There are 4.8 million people in the UK living with type 2 diabetes. That’s 1 in 16 of us! A diagnosis of diabetes comes with an increased risk of developing cardiovascular disease, cognitive impairment and certain types of cancer. How diabetes affects your body is complex, but the stages needed to reverse this condition might be relatively simple.
Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose, which over time can cause an array of problems such as weight gain, blocked arteries, and of course, type 2 diabetes.
The good news is, diabetes can be managed and even reversed. There is research to suggest dietary and lifestyle interventions may even be more effective than metformin; a common medication prescribed by GPs to manage blood sugar levels.
There can be a lot of confusion around how to balance blood sugars and what you should or shouldn’t be eating. A popular ‘diet’ that people are recommended to support their blood sugars is the Mediterranean diet. Here, Krista explores the principles of the Mediterranean diet and whether it’s an effective and realistic solution for those with type 2 diabetes.
The Mediterranean Makeover?
The word diet is something I try to avoid using due to its negative associations with restriction, calorie counting, avoiding certain foods etc. (I’m sure we all have our own thoughts and feelings towards that word). But before this word became a marketer’s dream, a diet is simply what we eat. So really, we’re all on a diet of some sort. Whether it’s one that involves eating vegetables, whole grains, protein and healthy fats, one that involves cutting out animal products, or one that is mainly focused on eating ultra-processed food; these are all diets.
When you think about the Mediterranean diet (MD), I’d like you not to see it as ‘another diet’ but more of a way of life. The MD is based on traditional foods that people used to eat in, unsurprisingly, countries surrounded by the Mediterranean Sea. So that includes France, Spain, Greece and Italy. But the good news is, you don’t need to live in the Mediterranean to enjoy the benefits (although if the opportunity arose, I wouldn’t need to think twice before packing my suitcase!).
The Mediterranean Diet Pyramid is a great visual of the food groups that are consumed as well as the quantity. The bottom of the pyramid represents the food groups that are eaten in larger amounts. As you work your way up the pyramid, you will see the food groups that were eaten less often.
- Vegetables, fruit, legumes, beans, spices and herbs are eaten in large quantities. The food is locally produced as well as seasonal, so people are getting a diverse range of antioxidants and polyphenols (the nutrients that are found in plants) throughout the year. These feed our gut bugs which are incredibly important as some of them can help improve insulin resistance. For more information on insulin resistance or type 2 diabetes, click here.
- Nuts and seeds which are great sources of magnesium, an important mineral for regulating blood glucose levels and extra virgin olive oil which is high in monounsaturated fatty acid, can help with reducing inflammation which is often high in those with type 2 diabetes are the principal sources of fat.
- Fish, particularly oily fish, is rich in protein and omega 3, an essential fatty acid that we can only get from our diet. Fish can help balance blood sugars and reduce inflammation and is recommended twice a week.
- Poultry, eggs and dairy are eaten weekly. Again, these are high in protein and eggs in particular are rich in nutrients such as choline which supports digestion and detoxification pathways. Eggs also contain selenium, a mineral which has antioxidant properties and can help reduce oxidative stress and inflammation.
- Fresh fruit is the typical daily dessert and sweets based on nuts, olive oil and honey are consumed only during celebrations.
Another key component of the Mediterranean diet is being physically active every day and there is a real social aspect around meals. You don’t see people walking around in a hurry trying to fit in a sandwich in between meetings or sitting at their desks eating out of Tupperware; they are present, take their time and enjoy their meals with family and friends.
This element is perhaps more important than we think. Another key hormone we need to be aware of with type 2 diabetes is the stress hormone, cortisol. Being on constant high alert and not taking the time to relax can cause cortisol levels to increase which can blunt your body’s sensitivity to insulin.
What I like about the Mediterranean diet is that no food is off-limits. It appreciates the importance of quantity with certain foods like consuming honey in small amounts which although nutritious, contains high amounts of fructose (hello sugar spike).
The food that is encouraged daily is rich in diversity, fibre, healthy fats and vitamins and minerals, all of which are supportive for type 2 diabetes and overall health and wellbeing. There is value in physical activity and social connection which can help promote what seems like a thing of the past; sitting together around a dinner table and taking time out to enjoy and digest food.
What sticks out the most about this ‘diet’ is just how realistic would be to implement into our everyday lives. Is it always possible to eat local and in season? Whilst not having specific measurements for each food group may encourage intuitive eating which I’m all for, it can take a while to get into that mindset when a lot of us have become so disconnected from food and unable to listen to our hunger signals. Also, wine in moderation? Again, we may need more understanding of what is moderate as this will differ from person to person. The MD can be traced back to as early as the Middle Ages so some aspects definitely feel outdated.
As far as ‘diets’ go, it doesn’t feel restrictive. It may not consider the nuance of an individual; legumes and beans for example are recommended as the main source of protein, but someone with poor digestive health may not be able to tolerate them well. The high carbohydrate content of legumes may also not be well tolerated if you have a diagnosis of pre or type 2 diabetes. However, I would encourage you to take elements of this way of eating including the diversity of vegetables, oily fish and social connection and use it as a guide to help implement change into your daily lives to help with those all-important blood sugars.