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Mediterranean Diet Promotes Heart Health and Diabetes Management

Updated on February 26, 2013

About the Author

As a health care professional for more than 30 years, I've always had an interest in nutrition. As a recently diagnosed type 2 diabetes, my interest in nutrition has become personal as well as professional. My doctor recommended following the Mediterranean style diet to gain improved control over blood sugar levels, thus began my quest to learn all I could about this eating style.

Mediterranean Diet: One of the Best Eating Styles for Your Health

The Western world has added much to the lives of others through science, culture and more, but in terms of nutrition--not so much. As other parts of the world adapt their eating styles to that of the Western world--chiefly the United States--the incidence of obesity, cardiovascular disease and metabolic syndrome has skyrocketed due to those adaptations.

Health experts recognized that the traditional diet/eating style of people living in Crete, Greece and southern Italy in the early 1960s promoted low levels of chronic health conditions and longevity in a part of the world where medical care was limited. In 1993, the Harvard School of Public Health, Oldways and the European Office of the World Health Organization introduced the Western world to the traditional Mediterranean pattern of eating in Cambridge, Mass.

Since that time, much study has been devoted to understanding and pinpointing the details of both the eating patterns and the lifestyle of this relatively small portion of the world that promotes health and longevity. Some of that study has proven through vigorous research that the food choices and lifestyle of the Mediterranean diet reduce the risk for cardiovascular disease. The American Heart Association promotes the Mediterranean diet and lifestyle as being heart-healthy--a significant endorsement by a valued health source.

This is but one example of how scientific study is demonstrating the health -- and life -- value of the Mediterranean diet.

Features of Mediterranean Style Diet

Nuts and whole grains are important features of the Mediterranean style diet.
Nuts and whole grains are important features of the Mediterranean style diet. | Source
Fruits and vegetables, olives and their  oil and minimal dairy comprise a significant portion of this style of eating.
Fruits and vegetables, olives and their oil and minimal dairy comprise a significant portion of this style of eating. | Source
Creative use of seasonings and spices reduces the need for added salt.
Creative use of seasonings and spices reduces the need for added salt. | Source

Mediterranean Diet Eating Pattern

The Mediterranean style diet advocates eating a diet rich in fruits and vegetables, beans, grains, nuts and seeds. Dairy in the form of yogurt or cheese is in the daily diet in low to moderate amounts. Fish, poultry and eggs replace red meat for the most part. This diet style is low in saturated fat, with most of the fat coming from olive oil and nuts. Daily physical activity is also part of the lifestyle.

If you're considering changing your eating habits to something healthier, the Mediterranean style diet's choices and patterns may fit the bill. Remember, you don't have to change everything at once. You can make diet and lifestyle adaptations gradually, perhaps by adding more fruits to your daily diet initially or switching from vegetable oil to olive oil for your cooking. As you begin to make healthier food and physical activity choices, you'll feel empowered to be in charge of your health.

If you're looking for authentic Mediterranean/Greek recipes, consider visiting Elena Paravantes' blog. Paravantes is a registered dietitian and a Greek-American. Her information will aid you in making changes in your eating style to a more Mediterranean style.

Mediterranean Food Pyramid


Mediterranean Diet Proven to Decrease Heart Disease Risk

In the largest research study done to date to determine the long-term outcomes for heart health as the result of following a specific type of diet/eating style, medical experts found that participants with high risk factors for heart disease responded favorably after following the Mediterranean diet for a median period of more than four years.

Over 7,000 people were involved in the study. To qualify as a participant, men had to be between the ages of 55 years to 80 years; women had to be between the ages of 60 years to 80 years.

None of the participants could have cardiovascular disease prior to the start of the trial and each had to have known high risk factors for the development of heart disease. Participants either had to have type 2 diabetes or three of these other high risk factors: overweight or obesity, be an active smoker, high blood pressure, have a family history of premature coronary artery disease, low HDL cholesterol level, high LDL cholesterol level.

