ilk.

          • Thanks, Tom. I’ve posted Seth’s blog here several times, and Doc G has commented there. He’s now been cited by Marion Nestle’s blog on her own blog.

            It’s a truly sad state of affairs when independent bloggers are doing better fact checking then bona fide news organizations.

  • David Fuentes

    Hi Dr Greger, I definitely think the ‘real’ mediterranean diet is good for having good health. And it’s an option for those looking for stop eating too much meat and processed foods. I also think that the problem with people trying to follow a vegetarian diet is the lack of information in regards to what they will actually need to eat in order to have good health. Meaning they may be missing vital minerals and vitamins their bodies are somewhat not deficient in. Let’s say, how does a young boy or girl become a vegetarian? when there is a high risk he/she just doesn’t know how to do it right. It seems to me it may turn out to be an exact science for many.

    • Thea

      David: I disagree with your assumption that getting it “right”, especially for children, is difficult/may be an exact science. Here are some pages that show just how easy it can be:

      And here is a NutritionFacts video showing that your typical omnivore is more likely to be deficient in nutrients than your typical omnivore. What this means is that the people who need a warning about their diets and “…what they will actually need to eat in order to have good health” are more likely to be the omnivores.

      Here is a great site for addressing nutrition in children specifically. It’s just not that hard to find:

      I bring this to your attention, because I think it is a very important point A lot of people are like you in that they think that there is something scary or difficult about changing to a whole plant food based diet. I used to think the same thing. But in truth, eating the way Dr. Greger and PCRM recommends is easy for anyone to understand and doesn’t require any extra complication than any thought-out diet would.

      • David Fuentes

        Hi Thea, I would agree with you if there was the case that people had it easy for eating right in the first place (let’s say, conventionally). In fact, they don’t. Grown ups. Most people do not have it clear about macro or micronutrients, now imagine having them get the right nutrient ratios with ‘only’ a plant based diet. I’m not saying it is not possible. It certainly is. But it is certainly not easy as well. That’s why a good way to start, at least, is going for a ‘real’ mediterranean diet approach. Hope I make more sense to you now.

        • Thea

          David: I still think you have an inaccurate picture of the difficulty of getting the right nutrient ratios with a plant based diet. Did you check out this page?:

          It’s terribly easy to load up your plate or day with 1/4 legumes, 1/4 whole grains, 1/4 fruits and 1/4 veggies. I would agree with Dr. Greger that a side of 1-2 ounces of nuts and seeds is in order. And viola! You have the right set of macro and micro nutrients. It’s super-easy.

          What is it about the “real” (I’m glad you put emphasis on the word “real” as I think that most people do not understand what the diet is supposed to be) mediterranean diet approach that you think is easier to understand or implement correctly than the whole plant food based diet?

          • David Fuentes

            Thea: I have checked the website before and usually read it. And I still believe it is not easy to change from a wrong ‘conventional’ diet to a plant based diet. Because of that, the mediterranean diet is not necessarily easier to understand but easier to follow. And probably it’s a good starting point for those aiming to change their diet to a plant based diet, or just to improve their health. On the other hand, being a nutrition coach myself, the biggest issue and challenge is having people change their processed food eating habits and the wrong ’emotional’ relationship they have with food. At the end, we focus so much on the foods we eat or the ones we ‘must’ eat and we forget the ‘who’ is eating and why. Eating right is not so technical after all.

          • Thea

            David: Your latest post makes more sense to me. re: “… the mediterranean diet is not necessarily easier to understand but easier to follow.” I presume by “easier to follow” you mean from a psychological perspective. I think that statement is very arguable, but I can see why you/someone would take that stance. It’s reasonable/logical.

            I don’t think this is the same argument you started with by mentioning a worry about nutrient ratios and plant based eating being an exact science. But I understand where you ended up. Thanks for your clarification.

          • David Fuentes

            Thea: I didn’t want to start an argument but express my point of view. It ‘seems’ an exact science for many but I know it is not. I do not like telling people they are wrong or right. I like to speak from my own experiences and training with myself and others. The MD is easier to follow not only from a psychological perspective (it is) but also from a physiological perspective. Again, not saying a plant based diet is wrong. If we want to help people improve their health, the MD is a good strategy and hope next videos show it is. It was nice talking to you. I will be more active in these forums and hope we can chat some more on other topics (or on this one!) soon,

          • b00mer

            If we learn from the video that a “real” mediterranean diet is in reality a 93% plant based diet, I don’t understand either where exactly the perceived difficulty lies. Is a plant based diet + a few servings of meat/dairy per week really that different from… a plant based diet?

