As the incidence of diabetes continues to rise, identifying the specific type of diet that helps to improve blood sugar control becomes increasingly important. In the past, a low-carbohydrate or low-fat diet has been recommended to improve blood sugar levels. A recent study published in the Annals of Internal Medicine concluded that a Mediterranean type of diet is superior to a low-fat diet in improving blood sugar control and lipid levels. It also delayed the need for diabetic medication in newly diagnosed patients with type 2 diabetes.
Significance of a Mediterranean diet
The reason why Mediterranean diet is superior to other diets is its focus not only on one single nutrient, but a whole food approach. The Mediterranean diet emphasize eating whole foods instead of processed foods, choosing whole grains over refined grains and using extra-virgin olive oil in place of butter and other types of oils. Its emphasis on substitution (replacing bad fats with good fats, simple carbohydrates with complex ones) rather than elimination makes it more likely for people to follow the Mediterranean diet long term.
Fiber
The Mediterranean diet typically contains high amounts of fiber, which may enhance satiety and reduce energy intake. This diet encourages use of legumes and nuts as major source of protein. Its emphasis on minimal amounts of animal products also decreases overall saturated fat intake. High fiber intake improves glycemic response after a meal as it takes longer to breakdown the food to release the glucose into the bloodstream.
Olive Oil
Olive oil, rich in monounsaturated fats, is the main type of fat used for cooking and condiments in a Mediterranean diet. Research suggests that olive oil has anti-inflammatory properties, which may decrease the risk of developing chronic diseases like diabetes. A study published in the Archive of Internal Medicine in 2007 demonstrated lower lipoprotein oxidation with a Mediterranean type of diet.
Energy Density
The Mediterranean diet emphasizes the consumption of fruits, vegetables and legumes; and therefore tends to have a lower energy density than the typical American diet. Some people are concerned that the higher-fat content of the Mediterranean diet (about 35 percent of total calories) may lead to weight gain. However, adherence to a Mediterranean diet is associated with a significantly lower incidence of obesity after 3 years of follow-up.
How to follow a Mediterranean diet
According to Dr. Willett, the chairman of the Department of Nutrition at the Harvard School of Public Health, people can modify a typical American diet to more closely match the Mediterranean diet by adopting a few changes. Replace butter with extra-virgin olive oil in cooking and food preparation. Extra-virgin olive oil can also be used in salad dressings and as condiments. Have a serving of fruit between meals and include a total of 1 ounce of mixed nuts per day as snacks. Always include vegetables (raw or cooked) as part of the meal. Replace meat and meat products with legumes or fish as a protein source on a regular basis.
References
- Annals of Intern Medicine; Effects of Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Esposito K; Maiorino MI et al.; 2009; 151(5):306-14.
- Archive of Internal Medicine.; Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial; Fito M, Guxens M, Corella D, et al., for the PREDIMED Study Investigators. Arch Intern Med. 2007;167:1195-1203.
- Journal of Nutrition; Adherence to a Mediterranean diet is associated reduced 3-year incidence of obesity; Mendez MA, Popkin BM et al.; 2006; 136(11):2934-2938.
- American Journal of Clinical Nutrition; Mediterranean diet pyramid: a cultural model for healthy eating; Willett WC, Sacks F et al.; 1995, 61(Suppl. 6): 1402S-1406S.
