Researchers studied 1,342 people to understand how the Mediterranean diet really works. They found that people who followed this diet most closely actually ate less carbohydrates and more protein and fat than typical diet guidelines suggest. These people had healthier body weights, smaller waistlines, and lower inflammation markers in their blood. The study suggests that the Mediterranean diet’s real-world success might come from a different balance of nutrients than what nutrition experts usually recommend, with carbohydrates on the lower end of the recommended range.

The Quick Take

  • What they studied: How people who follow the Mediterranean diet most successfully actually eat, and whether their eating patterns connect to having less body fat and less inflammation in their bodies
  • Who participated: 1,342 adult volunteers who completed health measurements and detailed food records showing everything they ate for 7 days
  • Key finding: People with the highest Mediterranean diet adherence ate significantly less carbohydrates but more protein and healthy fats than people with lower adherence, and they had noticeably lower body weight, smaller waistlines, and less inflammation (all differences were statistically significant)
  • What it means for you: If you’re following the Mediterranean diet, you may see better results with a lower carbohydrate approach than traditional guidelines suggest. However, this is one study showing an association, not proof that carbs cause the benefits—talk with your doctor before making major diet changes

The Research Details

This was a cross-sectional study, which means researchers took a snapshot of 1,342 people at one point in time rather than following them over months or years. Each person completed a health exam that measured their height, weight, waist size, body fat percentage, and a blood test for inflammation. They also filled out a detailed questionnaire about their Mediterranean diet habits and kept a food diary for 7 days showing everything they ate and drank.

The researchers then grouped people into three categories based on how closely they followed the Mediterranean diet: high adherence, medium adherence, and low adherence. They compared the actual nutrients these three groups were eating—how many carbohydrates, proteins, and fats—and looked for connections between these nutrients and their body measurements and inflammation levels.

They used statistical tests to find correlations and determine which nutrients best predicted whether someone was a high-adherence Mediterranean diet follower.

This approach matters because it reveals what successful Mediterranean diet followers actually eat in real life, not just what the diet is supposed to look like in theory. Many previous studies have looked at whether the Mediterranean diet is healthy, but this study digs deeper to understand the actual nutrient breakdown that makes it work. This real-world data is valuable because it shows what patterns are associated with better health outcomes.

This study has good strengths: a large sample size of 1,342 people, detailed food records over 7 days, and objective health measurements. However, as a cross-sectional study, it shows associations at one point in time rather than proving cause-and-effect. The study can’t prove that lower carbs cause better health—only that they’re connected. The findings are from a specific population, so results might differ in other groups. The study was published in a peer-reviewed journal, which means other experts reviewed it before publication.

What the Results Show

People with high Mediterranean diet adherence ate significantly less carbohydrates (around 40-45% of calories) compared to those with medium or low adherence. At the same time, they ate more protein and more fat than the other groups. This nutrient pattern was very different from standard nutrition guidelines that typically recommend 45-65% of calories from carbohydrates.

The health differences were striking: people in the high adherence group had lower body mass index (BMI), smaller waist circumference, less body fat, and significantly lower levels of C-reactive protein, a marker of inflammation in the blood. All of these differences were statistically significant, meaning they were very unlikely to happen by chance.

When researchers used statistical analysis to figure out which nutrient best predicted high Mediterranean diet adherence, lower carbohydrate intake was the strongest predictor. This suggests that eating fewer carbohydrates is a key characteristic of how successful Mediterranean diet followers actually eat.

The study found that protein and fat intake were both higher in the high-adherence group, but carbohydrate intake was the strongest single predictor of Mediterranean diet success. The inflammation marker (C-reactive protein) showed particularly strong associations with the nutrient patterns, suggesting that the nutrient balance may directly influence the body’s inflammatory response. Body composition measurements (waist circumference and fat mass) were all consistently lower in the high-adherence group across multiple measures.

Previous research has shown the Mediterranean diet is healthy, but most studies focused on the types of foods (olive oil, fish, vegetables) rather than the actual nutrient breakdown. This study adds new information by showing that successful followers eat a different macronutrient balance than traditional nutrition guidelines recommend. The finding that lower carbohydrates are associated with better outcomes challenges the conventional wisdom that carbohydrates should make up nearly half of daily calories.

This study shows associations but cannot prove that lower carbs cause the health benefits—only that they’re connected. Because it’s a snapshot in time, we don’t know if these patterns stay the same over months or years. The study measured food intake using 7-day food records, which depend on people accurately remembering and reporting what they ate. Different populations might show different results. The study doesn’t explain why lower carbs work better in the Mediterranean diet context—it just shows they do. We also don’t know about other lifestyle factors like exercise or sleep that might influence the results.

The Bottom Line

If you follow the Mediterranean diet, consider keeping carbohydrate intake on the lower end of recommended ranges (around 40-45% of calories rather than 55-65%) while maintaining higher protein and healthy fat intake. This approach appears to be associated with better body weight management and lower inflammation. However, this is based on one observational study, so moderate confidence is appropriate. Work with a healthcare provider or registered dietitian to personalize this approach for your individual health needs.

This research is most relevant for people already interested in the Mediterranean diet who want to optimize their results. It may also interest people with weight management goals or concerns about inflammation. People with certain medical conditions (kidney disease, heart conditions) should consult their doctor before changing carbohydrate or protein intake. This study doesn’t apply to people following other diet approaches unless they’re considering switching to Mediterranean.

Changes in body composition typically take 8-12 weeks to become noticeable with consistent dietary changes. Inflammation markers like C-reactive protein may improve within 4-6 weeks of dietary changes. However, individual results vary significantly based on starting point, overall lifestyle, and adherence to the pattern.

Want to Apply This Research?

  • Track daily macronutrient percentages (carbohydrates, protein, fat) for 2-week periods to see if you’re maintaining a lower-carb Mediterranean pattern. Aim to log carbohydrates at 40-45% of daily calories, protein at 20-25%, and fat at 30-35%.
  • Instead of focusing only on eating Mediterranean foods, use the app to monitor your actual nutrient breakdown. When choosing between two Mediterranean options, select the one with lower carbohydrates and higher protein. For example, choose grilled fish with olive oil and vegetables over pasta with tomato sauce.
  • Every 4 weeks, measure waist circumference and track how clothes fit as indicators of body composition changes. If available, request a C-reactive protein blood test every 3 months to monitor inflammation trends. Use the app to identify patterns in which meals and foods best match the lower-carb Mediterranean pattern.

This research shows an association between Mediterranean diet patterns and health outcomes but does not prove cause-and-effect. Individual results vary based on genetics, overall lifestyle, and other health factors. Before making significant changes to your diet, especially if you have existing health conditions, take medications, or have dietary restrictions, consult with your doctor or a registered dietitian. This information is for educational purposes and should not replace professional medical advice. If you experience any adverse effects from dietary changes, stop and contact your healthcare provider immediately.