What are the downsides of the Mediterranean diet?

December 16, 2025 •

4 min read

According to research published by the National Institutes of Health, while generally beneficial, the Mediterranean dietary pattern can present challenges for some, especially those on a tight budget or with specific nutrient needs. This article explores what are the downsides of the Mediterranean diet, offering a balanced perspective on its potential negative aspects.

Quick Summary

This article examines the less-discussed drawbacks of the Mediterranean diet, such as the potential for weight gain from calorie-dense foods, nutritional deficiencies like iron and calcium, high grocery costs, and the time-consuming nature of food preparation. It also addresses the challenge posed by its general guidelines for those who prefer more structured eating plans.

Key Points

Weight Gain Risk: Overconsumption of calorie-dense, healthy fats like olive oil and nuts can lead to weight gain if not properly portioned.
Nutrient Deficiencies: The diet's low emphasis on dairy and red meat can cause insufficient intake of calcium, vitamin D, and iron, requiring careful meal planning or supplementation.
High Food Costs: Fresh produce, quality seafood, and extra-virgin olive oil can be more expensive than processed foods, making the diet financially challenging for some.
Lack of Specific Guidelines: The diet’s flexible nature lacks strict rules for calories and portion sizes, which can be a disadvantage for those who prefer structured eating plans for weight management.
Increased Preparation Time: Relying on whole, unprocessed ingredients means more time spent on cooking and meal preparation compared to a Western diet of convenience foods.
Alcohol Recommendation: The moderate red wine component is not suitable for everyone, including pregnant women, those with certain medical conditions, or individuals with a history of alcohol overuse.

Unexpected Weight Gain

Despite its reputation for promoting healthy weight management, one of the most surprising downsides of the Mediterranean diet is the potential for weight gain. The diet is rich in healthy fats from sources like olive oil, nuts, and seeds. While these fats are highly nutritious, they are also very calorie-dense. A person may inadvertently consume an excess of calories if they do not practice proper portion control, which can lead to weight gain over time. This is a critical point for individuals who are following the diet with the primary goal of losing or maintaining their weight.

Potential Nutritional Deficiencies

Another significant drawback is the risk of certain nutritional deficiencies, particularly for those who aren't mindful of their food choices. The traditional Mediterranean diet is lower in dairy and red meat compared to a standard Western diet, which can lead to lower intake of certain essential nutrients.

Common Deficiencies

Calcium and Vitamin D: With reduced consumption of dairy products, calcium and vitamin D intake may decrease. It is important to find alternative sources or consider supplementation after consulting with a healthcare provider.
Iron: The diet’s emphasis on limiting red meat can result in lower iron levels, especially for premenopausal women who have higher iron requirements. Non-meat eaters must ensure they get enough iron from plant-based sources like lentils and spinach, and pair them with vitamin C to improve absorption.

High Cost of Ingredients

For many, the Mediterranean diet can be an expensive lifestyle change. The diet prioritizes fresh produce, high-quality extra-virgin olive oil, and seafood, which are often more costly than processed or fast food alternatives. While there are strategies for budgeting, such as buying seasonal produce and bulk legumes, the initial and ongoing costs can be a barrier for individuals on a tight budget. This financial strain is a real and often overlooked downside that can make adherence difficult.

Lack of Structured Guidelines

Unlike many commercial diet plans that provide rigid rules, the Mediterranean diet offers more of a lifestyle template than a strict rulebook. For some, this flexibility is a major plus, but for others, it can be a significant disadvantage. People who prefer or need more specific guidance on calorie counts, food portion sizes, and exact meal plans may find the diet's general recommendations challenging to follow effectively. The lack of a specific structure can lead to confusion and make it harder to meet certain health goals, especially for weight loss.

