The Mediterranean diet is a dietary pattern & lifestyle that is concentrated in plant-based foods such as fruits, vegetables, whole grains, unsalted nuts & seeds, olive oil as well as legumes (e.g. beans, peas, etc.) & lentils. Animal-based foods such as fish & seafood, eggs & low fat diary products are consumed in moderation & red meat only occsionally. Though there are many variations of the Mediterranean diet followed by people around the world, all variations follow the above principles.

The Mediterranean diet is concentrated in heart-healthy fats known as unsaturated fats. Unsaturated fats have been shown to decrease inflammation & improve blood cholesterol levels. There are 2 types of unsaturated fats:

1. 1. Monounsaturated fats such as olive and canola oil, avocado, almonds, pecans, cashews, pistachios & non-hydrogenated margarines
   2. 2. Polyunsaturated fats rich in omega-3 & omega-6 fatty acids found in fatty fish (e.g., salmon, trout, sardines, makerel, etc.), sunfower, safflower & corn oil, almonds, pecans, Brazil nuts as well as sunflower & sesame seeds.

The Mediterranean diet is also high in dietary fibre. Fibre is a type of carbohydrate that passes through the digestive tract undigested. Consuming adequate amounts of dietary fibre has been shown to improve blood cholesterol levels, improve blood sugar control & assist with bowel regularity. There are 2 main types of dietary fibre:

1. 1. Soluble fibre dissolves in water to form a gel-like substance. This type of fibre helps to lower blood cholesterol levels & improve blood sugar management. Good sources of soluble fibre include apples, oranges carrots, oats, oatmeal & oat bran, barley, psyllium (Metamucil®), chia seeds, flax seeds, beans & lentils.
   2. Insoluble fibre does not dissolve in water & moves through the digestive tract intact. This type of fibre helps stool move through the digestive tract more quickly to keep bowel movements regular. Research suggests that insoluble fibre can help reduce the risk for heart disease & certain types of cancer such as colon cancer. Good sources of insoluble fibre include whole grain breads & cereals, wheat bran, nuts & fruits & vegetables.

Research consistently shows that individuals who follow a Mediterranean-based lifestyle may have a lower risk of heart disease, stroke & type 2 diabetes.  Research has also shown promise in the reduction of dementia, Alzheimer’s disease & decreased rates of depression in individuals following the Mediterranean lifestyle.

The Mediterranean diet is best thought of as a “lifestyle” rather than a “diet” as it also focuses on regular physical activity, ensuring adequate sleep (at least 7-9 hours each night) & sharing meals with family & friends when possible. It is recommended that adults 18 years of age & older aim to get at least 150 mintes (2.5 hours) of moderate to vigourous physical activity each week & muscle strengthening activities at least twice per week. Excellent sources of physical activity include:

• Brisk walking, jogging or running
• Bike riding
• Skating, hockey, baseball, basketball, golfing, etc.
• Dancing
• Yoga
• Weight lifting
• Exercise band exercises
• Etc.

How to Follow a Mediterranean Eating Pattern:

•  Aim to include 1/2 plate of vegetables at lunch & dinner. All vegetables can fit! Choose a variety of different vegetables with different colours & textures. Vegetables can be enjoyed in many different ways: raw, roasted, sautéed, steamed, baked, etc. Try to avoid deep fried or breaded vegetables.
• Include a variety of fruits at all meals & snacks. Fruit is a great dessert option with no added sugar! Avoid fruit juice.
• Choose whole grain foods more often. Excellent sources of whole grains include: whole grain breads & cereals, brown rice, barely, oats, quinoa, etc.
• Include a variety of unsalted nuts & seeds in your diet every day. These can be eaten as a snack on their own or mixed into salads, cereals, etc.
• Consider including legumes & lentils such as beans or peas into your diet at least 2 times per week. These can be purchased dried or canned (choose the no-salt added or reduced sodium variety if choosing canned). Hummus (chickpeas) pairs wonderfully with vegetables and/or whole grain crackers!
• Try to drink at least 6 to 8 cups of sugar-free fluid each day
• Use olive oil to cook & flavour foods. Aim to include 1 tbsp of olive oil each day.
• Flavour foods with fresh or dried spices, herbs & other no-salt added seasonings instead of salt.
• Choose skim, 1% or 2% milk more often as well as low fat cheeses with 20% milk fat or less. 0%, 1% or 2% yogurt, Skyre or Kefir are also good low-fat dairy options.
• Aim to eat 2 servings of fish or seafood per week if you enjoy it.
• Consider limiting intake of red meat such as beef, pork, lamb, goat, etc. to 2 or less servings each week. Avoid processed meats as much as possible (e.g., hot dogs, sausages, bacon, salami, deli meat, etc.). Consider replacing red & processed meats with lean white meats such as chicken or turkey or plant-based protein options such as  beans, lentils, tofu, unsalted nuts/seeds, etc.
• Limit intake of sweets & desserts. This includes: candies, sugar, honey, jam, maple syrup, pastries, cakes, pies, ice cream, etc. to a couple of times per week or save them for special occasions like birthdays, anniversaries or other celebrations.
• Avoid sugar-sweetened beverages such as regular pop, iced tea, fruit juice, energy drinks, specialty coffee & tea beverages, etc. Consider replacing these drinks with water or low-fat dairy.
• If you enjoy drinking wine, limit intake to small-moderate amounts with meals. This means about 1 (5 oz) glass of 12% wine for women & 2 (5 oz) glasses of 12% wine for men. You do not need to drink alcohol to follow a Mediterranean dietary pattern.

Example Menu of Mediterranean Diet:

Breakfast:     

• 3/4 cup cooked steal cut oats with 1 cup 1% milk topped with 1 tbsp unsalted almonds, a pinch of cinnamon &  1 chopped medium banana paired with 1 cup of green tea

Lunch:

• 2 slices whole grain bread, 2 large eggs scrambled with peppers, onion & garlic in 2 tsp of olive oil paired with a 1 1/2 cups spinach & strawberry salad topped with 1 tbsp olive oil & vinegar vinaigrette with a glass of water to drink

Dinner:

• 2 1/2 oz baked salmon drizzled with 1/2 tbsp olive oil, 2/3 cup mashed sweet potato, 1/2 cup sliced cucumber, 1/2 cup steamed broccoli & 1 medium apple paired with a glass of water.

Snack Ideas: 

• 3/4 cup 2% plain Greek yogurt drizzled with 1 tsp honey & 1/4 cup unsalted walnuts
• 1/4 cup unsalted cashews with 1 medium peach
• 7 whole grain crackers 1 1/2 oz low fat cheddar cheese or 1/3 cup hummus

References:

The Mediterranean Diet: A Guide to Healthy Eating

Mediterranean Diet Sample Menu

https://oldwayspt.org/traditional-diets/mediterranean-diet

https://www.healthlinkbc.ca/health-topics/aa98646#:~:text=The%20Mediterranean%20diet%20emphasizes%20eating,and%20omega%2D3%20fatty%20acids