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Is the Mediterranean Diet Best for Diabetes?

Is the Mediterranean Diet Best for Diabetes?

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That’s why the Mediterranean diet is known as a heart-healthy style of eating. “In diabetes, it’s all about reducing your risk for having complications from the disease,” says Sharon Movsas, a registered dietitian with Montefiore Health System in the Bronx, New York. “One of the leading complications is cardiovascular disease, including heart attacks and strokes,” she says. If that wasn’t enough, diabetes also often comes with high blood pressure and cholesterol, both factors that increases the risk of heart disease.

A Mediterranean diet protects the heart by lowering and controlling blood pressure and cholesterol levels. According to a study published in February 2017 in Atherosclerosis, eating an olive oil-rich Mediterranean diet for 1.5 years improved arterial blood flow better than a standard low-fat diet in people with type 2 diabetes and prediabetes. That improvement in arterial function can help slow the development of atherosclerosis, or the buildup of plaque in artery walls. Other research indicates that the anti-inflammatory and antioxidant properties of the diet reduces odds of having a cardiovascular event (like a heart attack) by up to 30 percent.

The Mediterranean diet furthermore allows red wine, fat-free or low-fat dairy (such as yogurt), eggs, and lean meat all in moderation, says the Everyday Health nutritionist Kelly Kennedy, RD. Flavoring food with herbs and spices instead of salt is also encouraged. “It typically replaces saturated and trans fats with unsaturated fats, and this might explain the positive effect on insulin sensitivity,” Kennedy says. Research also suggests that it may be the high concentration of polyphenols (antioxidant plant compounds) in the foods typically included in the Mediterranean diet that assists in decreasing insulin resistance, per a review published in August 2017 in Oxidative Medicine and Cellular Longevity.

RELATED: 10 Foods High in Antioxidants

How a Mediterranean Style of Eating May Help Prevent Type 2 Diabetes

It’s not just people who have diabetes who benefit from this style of eating. Those who are at risk for the disease (like those managing metabolic syndrome), may reduce their odds of developing diabetes by 23 percent, concluded a systematic review and meta-analysis published in August 2015 in BMJ Open. Mediterranean eating was also superior to low-fat diets for blood sugar control, the researchers reported.

One of the misconceptions about the Mediterranean diet stems from the word “diet” in its name. “This is a way of eating, approaching food, and making a lifestyle change. It’s not something that people do for six months and be done,” says Bereolos. In fact, it appears to be just as good as other diets, like low-fat, low-carb, and the American Diabetes Association diet for long-term (greater than one year) weight loss, according to a review of randomized clinical trials published in April 2016 in The American Journal of Medicine.

Committing to the change is worth it. In addition to being associated with a lower risk of diabetes, following the eating plan is also linked to a lower risk of overall mortality, certain cancers, and diseases like Alzheimer’s and Parkinson’s, notes a review published in January 2018 in the European Journal of Clinical Nutrition.

RELATED: Mediterranean Diet Tied to a 30 Percent Reduced Diabetes Risk in Women

Complete Food List: Diabetes-Friendly Mediterranean Diet Foods to Eat and Avoid

Switching to a Mediterranean diet isn’t as radical or complicated as it might sound — and, though we wouldn’t discourage you from visiting, you don’t have to move to southern Europe to adopt the region’s eating style. Like many healthy diets, it starts with choosing fresh fruits and vegetables whenever you can, and using lean protein sources such as fish, skinless chicken, and legumes rather than red meat, says Dr. Hatipoglu.