Increased Time and Effort for Meal Preparation

Transitioning to the Mediterranean diet often requires a major shift in cooking habits and a significant increase in time spent on meal preparation. The diet emphasizes whole, unprocessed foods, which means less reliance on quick, pre-packaged meals. This can be a hurdle for busy individuals or families who rely on convenient food options. Meal prepping becomes a necessity for some, and this can be a lifestyle adjustment that not everyone is prepared for.

Comparison of Mediterranean Diet vs. Standard Western Diet Downsides


Aspect	Mediterranean Diet	Standard Western Diet
Cost	Can be higher due to fresh produce, fish, and quality olive oil.	Typically lower due to reliance on inexpensive processed and fast foods.
Preparation Time	Requires more time for cooking and meal preparation from whole foods.	Often minimal, with a high dependency on convenience and pre-packaged meals.
Nutrient Gaps	Potential deficiencies in calcium, vitamin D, and iron if not planned properly.	High risk of nutrient deficiencies due to low intake of whole foods, fiber, and micronutrients.
Weight Management	Can lead to weight gain if portion sizes of calorie-dense healthy fats are not controlled.	High risk of obesity due to high intake of processed foods, refined sugars, and unhealthy fats.
Guideline Clarity	Loose, lifestyle-based guidelines can be confusing for those needing strict rules.	Clear (but unhealthy) patterns of consumption due to widespread availability of processed foods.

Additional Practical Considerations

Beyond the potential health and financial drawbacks, there are other practical factors to consider before adopting the Mediterranean diet. The diet is inherently based on ingredients and traditions specific to the Mediterranean region. Outside this region, sourcing fresh, local produce year-round can be difficult and expensive. Furthermore, the diet traditionally includes moderate alcohol consumption, particularly red wine. While this is often viewed positively, it's not suitable for everyone, including those with a history of alcohol abuse, those taking certain medications, or those with specific health conditions like GERD. Always consult with a healthcare provider before incorporating alcohol into your diet. This is a critical step, as the dietary pattern should always be adapted to an individual's specific health needs.

Conclusion

While the Mediterranean diet is widely celebrated for its numerous health benefits, it is not without its downsides. Potential issues include unexpected weight gain from uncontrolled portions of healthy fats, the risk of developing nutritional deficiencies in iron and calcium, and the higher financial cost associated with purchasing fresh, whole ingredients. For those accustomed to a more structured eating plan or with limited time for meal preparation, the diet’s flexible, lifestyle-oriented approach can also present challenges. By understanding these potential drawbacks, individuals can make more informed decisions and adapt the diet to better suit their personal health needs and lifestyle, ensuring they can still reap its rewards while mitigating its disadvantages. A successful approach often involves careful planning, budgeting, and potentially supplementing certain nutrients under professional guidance. For more detailed information, the NIH offers a comprehensive review on the Mediterranean Diet and nutritional adequacy.

Frequently Asked Questions

Yes, it is possible to gain weight on the Mediterranean diet if you do not control your portion sizes. The diet is rich in healthy fats from nuts, seeds, and olive oil, which are high in calories.

The Mediterranean diet can be more expensive than a typical Western diet due to its reliance on fresh produce, quality olive oil, and fresh seafood. While budget-friendly strategies exist, it remains a potential financial barrier for some.

Some individuals may face potential deficiencies in calcium, vitamin D, and iron, largely due to the diet's lower emphasis on dairy products and red meat.

For some, the diet can be challenging to follow due to its lack of rigid rules and reliance on home-cooked, whole-food meals. This can require a significant lifestyle change and more time for planning and preparation.

No, the moderate red wine consumption often associated with the diet is not for everyone. Individuals who are pregnant, prone to alcohol overuse, or have certain health conditions should avoid alcohol.

A major limitation is the lack of specific, structured guidelines regarding calorie counts and portion sizes. This can be difficult for individuals who need more precise instructions to meet their health or weight goals.

To avoid iron deficiency, especially if you eat less red meat, focus on iron-rich plant-based foods like lentils and spinach. Pairing these with sources of vitamin C, such as citrus fruits, can help your body absorb the iron more effectively.