Why Doctors Love the Mediterranean Diet - and You Should, Too

You’ve probably heard of the Mediterranean diet and how it can help you keep your weight stable and live healthier and longer. The buzz first started in the 1990s and hasn’t let up since — in fact, more and more studies confirm the health benefits of traditional Mediterranean foods.

“The Mediterranean diet is one of the best researched for health benefits,” says Sara Baer-Sinnott, president of Oldways, a Boston-based nonprofit that promotes health through cultural food traditions. “It’s better for the environment, better for human health, and it’s delicious. I think people have to realize that healthy food can be delicious. It’s not a punishment to eat a healthy diet. I think it’s a way everybody could eat.” IIf you’re not familiar with the Mediterranean diet, you’re in for a treat — this isn’t one of those fly-by-night fad diets, but the traditional cuisines of Italy, Spain, Greece, Morocco, and other countries that border the Mediterranean Sea, loved the world over for their delicious flavors.

Read on to learn why this food has such staying power with nutrition experts, and how you can take small steps to eat, and live, more like people in the Mediterranean traditionally do.

The basics

Although there’s some variety in different countries and regions of the Mediterranean, the food has a few things in common:

• Fruits and vegetables — lots of them. Nutritionists often refer to the Mediterranean diet as “the poor man’s diet.” People here eat what they can afford — whatever grows nearby and is in season. Vegetables form the cornerstone of every meal, and fruit features heavily in desserts.

• Beans and legumes like lentils, chickpeas, and fava beans, which are packed with fiber, protein, vitamins, and minerals.

• Whole grains, such as farro and bulgur (types of wheat) are a great source of complex carbs, fiber, vitamins, and minerals.

• Seafood is an important source of protein. Fish like sardines, tuna, and salmon also contain heart-healthy omega-3 fatty acids.

• Red meat and dairy — but only a little. Mediterranean cuisines often use red meat as a seasoning rather than as the star of the meal. Ditto for dairy — their cheeses are so flavorful, you only need a little.

• Olive oil as a main source of fat, used to cook and dress salads. Extra virgin, the least processed variety, retains the most nutrients and may be good for regulating blood sugar and cholesterol levels.

• Nuts such as almonds, walnuts, and pistachios, are a source of healthy fats, protein, minerals, and other nutrients.

• Herbs and spices like garlic, thyme, and cumin, whose rich flavors and aromas allow them to replace some salt — and they’re loaded with minerals and antioxidants to boot.
• A little wine. In European countries, wine is part of daily life. Studies show that moderate drinking (up to a glass a day for women and two glasses for men) can benefit the heart.

The Mediterranean diet is more than just a diet, though — it’s a way of life. Besides choosing quality ingredients, people in Mediterranean countries also:

Enjoy their food. People in Mediterranean countries tend to sit down and enjoy meals with loved ones, not in front of their laptops or on their way out the door. It’s also rare for restaurants or cafes to offer food to go. As a result, people savor their food, leaving them satisfied and less likely to overeat.

Eat with others. Making meals a social event can reduce stress and might help you live longer. People in Ikaria, Greece, and Sardinia, Italy — identified as Blue Zones, regions with high concentrations of people who live to 100 or more — regularly eat with friends and family.

Watch their portions. To stretch out food budgets, it’s helpful to cut out red meat and other pricey foods, but also to eat less in general. Lunch is often the biggest meal in these countries — enough fuel for the rest of the workday, no afternoon snack needed. Dinner is often small and late.

Stay active. Even as they get older, people in these countries stay active by walking, cooking, gardening, and doing housework. It helps to live in a walkable towns and cities with good weather year-round.

The health benefits

People in parts of the Mediterranean tend to live longer and suffer less from age-related chronic ailments — which a large body of research says might have a lot to do with what they eat. So far, studies suggest that the Mediterranean diet could help you:

• Lose weight. A review of 16 studies showed that the Mediterranean diet can help people lose weight.
• Boost heart health. A 2014 study of 8,000 men and women in their 60s and 70s found that compared with those on a low-fat diet, those who followed a Mediterranean diet had less plaque build-up in their arteries. In a Spanish study of more than 7,000 people over 55, researchers reported that people on the most Mediterranean diet had a 30 percent lower risk of heart attack or stroke.
• Prevent diabetes. In a Spanish study that followed more than 13,000 people for more than four years, a Mediterranean diet reduced the odds of developing diabetes by up to 83 percent. In another review of 19 studies, researchers found that the diet lowers fasting glucose and A1C levels in people who already have diabetes.
• Cut cancer risk. In a 2015 trial of 4,000 women aged 60 to 80, a Mediterranean diet with four tablespoons a day of extra virgin olive oil lowered risk of breast cancer. Other studies have linked the diet to a lower risk of endometrial and colorectal cancers.
• Fight inflammation and arthritis. Studies show that this diet can fight inflammation and improve symptoms of rheumatoid arthritis. Mediterranean diets also have many foods in common with the anti-inflammatory diet promoted by the Arthritis Foundation.
• Protect your eyes. Researchers in Massachusetts followed more than 2,500 people for 13 years and found that a Mediterranean diet helped reduce the risk of blindness (from age-related macular degeneration) by 26 percent.
• Keep your mind sharp. Studies show that a Mediterranean diet, especially with additional servings of nuts and extra virgin olive oil, could prevent age-related memory loss and Alzheimer’s.

