Diabetes Reversal with a Mediterranean Diet- Do's and Don'ts

During a conversation with a patient, I sensed they had made peace with their diabetes. 

So I asked them a question. ‘Have you heard about the Mediterranean diet?’

They told me that the Mediterranean diet is a traditional diet that involves eating organic, natural foods, mostly plants. When I told them that traditionally, the Mediterranean's never had diabetes, heart disease, hypertension, or any such disease, they were amazed. 

After discussing a few of my client outcomes, they were convinced that together, we were going to reverse their diabetes. 

Today, let me share all the secrets of the Mediterranean diet with you. How does this magical diet work to manage and reverse your diabetes?

Introduction: Beyond Control? Rethinking Diabetes Management.

The most deeply established concept among people is that diabetes is an irreversible condition. There is nothing we can do about it. 

And the only way to coexist with diabetes is to manage it with medication, and sometimes, even insulin injections. However, it does not have to be that way. You can definitely be the driver of your health; and the only way you can do that is by making sustainable lifestyle changes.

Take a look at one of my client's story on managing her health:

When it comes to nutritional interventions, a modified Mediterranean diet works very well. Why modified you ask? Because there is something that works even better than a Mediterranean diet. 

A whole- food plant- based diet with very specific lifestyle modifications can not only help get your diabetes into remission, but also assure longevity. 

Here is how a plant-based diet derived from the Mediterranean will holistically manage your diabetes:

1. Reduce inflammation
2. Manage weight
3. Reduce calorie consumption
4. Prevent sugar spikes
5. Releases sugar slowly in the blood
6. It puts less pressure on the pancreas for insulin release
7. Prevent fat buildup in the body. 

Let's explore how you can tweek a traditional Mediterranean Died for diabetes management. 

The Mediterranean Magic: A World of Flavor & Health.

The Mediterranean diet is not just a set of dietary guidelines but a way of life inspired by the traditional eating habits of countries bordering the Mediterranean Sea. 

Research shows that the Mediterranean diet improves:

1. blood sugar control,
2. hypertension, and,
3. insulin sensitivity

With a few tweeks made to the Mediterranean diet, to make it more sustainable and culturally appropriate, my clients see excellent results wiht this type of eating. 

Here are the core principles of the Mediterranean diet:

Emphasis on Plant-Based Foods: 

The Mediterranean diet prioritizes fruits, vegetables, whole grains, legumes, nuts, and seeds as the foundation of meals. These foods are rich in fiber, vitamins, minerals, and antioxidants, providing numerous health benefits.

• You will not see the use of a lot of meat or dairy in a traditional Mediterranean plate of food.
• Instead, there is liberal use of pulses, whole grains, vegetables and fruits. 

Dr. Sean Hashmi discusses whole grains and their impact on type 2 diabetes. The research involved nearly 200,000 participants, whom they followed for 24 years.

The key findings of Dr. Sean are:

• Consuming whole grains generally reduces your risk of type 2 diabetes by 29%.
• Specific whole grains like oatmeal, cold breakfast cereals (unprocessed), and added bran showed the greatest reduction in risk (15-21%).
• Popcorn consumption showed an interesting trend. While popcorn itself has high fiber content, consuming one or more servings daily was linked to an increased risk of type 2 diabetes. This is because of the added sugars, fats, and perfluoroalkyl substances (PFAS) often found in commercially prepared popcorn.

Use of Olive Oil as the Primary Fat: 

Extra virgin olive oil is the primary source of fat in the Mediterranean diet. It is rich in monounsaturated fats, antioxidants, and anti-inflammatory compounds, contributing to heart health and overall well-being.

While Olive oil can be healthy, commercially bought olive oil's can often be more harmful than healthful. 

Here's the thing: not all commercially available "extra virgin" olive oil lives up to the name.

The term "extra virgin" refers to the quality and processing method. It implies the oil is extracted from the first pressing of olives using mechanical means, without excessive heat or chemicals. This process preserves the oil's natural flavor, aroma, and beneficial antioxidants. However, some manufacturers resort to less scrupulous practices to maximize profits.

1. One concern is adulteration, where cheaper oils like sunflower or soybean oil are mixed with olive oil. This dilutes the quality and health benefits you expect from extra virgin olive oil.
2. Another issue is mislabeling, where lower-grade olive oils are disguised as extra virgin. This can be due to poor quality control or misleading marketing tactics.

We suggest clients to minimize the use of oil's (any oil's) in general to no more than 1 tbsp per day. The benefits of the Mediterranean diet are not because of Olive oil consumption, but because of overall high consumption of whole- foods. Thus, look at filling your plate with enough vegetables and pulses. 