The chosen participants were then randomly assigned to follow one of three diets: 1) The control diet, a low-fat diet 2) Mediterranean diet with added extra virgin olive oil or 3) Mediterranean diet with added nuts -- either walnuts, hazelnuts or almonds.

The Mediterranean diet with added extra virgin olive oil participants were directed to take in at least four tablespoons of the oil daily, while the participants following the Mediterranean diet with added tree nuts were directed to eat at least one-quarter cup per day of the supplied nuts.

Up until the results of this study, most research seemed to point in the direction of a low-fat diet to promote heart health. The results demonstrated in this study showed that what matters is the type of fat consumed; participants following the two Mediterranean diets exhibited a 30 percent reduction in heart attacks, strokes and death over the seven-year study period compared to those following the control diet.

The conclusion reached by the research is that following a Mediterranean style diet for people with high risk factors for heart disease resulted in a "substantial reduction in the risk of major cardiovascular events"* and should be considered a front-line tool in the prevention of heart disease in high-risk individuals.

* New England Journal of Medicine, "Primary Prevention of Cardiovascular Disease with a Mediterranean Diet," Feb. 25, 2013.

Recipe: Lemon Cilantro Shrimp Stir Fry

Recipe: Tabbouleh

Great Couscous Recipe

Mediterranean Diet: A Proven Weapon Against Metabolic Syndrome

Metabolic syndrome, also called insulin resistance syndrome, is a group of risk factors that predispose a person to the development of type 2 diabetes, stroke and coronary artery disease. With the rise of obesity in the United States and other countries where the typical American diet is followed has come a rise in metabolic syndrome and the chronic illnesses related to the syndrome's risk factors.

In an article published in the "American Journal of Clinical Nutrition" December 2009, a group of researchers from Tufts University in Boston, Massachusetts wrote that a Mediterranean style diet may protect against metabolic syndrome in Americans.

In a more recent study, a meta-analysis of 50 studies that included more than 500,000 study participants published March 2011 in the "Journal of American College of Cardiology" found that the classic Mediterranean pattern of eating reduced health factors associated with insulin resistance such as both systolic and diastolic blood pressure, waist circumference, and HDL and triglyceride levels, as well as decreasing the incidence of insulin resistance itself. The researchers concluded their published results with this statement: "These results are of considerable public health importance, because this dietary pattern can be easily adopted by all population groups and various cultures and cost-effectively serve for primary and secondary prevention of the MS and its individual components."

Research Correlates Mediterranean Diet with Liver Health

In a first of its kind study, researchers in Melbourne, Australia's St. Vincent's Hospital followed 12 study participants for six weeks, monitoring the effects of the Mediterranean diet versus the National Heart Foundation diet. Each of the study participants was verified to have non-alcoholic fatty liver disease via liver biopsy prior to the study.

After the six week period, participants who had followed the Mediterranean diet experienced a 39 percent decrease in liver fat; those following the heart diet had no significant change in liver fat. The Mediterranean diet also increased insulin sensitivity after the trial, an important factor in preventing the onset of type 2 diabetes.

Interestingly, the participants following the Mediterranean diet experienced these improvements even in the absence of weight loss.

In other research, scientists looked into the correlation between monounsaturated fats, particularly olive oil -- the major fat in the Mediterranean diet -- with non-alcoholic fatty liver disease. This disease, often associated with metabolic syndrome/insulin resistance, can develop into cirrhosis or fibrosis of the liver.

Researchers determined that olive oil's health benefits extended beyond it merely being a monounsaturated fat; its polyphenols also provide protection such as aiding in improved glycemic tolerance. Olive oil has also been determined to have anti-inflammatory and antioxidant properties. Finally, olive oil's principle benefits were noted to be its ability to decrease LDL oxidation and improvement of insulin resistance -- both important factors in preventing or reducing non-alcoholic fatty liver disease.