          • David Fuentes

            Hi. The MD includes moderate to high consumption of fish and other seafoods as well as low consumption of meat and diary. It includes olive oil. Fats are important in the MD. So, calorically there is no way only 7% of total calories come from that. So it is probably around 50/50.

          • b00mer

            “[…] foods of animal origin (e.g. meat, fish, eggs, and dairy products) made up only 7% of energy in the Cretan diet.” Did you not watch the video or do you disagree with the Nestle figure? Did you find your 50/50 figure in the literature or is it a guess based on personal opinion?

          • David Fuentes

            I would not agree with the numbers in the study only guided by common sense (for what I stated in my first reply) but I also need to disagree based on my own experience of following a mediterranean diet, studying about it and knowing other people who follow it. It’s not good to guess when talking about good nutrition. I did say ‘probably around’ so it’s not a fix number, depends on each person but it’s close. In my case, fats accounts for about 20% and Protein about 25%. Hope it’s clearer now.

          • b00mer

            Since the main point of the video is that the real Medi diet is different from what many people who follow it consider it to be, I assumed we were both referencing the actual diet. What you or your friends eat does not have any bearing on what the historical Medi diet (with accompanying health benefits) actually was.

            So if we are to discuss the real Medi diet according to research, it was almost entirely plant based, with 7% of calories coming from animal products, and a few tablespoons of oil per day. I agree that addition of a few tbsp of oil will change macronutrient ratios drastically, so the historical Medi diet is not a low fat plant based diet.

            However the original premise of this conversation was that it is more difficult to eat a plant based diet than a Mediterranean diet.

            The question remains, is a [whole foods] plant based diet really that much more difficult than a plant based diet [plus 3 tbsp oil per day and a few servings of animal products per week]? In practical terms, the difference is a basically a matter of cooking techniques and condiments.

            In nutritional terms, whole plant foods rank highest in nutrient density, while animal products and oils are at the bottom of the list. Substituting additional whole plant foods for oils will increase micronutrient intake. Substituting additional whole plant foods for animal products will increase intake of most vitamins and minerals, with a few exceptions. However if all of the calories of the diet are consumed through whole plant foods, 100% RDA can be achieved for every micronutrient with the exception of vitamin B12 (with supplementation necessary for everyone over 50) and vitamin D (a matter of latitude and season more so than diet). So it still is not clear where the perceived difficulty is. I can understand if it’s a psychological difficulty in that one just really enjoys oils and animal products and doesn’t want to give them up, but the difficulty in execution or nutritional adequacy is still not apparent.

          • David Fuentes

            I forgot saying again that fats, coming from all sources, usually account for 35-40% of all calories in a mediterranean diet. I have read that study and I’m pretty sure it states some similar data.

          • Guest

            plant based YES,- but not WHOLE FOOD plant based. If it were, they wouldn’t use oil.

        • Charzie

          David, I get what you are trying to say, but honestly, most people I’ve talked to or heard of think a Mediterranean diet pretty much means to eat whatever you want that’s Italian, make sure to load up on the olive oil, and have a glass of wine or two for good measure. The idea that it is a primarily plant based diet is lost on the average person entirely! Sad but true! (Jeff Novick did a great video about it!) With the possible elimination of the cholesterol warning in the new dietary guidelines on top of that, I really am concerned it will just be a disaster for all those who will see it as another green light to eat all the meat, eggs and dairy they want. Of course…I guess that may well be the intent…business as usual.

          • David Fuentes

            Hi Charzie, hope the next videos show what the mediterranean diet is really about. Definitely not all that’s Italian! Now, olive oil is part of this diet and in spite of what Mr. Novick thinks, there is enough strong evidence and studies showing its benefits. But I also strongly believe that the most important factor in the MD is that around 50%-60% of it is whole and plant foods based. Real magic comes from that. I agree with you that the cholesterol warning should be kept, mostly because people tend to go crazy when they are green lit and not all individuals are the same (metabolically) when dealing with cholesterol. Besides, most people really don’t know how to differentiate when there is too much of a bad fat in a food or food product. Let’s see what happens.

