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• Mediterranean Diet

Mediterranean Diet

Guidelines
Risk
Cautions
Integrative
Programs
Commentary
More
Information

A Mediterranean diet derives from the eating patterns commonly or traditionally consumed in regions that border the Mediterranean Sea. It focuses on these foods:

The Mediterranean diet also includes generous amounts of physical activity.¹

Clinical Practice Guidelines

2013 evidence-based clinical practice guidelines from the American College of Chest Physicians included these nutrition recommendations related to lung cancer:²

• A diet rich in non-starchy vegetables and fruits, and also limiting the consumption of a large amount of red meat and processed meat is suggested to reduce the risk of lung cancer
• High-calorie and protein supplements to achieve weight stabilization for lung cancer patients who have experienced weight loss

Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Clinical Evidence

Adherence to the Mediterranean diet has been associated with reduced risk or mortality related to several types of cancer and cancer in general. Findings from large studies of diet and cancer:

Read more

Cautions

Almost no concerns or cautions are associated with this diet, with just a few exceptions for children and for some cancer patients:¹²

• Children should drink whole milk until age two.
• Whole nuts are not recommended for children under age four due to potential choking hazards.
• Wine and other alcoholic beverages are not legally consumable by children.
• Cancer patients with special nutritional needs should consult a dietician before changing diet.

Integrative Programs, Protocols and Medical Systems

• Programs and protocols
• Alschuler & Gazella complementary approaches¹³
• Cohen & Jefferies Mix of Six anticancer practices¹⁴
• Lemole, Mehta & McKee protocols¹⁵
• McKinney protocols¹⁶

Commentary

Laura Pole, RN, OCNS, February 11, 2018: Several other diets—also plant-based with many elements similar to the Mediterranean diet—are used for cancer prevention and/or for people with cancer. Some examples:  

• The American Institute for Cancer Research recommends a plant-based diet very similar to the Mediterranean diet. The AICR website describes their Cancer Protective Diet as consisting of mostly plant foods, with the addition of dairy, eggs, fish, poultry and moderate amounts of meat, and with minimal processing and little added sugar and fat.
• Ornish Spectrum Diet: used as part of the Ornish Lifestyle Medicine Program for Prostate Cancer¹⁷
• Keith Block’s Life Over Cancer Core Diet Plan¹⁸
• DASH (dietary approaches to stop hypertension) eating plan from the National Heart, Lung, and Blood Institute

Written by Nancy Hepp, MS, and Laura Pole, RN, MSN, OCNS; most recent update on January 8, 2019. Note: BCCT has not conducted an independent review of research of the Mediterranean diet. This summary draws from the Memorial Sloan Kettering Cancer Center’s About Herbs, Mayo Clinic and other sources as noted.

