Why is the Mediterranean Diet healthy?
What is the Mediterranean diet?
The Mediterranean diet is based on the traditional foods and eating patterns of people in the Mediterranean region including Italy, Greece and Spain. Research has shown that people in these regions have lower rates of chronic disease due to the Mediterranean diet. The diet is predominantly plant-based with moderate amounts of lean proteins (including vegetarian proteins and seafood) and plenty of nuts, seeds and olive oil. Olive oil is rich in unsaturated fats, vitamin E and beta carotenes.
In a nutshell, the Mediterranean diet is based on whole foods, high in dietary fibre and healthy fats (especially Extra Virgin olive oil).
What foods does it include?
- Fruits and Vegetables
- Extra virgin olive oil (Oh, hi Goldi!)
- Whole Grain breads and cereals
- Legumes (think: chickpeas, lentils, kidney beans, black beans), nuts and seeds
- Fish and seafood
- Cheese, Yoghurt and milk
- Chicken or turkey
- Red wine (1-2 glasses with meals, if you choose to drink, no more than 10 per week)
- Red meat (include less often)
- Sweets or savoury snacks (include less often)
What foods aren’t allowed?
The best thing about the Mediterranean diet is that it doesn’t ban foods! Unlike fad diets that create food rules around what you can’t eat or certain times of the day to avoid food, the Mediterranean diet is about balance. The diet doesn’t stipulate foods to avoid or label anything as “bad”. Research shows that when we label foods “good” or “bad”, this increases feelings of guilt or emotion when eating certain foods. When you feel guilty about eating something, the natural reaction is to then try to restrict it next time. Considering a food “restricted” or “banned”, drives us to want it more and eventually overeat it when we next have access to it. Once you overeat it and feel “bad” about it, it kicks off the cycle of restriction and overeating once again. This creates disordered eating patterns but also sets up the diet to fail, as it’s not sustainable.
On the other hand, the Mediterranean diet classifies foods as “daily”, “weekly” or “sometimes” foods. This creates a healthier relationship with foods as well as makes this diet more of a sustainable approach to eating.
What are the health benefits of the Mediterranean Diet?
Cardiovascular disease risk
Replacing foods high in saturated fat (butter, cream) with sources of unsaturated fat (olive oil), reduces levels of LDL cholesterol in our bloodstream (1) This is the kind of cholesterol that can lead to fatty plaques and deposits, increasing the risk of heart attack and stroke. Increasing soluble fibre in the diet (oats, nuts, seeds, legumes, fruits and vegetables) also helps to lower cholesterol levels (2). Following a Mediterranean diet not only reduces cholesterol levels but an overall reduction in rates of coronary heart disease, ischemic stroke and cardiovascular disease. (3)
Blood sugar levels
The inclusion of legumes has been shown to have positive effects on blood sugar levels with one study showing a 20% reduction in blood glucose when half of the high GI starch was replaced with lentils. (4) By including wholegrains such as wheat pasta, seedy bread or long grain rice, this increases the fibre content of the diet. Fibre has been shown to reduce the rise in blood sugar levels post meals (5). Studies have shown a decrease in not only fasting blood sugar levels but also haemoglobin A1C levels (long-term average blood sugar) when following the Mediterranean diet. (6).
While this remains a new area of research, more and more evidence is emerging about the role of the gut microbiome in mental health. To promote a healthy gut microbiome, one should focus on getting a variety of high-fibre foods such as whole grains, fruits and veggies (all of which the Mediterranean Diet promotes). Other tips for a healthy gut include getting plenty of sleep, physical activity and managing stress. One 2019 study (7) looked at the effect of the Mediterranean Diet on depressive symptoms and found at 3 months, participants in the Mediterranean diet group reported a greater reduction in depressive symptoms and improved mental health and quality of life. A similar study in 2017 showed similar results. (8)
Finally, there have been positive associations between sleep quality and the Mediterranean diet. A study of 1936 individuals living in Catania, Italy, investigated sleep quality and found 68% of the cohort reported high sleep quality, with this score increasing with each additional marker of the Mediterranean diet score. (9) Similar results were seen in the Hellenic Longitudinal Investigation of Aging and Diet (10).
How does it compare to the Australian Dietary Guidelines?
- Meat and alternatives: Compared with the Australian dietary guidelines (ADG), the Mediterranean diet focuses on less red meat, with a weekly limit of 80-100g, compared with the 450g weekly limit in the Australian guidelines. Instead, the preference for protein is chicken, turkey, fish, legumes or eggs.
- Dairy: The serve sizes for calcium are the same as the ADG, aiming for around 2 serves daily from cheese, yoghurt and cow milk.
- Fruit: The Mediterranean diet includes extra fruit (2-3 serves, compared with 2 serves per the ADG) with each serve equalling 1 whole piece or 1 cup diced or 1½ tablespoons dried.
- Veggies: The vegetable/salad quota is the same for both the Mediterranean diet and ADG with a daily recommendation for 5 serves (1 serve = ½ cup of cooked vegetables or 1 cup of salad/raw vegetables). The Mediterranean diet further specifies to include leafy greens and tomatoes every day.
- Grains: This category remains the same as the ADG, recommending 4-6 servings per day (1 serve = 30g cereal, 1 slice of bread, 1 small wrap, ½ cup cooked rice or pasta). Both diets focus on high fibre options such as grainy bread or whole oats.
Sourced from: https://dietamediterranea.com/en/nutrition/
What else is important?
When looking at the Mediterranean diet, it’s important to consider not only what foods are included but how they are eaten. A Mediterranean-style meal is usually consumed with family, friends and loved ones. Eating in this style focuses on flavour, enjoyment and celebration of good quality, local and seasonal produce.