          • Charzie

            As a whole foods plant based vegan, and a former diabetic, I don’t use free oils that have been processed out of food because it is not a whole food, just empty calories devoid of it’s nutrients and a direct contributor of T2 diabetes. ..a disease most people equate with sugar. Despite being predominately vegetarian previously, (what I considered “Mediterranean”) I had to eliminate free fats and all animal products in order to get off the medications and get my glucose into the normal range, which took about 2 weeks, so it was pretty clear what got me there in the first place. A high fat meal will raise my glucose higher and longer than even sugar, so I more than proved it to myself initially. Obviously not an option for me and the escalating numbers of other T2 diabetics out there. Nobody has all the answers I’m sure, but we each need to take responsibility for our own health, in general, and muddying the message with all the conflicting opinions helps nobody. What a person *chooses* to do is her or his own business, but at least present them with the clear facts, as best as they are known, to be able to make that choice. This site and others like it giving me that info saved me a whole lot of grief, and maybe even my life.

    • george

      David: The book “Becoming Vegan” has one full chapter – all research based – on raising vegan children.

      • David Fuentes

        Hi George. I’ll check on it. Love reading new books. Thanks.

      • SeedyCharacter

        There’s also Carol Adam’s great book “Help, My Child Stopped Eating Meat!”

        • David Fuentes

          Thanks for the book recommendation!

          • SeedyCharacter

            You’re most welcome, David. I love all of Carol Adams’ work. ‘The Inner Art of Vegetarianism’ and its companion workbook are really wonderful.

    • KWD

      Just want to comment that I think I understand what you’re saying. When one first makes the choice to try and follow a vegetarian diet, more than likely, one is missing critical information (awareness of foods, cooking methods, utensils and overall planning) on what a healthy vegetarian diet actually looks like and that’s why the MD might be a good starting template of sorts.

      For me, in 2001, I just thought, “stop eating meat”. So rather than change my entire diet, I compensated by eating more pasta, bread, dairy, eggs and added frozen processed vegetarian foods. I thought by just giving up meat, I was making a great health choice and never considered delving further into nutrient needs. I rarely ate whole fruits let alone whole vegetables, legumes, nuts and seeds. Someone gave me a cookbook and many of the core ingredients were foreign to me. I remember opening the first can of beans I ever purchased and thinking, “this is going to be disgusting”. *sigh* And, I didn’t love them after the first try.

      For several years I was repeatedly sick with colds and sinus infections, gained weight and felt – blah. It wasn’t until I moved to an urban area 10 years ago and was exposed to ethnic foods that I’d never before tried and a macrobiotic food bar near my new home that it finally clicked with me that the way I was eating was inadequate, that I should approach my diet thoughtfully and put forth effort in learning what my body needs and from which foods I can obtain the nutrients.

      • David Fuentes

        That’s conscious eating. So good you accomplished it.

  • Kathryn Rogers

    Dr Greger Thank you for all the invaluable information you provide. I watched a video that you did over 10 years ago and it said to avoid vegetable oils such as safflower. Is high oleic safflower oil the same and should it be avoided as well?

  • charles grashow
    Mediterranean diet: Olive oil, goat’s milk, wild greens, wine, and coffee are all cited for health benefits. “Subjects consumed about six times as many beans a day as Americans.”

    Drink some goat’s milk
    Adding some goat milk to your diet could provide a great source of calcium, potassium, and the stress-relieving hormone tryptophan. It’s also hypoallergenic and can usually be tolerated by people who are lactose intolerant.

    Eat a Mediterranean-style diet
    Ikarians eat a variation of the Mediterranean diet, with lots of fruits and vegetables, whole grains, beans, potatoes and olive oil. Try cooking with olive oil, which contains cholesterol-lowering mono-unsaturated fats.
    Eat locally, seasonally and sparingly. The octagenarians, nonagenarians and centenarians I spoke with on Ikaria all described the eating habits of their early years — years of dire poverty, dearth and isolation — not so much in terms of what they ate but of how little they ate, because there simply wasn’t that much food.

