By Caroline L. Young, MS, RDN, LD, RYT
I’m a registered dietitian nutritionist (RDN) who is not an advocate for extreme diets that cut out whole food groups. But there are two eating patterns I can get behind: Flexitarian and Mediterranean. I view them as eating patterns because they are relatively sustainable and health-promoting. Both the Mediterranean and Flexitarian diets include all food groups and provide more variety than fad diets.
“Both the flexitarian and Mediterranean eating patterns allow people to prioritize foods they truly enjoy, rather than adhering to meal plans or food rules,” said Cara Harbstreet, MS, RD, LD of Street Smart Nutrition.
And as plant-based protein sources that are high in good and unsaturated fats, peanuts and peanut butter are a natural fit within Mediterranean and Flexitarian ways of eating.
Unfamiliar with the Mediterranean and Flexitarian diets?
I’m glad to break it down:
The Mediterranean Diet
It’s a way of eating that includes plant-based meals with small amounts of animal proteins. The Mediterranean Diet emphasizes grains (at least half which are whole grains), fresh fruits and veggies, nuts and legumes (including peanuts) – which are all foods high in fiber. It also includes fish and other seafood, as well as olive oil as the main fat source for cooking. It offers more good, monounsaturated fats (found in foods like peanuts, peanut butter, seeds and olive oil) than the typical American diet, which is heavier on saturated fats from animal protein. And the Mediterranean diet offers choice when it comes to foods such as sweets and animal proteins such as red meat, cheese, butter and eggs – it suggests eating them in small amounts or not at all.
“In addition to wealth of research showing all its health benefits, I really like the Mediterranean Diet because it’s a lifestyle that’s bursting with incredible flavors and ingredients but isn’t complicated to cook,” said Deanna Segrave-Daly, RD and co-author of “The 30-Minute Mediterranean Diet Cookbook: 101 Easy, Flavorful Recipes for Lifelong Health.“ Bowls of whole grains, delicious fruits and veggies, robust olive oil, delicate fish and seafood, filling nuts and seeds, hearty herbs and spices - what’s not to love?”
As Segrave-Daly mentioned, there is significant research showing benefits of a Mediterranean eating pattern. A recent 2018 study published in the New England Journal of Medicine showed that people who ate a Mediterranean diet had a lower incidence of cardiovascular disease than people following a low-fat diet. The study was a randomized controlled trial (the gold standard in research) and included 288 participants ranging from 55 to 80 at high risk for cardiovascular disease, who made it to the study’s end-point. They were divided into three dietary groups — Mediterranean with emphasis on olive oil, Mediterranean with emphasis on nuts or a reduced-fat diet. Participants were followed over a five-year time period.
As all research does, this study had its limitations; including use of food frequency questionnaires which are subject to human error and the possibility that some cardiovascular events went undetected.
The Mediterranean Diet is not necessarily a one-size-fits-all approach to eating, however, which is why it is important to get guidance from an RDN before adopting such an eating style. For example, since the Mediterranean diet does not include much red meat, it’s good to know your iron status before adopting it. And other high-iron foods such as beans, dried fruit, salmon and tuna, should be eaten along with vitamin C, which helps you absorb iron. And since the Mediterranean diet isn’t heavy on dairy, calcium supplements may need to be added to your plan.
The Flexitarian Diet
Much newer to the scene, the Flexitarian Diet is a way of eating that is primarily vegetarian with occasional fish and meat intake. Like the Mediterranean Diet, it includes all food groups but emphasizes nutrient-dense foods, including plant-based proteins such as peanuts, peanut butter, seeds, tofu, etc. Typical flexitarians include meat or seafood in their meals on some days of the week, but not every day.
But unlike the Mediterranean Diet, which has been extensively researched over time, research on the Flexitarian Diet is still emerging as the diet trend gains in popularity among consumers. One 2017 review published in Frontiers of Nutrition, which analyzed 25 studies — including both randomized controlled trials and observational studies from 2000 to 2016 — concluded that it may have emerging health benefits related to weight and metabolic health, including reduced blood pressure and diabetes risk. However, the authors emphasized the necessity of a more formal definition of the term, as well as the importance of more research on the diet to clarify its benefits and for health professionals to make any formal recommendations.
The Bottom Line
Eating patterns like these enable you to enjoy a varied, balanced diet — without cutting out whole food groups.
“Since both of these eating styles focus on the bigger picture, there’s little judgement or shaming for ‘going off plan’ for a few meals or days,” Harbstreet said. “They also include a wider variety of foods, opening the door for more mindful and enjoyable eating experiences.”
And for people who are heavy meat-eaters, the Mediterranean and Flexitarian patterns offer a middle ground without all-or-nothing rules. Plus, following them will not create added stress because they allow for flexibility in your eating. They also accommodate pleasure and choice in eating, as well as sustained and balanced nourishment – which I believe are key factors in cultivating and maintaining healthy diets, and relationships to food.
To learn more about developing a balanced approach to eating, click here.
To learn more about plant-forward eating patterns and health benefits, click here.
To learn about the drawbacks of restrictive diets, click here.
To learn about the environmental benefits of plant-forward eating,click hereand here.
To try out some of our delicious plant-forward recipes, click here.
 Mediterranean diet. MedlinePlus website.
https://medlineplus.gov/ency/patientinstructions/000110.htm. Updated July 12, 2918. Accessed November 17, 2018.
 Iron in Diet. MedlinePlus website. https://medlineplus.gov/ency/article/002422.htm. Updated January 7, 2017. Accessed November 16, 2018.
 Appendix 4. USDA Food Patterns: Healthy Mediterranean-Style Eating Pattern. Dietary Guidelines for Americans. https://health.gov/dietaryguidelines/2015/guidelines/appendix-4/. Published December 2015. Accessed November 16, 2018.
Estruch R, Ros E, Salas-Salvado J, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra Virgin Olive-Oil or Nuts. N Engl J Med. 2018; 378:4.
Definition of flexitarian in English. English Oxford Living Dictionaries website.
https://en.oxforddictionaries.com/definition/flexitarian. Accessed November 16, 2018.
Derbyshire E. Flexitarian Diets and Health: A Review of the Evidence-Based Literature. Front Nutr. 2017;3:55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216044/pdf/fnut-03-00055.pdf.