Researchers in Australia wanted to know if doctors would keep recommending the Mediterranean diet to patients with heart disease and type 2 diabetes, even after their training ended. Two years after teaching doctors about this healthy eating approach, they surveyed 67 healthcare workers to see who was still using it. Dietitians almost always kept recommending it, but other doctors only did about half the time. The study found that doctors were more likely to stick with the Mediterranean diet approach if they understood it was part of their job, believed in the science behind it, and received good training when they started. This research helps us understand what makes healthy eating advice stick in real medical practice.

The Quick Take

  • What they studied: Whether doctors and nurses continued recommending the Mediterranean diet to patients with heart disease and type 2 diabetes two years after receiving training on this approach.
  • Who participated: 67 healthcare workers in Australia (6 dietitians and 61 other doctors and nurses) who had been trained to recommend the Mediterranean diet to their patients.
  • Key finding: All 6 dietitians kept recommending the Mediterranean diet, but only about half of the other 61 healthcare workers did. Doctors were more likely to keep using it if they understood it was their job to do so, believed in the science, and received good training when they started.
  • What it means for you: If you have heart disease or type 2 diabetes, your doctor is more likely to recommend the Mediterranean diet if your healthcare team has clear training and understands why this diet matters. This suggests that good training programs can help make healthy eating advice more common in regular medical care.

The Research Details

Researchers in Australia ran a program from May 2021 to October 2022 that taught doctors, nurses, and dietitians how to recommend the Mediterranean diet to patients with heart disease and type 2 diabetes. Two years later, in October 2024, they sent surveys to all 67 healthcare workers who had received the training. The survey asked 14 questions about whether recommending the Mediterranean diet had become a normal part of their work. Researchers used these answers to figure out which factors helped doctors stick with the Mediterranean diet approach over time.

The study used a special measurement tool called the NoMAD questionnaire, which was designed to measure whether new medical practices become routine in healthcare settings. This tool looks at things like whether doctors think the practice is part of their job, whether they understand the science behind it, and whether they feel supported by their team.

Understanding what helps doctors stick with healthy eating advice is important because training programs are expensive and time-consuming. If we know what makes doctors keep using good practices, we can design better training programs that have lasting effects. This study shows that it’s not enough to just teach doctors about the Mediterranean diet—they also need to understand why it’s their responsibility and feel supported by their workplace.

This study has some strengths: it surveyed all the doctors who received training, it used a scientifically-designed measurement tool, and it looked at real-world medical practice. However, the study is limited because it only looked at one healthcare system in Australia, so results might be different in other countries or settings. The survey was done 2 years after training, which is good for measuring long-term effects, but we don’t know if the results would be the same after 5 or 10 years. Also, doctors answered questions about themselves, which means they might have reported what they thought was the ‘right’ answer rather than what they actually do.

What the Results Show

The most striking finding was that all 6 dietitians reported that recommending the Mediterranean diet had become a normal part of their work. However, only 52% of the other 61 healthcare workers (doctors, nurses, and other staff) said the same thing. This big difference suggests that dietitians, who specialize in nutrition, were much more likely to make the Mediterranean diet a routine part of their practice.

When researchers looked at what predicted whether doctors would stick with the Mediterranean diet, they found four important factors. First, doctors were 15.7 times more likely to keep using it if they believed it was legitimately part of their job. Second, they were 3.8 times more likely if they had a shared understanding with their team about the science supporting the diet. Third, doctors were 6.1 times more likely if they felt personally involved in supporting the approach (what researchers call ‘cognitive participation’). Fourth, they were 5.7 times more likely if they felt their whole team was working together on it.

For doctors who had started working at the healthcare center within the past 2 years, receiving good training and orientation about the Mediterranean diet made a huge difference. Among these newer doctors, 71% kept using the Mediterranean diet if they received proper handover training, compared to only 29% of those who didn’t get this training.

The study found that newer staff members (those who started within 2 years) were particularly helped by receiving good training. This suggests that the way we introduce new doctors to healthy eating practices matters a lot, especially when there’s high turnover in the workplace. The research also showed that having a shared understanding of the science was important—doctors who felt their team was on the same page about why the Mediterranean diet works were more likely to keep recommending it.

This study adds new information to what we already know about getting doctors to use healthy eating advice. Previous research has shown that training programs can teach doctors about the Mediterranean diet, but this study is one of the first to look at whether doctors actually keep using it years later. The findings support earlier research showing that doctors are more likely to stick with new practices if they feel it’s part of their job and if their workplace supports them. The study also confirms that good training for new staff is important, which other healthcare research has suggested.

This study only looked at one healthcare system in Australia, so we don’t know if the same results would happen in other countries or in private medical offices. The study relied on doctors reporting what they do, rather than actually watching them give advice to patients, so some doctors might have said they use the Mediterranean diet more than they actually do. The study didn’t include information about how many patients each doctor saw or how serious their health problems were, which could affect whether doctors recommend the diet. Finally, we don’t know what happened to doctors who left their jobs after the training, so the results might not tell the whole story about whether the training worked long-term.

The Bottom Line

If you have heart disease or type 2 diabetes, ask your doctor about the Mediterranean diet. The evidence strongly supports this eating pattern for both conditions. Healthcare systems should invest in clear training programs for all staff members, not just dietitians, and make sure new employees receive good orientation about recommending the Mediterranean diet. Doctors should feel supported by their workplace and understand that recommending healthy eating is part of their job. (Confidence: Moderate to High—based on this study and previous research)

This research matters most for people with heart disease or type 2 diabetes who want their doctors to recommend evidence-based eating approaches. It also matters for healthcare administrators and doctors who want to make sure their medical advice stays consistent and evidence-based over time. If you’re a doctor or nurse, this research suggests that good training and workplace support will help you stick with recommending the Mediterranean diet to your patients.

Based on this study, doctors who receive good training and support can start recommending the Mediterranean diet immediately. However, it takes about 2 years for the practice to become truly routine. If you’re a patient starting the Mediterranean diet based on your doctor’s recommendation, you might see improvements in heart health markers within 3-6 months, though long-term benefits develop over years.

Want to Apply This Research?

  • Track how often you discuss the Mediterranean diet with your healthcare provider at each visit. Users can log whether their doctor recommended specific Mediterranean diet foods (olive oil, fish, vegetables, whole grains) and rate how confident they feel following the recommendations.
  • Users can set a weekly goal to try one new Mediterranean diet recipe or food item. The app can send reminders to discuss Mediterranean diet progress with their doctor at the next appointment and help users prepare questions about how to follow this eating pattern.
  • Track monthly check-ins with your healthcare provider about Mediterranean diet adherence. Users can log blood sugar levels, cholesterol numbers, or weight changes alongside their Mediterranean diet compliance to see if the eating pattern is helping their health goals. Set quarterly reviews to assess whether your doctor is consistently recommending this approach.

This research describes how doctors use the Mediterranean diet in medical practice, but it does not provide personal medical advice. The Mediterranean diet has strong scientific support for heart disease and type 2 diabetes, but individual results vary. Before making major changes to your diet or healthcare, consult with your doctor or a registered dietitian who knows your complete medical history. This study was conducted in Australia and results may differ in other healthcare settings. If you have heart disease, diabetes, or other serious health conditions, work with your healthcare team to develop a personalized eating plan.