Mediterranean Area

show route and directions
A markerCrete -
Crete, Greece
get directions

B markerNaples, Italy -
Naples, Italy
get directions

Classic Mediterranean Diet as a Diabetic Diet

The incidence of diabetes, especially type 2 diabetes, has increased nearly proportionately with the rate of overweight and obesity in the United States and elsewhere. Diet and nutrition are central in the control and management of this chronic illness.

The classic Mediterranean diet eating pattern was recommended to me by my health care provider three years ago when first diagnosed with type 2 diabetes. My own results have been positive, with improved blood sugar levels with fewer high and low spikes. But the results of any one individual is far from scientific proof, but fortunately there is research that suggests my experience is not unexpected.

In the Sept. 2009 "Annals of Internal Medicine," researchers compared the effects of a Mediterranean style diet with that of a low-fat diet on blood glucose control and the need for initiation of antihyperglycemic drug therapy as well as weight loss. More than 200 study participants who were overweight, diagnosed with type 2 diabetes and had never been prescribed anti-diabetic medication.

After four years, 44 percent of those who adhered to the Mediterranean style diet required prescription treatment for the diabetes compared with 70 percent of those who adhered to the low-fat diet. In addition, those who followed the Mediterranean diet also lost more weight and had some increased blood sugar control and improvement in coronary risk measures than their counterparts who followed the low-fat diet.

In Jan. 2013, "The American Journal of Clinical Nutrition" published results of a review and meta-analysis assessing the effect of various diets on blood sugar, glycemic, control, weight loss and lipid levels. Among the various diets studied for this comparison were the Mediterranean, vegetarian, vegan, low-carbohydrate, American Diabetes Association, European Association for the Study of Diabetes, low-protein and others.

The Mediterranean diet was the only one of those studied that not only improved glycemic control, improved weight loss and an increase in HDL cholesterol levels, gaining this eating style a recommendation for consideration of use in overall diabetic therapy.

Mediterranean Diet May Sustain Cognitive Function

A recent study performed at Rush University Medical Center looked into the dietary habits and cognitive function of almost 4,000 Midwesterners aged 65 and older. The study scored the participants on how well they followed the traditional Greek diet and another score for how well they adhered to the 2005 Dietary Guidelines for Americans.

The study, funded by the National Institute on Aging, re-tested study participants' cognitive functions and relation of scores for both the Mediterranean diet and U.S. dietary guidelines every 3 years, with an average follow-up time for each participant of more than seven years. The research team found that higher scores for adherence to the Mediterranean diet resulted in the smallest declines in cognitive function, while such scores on adherence to U.S. dietary guidelines did not. This suggests that the Mediterranean diet may be useful in slowing cognitive decline. Further studies will need to be done before definitive determinations can be made.

Update Oct. 7, 2012: Australia researchers, using data from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing cohort, determined that the older adults who most closely adhered to the Mediterranean diet had significantly lower incidence of Alzheimer's disease and mild cognitive impairment.

Why can't scientists make up their collective mind as to whether the classic Mediterranean eating pattern aids in keeping or promoting cognitive function? Part of the dilemma is that all research conducted has not come to the same conclusions. For example, a French study published Jan. 2013 in "The American Journal of Clinical Nutrition" that followed over 3,000 study participants found no significant differences in the cognitive functions of those who followed the Mediterranean style diet than those who did not. For now, these results bring into question earlier research with different conclusions.

Mediterranean Diet and Skin Cancer

The results of a study published in the peer-reviewed journal, Nutrition Reviews, discusses the potential that a diet rich in antioxidants and omega-3 fatty acids, as is the Mediterranean/Greek diet, may afford protection against the development of melanoma -- the most lethal form of skin cancer.

Dr. Niva Shapira noted the lower incidence rate of melanoma in the Greek as compared to other regions of the world with similarly sunny climates. Shapira notes that a diet rich in olive oil, fish, and fresh fruits and vegetables provides the antioxidant power to combat the oxidizing damage of the sun.