Fill your kitchen with a few staples to help you make the transition. As Kennedy says, “The key with the Mediterranean diet is that it emphasizes minimally processed foods.” Here’s a shopping list to help you stock up:

Foods to Eat on the Mediterranean Diet

Whole grains

  • Brown rice
  • Barley
  • Quinoa
  • Bulgur
  • Farro
  • Buckwheat
  • Wheat berries
  • Whole-grain bread, rolls, tortillas, and pasta

Nuts, seeds, beans, and legumes

  • Almonds
  • Walnuts
  • Pistachios
  • Cashews
  • Sunflower seeds
  • Sesame seeds
  • Beans (kidney beans, white beans, cannellini beans)
  • Chickpeas
  • Lentils
  • Peas
  • Peanuts

Vegetables

  • Avocados
  • Bell peppers
  • Brussels sprouts
  • Asparagus
  • Tomatoes
  • Leafy greens (spinach, lettuce, kale, collards)
  • Broccoli
  • Cabbage
  • Cucumbers
  • Eggplants
  • Leeks
  • Artichoke
  • Beets
  • Carrots
  • Celery
  • Fennel
  • Radish
  • Onions
  • Zucchini

Fruits

Healthy fats

  • Olives
  • Olive oil

Drinks

  • Water
  • Coffee
  • Tea
  • Wine (in moderation)

Fresh fish and seafood

  • Salmon
  • Sardines
  • Halibut
  • Shrimp
  • Mussels
  • Albacore tuna
  • Trout
  • Mackerel
  • Herring

Healthy dairy, eggs, and poultry

  • Reduced-fat cheese
  • Low-fat or nonfat yogurt
  • Low-fat or nonfat milk
  • Eggs
  • Poultry (chicken, turkey, etc.)

Herbs and spices

Foods to Limit on the Mediterranean Diet

  • Beef
  • Lamb
  • Pork
  • Burgers
  • Butter
  • Sweets (cakes, cookies, candy)

Foods to Avoid on the Mediterranean Diet

  • Processed meats (hot dogs, sausage, deli meat, chicken nuggets)
  • Ultra-processed foods (chips, muffins, sugary cereals)
  • Fast food
  • Soda and other sweetened drinks

RELATED: 13 Quick and Easy Snacks for People With Diabetes

7-Day Meal Plan for a Diabetes-Friendly Mediterranean Diet

Here are some basic meal ideas that fit in a diabetes and Mediterranean diet, in part courtesy of Bereolos and Movsas.

DAY 1

Breakfast Greek yogurt topped with sliced almonds and raspberries

Lunch Green salad topped with chickpeas, quinoa, and a hard-boiled egg drizzled with vinaigrette.

Snack Walnuts and a sliced pear

Dinner Whole grain pasta with ground turkey, broccoli, and mushroom sauce

Dessert Small fig bar

DAY 2

Breakfast Veggie omelet with cheese

Lunch Lentil soup with side salad topped with olive oil and lemon

Snack Slice of whole-grain bread topped with ricotta and a sliced fig

Dinner Roasted chicken with zucchini and farro

Dessert Grilled peach

DAY 3

Breakfast Muesli with berries

Lunch Vegetarian chili with whole-grain crackers

Snack Hummus and sliced vegetables

Dinner Salmon with orzo and Brussels sprouts

Dessert Fruit sorbet with a sprinkle of nuts

DAY 4

Breakfast Slice of veggie frittata with fruit

Lunch Whole-grain pita with hummus, chopped vegetables, and olives

Snack A container of low-fat yogurt

Dinner Shrimp with artichokes and olives

Dessert A few candied walnuts

DAY 5

Breakfast Slice of whole-grain toast with cheese and fresh fruit

Lunch Green salad topped with roasted squash, pumpkin seeds, and salmon

Snack Mixed nuts

Dinner Sauteed kale with cannellini beans (aka beans and greens)

Dessert Berries with a dollop of Greek yogurt

DAY 6

Breakfast Shakshuka (eggs cooked in spicy tomato sauce)

Lunch Chickpea, quinoa, and veggie bowl

Snack Sunflower seeds

Dinner Lamb with potatoes and green beans

Dessert Poached pear

DAY 7

Breakfast Yogurt with fruit and low-fat, low-sugar granola

Lunch Avocado whole grain toast with pumpkin seeds and a dash of lemon juice on top

Snack Roasted chickpeas

Dinner Halibut with sautéed spinach and ratatouille

Dessert Fig stuffed with ricotta

RELATED: A Complete Mediterranean Diet Food List and 14-Day Meal Plan

Where to Find Diabetes-Friendly Mediterranean Diet Recipes

It’s not hard to find recipes that are compliant with the Mediterranean diet. Here are some standout resources for meal inspiration.