    Meat was rare, for some as rare as two to three times a year on the big holidays. For others who may have had animals (mainly chickens), they could afford to slaughter a few times a month. Fish was accessible if one fished; gardens were carved into terraces along Ikaria’s steep slopes and watered sparingly.

    The 100-year-olds ate what they found in nature, from snails to mushrooms to wild greens, as well as what their gardens provided. There was and is still virtually no processed food on the island, except in some restaurants.

    • Harvey

      It was their lifestyle more than their diet. They were physically very active, religious and fasted a lot. They probably benefitted from calorie restriction.

  • This has been said (as I’m scrolling through the comments) but it can’t be said enough: thank you for all your work. It is your daily posts and videos that has kept me as on track as I am about eating plant-based. Occasionally hearing and learning what’s good or harmful for the body doesn’t compare to study after study supporting a whole-foods diet that you post.

  • veganchrisuk

    Jeff Novicks take on the Med diet makes me laugh – the same conclusions but with a bit more comedy…..

  • smith

    there studies that after age 65 a low protein diet lower your mortality.
    below age 65 it increase mortality

    • Tom Goff

      There is one study to my knowledge. It only demonstrates an association: there is no mechanism demonstrated that would explain such an association. Perhaps the most obvious explanation is the common observation that many people take up (low protein) vegan and vegetarian diets after they have been diagnosed with a serious and/or chronic illness. Older people are more likely to be diagnosed with a serious and/or chronic illness than people under 65. People diagnosed with a serious and/or chronic illness are more likely to experience higher mortality.
      The mechanisms by which animal foods adversely are however known. We also know from other studies that low carb high animal food diets adversely affect mortality whereas low carb high vegetable protein diets don’t.

      • smith

        my own theory is base on methonine as life fuel.

        So if you comsume less of the fuel , u last longer.

        However at the end of life , the body suffer from other deficiency so u need extra fuel or more protean to patch things up.

  • smith

    the balance point diet encourage olive oil but ban all grains.

    it is tested to be able to reverse your arteries age by 20 years.

    • b00mer


      This website teaches for free how to regain health by eating a whole foods plant based diet.

      No one is going to buy your $400 two week diet plan. Lay off on the spam.

      • smith

        I have no commercial links with the company. I only wish to point out an alternative view that is plausible and science and evidence based.

        • largelytrue

          Then point out good evidence, together with some sign that you have processed it carefully.

          • smith

            the basic theory and verified experimental facts are that if u eliminate grains from diet , your LDL and TRIGLYCERIDE drop to extreame levels. It is all in the book.

            We know protean are bad.

            So is high glucose. which is grain.

            all that is left in diet are veg and oil and nuts and fruits.

            which is what the balance point diet are mostly made up of.

          • largelytrue

            By, “together with some evidence that you have processed it carefully”, I mean something more than the ability to point to the book touting the diet. Or the ability to make raw claims about grains without any reference to scientific evidence.

            I mean showing that you have some detailed ideas of how scientific research is supposed to support your claims. If you believe the Balance Point Diet book is mostly correct, that’s fine, but because mere opinion is often wrong, you need to understand how that argument relates to actual scientific research. If the book was written well then it should refer to actual studies and if you read it carefully then you can present what you think to be some of the most important ones for making a point here (about grains for instance).

            Otherwise you give no indication that you didn’t simply read the book, accept its scientific claims uncritically, and then go online to parrot the book’s beliefs.

    • Charzie

      Go troll elsewhere, the folks here are smarter than that!

  • Titus Livy

    I noticed that people who frequently ate fish and olive oil received higher Mediterranean Diet scores. Does the evidence really support the belief that these foods add protection to that provided by grains, legumes, fruits, and vegetables?

  • Elaine Gardner

    Yup! People have no idea what the “Mediterranean” diet means. Thank you for clearing that up Doc!

  • Daniel

    Great videos! Thanks so much, Michael! You’re not just a contributing factor but actually one of the main reasons for me becoming a vegan. :) I have one question if you got the time..
    Here in sweden there is a bit of a hype about a mushroom called ‘chaga’ which is good for tea making and supposedly packed with antioxidants. Is there any way to know if this is true or not? Have you maybe heard about this? I have searched the web for scientific evidences but can’t find any..

