I'm a Dietitian with Syrian Roots—This Is the Mediterranean Diet That I Know and Love

Growing up, my parents and I would travel to Syria from Canada in the summers to visit with my aunts, uncles, grandparents and seemingly endless number of cousins. I fondly remember walking the lively streets on our way to visit local farmers' markets, lined with colorful seasonal fruits like watermelon, cherries and figs. We'd pick up freshly baked pita bread and saj (a type of unleavened bread) that we'd later use to scoop up labneh, olive oil and za'atar. I have such special memories of those trips, absorbing my ancestors' food, traditions and culture.

Every time I hear a reference to the Mediterranean diet, I'm brought back to the beautiful memories of my Mediterranean Middle East upbringing. And as a registered dietitian, I'm thrilled to see all the positive attention this ancient eating pattern receives.

Abundant in fruits, vegetables, whole grains, legumes, lean protein, olive oil, nuts and seeds, the Mediterranean diet has been deemed one of the healthiest ways of eating. Research shows that following this diet pattern provides an array of benefits, from helping to stabilize blood sugar levels, to improving mood and memory, reducing the risk of heart disease and certain types of cancer, and playing a role in fertility and healthy pregnancy outcomes. Even more so, a 2023 meta-analysis published in Heart notes that women who follow this diet may reduce their risk of cardiovascular disease and mortality by nearly 25%.

Yet, I see so much of my Mediterranean diet missing from the narrative. Foods like pasta, tomatoes, olives and feta cheese are often mentioned in unison with the diet—but what about foods from my family's country and all the other countries that border the Mediterranean Sea? Where is the freekeh, bulgur, pomegranate and okra?

There are innumerable healthy and delicious foods and dishes from the Mediterranean region that are underrepresented when we talk about the diet. It's time to expand the understanding and the recommendations around the diet to be as diverse as the countries and cultures within this vast region, and beyond. You can think of it as the new Mediterranean diet. ​​

Into the Origins of the Mediterranean Diet

The origins of the term "Mediterranean diet" stem back to the Seven Countries Study, where, in the 1950s, American scientist Ancel Keys studied the eating patterns of the people living in seven countries—Finland, Holland, Italy, the United States, Greece, Japan and Yugoslavia (now Croatia/Serbia), per a 2015 "50-year journey" systematic review in Nutrition, Metabolism and Cardiovascular Diseases.

His research showed that areas with lower intakes of saturated fats, such as Italy and Greece, had the lowest risk for coronary heart disease. He called their eating habits the "Mediterranean diet," and his research ultimately influenced U.S. dietary guidelines on saturated fats. However, according to a 2021 article in the Journal of Critical Dietetics, many researchers have revealed methodological issues in Keys' study and conclusions. For example, Keys collected data from Greek participants during Lent, when most abstain from meat and dairy, which are primary sources of saturated fat.

It's not to say that the countries and their cuisines aren't healthy, but rather that the collected data didn't represent their actual, habitual diet. Furthermore, with such a narrow gaze on Italy and Greece, Keys' research misrepresents the region's diverse culture and food history.

So what does the actual diet of those in the Mediterranean region truly look like?

The recommendations we so often see today describe it as a diet that emphasizes high intakes of olive oil, vegetables, fruits, whole grains, nuts, seeds and legumes; moderate intakes of fish, seafood, dairy (mainly cheese and yogurt) and red wine; and low intakes of poultry, red meat, refined grains and sugars.

However, this overgeneralization is not an accurate portrayal of the traditional eating pattern of the Mediterranean people, per a 2021 narrative review in Public Health Nutrition. Red meat, poultry, eggs and dairy products are an integral part of the traditional Mediterranean diet, with people in some countries consuming these foods more regularly than others. Furthermore, not all people in the region drink wine. Many countries in the Mediterranean are predominantly Muslim, which means wine or any alcoholic beverage is prohibited for consumption.

Mediterranean food lists, articles and sample meal plans found online often lack diversity and fail to highlight traditional foods from African and Middle Eastern countries like Egypt, Morocco, Libya, Syria and Lebanon. (Editor's Note: At EatingWell, we acknowledge that some content in our archive is problematic. We are working on updating our nutrition advice and meal plans to be more inclusive.)

Such a limited scope of the Mediterranean region means folks are missing out on the incredibly flavorful foods and dishes—and the health benefits they provide—from these historically underrepresented countries.

Let's zoom out and take a look at the larger Mediterranean region and all the deliciousness there is to be had.

The Mediterranean Region's Countries and Cuisines

The Mediterranean region goes far beyond the countries most often referenced when talking about the Mediterranean diet (think: Italy, Greece, France and Spain). It spans three continents—Europe, Southwest Asia and Africa—and there are a total of 21 countries and two territories that have coastlines on the Mediterranean Sea, which are:

• Albania
• Algeria
• Bosnia and Herzegovina
• Croatia
• Cyprus
• Egypt
• France
• Gibraltar
• Greece
• Israel
• Italy
• Lebanon
• Libya
• Malta
• Monaco
• Montenegro
• Morocco
• the Palestinian territories
• Slovenia
• Spain
• Syria
• Tunisia
• Turkey

As described in a study published in the Asia Pacific Journal of Clinical Nutrition, which looked at the traditional foods regularly consumed by individuals from 18 Mediterranean countries, and for the purpose of this conversation, the Mediterranean countries can be divided into four regions based on their food habits: Eastern Mediterranean, Western Mediterranean, the Adriatic region and North African. It's important to note that although there are many similarities among the Mediterranean countries, each has its own cuisines and food traditions.

