The Mediterranean diet

The Mediterranean diet is an eating pattern that draws its tenets from the food habits of people living in the Mediterranean regions of Greece, France, Spain, Portugal, and Italy.  It is found that people who follow the Mediterranean lifestyle and diet demonstrate less chance of developing chronic disorders including cancer, cardiovascular disorders, and stroke.

Health benefits of the Mediterranean diet

1. Adherence to the Mediterranean diet has been associated with reduced risk of cancer mortality and a decrease in the risk of several types of cancers especially prostate, gastric, colorectal and breast cancer.
2. It improves glycemic control among patients with type 2 diabetes and reduces the risk of cardiovascular complications.
3.  Several studies have shown that observance of the Mediterranean diet is associated with reduced risk for cardiovascular disorders and stroke.
4.  Research studies show that adherence to the Mediterranean diet and monitoring the diet is beneficial for attaining weight loss when compared to the low-fat diet. 

The Mediterranean diet pyramid

Components of the Mediterranean diet

The Mediterranean diet is a combination of dietary elements and lifestyle modifications. It consists of:

• Whole, unprocessed fruits and vegetables, and whole grains to be consumed daily.
• Healthy fats in the form of olive oil.
• Fish, poultry, and eggs to be consumed weekly.
• Intake of dairy products in moderation.
• Occasional intake of red meat, and sweets.
• Red wine in moderation with meals.
• Adding herbs and spices instead of salt and fats for taste.
• Sharing meals with family and friends.
• Being physically active.

Recommended foods

Vegetables	Non-starchy vegetables: Artichoke, Cucumbers, beets, asparagus, cabbage, Tomatoes, Brussels sprouts, broccoli, kale, onions, spinach, cauliflower, zucchini, mushrooms, salad greens, etc.
Fruits	Fresh fruits such as melons, apples, oranges, pears, peaches, strawberries, grapes, figs, dates, etc.
Whole grains	brown rice, whole oats, whole wheat, barley, corn, buckwheat
Legumes	chickpeas, pulses, lentils, beans, peas, etc.
Tubers	Yams, potatoes, sweet potatoes, turnips, etc.
Nuts and seeds	Almonds, peanuts, cashews, walnuts, Brazil Nuts, macadamia nuts, sunflower seeds, pumpkin seeds.
Fats	Extra virgin olive oil, avocado, olives, sunflower oil.
Fish	Oily fishes such as sardines, trout, tuna, salmon, herring, mackerel, etc. clams, oysters, mussels, shrimp and crab.
Poultry and eggs	Chicken, duck, turkey, etc. Eggs: duck eggs, chicken eggs, and quail eggs.
Dairy products	unprocessed cheese, Greek or plain yogurt
Herbs and spices	Basil, mint, sage, rosemary, cinnamon, nutmeg, pepper, garlic, etc.
Beverage	Drink plenty of water. Tea and coffee may be consumed without adding sweeteners.

Foods to avoid

• Sweetened foods: candies, table sugar, ice cream, sweetened fruit juices and drinks and so on.
• Refined and processed grains and foods: white bread, white rice, pasta from refined wheat, etc.
• Saturated fats and trans fats: butter, margarine.
• Hydrogenated and refined oils: palm oil, canola oil, cottonseed oil, and others.
• Processed meat: sausages, salami, hot dogs, cured bacon, etc.

Nutrients in the Mediterranean diet

The essential nutrients present in the Mediterranean diet include:

• Healthy fats: Substituting the intake of saturated fats with monounsaturated fats and polyunsaturated fats prevent cardiovascular disorders and obesity. Olive oil, the primary source of fat in the Mediterranean diet is a rich source of monounsaturated fat.
• Fiber: Fiber is essential for good digestion and therefore is believed to reduce the risk for bowel cancers, diabetes, and cardiovascular disorders. Fruits, vegetables, legumes and whole grains in the Mediterranean diet are rich sources of fiber.
• Vitamins and minerals: fruits and vegetables are rich sources of vitamins and minerals. Lean meats provide the essential vitamin B12.
• Antioxidants: antioxidants play a major role in preventing diseases such as cancer arising from the accumulation of free radicals. Plant-based foods are rich in antioxidants.

Sample meal plan

Sample menu for a day based on the Mediterranean diet:

Breakfast: Yoghurt with slices of fruits and nuts.

Lunch:  Whole grain sandwich with vegetables and a piece of fruit

Afternoon snack: Berries or grapes

Dinner: Poached salmon with brown rice and stir-fried vegetables in olive oil.

Dessert: Apple slices with almond butter or any fruit

References

Schwingshackl, L., Schwedhelm, C., Galbete, C., & Hoffmann, G. (2017). Adherence to Mediterranean Diet and Risk of Cancer: An Updated Systematic Review and Meta-Analysis. Nutrients, 9(10), 1063. https://doi.org/10.3390/nu9101063

Esposito, K., Maiorino, M.I., Bellastella, G. et al. (2017). Mediterranean diet for type 2 diabetes: cardiometabolic benefits. Endocrine 56, 27–32. https://doi.org/10.1007/s12020-016-1018-2

Gepner, Y., Shelef, I., Komy, O., et al. (2019). The beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content. Journal of hepatology, 71(2), 379–388. https://doi.org/10.1016/j.jhep.2019.04.013

Lăcătușu, C. M., Grigorescu, E. D., Floria, M., Onofriescu, A., & Mihai, B. M. (2019). The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription. International journal of environmental research and public health, 16(6), 942. https://doi.org/10.3390/ijerph16060942

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