    Thanks again!
    All the best,
    // Daniel

    • b00mer

      Hi Daniel,

      You might be interested in perusing this site’s information on various types of mushrooms.

      They are indeed a powerhouse of nutrition, but most unprocessed edible plants/fungus are! They are undoubtedly a great addition to every diet, including a vegan one, but one should be careful when elevating one particular food above all others as a “superfood”. Plain old carrots, apples, and broccoli for example are all superfoods in their own right, and may be cheaper, more accessible, or even more enjoyable to some than something labelled as an exotic (and often expensive) miracle plant. As you’ll see with the videos on this site, different mushrooms show different health benefits so it’s probably a good idea to consume a variety, or of course, simply consume whichever one you like best and you’ll receive numerous health benefits. And of course there’s no reason to limit yourself to tea. Stir fry, stew, pizza, etc are all great ways to increase your mushroom consumption.

    • Arjan den Hollander.

      I bought Hericium Erinaceus (Lion’s Mane Mushroom) recently after I realized my nervous system could have been under a half year long mild auto immune attack. It might help with re-myelination and nerve growth factor so I thought what the hell lets give it a try.

      Years ago I’ve used Cordyceps for a period, it certainly didn’t hurt me any one the contrary I’m still convinced it had some mild positive effects though I cannot be more specific or really recommend it for a specific reason. The powder is becoming less expensive nowadays so there might come a time I acquire it once more.

      I’d also love to know more about mushroom options, if NF has opinions to offer I’d be an eager reader.

      • b00mer

        Hi Arjan, is your question in reference to the Medi diet in this video? The Nestle paper states 93% plant based by energy.

  • GaryS

    The 1950s Mediterranean diet with a trace of meat sounds similar to the 1950s Okinawan diet I chose to follow, minus the cheese, wine and olive oil.
    I was impressed seeing all the old ladies and men tending to their small gardens with their brains still intact at 100+ yrs old. And doing group exercises.
    But I have a fondness for Okinawa, I was the youngest US Marine stationed there in 1974 at age 17. You’re supposed to be 18 before you go overseas.
    While I was there I ate a lot of shrimp fried rice with hot sauce of course.

    I like to keep diet and things simple like back in the good old 1950s or until something new is proven to be better. So far, good luck with that…

    • Tom Goff

      I don’t know what the 1960s Okinawa diet was but you may be interested in this paper about the diet in 1949-50. The paper is primarily about calorie restriction but it has an interesting table (Table 1) showing the both the amounts and percentages for each foodstuff type.

      • Thea

        Tom: I’ve seen some of those figures before, but I don’t remember seeing the original study before. Thanks!

      • GaryS

        Thanks Tom. I haven’t seen the full study.
        Took a while to read through it, but you can get some good tips on the diet.
        Lower calories are at 1,785 vs 2,000 average.
        Higher flavonoids in soy products and sweet pots. Sweet pots = 50% of calories and then some rice for grains.
        More antioxident rich veggies.
        Low glycemic index carbs.
        Less salt.
        Energy poor but nutrient dense foods, like sweet pots, veggies and beans.
        Fish or meat product of 2 oz per day average and maybe a tsp of oil per day. Of course there’s no need for fish or meat every day.

        I include a portion of sweet pots a day in my meals and beans in 2 meals with raw and cooked veggies and some fruit.

    • Thea

      GaryS: re: “I was impressed seeing all the old ladies and men tending to their small gardens with their brains still intact at 100+ yrs old.” Cool to hear a first hand account of this. Thanks for sharing!

  • Darryl

    Table 3 in Trichopoulou et al 2003. Adherence to a Mediterranean diet and survival in a Greek population is fascinating. While only fruit & nut intake and MUFA/SFA ratio were statistically significant, it does offer some insight as to which factors are likely important: increment g/day mortality HR
    Fruits and nuts 200 0.82 (0.70–0.96)
    Vegetables 230 0.88 (0.74–1.04)
    Legumes 5 0.92 (0.83–1.03)
    Cereals 60 0.95 (0.83–1.08)
    Olive oil 20 0.96 (0.83–1.10)
    MUFAs 15 0.98 (0.84–1.15)
    Nonalcoholic bev. 220 1.00 (0.85–1.17)
    PUFAs 5 1.00 (0.92–1.08)
    Sweets 15 1.01 (0.90–1.13)
    Fish 15 1.02 (0.92–1.12)
    SFAs 10 1.05 (0.89–1.23)
    Meat 50 1.06 (0.93–1.22)
    Potatoes 50 1.07 (0.95–1.21)
    Eggs 10 1.07 (0.98–1.17)
    Dairy products 140 1.11 (0.98–1.26)A larger or longer study would have been welcome to tighten up confidence intervals, but mainstays like olive oil, fish, and feta cheese don’t appear protective. The benefit is all from the fruits and nuts, and very likely vegetables and legumes.

