Modifying the Mediterranean Diet for Your Diabetic Meal Plan

The so-called Mediterranean diet is a perfect example of a diet you can live with, not a diet you’ll go on — the Mediterranean diet is a general pattern of eating.

A diet for effective diabetes management controls blood glucose averages, helps you manage body weight, and reduces risk factors for heart disease like cholesterol and blood pressure.

Literally hundreds of studies have examined the health effects of the food and/or the Mediterranean lifestyle, which includes physical activity and stress reduction.

Balancing grains, legumes, and fruit

Dietary fiber is a key component of the Mediterranean diet, and the fiber comes along with carbohydrates and other key nutrients from unrefined grains, legumes (beans and peas), fresh fruits, and vegetables. One benefit of dietary fiber is simply making you feel full sooner and for a longer period between meals. That’s called satiety.

Legumes — beans, chickpeas, peas, and lentils — are a key source of low-fat protein in a Mediterranean diet and are a rich source of soluble fiber. Soluble fiber helps reduce cholesterol, especially LDL (bad) cholesterol, a key risk factor for heart disease. Whole grain consumption is associated with lower blood pressure, even in relatively small amounts.

High blood pressure along with diabetes is a double whammy for your kidneys, as well as a risk factor for heart disease and stroke.

Fruits and vegetables in the Mediterranean diet also contribute to satiety and add an assortment of vitamins and nutrients to the mix. Fresh fruit is the dessert of choice, and the fruits and vegetables should be enjoyed without added sugar, fat, or salt (sodium).

The dietary fiber from this fruit and vegetable part of the Mediterranean diet, as well as from legumes and grains, can benefit your health in another very important way — blood glucose control.

A typical Mediterranean diet gets about 50 percent of daily calories from carbohydrate, and the great majority of the carbs come from legumes, unrefined grains, and fruit. These sources tend to have a lower glycemic index than added sugars or refined grains because the liberation of glucose during digestion is slower.

The key issue is that the effect on blood glucose levels from low glycemic index foods is gradual. The Mediterranean diet has been shown as appropriate, even beneficial, to blood glucose control.

And, while the glycemic index of the primary sources of carbohydrates surely is important, that fact alone doesn’t seem to account for the total picture of this eating plan and diabetes. The Mediterranean diet reduced A1C more than any of the diets in the comparison, including, by the way, low glycemic index diets.

If your idea of beans and grains is bland and blander, you’re in for a surprise. Mediterranean cuisine livens up the main ingredients with vinegars, capers, rosemary, mushrooms, citrus, mint, garlic, honey, fennel, peppers, cumin, paprika, onions, saffron, thyme, tomatoes, sage, bay leaf, oregano, nuts, dill, yogurt — to name just a few.

Swapping meat for fish and olive oil

The predominant sources of protein and fat in the typical Mediterranean diet are what sets this eating plan apart from other patterns, especially from the eating patterns typical in the United States.

On balance, the protein component is relatively low (15 to 20 percent of daily calories), and the fat component relatively high (35 percent of daily calories). But, the specific foods providing the bulk of these macronutrients are somewhat unique to the Mediterranean diet.

For starters, the consumption of dairy products is low, especially milk. Yogurt and cheese make up the dairy component of this eating plan, and these foods, even if eaten every day, are consumed in moderation. Likewise, poultry and eggs provide a portion of the diet’s protein, but are eaten in moderation also. Poultry or eggs may be on the menu a few times each week.

The most distinctive trait of the Mediterranean diet is that red meat is consumed very sparingly and in small 2- to 4-ounce portions. Limiting meat consumption leads to a general reduction in unhealthier saturated fats, enhancing the cardiovascular benefits of a Mediterranean diet.

Fish, seafood, and nuts not only supplement the dietary protein already provided by legumes, but also add healthy unsaturated fats, including omega-3 fatty acids, into the mix. Your Mediterranean diet might add a small serving of nuts every day and a serving of fish or seafood several times a week.

Olive oil contains mostly healthy mono-unsaturated fats (oleic acid), vitamin E, and natural phenols with healthy antioxidant properties.

With respect to diabetes, a 2011 study actually looked at individual variations in the composition of a fat that is part of cell membranes, phosphatidylcholine, and found when oleic acid was a component of this complex molecule insulin resistance was lower. Among the 360 participants in Spain, none with diabetes, every 1 percent increase in the oleic acid composition of phosphatidylcholine represented a 20 percent reduction in insulin resistance (prediabetes).

Olive oil, therefore, may offer clear benefits for both cardiovascular health, and blood glucose control.

Finally, the Mediterranean diet’s combination of fats seems to strike a beneficial balance between omega-3 fatty acids and the less famous omega-6 fatty acids. You need both omega-3 and omega-6 fatty acids, and both are healthy fats. The typical Western diet may favor omega-6 fatty acids by 20 to 1 or more, but in a typical Mediterranean diet the balance is closer to a healthy 4 to 1.

Having wine with dinner

Encouraging a glass of red wine with dinner is the perfect way to cap off this discussion of the Mediterranean diet, because having wine in moderation is typical for the people of this region. Moderate consumption of alcohol, defined as no more than two drinks per day for men or one drink per day for women, has health benefits when compared to heavier drinkers or tea totalers.

And red wine, in particular, contains antioxidants including the phenol resveratrol. Alcohol consumption is not advised for some health conditions that are common among people with type 2 diabetes, like high blood pressure or high triglyceride levels.

Always consume your alcohol with food to avoid hypoglycemia, especially after the evening meal when you go to bed.

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