Why I tell some clients to ignore their Mediterranean diet

If you’ve been following the Med Diet with minimal benefits, this one is for you!

The Mediterranean diet is the most researched diet that shows positive effects on health, wellbeing and longevity. Due to its many health benefits, many are convinced this is the diet to follow.

Yet, I regularly see people who wonder why their cholesterol, blood pressure, sugar levels, inflammatory condition or weight is not at all where they’d like it to be, even though they have been eating in Mediterranean style, the supposedly holy grail in diet land.

Santorini, Greece, isn’t it stunning?!

When we further explore their eating habits, it is often easy to see where they’re going wrong. Yes, they have been eating Mediterranean style foods, or diet, but the health benefits follow from the traditional Mediterranean diet pattern, not necessarily the individual foods. Confusing much? Absolutely, let me explain with an example!

Take a client in her 50s, let’s call her Susan, who has been advised multiple times by her doctor to start taking a statin, which is a cholesterol lowering drug. Her blood sugars are also higher than the recommended range.

Because this means she is flirting with diabetes, her doctor wants to run some repeat blood tests in a few months to confirm whether or not also a medication that helps lower blood sugars, would be the next step for her.

Susan is reluctant to start medications for both cholesterol and blood sugars, but also feels completely lost and confused. After all, she has been eating according to the Mediterranean diet pattern, which is touted as the best, protective diet against cardiovascular (heart) disease and type 2 diabetes. Or so she thinks she has been eating this beneficial diet pattern.

The Mediterranean diet, but the wrong way

Simply put, the Mediterranean diet is a way of eating based on the traditional dietary patterns of people who live in countries that border the Mediterranean Sea.

Going back to Susan, the following is how she interprets the Mediterranean diet.

• Typically her day starts with a “All Natural Honey & Almond crunch” muesli with sliced banana and half a cup of Greek yogurt. She usually has a glass of water with lemon juice and a cup of coffee with a teaspoon of coffee creamer.

• After breakfast she drives to work, where she does mostly desk work with some walking and standing activities throughout the day.

• Around 10:30am she’ll have a break from work with a barista made latte and a dark chocolate & cranberry nut bar.

• For lunch she chooses a lightly buttered ciabatta bun with ham, salami, sliced tomato and cucumber and lettuce leaves. She skips the salad dressing. During lunch time she drinks a refreshing berry flavoured bottle of spring water.

• During the 3pm slump, Susan eats a small homemade blueberry muffin and drinks a cup of unsweetened green tea, perking herself up to get through the last couple of hours of the working day.

• Coming home she gets dinner started. While making a beautiful homemade lasagna, to which she makes sure to add extra vegetables, she enjoys a glass of red wine with her partner while nibbling on some whole wheat crackers and blue cheese. She’ll have another glass of red wine with dinner, but doesn’t have dessert.

We’re choosing the “wrong” foods too often

Sounds reasonable? On the surface, maybe yes. After all, she’s eating nuts, fruits and vegetables, makes her own baking and dinner is a homemade meal enjoyed with red wine. She also doesn’t seem to go wildly overboard on portion sizes.

All these foods and drinks are commonly seen as healthy options and part of the Mediterranean diet. Some food choices, like ciabatta, salami and lasagna of course also originate from that region. But, in contrary to what you’d believe looking at your local trattoria’s menu, these types of foods are not main foods in the traditional Mediterranean diet pattern. We’re confusing popular Mediterranean cuisine with the, well researched for its health benefits, traditional Mediterranean diet pattern.

Besides that, we often forget that the traditional Mediterranean diet pattern contains mostly foods that are less processed. For example, Susan thinks she is doing well by eating her “All Natural Honey & Almond Crunch Muesli” and dark chocolate & cranberry nut bar, but doesn’t realize that, although these contain nuts (which are a big part of the Mediterranean diet pattern), these are more processed options and contain a lot of sugar, compared to eating a serve of whole nuts.

Then what is the traditional Mediterranean diet pattern?

Key features of the traditional Mediterranean pattern (not cuisine) is that overall, the diet contains mostly foods that are less processed, low in saturated fats and sugar, high in omega-3 fatty acids (healthy fats), high in fiber and very rich in antioxidants.

This means eating mostly plant-based foods like minimally processed vegetables, fruits, nuts and seeds, legumes and lean protein (minimal red meat). Fats come mostly from oily fish, nuts/seeds and olive oil. Saturated fats (the type of fat that in excess consumption raises cholesterol levels) from dairy and meat products are only a very small part of the total fat in the diet.

Although Susan was eating foods from the Mediterranean cuisine, she was not following a traditional Mediterranean diet pattern, and this may be the reason why her blood work came back with not such great results.

Nearly 50% of the fats in her diet are saturated fat and some trans fats, which are the types of fats that increase cholesterol levels. To keep cholesterol at healthy levels, it is recommended to limit saturated fats to roughly 10% of total fat consumption. You can see there is a big difference here, what could explain her struggle with keeping cholesterol in check!

About a third of the total carbohydrates in her diet come from simple sugars. To help reduce her blood sugar levels and get out of that threatening pre-diabetes range, cutting back on foods that contain sugars would be very helpful.

Based on her food diary, on this day she also consumed about 40% more calories than that she expends based on her activity level. If this is consistent, over time Susan will also notice weight gain.

How to get it right

Ok, so we thought we were eating the right things for our health, in Mediterranean style, but we’ve got it wrong. Now what?

Before moving onto how to get it right, I want to underscore again the fact that it is not Mediterranean style foods, but mostly the diet pattern rich in antioxidants, fiber, healthy fats, protein and complex carbohydrates that give such wonderful health benefits.

This means that we don’t have to necessarily eat Greek, Italian and Spanish foods, we can enjoy Mexican, Indian and Asian foods while still applying the “rules” of the Mediterranean diet pattern and reap its benefits!

To show you how to put these lessons into practice, please enjoy my Asian style salmon salad at the end of this article.

But first, to give you some practice and insights, let me show you how Susan can tweak her diet in a way that still feels close to what she is already doing and what she likes, but according to the beneficial, more traditional Mediterranean diet pattern.