How to go Mediterranean

Photos courtesy of Paul Canales

Forget bland food and strict rules. The Mediterranean diet is easy and practical, not to mention delicious. “There’s a certain comfort to it,” says Paul Canales, chef and co-owner of Duende, a Spanish restaurant in Oakland, California. He recalls the simple, savory lunches of fish and bean soups that his father, originally from Spain, would make on weekends. “It’s very simple, approachable, satisfying, and also very flavorful.”

Here’s how to work Mediterranean elements into your food.

Focus on fruits and veggies. Eyeball your plate. Fruits and vegetables should fill about half, fish, beans, or other protein should fill a quarter, and whole grains another quarter.

Swap out foods that don’t fit the diet with those that do — or at least come closer. (If you eat like a typical American, you’ll want to cut down on red meat, refined grains, and dairy fat like butter.) “In the beginning, try things that aren’t all that Mediterranean,” says Washington, DC–based dietitian Janis Jibrin. You could substitute steak with fish tacos, make quinoa or polenta instead of white rice, and so on.

Here are some more ideas from Jibrin and others. Instead of...

• French toast ... try eggs scrambled in olive oil with a slice of whole grain bread
• donuts or pastries ... try ripe, seasonal fruit topped with a dollop of yogurt, honey, and chopped nuts
• chips ... try popcorn cooked in olive oil
• crackers and cheese ... try carrots with greek yogurt dip (just add salt, pepper, and garlic); pita bread with hummus
• cookies ... try a handful of nuts and dried fruits
• mayonnaise ... try hummus, avocado, or seed butter like tahini or sunflower butter
• hamburger ... try salmon, turkey, or bean burgers (you can also try replacing half the beef with black beans)
• spaghetti and meatballs ... try spaghetti squash or a whole grain pasta with sundried tomatoes, lemon juice, herbs and olive oil. Or pasta puttanesca with tangy tomato sauce with anchovy paste and olives.

Take shortcuts. Short on time, or feeling less-than-confident in the kitchen? Keep it simple. Buy pre-cut produce. Invest in a slow cooker or pressure cooker for beans. You can find any number of easy recipes online at sites like epicurious.com or Cooking Light.

Recipe: Canales’ quick ensalada de col (cabbage salad): Add one part champagne vinegar (or any white wine vinegar) to two parts olive oil, and mix in chopped garlic and a little cream. Drizzle over thinly sliced Savoy cabbage, and top with chopped green olives, pistachios or almonds, and grated Mahón cheese (a sharp, buttery cheese similar to good white cheddar).

Plan ahead. Spend Sunday prepping some meals for the week. Throw some beans into the slow cooker. Buy three to four days’ worth of produce at the farmer’s market, and spend two hours chopping, cooking, and bagging them. Keep a couple of cans of tuna on hand. “Then when you come home from work, it’s not a big burden,” Canales says. “You can have a rippin’ salade nicoise and a little glass of rosé.” Sick of salad? Dress it with salad dressing or curry paste and wrap in a slice of whole wheat lavash or other flatbread.

Spend smart. Eating healthy can be expensive — but it doesn’t need to be. To get the most bang for your buck, choose dry beans over canned, buy from the bulk bins, grow some herbs, and choose what’s local and in season. “Don’t be afraid of frozen vegetables or fruit,” which are picked and frozen at peak ripeness, when they pack the most nutrients, says Kristin Kirkpatrick, a wellness manager at the Cleveland Clinic Wellness Center.

Be mindful. Pay attention to your body before you reach for seconds. Set your fork down occasionally, and chew more. “Slow down and taste your food,” Canales says. “Relax. Unplug…. Give yourself a little self-love.”

Sip some herbal tea. Take a cue from the Ikarians, and brew some antioxidant-rich herbal tea. Sage, oregano, and wild rosemary teas can also regulate blood pressure by flushing excess water and sodium from the body.

Try goat milk instead of cow milk. A staple of the Ikarian and Sardinian diets, goat milk contains more potassium, calcium, and magnesium than cow milk, and a little less lactose as well. You can find goat milk and yogurt in many markets.

Keep it fun. Take a voyage around the Mediterranean — serve Italian dishes one week, then Greek, and Moroccan the next. Make an adventure of wandering your local herb and spice shop.

Melissa Pandika is a freelance writer based in Oakland, California.

Editor: Deepi Brar

Selected references

• The Mayo Clinic. The Mediterranean Diet: A Heart Healthy Eating Plan. Mayo Clinic website.
• Harvard School of Public Health. Healthy Dietary Styles. The Nutrition Source.
• Oldways. Characteristics of the Mediterranean Diet. Oldways website.
• Esposito K, Kastorini CM, Panagiotakos DB, et.al. Mediterranean Diet and Weight Loss: Meta-Analysis of Randomized Controlled Trials. Metabolic Syndrome and Related Disorders. February 2011. [Link]
• Estruch R, Ros E, Salas-Salvadó J, et. al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. The New England Journal of Medicine. April 4, 2013. [Link]
• Esposito, K, Maiorino MI, Ceriello A, et al. Prevention and Control of Type 2 Diabetes by Mediterranean Diet: A Systematic Review. Diabetes Research and Clinical Practice. August 2010. [Link]
• Blue Zone Explorations: Ikaria and Sardinia. Blue Zones website.

MELISSA PANDIKA
Rally Health