American Diabetes Association (ADA)

Check out the ADA’s Diabetes Food Hub. Movsas likes this site because it helps you plan your meals ahead of time — a recipe for success. You can search depending on your wants (a vegetarian meal, budget-friendly) and you’ll get a list of recipes that fit. It will also help you create a shopping list.

Cookbooks

Poring over a cookbook is a great way to learn new skills, understand the style of cooking, and whet your appetite. Try The Mediterranean Diet Cookbook for Beginners by Elena Parvantes, RDN, or The Mediterranean DASH Diet Cookbook by Abbie Gellman, RD, CDN, or The Mediterranean Diabetes Cookbook by Amy Riolo.

Blogs

Try out new culinary skills, get step-by-step instructions, and sign up for meal plans through blogs like The Mediterranean Dish.

RELATED: 11 Easy Mediterranean Diet Recipes for Beginners

5 Expert Tips for Maintaining a Mediterranean Diet While Managing Diabetes

Even though the Mediterranean diet is inherently healthy for people managing type 2 diabetes, you’ll still need to watch your carbs. Here are some quick tips to keep in mind overall as you make the switch.

1. Watch the Legumes

“Beans, peas, chickpeas, and lentils all have phenomenal nutrients and fiber, but fundamentally, they’re still a carbohydrate, and that will affect your blood sugar,” says Bereolos. That does not mean you should actively avoid them, but be aware of the amount of carbs they’re contributing to your diet, especially if you’re taking insulin.

2. Talk to Your Doctor About Alcohol

Alcohol in moderation, particularly red wine, is allowed on the Mediterranean diet. But that doesn’t mean it’s right for you and your health. “Ask your physician about alcohol and possible interactions with the medications you’re taking,” says Bereolos.

3. Make Small Changes to Your Plate

A registered dietitian or a CDCES can help you develop a strategy for making a Mediterranean eating plan work for your food preferences and lifestyle. “I encourage people to be as honest as they can with their healthcare team — that’s the only way you’ll be able to get the information you need,” says Bereolos. For example, if you’ve been eating a fast-food breakfast five days a week, tell your provider. “We will work with where you’re at and help you make a change that works for you,” she says.

4. Keep in Mind That Portion Size Still Matters

Weight management in diabetes is important for controlling blood sugar, blood pressure, and cholesterol, says Movsas. For that reason, even if you’re eating healthy foods, “portions matter. Excessive calories can come from overeating healthy foods like olive oil, whole grains, and beans,” she says. Drizzle vegetables in 1 tablespoon of olive oil (120 calories, 0 grams [g] carbs) or stick with a half cup of brown rice (119 calories, 25 g carbs) rather than eating unlimited amounts.

5. Know the Meaning of ‘Occasional’

Red meat (and even some of your favorite processed foods) is still an option when you go Mediterranean, but these foods are to be eaten “on occasion.” “My definition of ‘occasion’ is not three or four times per week. It’s one to two times per month,” says Bereolos. If you eat more in the beginning — that’s okay. She doesn’t want you to feel guilty or regretful, just move forward and take steps toward the goal of eating in a more Mediterranean way.

A Summary on Going Mediterranean for Diabetes Prevention and Management

Begin to mesh the Mediterranean diet into your life — swapping high-fat meats for beans, lentils, and fish, adding more fruits and vegetables to your plate, and making most of your grains whole — and you should see big improvements in diabetes control and your health.

Additional reporting by Diana Rodriguez.

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