- The Mediterranean diet is incredibly flexible and easy to adapt to all kinds of preferences.
- If you don’t eat fish, there are lots of ways to make it work for you.
- Focus on fruits, vegetables, whole grains, nuts, seeds, beans, lentils and olive oil.
The Mediterranean diet consistently ranks among the healthiest eating patterns in the world, and for good reason. Research has found that it may help protect against chronic illnesses, such as cardiovascular disease, cancer, cognitive decline, metabolic syndrome, and overweight and obesity. It is so powerful that it’s even been linked to a longer life expectancy.
It’s also incredibly flexible. That makes it easy to adapt to a wide range of preferences. And if fish isn’t one of yours, that’s completely fine. “Fish is a feature of the Mediterranean diet, not a requirement,” says Drew Hemler, M.Sc., RD, CDN, FAND. “Fish is commonly included because it’s a convenient source of omega-3 fats, but it’s not the only way to follow a Mediterranean-style pattern. The real magic comes from overall food quality, variety and balance, not any single food.”
“The foundation of the Med diet is plant-forward eating, along with lifestyle habits like shared meals and regular movement,” says Hemler. At its core, you’ll find a wide variety of fruits, vegetables and whole grains, along with healthy fats from olive oil, nuts and seeds, and plant-based proteins, such as beans and legumes. It does contain a little animal protein, mainly from a few weekly servings of fish. Poultry, eggs, cheese and yogurt are also occasionally included, typically in small amounts.
With all those foods to choose from, there are lots of ways to make the Mediterranean diet work for you, no fish required. Here’s how:
1. Build Meals Around Fruits, Vegetables and Whole Grains
A hallmark of the Mediterranean diet is its abundance of fruits, vegetables and whole grains. These aren’t just delicious. They are also responsible for many of its health benefits. For example, research shows that Mediterranean diet staples, like tomatoes, olives and whole wheat, are filled with potent antioxidants, such as polyphenols, carotenoids and flavonoids, that help guard against inflammation and oxidative stress and protect our bodies from microbes that can cause illness.
2. Lean Into Plant-Based Proteins
The Mediterranean diet gets the bulk of its protein from plant sources, especially pulses, like beans, chickpeas and lentils. In addition to providing heart-healthy plant protein, pulses are also rich in disease-preventing fiber, folate, minerals and bioactive compounds. At the same time, they have zero cholesterol, are exceptionally low in saturated fat and have a low glycemic index.
Given all the recent hype telling us to eat more protein, this may all come as a surprise. Instead of asking Where’s the protein? Hemler recommends taking a different approach. Start your meals with a base of roasted vegetables, salads or grain bowls, then layer in proteins afterward, he says.
3. Prioritize Healthy Fats
“While fish is a part of the healthy Mediterranean diet, it is not the only part,” says Joan Salge Blake, Ed.D., RDN, LDN, FAND. “The Mediterranean diet is plant-forward and lower in animal-based foods. As a result, it’s naturally low in heart-unhealthy saturated fat. Even with little or no fish, this modified Mediterranean diet is healthier than the typical American diet.”
Yet, it’s hardly a low-fat eating pattern. Healthy fats are a cornerstone of the Mediterranean diet, especially extra-virgin olive oil, which may promote healthier blood pressure, cholesterol and blood sugar. Olive oil’s low saturated fat content is one reason, but it’s not the only one. Research suggests that olive oil’s ample polyphenols may also be a driving factor behind many of its health benefits.
The Mediterranean diet’s healthy fats don’t stop with olive oil. There are other healthy fats, too, especially from nuts, like walnuts, almonds and pistachios.
4. Add in Plant Omega-3s
You don’t have to eat fish to follow the Mediterranean diet, but without it, you might miss out on omega-3 fats. Unless you have a strategy. “While fish are an excellent source of the heart-healthy omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), specific plant foods such as flaxseed oil, flaxseeds, chia seeds, English walnuts and canola and soybean oils contain alpha-linolenic acid (ALA), another omega-3 fatty acid,” says Salge Blake.
That said, you’ll need to consume a fair amount of ALA-containing foods to reap their heart-healthy benefits, she says. “ALA can be converted into EPA and then to DHA in the liver, but the process is limited,” she explains. In fact, our bodies convert less than 15% of ALA to EPA and DHA.
5. Don’t Forget About Lifestyle
The Mediterranean diet isn’t just about what you eat. It’s about how you live. In today’s always-on culture, rest and downtime often take a hit, social time gets pushed aside, and regular movement can feel like one more thing to check off your to-do list. The Mediterranean lifestyle takes a different approach, one where movement, rest and social connection are naturally woven into daily life. Rather than relying on structured gym sessions, activity comes from everyday routines like walking to run errands, shop for food, meet friends for coffee or get kids where they need to go. And leisurely meals with friends and family are a regular event.
Whether you eat fish or not, these lifestyle habits are well worth adopting. Research shows they add not only years to your life, but life to your years. In fact, one large, long-term study found that people who embraced the Mediterranean lifestyle, not just the diet, had lower rates of dying from any disease. Sometimes, it really is as simple as shutting the laptop a little earlier and saying yes to that dinner with a friend.
Meal Plan to Try
7-Day Mediterranean Diet Meal Plan for Beginners, Created by a Dietitian
Our Expert Take
The Mediterranean diet works because it’s flexible, not because it follows strict rules. Built around nutrient-dense fruits and vegetables, whole grains, healthy fats and plant-forward proteins, it leaves plenty of room to adapt to your preferences. Fish can be part of the plan, but it’s not required. What matters most is eating a wide variety of plant-based foods and healthy fats while embracing the Mediterranean lifestyle, which values rest, social connection and everyday movement. “The Mediterranean diet is one of the most flexible and culturally adaptable eating patterns out there,” says Hemler. “If you focus on whole foods, healthy fats and the enjoyment of eating with others, you’re doing it right … fish or not.”