In June 2011, in "Cancer Letters," researchers identified carnosol, a substance present in many of the herbs used frequently in Mediterranean cooking such as rosemary, oregano, sage and parsley has been evaluated and found to be have anti-cancer properties in several types of cancer, including skin cancer. Further research will be needed to determine carnosol's value as a cancer protection agent and perhaps as a cancer treatment.


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    • L.L. Woodard profile image

      L.L. Woodard 5 years ago from Oklahoma City

      Skgrao, that might be an excellent topic for one or more hubs!

    • skgrao profile image

      S K G Rao. 5 years ago from Bangalore City - INDIA.

      No Sir I have not written on Jain Food.

    • L.L. Woodard profile image

      L.L. Woodard 5 years ago from Oklahoma City

      Skgrao, thanks for this information on Jain Food. I'll have to do some research and learn more about it. Is this something you have written about in a hub?

      Thanks for the read and comment.

    • skgrao profile image

      S K G Rao. 5 years ago from Bangalore City - INDIA.

      I have read some where that in one community in India 80% of men & women are found to have no diabetes with Indian Food not available in many restaurants.The 20% ate other than their community food.It's Called Jain Food.

    • L.L. Woodard profile image

      L.L. Woodard 5 years ago from Oklahoma City

      @healthylife2: Although one style of eating usually doesn't fit everyone, there are so many of us who can benefit from learning about and following the Mediterranean style of diet. I appreciate your comments, vote and Sharing.

      @RTalloni: Dieting, in the accepted sense of the word, isn't a realistic way to live, so many folks who diet to lose weight simply return to old habits when the "diet" is over. I agree with you; healthy eating is the way to go. Thank you for your read and comments.

    • RTalloni profile image

      RTalloni 5 years ago from the short journey

      Thanks for this interesting look at the benefits of following the mediterranean diet (way of eating). Healthy eating, as opposed to dieting, is one of the major keys to a healthful life and you provide some good information here.

    • healthylife2 profile image

      Healthy Life 5 years ago from Connecticut, USA

      I found this so interesting since I have heard so much about this diet. Very interesting how beneficial it is for fatty liver disease and possibly to protect against skin cancer. Regardless this diet could benefit many people because it is overall very healthy. Voted up and shared.

    • L.L. Woodard profile image

      L.L. Woodard 5 years ago from Oklahoma City

      Sandeep, I'm pleased to know you found the information in this hub on the Mediterranean diet of use. Let me know how you are adapting to the changes, please.

    • profile image

      sandeep 5 years ago

      right thing i was searching for

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      HawaiiHeart, the Mediterranean diet is more an eating style than a short-term method of weight loss.

      I'm finding it pretty easy to incorporate the differences between the typical American eating style to the Mediterranean style. I haven't done it all at one time, but anyone could if they chose to.

      I appreciate your read and comment.

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Debbie Roberts, thanks for your input. Perhaps at some recent point in time the Mediterranean style diet will need to have a name change. It's unfortunate that Western-style eating habits are creeping all over the globe to the detriment of younger generations.

      Thank you for SHARING.

    • HawaiiHeart profile image

      HawaiiHeart 6 years ago from Hawaii

      Great info. I've heard about the Mediterranean diet. It would be interesting to try.

    • debbie roberts profile image

      Debbie Roberts 6 years ago from Greece

      Sadly the Mediterranean diet is not what it once was, especially among the younger generation. Here in Greece the older people are far fitter and healthier than the youngsters because they still eat a diet rich in local foods like walnuts, olives, fish and plenty of home grown vegetables. The youngsters are opting for a diet ruined by fatty cheese pies and fast foods.

      You're hub is informative, voted up and shared.

    • georgescifo profile image

      georgescifo 6 years ago from India

      Always Welcome Woodard!!

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Georgescifo, it sounds then like you enjoyed the way the food was cooked and the seasonings and spices in the Libyan food. I'm going to have to look more deeply into that for myself.