Moderate Consumption of Dairy: 

Dairy products appear less than 10% of your plate in a Mediterranean Diet. They are not the star of the meal, nor are consumed on a daily basis. 

The few times dairy products are used is also for its probiotic benefits like in Greek Yogurt. Commercially produced dairy products like cheese and butter are rarely seen in the Mediterranean region. 

While working with clients, we avoid the use of any dairy products due to them being high in saturated fats and often adulterated. But what about Ghee? Watch this:

Limited Intake of Red Meat and Sweets: 

The Mediterranean diet includes red meat and sweets sparingly. Red meat is often replaced with plant-based protein sources like legumes and nuts, while sweets are reserved for special occasions and consumed in small amounts.

Hamburgers and processed meats are unheard of. Similarly, processed white sugar is almost never used. Instead, fruits and dates are used as sweeteners. 

We suggest our clients to ditch meat completely too. People are often better at all or nothing VS moderation. Especially when it comes to disease reversal, it is absolutely essential that people go the extra mile to work on their nutrition.

Herbs and Spices for Flavor: 

Mediterranean cooking uses herbs and spices liberally to add flavor to dishes without relying on excessive salt or unhealthy fats. Common herbs and spices include garlic, oregano, basil, rosemary, thyme, and cinnamon.

Many of these herbs are highly anti- oxidant and anti- inflammatory too, thus, protecting your body against ageing and diseases. 

Physical Activity and Lifestyle Factors: 

Regular physical activity, along with other lifestyle factors like adequate sleep, stress management, and social engagement, are integral components of the Mediterranean lifestyle. These factors contribute to overall health and well-being, complementing the benefits of a nutrient-rich diet.

Ancel Keys was a scientist who studied the relationship between diet and coronary heart disease. He noticed that people in countries around the Mediterranean Sea had a lower rate of coronary heart disease than people in other parts of the world.

Whole Foods: The Foundation for Reversal. 

The single most detrimental food component in the Indian diet is refined grains. White bread, white flour, and boiled white rice are staples. 

Whole grains offer you the whole part of the grain, including fiber and minerals, while refined grains fill the portion with starch (sugar) only. 

Highly processed foods are high in calories and low in vitamins, minerals, and fiber content. They keep you full for a shorter time, and you will eat a larger portion of a processed meal to feel full at a certain time. 

Packaged snacks contain trans fats, cholesterol, refined sugars, and high salt content. 

All these factors contribute to blood sugar spikes, weight gain, high triglyceride levels, hypertension, eventual kidney damage, and an increased risk of developing Diabetes. 

There are components in a Mediterranean diet too that can be processed. Such as occasional use of white meat, alcohol and oil's. But is there any study that compared a Mediterranean diet with a whole- food plant- based diet only?

Yes! Dr. Neal Barnard, a pioneer in lifestyle medicine, discussed a study comparing a vegan diet to a Mediterranean diet for weight loss.

Dr. Barnard says that a vegan diet is better for weight loss than a Mediterranean diet. He argues that people who follow a vegan diet tend to lose more weight than people who follow a Mediterranean diet.

• The Mediterranean diet typically includes olive oil, fruits, vegetables, nuts, whole grains, and fish or poultry in moderation.
• On the other hand, a vegan diet excludes all animal products. 

While both the above diet types work, it really comes down to how good you are at following the definition of moderation. I personally feel client's do much better on a whole- food vegan diet than Mediterranean. 

Actionable Tips for Your Mediterranean Plate. 

You do not have to visit the libraries and look for the original Mediterranean diet or how those people used to eat in those times. The Mediterranean diet is based on some core principles. They are quite easy. 

When you inculcate them into your lifestyle, you will see how well your blood sugars will manage themselves. But first, lets look at some lifestyle changes that will help with diabetes management:

• Load Up on Plant Foods: 

Fill your plate with a colorful array of fruits and vegetables. Aim to include a variety of types and colors to ensure you get a wide range of nutrients. Try to make half of your plate filled with vegetables at each meal.

My clients additionally try to keep one meal raw. Smoothie bowls, one- pot salad meals or even fruit- cereal bowls are a great idea.

• Choose Whole Grains: 

Opt for whole grains like brown rice, quinoa, bulgur, barley, and whole wheat bread and pasta. These are rich in fiber, which helps regulate blood sugar levels and keeps you feeling full and satisfied.

