An authentic Mediterranean Diet menu is nearly impossible to find at restaurants in the United States. Most places that claim to be Mediterranean—whether they be Italian, Greek, Spanish, or something else—invariably fall back into the American comfort zone of Mediterranean “sounding” dishes that depart significantly from the genuine, traditional way of eating found in their countries of origin.

That said, if you wanted to create an authentic Mediterranean Diet menu at home, you’d only need to follow the simple food “rules” of our Italian, Greek, and Spanish friends. The first step is the most important; shopping for local, seasonal, organic ingredients.

Below you’ll find some sample suggestions and links to recipes. 

Courses in a Mediterranean Diet Menu

Obviously there could be a thousand variations, but here are some suggestions to get started if you favor the Italian version of a Mediterranean Diet menu:


In Italian, an appetizer is called an “antipasto.” The word literally means before (anti) the meal (pasto). 

Some popular appetizers in Italy would be Caponata, Spiedini, or Bruschetta (pronounced; brew-SKET-tah, and not brew-SHET-tah). Often these dishes are pre-made and kept at room temperature so that they can be served quickly after the diner orders their meal. Then once the appetizer/antipasto has been served, the pace of the meal becomes deliberately slow or the rest of the evening. 

Check out these further suggestions: Italian Appetizers 

First Courses

A first course, or primo piatto, is usually pasta, rice (risotto), or some other starch. In Sicily it could be cous-cous. In the North, it might be polenta, which is made from corn meal. In the past, these were meant to fill you up so that your hunger for meat or other expensive ingredients would be reduced. 

Just to be clear, in Italy the pasta itself is the star here and the sauces are merely to add a dash of flavor and imagination. Be aware that there will be less sauce and less meat or seafood on your pasta than you might expect—and that’s how it’s supposed to be.

Also, it’s important to know that certain sauces go with specific shapes of pasta, and this is not to be taken lightly. So no, you may not “mix and match” to your pleasure. 

Second Courses

The second course, “il secondo,” is what we foreigners would consider the main dish or entree.  This might be either meat, fish, or fowl, largely depending on the region. A big, juicy (rare) steak in Tuscan, or a lighter involtini di pesce spada (swordfish rolls) in Sicily. You can never go wrong when you stick to local specialties. 

Most of the time your main dish will come ala carte, with a few exceptions. For example, uno stinco (a pork shank) is typically roasted in the oven with potatoes and rosemary. But in general, if you want a side dish you must order it separately.

It should also be noted that often Italians will have a first course OR a second course, but not always both. It’s up to you and don’t feel like you have to order off the entire Mediterranean Diet menu.

Side Dishes

Side dishes (contorni) are usually vegetables or a salad. The vegetables will be local and seasonal, so you always have to ask what’s fresh and available. Salads are always simple, even plain. Often it is literally just fresh lettuce with salt and oil. No bizarre tofu cubes, wierd sprouts, or superfulous croutons. And certainly no “Parmesan” cheese! 

Furthermore, salad dressings (including the so-called “Italian” dressing) don’t exist. Salads are typically dressed with only salt, olive oil, and maybe either a bit of vinegar or a squeeze of lemon. That’s it.

If you’re thinking to yourself that these contorni sound a little boring, I sympathize with you.  What can be so delicious about plain vegetables, right? Well, that’s because we’re imagining the tasteless “fake” vegetables that are endemic to the mega-chain supermarkets outside of Mediterranean Europe. Not so in Italia.

Here are some great suggestions for the perfect contorni: Best Italian Side Dishes


As a general rule, the desserts in Italy are less rich and much less sugary-sweet than in other countries. Ricotta cheese is a common ingredient in many regions, especially in the south. And everybody knows about tiramisu

There are also cookies called cantucci, which in Tuscany are served with a dessert wine for dunking. And of course gelato is never a bad choice.You can have it at the restaurant or at a gelateria on your walk home.

If you have a sweet tooth, check these out: Best Italian Desserts


For an Italian, water or wine are the only two acceptable beverages to accompany lunch or dinner. Soft drinks, such as Coke, may be consumed on their own in the middle of the day, or as a digestive. But never with your meal. Unless you’re like 12 years-old…and even then.

Furthermore, coffee always comes at the very end of the meal, and never before or during (this rule is not flexible and you may get instantaneously deported if you break it). And no, you may not have a cappuccino at this hour, either.  How could you even consider pouring warm, foamy milk on top of your pasta and fish? Fa schifo! 

However, if you really can’t take the full bitterness of an espresso, it’s acceptable to make it macchiato, just a tiny “spot” of milk to neutralize the acidic coffee. Add sugar to your taste.

Of course, after you drink an Italian coffee, you might want to follow it with an “amazzacaffè,” or “coffee killer,” as they are called in Rome. These are also called “amari,” or bitter after dinner drinks meant to cleanse your palate and aid in digestion.

A good choice is the Sicilian brand Averna, as it can be found in almost every restaurant throughout Italy. Limoncello is another good choice, although it is very sweet, not amaro (bitter).  It’s the perfect choice after fish. Or if you’re really brave, try a grappa, which in America we call “moonshine” or “firewater.” Make sure to have a designated driver and don’t attempt to light a cigarette for at least 20 minutes after.

One final word on meals in Italy. “Feasts” are reserved for special occasions. This should go without saying, but the fact is, that people eat less in Italy than in the U.S. or U.K., both in volume and frequency. One common mistake in the Mediterranean Diet is that people assume that if it’s healthy, they can eat as much as they want!

Rick Zullo

Former doctor, current science teacher, and life-long food lover, Rick's passion for Mediterranean cuisine was ignited while living as an expat in Rome, Italy. 


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