  • Eat simply for health. Whole plant foods are the way to go. Thanks for the clear, concise info. ;)

  • balconesfalk

    For the benefit of the no-oil devotees I have a tale to tell. I managed to get the oils and fats out of my diet for a time, say a few weeks. I was experiencing arthritic like pains in my joints–I am 72 years old. While driving down a street I spotted a sign offering 2 Jack-In-the-Box tacos, dripping with fat, for 99 cents. As if by magnetic force I was drawn to the drive-through window. I consumed both tacos by the end of the driveway. I hadn’t gone two blocks before the pains abated, as if by magic. Now I do use olive oil, frequently but sparingly, along with two or three fish and/or krill oil softgel capsules, for Omega-3’s to balance the Omega 6’s in the olive oil, and all’s well.

  • Give peas a chance

    I’ve been veg for awhile now and at 45, have never felt better. What I think the Okinawan, Mediterranean and the Ornish and Esselstyn patients have taught us is clear: taking out mammal meats, dairy and processed foods and replacing them with whole plant foods: legumes, veggies, whole grains and fruits brings the best health known to date. If 100 percent vegan, be sure to have Omega-3 sources: flax, walnut, tempeh, cooked cauliflower etc… I have experimented and found, for me a lower fat version of Med diet with influence of Okinawans: tempeh, cruciferous veggies, turmeric and a little sardine fish as condiment 1-2 per month work best for me.

  • Paul

    Again, another info based off false pretenses and to even mention Keyes in any video is a joke, he hand picked 7 countries that fit his hypothesis and thru out the rest. If your worried about Iron in the blood, thick blood, etc then worry about Heme or Non-Heme Iron, it has little to do with disease especially cardiovascular disease. The Paradigm of how heart disease is caused (LDL and clogged arteries) is another falsehood to help Big Pharma make more money. And Keyes started this entire process and underhandedly has brought down America. Most illnesses today are simply due to inflammation, or a state of acidosis, not LDL or Iron! That is like saying the fireman at the fire caused it, when we all know he is only there to put out the flames … LDL same thing. Want to know more about the real cause of heart disease, go to and learn about lactic acid, how Quabain, not available here in the USA, turns lactic acid into pyruvate, and how the autonomic nervous system is responsible for most heart issues if not all. Quabain duplicates the normal hormone int he human body responsible for squelching this inflammation… and guess what is needed to produce this in the adrenal glands?? You guessed it, CHOLESTEROL. Learn more at that link provided, Dr. Sroka and this info should be mandatory reading for all cardiologist. Good Health.

  • allen cohen

    I love reading and listening to Dr Greger, which I pretty much do on a daily basis. I am going on 74 years old. I am a white male in excellent health. As a youngster I ate, please excuse me, hamburgers, French Fries, and drank Coca Cola, several times per week. At age 18, on my birthday, I had a hemorroidal operation. After which the surgeon, scared the daylights out of me, and said I would be back in 6 months, for another surgery, etc, etc, and then eventually Cancer of the rectum. Holy macro, what should I do ? He said, what you have been eating, stop it. What you have not been eating, start it ! I did what he said, and 55 years later, I never have a problem, with BMs, or any other intestinal problem. I eat as in the Mediterranean diet, exactly as Dr Greger advises. His advice works I am proud to say. Listen to Dr Greger and live a long and healthy life. Ignore it and you will spend much time in the hospital eating their food ! Terrible don’t eat it ! Much appreciation to Dr Greger and other doctors and health nutritionists, whom tell us how to live and eat. All we have to do, is listen, and enjoy life ! This comment is offered very respectfully.