Mediterranean Diet
The Mediterranean diet emphasizes:
- Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
- Replacing butter with healthy fats such as olive oil and canola oil
- Using herbs and spices instead of salt to flavor foods
- Limiting red meat to no more than a few times a month
- Eating fish and poultry at least twice a week
- Enjoying meals with family and friends
- Drinking red wine in moderation (optional)
- Getting plenty of exercise
“Mediterranean Plate” by Jason Lander is licensed under CC BY 2.0
The Lyon Diet Heart study is an excellent example (1). This randomized prospective trial evaluated secondary prevention of cardiac disease by comparing those with a Mediterranean diet with increased omega-3 vs. the standard recommendation of the American Heart Association diet. Both groups received maximal medical management. This study found an amazing reduction in cardiovascular death of over 70% and a decreased in all cause mortality of 60%. These dramatic results occurred without a change in total cholesterol, triglycerides or HDL.
In those with metabolic syndrome, a decrease in insulin resistance has been seen with a Mediterranean diet. In one study, subjects randomized to the Mediterranean diet for two years showed lower insulin resistance, lower high sensitivity CRP, and a higher rate of resolution of metabolic syndrome (2). Those in the intervention group were instructed to increase whole grains, fruits, vegetables, nuts and olive oil. The control group was recommended a "prudent diet" of 50%-60% carbohydrates, 15%-20% proteins and less than 30% total fat. Similar effects are expected in diabetes when a Mediterranean diet is implemented.
1. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: Final report of the Lyon Diet Heart Study. Circulation. Feb 16 1999;99(6):779-785.
2. Esposito K, Marfella R, Ciotola M, et al. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: A randomized trial. JAMA 2004; 292:1440-1446.