The Eastern Mediterranean Region

The Eastern Mediterranean region includes Middle Eastern cuisine and comprises Greece, Cyprus, Turkey, Syria, Lebanon, Israel, the Palestinian territories and Egypt. These cuisines feature lots of yogurt, particularly labneh and Greek yogurt, and fresh cheeses such as halloumi and feta. Herbs often used include parsley, sumac, mint, coriander and oregano, adding a wealth of aroma and flavor to their dishes. A Middle Eastern seven-spice mix called bharat (or baharat) is added to many types of meat to tenderize them and boost their flavor. Herbs and spices are rich in antioxidants, vitamins and minerals, which offer a range of health benefits, including reducing inflammation and risk for chronic diseases, per a 2019 article in The Journal of AOAC International.

Eastern Mediterranean grains include fresh pita bread, lavash, rice and bulgur. Burek is a staple dish across the region that consists of phyllo dough stuffed with cheese or meat. Poultry, lamb and goat meat are grilled like kebabs or gyros or ground up, such as in kibbeh. Chickpeas are used to make hummus and falafel, whereas fava beans are used to make ful mudammas, a staple bean salad dish of Middle Eastern and Egyptian cuisine. A variety of nuts, such as almonds, walnuts and pistachios, are sprinkled over savory dishes or added to sweet pastries like baklava.

The Western Mediterranean Region

The Western Mediterranean region—Italy, France and Spain (and Malta)—is the one that often gets all the attention when talking about the Mediterranean diet. Looking into the households of these countries, there are several eating habits that distinguish this region from the rest of the Mediterranean. For example, wine is commonly used in dishes as a flavor enhancer or on its own. Pork, which is a great source of choline—a nutrient that helps support our cognitive function—is consumed more often here than in other countries across the vast Mediterranean region.

The staple grains include pasta, rice, polenta, potatoes and leavened bread. Garlic, capers, anchovies, fennel and pine nuts, all sources of antioxidant compounds, are commonly used to enhance the flavor of dishes. Olive oil is consumed throughout, although people in France consume more butter.

The Adriatic Region

Croatia, Bosnia and Herzegovina and Albania border the Adriatic Sea—an extension of the Mediterranean Sea. In Adriatic cuisine, dairy is consumed as ricotta, cottage cheese, sour cream, butter, buttermilk and clotted cream. Dairy is not only a great source of calcium, but fermented dairy foods contain probiotics, which are beneficial bacteria that are key to our gut health.

Common vegetables include eggplant, okra, potatoes, pumpkin and cabbage. Prsut is a salted dry-cured ham that is served in Croatian meals with cheese and olives. Cevapi is a signature Bosnian meal that consists of grilled beef or veal kebabs served with flatbread (called somun) and ajvar, a red pepper paste. The most popular spices used are paprika, pepper, parsley, bay leaves and sage, which not only boost flavor but also support overall health.

The North African Region

Morocco, Algeria, Tunisia and Libya make up the North African region. The cuisine is rich in spices such as cumin, coriander, saffron, cinnamon and cloves. Harissa and ras-el hanout are spice mixes used to add warmth and flavor to a variety of dishes. Dried fruit like raisins, dates and apricots—good sources of fiber—are used in savory dishes and desserts.

Couscous, a type of pasta made from rolled semolina, is commonly served with stews and meat dishes. Couscous is rich in selenium, an essential mineral that helps with reducing inflammation and plays a role in thyroid and immune health. Bread and rice are also consumed with various meals. The Moroccan tagine is one of the most popular dishes of North African cuisine. Meat and vegetables are slow-cooked in a cone-shaped ceramic pot. Other common ingredients include potatoes, pumpkin, chickpeas and lamb.

Bottom line: There is no single food or cuisine, but rather a diverse array of foods, traditions and ethnic dishes that make up the Mediterranean diet.

Embracing the New Mediterranean Diet

The Mediterranean diet is an eating and lifestyle pattern that originates from the vast area that is the Mediterranean region. But the principles of the diet are not confined to just that region. Anyone can follow the Mediterranean diet if they choose to eat this way—no matter where they are in the world. It can be adapted to all cultures, incorporating traditional dishes from your cultural roots and the foods you like.

So, how can you embrace this new Mediterranean diet? Start by assessing your current eating habits and identifying areas where you can add an extra serving of vegetables and fruits. Add fresh herbs to your salad dressing, or pick up a new spice from the grocery store to experiment with. Incorporate dried fruits into your afternoon snack, and sprinkle nuts and seeds onto main dishes. Try a variety of animal- and plant-based proteins like lamb, goat, seafood and tofu. Lastly, remember that the Mediterranean diet is a lifestyle that encourages daily movement, socializing with friends and family, and mindfulness in eating and everyday life.

This lifestyle was certainly my experience, especially when visiting Syria in the summer. Cooking and eating is an event that people take pride in as they serve freshly prepared meals to friends and family. Taking a daily stroll and socializing with others is part of the lifestyle, ultimately improving mood and energy and lowering the risk for chronic diseases like heart disease and diabetes. The Mediterranean diet is not a quick-fix diet but an eating pattern and way of living that has been enjoyed for generations. That's the Mediterranean diet I have come to love and share with you.