1. Mayo Clinic. Nutrition and healthy eating: Mediterranean diet: a heart-healthy eating plan. November 3, 2017. Viewed February 16, 2018.
2. Deng GE, Rausch SM et al. Complementary therapies and integrative medicine in lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May;143(5 Suppl):e420S-e436S.
3. Castelló A, Fernández de Larrea N et al. High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study. Gastric Cancer. 2017 Nov 14; Buckland G, Agudo A et al. Adherence to a Mediterranean diet and risk of gastric adenocarcinoma within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study. American Journal of Clinical Nutrition. 2010 Feb;91(2):381-90.
4. Donovan MG, Selmin OI, Doetschman TC, Romagnolo DF. Mediterranean diet: prevention of colorectal cancer. Front Nutr. 2017 Dec 5;4:59.
5. Schwingshackl L, Schwedhelm C, Galbete C, Hoffmann G. Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis. Nutrients. 2017 Sep 26;9(10). pii: E1063.
6. Bloomfield HE, Kane R, Koeller E, Greer N, MacDonald R, Wilt T. (Editors). Benefits and Harms of the Mediterranean Diet Compared to Other Diets. Washington (DC): Department of Veterans Affairs (US); November 2015.
7. Dinu M, Pagliai G, Casini A, Sofi F. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. European Journal of Clinical Nutrition. 2018 Jan;72(1):30-43.
8. Bonaccio M, Di Castelnuovo A et al. High adherence to the Mediterranean diet is associated with cardiovascular protection in higher but not in lower socioeconomic groups: prospective findings from the Moli-sani study. International Journal of Epidemiology. 2017 Oct 1;46(5):1478-1487.
9. Scutti S. The Mediterranean diet doesn't benefit everyone, study says. CNN. July 31, 2017. Viewed February 8, 2018.
10. Bonaccio M, Di Castelnuovo A et al. Socioeconomic status and impact of the economic crisis on dietary habits in Italy: results from the INHES study. Journal of Public Health (Oxford, England). 2017 Nov 8:1-10.
11. Patino-Alonso MC, Recio-Rodríguez JI et al. Factors associated with adherence to the Mediterranean diet in the adult population. Journal of the Academy of Nutrition and Dietetics. 2014 Apr;114(4):583-9.
12. Howard J. Is the Mediterranean diet good for kids, too? CNN. February 1, 2017. Viewed February 8, 2018.
13. Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer. Berkeley, California: Ten Speed Press. 2013.
14. Cohen L, Jefferies A. Anticancer Living: Transform Your Life and Health with the Mix of Six. New York: Viking. 2018.
15. Lemole G, Mehta P, McKee D. After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer. New York, New York: Rodale, Inc. 2015.
16. McKinney N. Naturopathic Oncology, 3rd Edition. Victoria, BC, Canada: Liaison Press. 2016
17. Ornish Living. Prostate Cancer Was My Doorway into Vibrant Health and an Expansive and Happy Life. Ornish Lifestyle Medicine. Viewed January 7, 2018.
18. Block KI. Life Over Cancer. New York: Bantam Dell. 2009.
19. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008 Sep 11;337:a1344.
20. Willett WC. The Mediterranean diet: science and practice. Public Health Nutrition. 2006 Feb;9(1A):105-10.
21. Estruch R, Ros E et al. Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine. 2013 Apr 4;368(14):1279-90.
22. Bloomfield HE, Kane R, Koeller E, Greer N, MacDonald R, Wilt T. (Editors). Benefits and Harms of the Mediterranean Diet Compared to Other Diets. Washington (DC): Department of Veterans Affairs (US); November 2015.
23. Benetou V, Orfanos P et al. Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporosis International. 2013 May;24(5):1587-98.
24. Bertoia ML, Triche EW et al. Mediterranean and Dietary Approaches to Stop Hypertension dietary patterns and risk of sudden cardiac death in postmenopausal women. American Journal of Clinical Nutrition. 2014 Feb;99(2):344-51.
25. Esposito K, Kastorini CM, Panagiotakos DB, Giugliano D. Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metabolic Syndrome and Related Disorders. 2011 Feb;9(1):1-12.
26. Huo R, Du T et al. Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: a meta-analysis. European Journal of Clinical Nutrition. 2015 Nov;69(11):1200-8.

View All References

More Information

• Memorial Sloan Kettering Cancer Center. About Herbs: Mediterranean Diet
• Mayo Clinic. Nutrition and healthy eating: Mediterranean diet: a heart-healthy eating plan
• American Institute for Cancer Research: Mediterranean Diet, Heart Disease and Cancer Risk
• WebMD: Mediterranean, DASH Top Best Diets List
• Lorenzo Cohen and Alison Jefferies: Anticancer Living: Transform Your Life and Health with the Mix of Six
• Memorial Sloan Kettering Cancer Center: About Herbs, Botanicals and Other Products
• Neil McKinney, BSc, ND: Naturopathic Oncology, 3rd Edition
• Healing Kitchens Institute
• Rebecca Katz: Cancer-Fighting Kitchen Course for Commonweal
• Barbara MacDonald, ND, LAc: The Breast Cancer Companion: A Complementary Care Manual: Third Edition