Doing the Mediterranean diet? Dietitians reveal the 70 essential items you need to get all the cholesterol-lowering benefits

The Mediterranean diet has been the darling of the nutrition world for the last 30 years. 

The eating style common in regions like Greece, Italy and Spain typically involves fresh produce, lean meat like fish and chicken, and whole grains, while eating less red meat and sweets.

Research consistently shows that eating a Mediterranean diet reduces the risk of heart disease by 25 percent, and premature death by 23 percent.

It's also been helpful for people trying to lose weight. A 2015 Harvard study revealed obese people lost between nine and 22 pounds while eating a Mediterranean diet for year. 

Dietitians say that the Mediterranean diet is particularly easy to stick to as it flexible  -allowing you to eat foods that might be off-limits in other diets, like cheese, Emily Kyle, a registered dietitian nutritionist based in New York said. 

The latest iteration of the Mediterranean Diet pyramid was released in 2009 and incorporated the use of regional herbs and spices 'because they give regional identity to different dishes,' Sara Baer-Sinnott, who is credited with popularizing the diet, told DailyMail.com 

But the loose guidelines can make shopping for groceries confusing. Luckily, nutrition experts have crafted a perfect shopping list.

Three experts - Ms Kyle, Kansas-based registered dietitian Cara Harbstreet, and Morgan Porpora, a registered dietitian based in New York- told Women's Health of their ultimate Mediterranean-diet shopping list.  

Opt for light vegetables...and frozen is fine too 

Summer squash is high in nutrients like Vitamin C, A and B6- as well as high in water and low in calories, according to the University of Wyoming. 

The shopping list includes: apples, berries, broccoli, brussel sprouts, cauliflower, cucumber, dates, figs, grapefruit, grapes, kale, melon, mushrooms, onions, oranges, parsnips, peaches, pears, peppers, spinach, summer squash, sweet potatoes, tomatoes and turnips.

Though it's best if you can eat these foods fresh, dietitians say that you could also enjoy some them frozen.

These foods are especially rich in fiber and water, which might help your gut digest them slowly. 'Especially compared to a standard western diet, the composition of meals in a Mediterranean Diet is so much better for our gut', Porpora told Womens Health. 

Also, fresh produce has plenty of antioxidants, which can help protect your body against stress, according to Harvard T.H. Chan School of Public Health. 

Lots of pulses, nuts and seeds to control cholesterol

Walnuts are a recommended source of vitamins and fat on the Mediterranean diet

In the legume, seed and nut camp, the dietitians recommend the following: Almonds, barley, black beans, brown rice, cashews, chickpeas, fava beans, flaxseeds, hazelnuts, kidney beans, lentils, oats, peas, pinto beans, pistachios, pumpkin seeds, quinoa, rye, sesame seeds, sunflower seeds and walnuts. 

This colorful class of food is full of dietary fiber and protein and has been shown to help lower cholesterol. 

Since these are plant products, they also contain a lot of nutrients like B vitamins, magnesium and copper, according to Dr Rani Polak, physical medicine and rehabilitation specialist at Harvard Medical School. 

Despite this, he wrote, relatively few American's incorporate this food group into their weekly diet. 'Although research supports the benefits of legume consumption, only 8 percent of U.S. adults report eating legumes on any given day,' Polak wrote.

On a Mediterranean diet, experts recommend eating at least three servings of legumes a week, The New York Times reported. 

The super-food quinoa also falls under this group, which you might be surprised to find is actually a seed, not a grain. 

Fat in abundance! But the healthy kind...

In moderation, unsaturated fats like olive oil might help you lower your cholesterol, studies show 

In this category, the dietitians recommend you pick up the following: avocado oil, avocados, basil, cinnamon, extra virgin olive oil, garlic, mint, olives, oregano, nutmeg, rosemary, sage, thyme and walnut oil.

Fat is an essential part of any diet. The USDA recommends adults should have fat be 20 to 35 percent of their daily calories- so in a 2,000 calorie diet, that's anywhere from 44 to 78 grams a day. 

By comparison, the Mediterranean diet is a bit higher in fat than the average American diet. Fat in the Meditterean diet should represent around 30 to 40 percent of your daily calories- which is about 67 to 88 grams of fat per day. 

But the kinds of fats that are featured in the Mediterranean diet are different than those found in the average American diet. 

Crucially, the majority of the fats in the Mediterranean are unsaturated fats, like olive oil, avocado and salmon. These are popularly known as 'healthy fats' because they might help improve cholesterol and in turn, stave off cardiovascular disease, according to the American Heart Association (AHA). 

But saturated fats, which are found in  butter, pork and palm oil, are the type with the strongest links to heart disease. 

Prior to 2009, the official recommendations for the Mediterranean diet didn't include herbs and spices, however this was later updated.

Choose feta and mozzarella...but not too much 

Some of the best cheeses to choose from are un-processed, like feta, parmesan and mozzarella dietitian Julia Zumpano said

When it comes to dairy, the dietitians recommend picking up cheese, greek yogurt and milk. While dairy is included in the Mediterranean diet, you should eat less of it than you would in an American diet, Julia Zumpano, a registered dietitian with the Cleveland Clinic, said. 

This is because traditionally, countries that border the Mediterranean don't drink cows milk or have highly processed dairy products like American cheese. 

For the couple servings you might have a week, Ms. Zumpano recommends un-processed cheeses like mozzarella, feta and parmesan. 

She also says that you can have a bit of ice cream every once in a while.  'A little goes a long way,' she wrote. 

Swap some beef for mackerel 

Mackerel is one example of a lean protein that the dietitians recommend on a Mediterranean diet 

When heading to the butcher counter at the grocery store, this is what the dietitians recommend you look out for: beef, pork, poultry, clams, mackerel, salmon, sardines, shrimp, trout and tuna. 

Meat is supposed to be consumed in moderation on this diet- you should aim for 3 ounce serving sizes a few times a week, according to Harvard Health Publishing.

By contrast, the average American ate about 16 ounces of meat per week, according to 2022 research from the University of North Carolina. 

The health benefits of cutting back on meat are supported by a growing body of research.

Lower meat consumption was found to extend your life expectancy by 9 months and reduce your carbon foot print by 25 percent, in a 2023 study from McGill University. 

Opting out of eating meat on the weekends reduced participants odds of developing bowel cancer by nine percent in a 2022 study from the University of Oxford. 

When you do want to tuck in for a bit of animal protein- the dietitians said you should, opt for lean meats that are lower in saturated fats- like fish instead of beef.