      Thank you for taking the time to respond back.

    • georgescifo profile image

      georgescifo 6 years ago from India

      @Woodard, well, the most appealing about the Libyan food was the essence and smell especially one of their favorite dish named kuskus.

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Georgescifo, thanks for the read and the comment. What about the eating style in Libya most appealed to you?

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Thanks for the info and yes, I think you should write a hub about it. You can count me in as a reader of that.

    • georgescifo profile image

      georgescifo 6 years ago from India

      I was really amazed at the food culture that prevail in Libya and consider that as the best mediterranean diet ever I had..

    • SanneL profile image

      SanneL 6 years ago from Sweden

      Fish and seafood are very popular in Greece. It's understandable thinking of all the coastline. Some of the more popular are also the cheapest. I'm talking about gavros (anchovies), sardeles (sardines) and kolios (mackerel).

      Grilled octopus as an appetizer with a glass of ouzo is just heaven! The tarama salata (fish-row salad) is a very popular dip. We make it ourselves. Other fish that's popular are marides (smelt) and gopa (bogue). Then we have the oh, so popular psarosoupa (fish soup) made with rofos (grouper). I almost forgot the Kalamari (squid). Oh my gosh. . .Maybe I should write a hub about it! Ha! Ha! Ha!

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      SanneL, I envy that you get to spend a lot of time in Greece! I've never been there, but would like to visit at some point in time.

      What sort of fish/seafood do you find to be popular there?

      Thanks for SHARING.

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Thanks, Peggy W. I am finding better blood sugar control with my type 2 diabetes since beginning to incorporate this eating style.

      For the most part, it hasn't been that difficult for me, except for cutting back on the red meat. One step at a time, that's the way I see it.

      Thanks for SHARING.

    • SanneL profile image

      SanneL 6 years ago from Sweden

      Since I spend much of my time in Greece, it's very easy for me to follow the Mediterranean diet. It's very healthy, fun and so delicious. Great hub! Voted up!

    • Peggy W profile image

      Peggy Woods 6 years ago from Houston, Texas

      You have made a good case for following the guide-lines of a Mediterranean diet. We like many of those things and just need to incorporate more of them into our daily lifestyle. Voted useful and will share.

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Brett, you are so right; eating health doesn't have to be boring or tasteless. I think you can mix just about styles of cooking and still make healthy choices.

      Thanks for SHARING.

    • Brett.Tesol profile image

      Brett Caulton 6 years ago from Thailand

      An interesting read. I tend to mix the Mediterranean and Asian styles, as I love the flavors of both, they taste good, but you also feel like you are eating healthily. Being healthy doesn't have to be boring!

      Thanks for SHARING.

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Eye say, glad you found the information here to your liking. I've been striving to follow this eating style over the past few months and have been doing so fairly well. My doctor recommended it to me for blood sugar control and so far it has helped. Good luck to you.

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Appreciate you stopping by to read and comment, RebeccaMealey. I'm making in-roads into changing my own eating style to be more like that of the Mediterranean diet and feeling better for it. My blood sugar levels have improved, too.

      Thanks for SHARING.

    • L.L. Woodard profile image

      L.L. Woodard 6 years ago from Oklahoma City

      Alocsin, that's a great observation! I'd never given a thought to the correlation you made.

      Thanks for SHARING.

    • eye say profile image

      eye say 6 years ago from Canada

      this looks very healthy and easily combined with my other diets, I think I'll include many of the foods form this diet. Thanks for the info, appreciated!

    • rebeccamealey profile image

      Rebecca Mealey 6 years ago from Northeastern Georgia, USA

      I have always believed in the Mediterranean diet. Thanks for reminding me! voted up and SHARED again!

    • alocsin profile image

      alocsin 6 years ago from Orange County, CA

      How interesting that the cradle of civilization is also the cradle of good health. It's unfortunate we've forgotten those roots. Voting this Up and Useful. Thanks for SHARING.


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