The meal is usually served family meal style, with shared plates and dishes on the dining table for every member to help themselves. This style of eating has been shown to assist fussy eating also by creating choice within limited options. Dishing up your own meal, also allows you to eat to your appetite, honouring your internal body cues, rather than just finishing what’s on the plate.
The Mediterranean diet pyramid (above) references other important aspects of the food focusing on traditional, local, eco-friendly products, as well as biodiversity and seasonality. It talks about culinary activities, celebrating not only the food itself but the process of preparing, cooking and serving the food. The pyramid acknowledges the importance of not only physical activity but also rest. The final point of “conviviality” refers to being friendly, and lively together and I like to think that refers to not only how one should approach life but also food, sharing food with festivity and cheer!
How can I incorporate the Mediterranean Diet into my day?
- Rolled oats with blueberries and almonds
- Untoasted muesli with natural yoghurt and grated apple
- Poached eggs with grilled tomato on multigrain toast, drizzle with olive oil
- Ricotta and Fig Toast: https://www.tastegoldi.com/read/ricotta-and-fig-toast/
- Tuna or cannellini bean salad with spinach, tomato and cucumber (dressing: balsamic vinegar and olive oil or lemon juice, tahini and olive oil)
- Heirloom Tomato Salad and Balsamic Vinegar: https://www.tastegoldi.com/read/heirloom-tomato-salad-balsamic-glaze/
- Chicken, avocado and salad wraps
- Broccoli, pesto and ricotta wholemeal pasta salad
- Basil Pesto Pasta with Easy Peasy Olive Squeezy Kale Salad: https://www.tastegoldi.com/read/easy-peasy-olive-squeezy-kale-salad
- Lentil and vegetable soup
- Homemade pizzas (go for a wholemeal base) and add plenty of olive oil and veggies (think zucchini, goats cheese, toasted almonds and mint).
- Salmon with broccolini, avocado and roast potatoes.
- Veggie sticks with cottage cheese or hommus
- Fruit salad with greek yoghurt
- Trail mix of dried fruit and nuts
- Herby popcorn https://fb.watch/etYmQqQskE/
Pulling it all together
- Use olive oil as your main source of fat (get liberal with Goldi!)
- Include plenty of fruits and vegetables (dress those salads with Aceto!)
- Serve whole grains at each meal
- Include dairy or calcium-rich alternatives daily
- Limit red meat
- Include legumes and oily fish in abundance
- Eat locally and seasonally
- Be active every day
- Enjoy your food!!
- Mousavi, S.M., Jayedi, A., Jalilpiran, Y., Hajishafiee, M., Aminianfar, A. and Esmaillzadeh, A., 2022. Dietary intake of total, animal and plant proteins and the risk of coronary heart disease and hypertension: a systematic review and dose-response meta-analysis of prospective cohort studies. Critical Reviews in Food Science and Nutrition, 62(5), pp.1336-1349.
- Hewat, C., Colquhoun, D. and Clifton, P., Dietary intervention to lower serum cholesterol. Drugs, 10(15), p.10.
- Martínez-González MA, Gea A, Ruiz-Canela M. The Mediterranean Diet and Cardiovascular Health. Circ Res. 2019 Mar;124(5):779-798. doi: 10.1161/CIRCRESAHA.118.313348. PMID: 30817261.
- Dita Moravek, Alison M Duncan, Laura B VanderSluis, Sarah J Turkstra, Erica J Rogers, Jessica M Wilson, Aileen Hawke, D Dan Ramdath, Carbohydrate Replacement of Rice or Potato with Lentils Reduces the Postprandial Glycemic Response in Healthy Adults in an Acute, Randomized, Crossover Trial, The Journal of Nutrition, Volume 148, Issue 4, April 2018, Pages 535–541, https://doi.org/10.1093/jn/nxy018
- Clarke, S.T., Sarfaraz, S., Qi, X., Ramdath, D.G., Fougere, G.C. and Ramdath, D.D., 2022. A Review of the Relationship between Lentil Serving and Acute Postprandial Blood Glucose Response: Effects of Dietary Fibre, Protein and Carbohydrates. Nutrients, 14(4), p.849.
- Sleiman D, Al-Badri MR, Azar ST. Effect of Mediterranean diet in diabetes control and cardiovascular risk modification: a systematic review. Front Public Health. 2015 Apr 28;3:69. doi: 10.3389/fpubh.2015.00069. PMID: 25973415; PMCID: PMC4411995.
- Parletta N., Zarnowiecki D., Cho J., Wilson A., Bogomolova S., Villani A., Itsiopoulos C., Niyonsenga T., Blunden S., Meyer B., Segal L., Baune B.T., O’Dea K. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED). Nutr. Neurosci. 2019;22(7):474–487. doi: 10.1080/1028415X.2017.1411320.
- Jacka FN, O'Neil A, Opie R, et al. A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial). BMC Med. 2017;15(1):23.
- Godos J, Ferri R, Caraci F, Cosentino FII, Castellano S, Galvano F, Grosso G. Adherence to the Mediterranean Diet is Associated with Better Sleep Quality in Italian Adults. Nutrients. 2019; 11(5):976. https://doi.org/10.3390/nu11050976
- Mamalaki, E., Anastasiou, C. A., Ntanasi, E., Tsapanou, A., Kosmidis, M. H., Dardiotis, E., ... & Yannakoulia, M. (2018). Associations between the Mediterranean diet and sleep in older adults: Results from the Hellenic longitudinal investigation of aging and diet study. Geriatrics & gerontology international, 18(11), 1543-1548.