Whole grain consumption is linked with longevity and prevention of chronic diseases. Do not fear whole- grains, but embrace them. If you understand hindi, watch this to further understand how whole- grains help with diabetes management:

• Healthy Fats: 

Incorporate healthy fats into your diet, such as olive's, nuts, seeds, and avocados. These fats provide essential nutrients and help improve insulin sensitivity. Use olive oil for cooking and as a dressing for salads and vegetables.

I suggest my clients add 1-2 tbsp of fats per meal. Adding extra is not necessarily beneficial. 

• Stay Hydrated: 

The best way to stay hydrated is to have water rich fruits and vegetables in your diet. Eating your water provides you with not only hydration, but also fiber and nutrients.

Besides that, drink enough water throughout the day to support overall health. Limit sugary drinks and opt for water, herbal teas, or sparkling water flavored with fresh citrus or herbs.

• Practice Mindful Eating: 

Slow down and savor your meals, paying attention to hunger and fullness cues. Avoid distractions like TV or screens while eating, and focus on enjoying the flavors and textures of your food.

I suggest my clients to take 20 minutes to finish meals and chew the food well. 

• Moderate Dairy: 

Ideally, do not consume any dairy products. Aim to switch to dairy alternatives that you can make at home like coconut milk and soy curds.

I personally love masala buttermilk made from peanut curds. Tofu and soy products also routinely appear in my weekly menu. 

• Limit Red Meat: 

When you are looking at reversing any disease, meat should be completely off your plate. It is not just about the fats in meat that can keep you diabetic, but also endotoxins and choline that disrupts the gut health. 

I suggest my clients do not include more than a serving of meat (purely from a taste perspective) per week. Try to make plant- based alternatives at home instead. 

The above being said, always work with an expert when it comes to Diabetes Management. Our team consists of doctors, nutrition coaches, fitness coaches and wellness experts working in synchronization to help clients. As the client is healing, our doctors tweek their medication dosage to avoid hypoglycemic episodes. 

Sample Meal Plan: A Mediterranean Feast for Diabetes Management.

Mediterranean foods and recipes are known for their aroma, flavors, and taste profile. That's good news there for us, right?

Here is a breakdown of breakfast, lunch, dinner, and snacks, and some options to avail from. You can mix and match your favorite ingredients, and play around for exciting recipes. A clean lifestyle does not have to be all boring, monotonous, and flavorless. 

Note, it is absolutely essential you work with a nutritionist when it comes to disease management. All the below recipes might not work for every body type. 

Breakfast:

• Whole grain toast with a generous spread of hummus and microgreens.
• Vegan White Bean Shakshuka: Switch the eggs in this recipe for tofu, giving this recipe the necessary proteins and still keeping it very healthy!
• Green Goddess Smoothie: My personal favorite way to start the day. I love this refreshing drink- on- the- go breakfast and so do my clients!

Mid-Morning Snack:

• A handful of almonds or walnuts.
• A small piece of fruit like a pear or a peach.

Lunch:

• Spinach Pasta with Za'atar, Lemon and Parsley: Load up on the vegetables and keep the whole- grain pasta al dante for a mouthful of health and goodness.
  
  
  
  
  
  
• Herby Freekeh Salad with Pomegranate Dressing: Summer's a re hot in the Mediterranean region and sitting for a citrus packed salad is worth every bite!
• One Pot Khichdi: We tweek the Mediterranean recipes for our clients but still follow the same dietary principles. This vegetable and lentil khichdi made with brown rice is addictive to say the least!

Afternoon Snack:

• Sliced bell peppers and cucumber with Mango-Avocado salsa (made with cilantro, mango cubes, and avocado).
• A few whole-grain crackers.

Dinner:

• Baked Jacked Potatoes: Use all your  knowledge on spices to whip up this delicious and comforting recipes. Complete with black beans, veggies and a creamy cilantro sauce.
• Couscous Stew: A one pot meal that is actually a staple amongst dinner rotations at my home. We love to pair this with a whole grain toast or even pita crackers. Air fry the crackers instead of baking them. 
  
  
  
  
  
  
• Quinoa pilaf: Cooked with diced tomatoes, onions, garlic, and a sprinkle of vegan feta cheese (made with cashews, almonds, and coconut oil).

Superfood Spotlight: Mediterranean Gems. 

When we look at the core principles of a Mediterranean diet, some superfoods (high nutritional value) make its backbone. My clients are taught habits that makes including these superfoods their second nature. Lets look at some of the superfoods.

