RELATED: 8 Scientific Health Benefits of the Mediterranean Diet
How a Mediterranean Diet May Help You Manage Type 2 Diabetes
Overall, the Mediterranean diet offers more of the foods your body needs, such as vegetables, whole grains, and healthy fats, and less of what it doesn’t, including red meat, refined carbohydrates, and sugary fare, says Nicole M. Bereolos, PhD, MPH, a certified diabetes care and education specialist (CDCES) in Dallas. In past research published in the American Journal of Clinical Nutrition, scientists in the United Kingdom compared the Mediterranean diet with vegetarian, vegan, low-carbohydrate, high-protein, high-fiber, and low-glycemic index diets, and found that the Mediterranean diet came out on top. Study participants following Mediterranean, low-glycemic index, low-carbohydrate, and high-protein diets all experienced better blood sugar control, as was indicated by their lower A1C scores. (A1C is a measure of average blood sugar levels over a three-month period.) But people following the Mediterranean diet saw significant additional benefits — they lost the most weight and saw improved cardiovascular health, including better cholesterol levels. “The Mediterranean diet is rich in fruits and vegetables, and uses whole grains and lean protein, such as fish, as well as olive oil and nuts as the sources of fat,” says Betul Hatipoglu, MD, an endocrinologist with University Hospitals in Cleveland. “These healthy choices make the diet very rich in monounsaturated fat and fiber, and both have been known to lower cholesterol and blood sugar in people with diabetes.” 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 riceBarleyQuinoaBulgurFarroBuckwheatWheat berriesWhole-grain bread, rolls, tortillas, and pasta
Nuts, seeds, beans, and legumes
AlmondsWalnutsPistachiosCashewsSunflower seedsSesame seedsBeans (kidney beans, white beans, cannellini beans)ChickpeasLentilsPeasPeanuts
Vegetables
AvocadosBell peppersBrussels sproutsAsparagusTomatoesLeafy greens (spinach, lettuce, kale, collards)BroccoliCabbageCucumbersEggplantsLeeksArtichokeBeetsCarrotsCeleryFennelRadishOnionsZucchini
Fruits
MelonsFigsDatesGrapesPomegranatesCitrus fruits (oranges, lemons, grapefruit)Berries (raspberries, blueberries, blackberries)Apples
Healthy fats
OlivesOlive oil
Drinks
WaterCoffeeTeaWine (in moderation)
Fresh fish and seafood
SalmonSardinesHalibutShrimpMusselsAlbacore tunaTroutMackerelHerring
Healthy dairy, eggs, and poultry
Reduced-fat cheeseLow-fat or nonfat yogurtLow-fat or nonfat milkEggsPoultry (chicken, turkey, etc.)
Herbs and spices
BasilGarlicCuminClovesCinnamonChili powderSaffronMintGingerOreganoNutmegRosemary
Foods to Limit on the Mediterranean Diet
BeefLambPorkBurgersButterSweets (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 foodSoda 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.