• Legumes and Pulses

Legumes are naturally low in fat and practically free of saturated fat. Because they are plant foods, they are cholesterol-free as well. Pulses and legumes are a good source of plant protein, keep you full for long hours, and also help reverse diabetes.

You can eat legumes and pulses in soups and stews, salads, curries and stir-fries, and even burger patties.

• Whole Grains

Whole grains are a rich source of phytochemicals, antioxidants, and vitamins and minerals. When you increase the content of whole grains in your diet, the fiber allows the glucose to be absorbed and released slowly into the blood. 

This enables the body to avoid sudden sugar spikes and also manage blood glucose levels more efficiently without the need for extra insulin.

I insist my clients to eat whole- grains for all meals. Emphasis on the "whole" though!

• Fruits and Vegetables

A diet rich in vegetables and fruits can lower blood pressure, reduce the risk of heart disease and digestive problems, and positively affect blood sugar. The fiber keeps the appetite in check. 

Eat a variety of types and colors of produce to give your body the mix of nutrients it needs.

• Nuts & Seeds

Nuts and seeds keep you full for a longer time. That is why I strongly recommend that my clients eat nuts and seeds as snacks on most days of the week. Worried about weight gain with nuts? Read this:

• Does Eating Cashew's Lead to High Cholesterol?

Nuts are rich in good fats, protein, and even carbohydrates. Besides, they carry immense nutritional value such as antioxidants, vitamins, and minerals. 

One interesting fact about nuts and seeds is that despite their nutritional content, they are incredibly helpful in reducing weight.

Reversal and Beyond: A Sustainable Lifestyle.

I cannot possibly overstate the power of plant-based nutrition in reversing diabetes. Research consistently shows that adopting a plant-based diet can significantly improve blood sugar control, reduce insulin resistance, and even reverse type 2 diabetes. 

Here are some key ways plant-based foods can help in this endeavor:

• Rich in Fiber: 

Fiber is only found in plants. Thus, the more plants on your plate, the more fiber you are consuming. Plant-based foods such as fruits, vegetables, whole grains, legumes, nuts, and seeds are rich in dietary fiber. Fiber regulates blood sugar levels by slowing down the absorption of glucose in the bloodstream. 

We are also now starting to understand that fiber changes your gut microbiome. The same then further reduces insulin resistance and makes your body better at utilizing blood glucose. There are many pathways by which fiber helps with diabetes management. 

• Low in Saturated Fat: 

Unlike animal-based foods, plant-based foods are generally low in saturated fat and cholesterol. High intake of saturated fat has been linked to insulin resistance and an increased risk of developing type 2 diabetes. 

Plants also have the compound phytosterols that help fight the bad cholesterol. 

• Antioxidant- Rich: 

Plant-based foods are abundant in antioxidants, which help combat oxidative stress and inflammation. 

Fruits and vegetables, in particular, are packed with vitamins, minerals, and phytochemicals that possess antioxidant properties. Plant foods can provide a load of antioxidants to support overall health and diabetes reversal efforts.

• Promotes Weight Loss:

Plant-based diets are extremely effective for weight loss and weight management. A well-managed weight is your first step towards reversing diabetes.

You can naturally lower your calorie intake by prioritizing unprocessed plant foods and eliminating animal products and highly processed foods. This will help you attain sustainable weight loss and improvements in insulin sensitivity and blood sugar control.

• Improves Gut Health: 

The fiber found in plant-based foods also serves as food for beneficial gut bacteria, promoting a healthy gut microbiome. 

Emerging research suggests that the gut microbiome plays a significant role in metabolism, inflammation, and insulin sensitivity. By consuming a plant-based diet rich in fiber and prebiotics, you can support your gut health and overall well-being.

• Lowers Risk of Chronic Diseases: 

Beyond diabetes reversal, adopting a plant-based diet has been associated with a lower risk of various chronic diseases. Plant diet will reduce your risk of heart disease and hypertension, which often coexist with diabetes. 

Remember, it is always important to consult a physician before you decide to change anything. 

Conclusion

While a Mediterranean diet can be a fantastic tool to help bring your blood sugar under control, it is very important to make sure you take the necessary principles from the Mediterranean eating pattern and adopt it into your ethnic eating pattern. 

The Mediterranean diet celebrates indulgence in delicious foods that is also healthy for you. Making your plate more plants and less animals is the key. Liberal use of herbs and spices is suggested. 

Join my online diabetes coaching program to stay on top of your blood sugar profile. My team of doctors, nutrition coaches, fitness and wellness experts work in synchrony to help reverse chronic diseases.