By michael - February, 26th 2014

How does the Mediterranean Diet work?

It depends—there isn’t “a” Mediterranean diet. Greeks eat differently from Italians, who eat differently from the French and Spanish. But they share many common understandings. Working with the Harvard School of Public Health, Oldways, a nonprofit food think tank in Boston, developed a consumer-friendly Mediterranean diet pyramid that emphasizes fruits, veggies, whole grains, beans, nuts, legumes, olive oil, and flavorful herbs and spices; eating fish and seafood at least a couple of times a week; enjoying poultry, eggs, cheese, and yogurt in moderation; and saving sweets and red meat for special occasions. Top it off with a splash of red wine (if you want), remember to stay physically active, and you’re set.

Because this is an eating pattern—not a structured diet—you’re on your own to figure out how many calories you should eat to lose or maintain your weight, what you’ll do to stay active, and how you’ll shape your Mediterranean menu.

Will you lose weight?

While some research has linked the Mediterranean diet to weight loss or a lower likelihood of being overweight or obese, the jury’s still out, according to a 2008 analysis of 21 studies in Obesity Reviews. Still, if you build a “calorie deficit” into your plan—eating fewer calories than your daily recommended max, or burning off extra by exercising—you should shed some pounds. How quickly and whether you keep them off is up to you.

Here’s a look at a few studies addressing weight loss:

• One, published in 2010 in Diabetes, Obesity, and Metabolism,assigned 259 overweight diabetics to one of three diets: a low-carb Mediterranean diet, a traditional Mediterranean diet, or a diet based on recommendations from the American Diabetes Association. All groups were told to exercise 30 to 45 minutes at least three times per week. After a year, all groups lost weight; the traditional group lost an average of about 16 pounds while the ADA group dropped 17 pounds and the low-carb group lost 22 pounds.
• Another study, published in the New England Journal of Medicine in 2008, assigned 322 moderately obese adults to one of three diets: calorie-restricted low-fat; calorie-restricted Mediterranean; and non-calorie-restricted low-carb. After two years, the Mediterranean group had lost an average of 9.7 pounds, the low-fat group 6.4 pounds, and the low-carb group 10.3 pounds. Although weight loss didn’t differ greatly between the low-carb and Mediterranean groups, both lost appreciably more than the low-fat group did.
• In a third study, published in the International Journal of Obesity in 2001, researchers assigned 101 overweight men and women to either a low-fat diet or a Mediterranean-style diet. After 18 months, the Mediterranean group had lost an average of 5½ pounds, while the low-fat group had gained about 2½ pounds.

Does it have cardiovascular benefits?

Clearly. The Mediterranean diet has been associated with a decreased risk for heart disease, and it’s also been shown to reduce blood pressure and “bad” LDL cholesterol. If your Mediterranean approach largely shuns saturated fat (which contributes to high cholesterol), and includes healthier mono- and polyunsaturated fats in moderation (which can reduce cholesterol), you’ll do your heart a favor.

• A study published in the New England Journal of Medicine in 2013 found that about 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in high-risk people if they switch to a Mediterranean diet. These findings are based on the first major clinical trial to measure the eating approach’s effect on heart risks; it ended early, after about five years, because the results were so clear. Researchers say the study’s results provide evidence that the diet is a “powerful” tool in reducing heart disease risk, including among those already on statins or blood pressure drugs.

Can it prevent or control diabetes?

The diet appears to be a viable option for both.

Prevention: Being overweight is one of the biggest risk factors for type 2 diabetes. If you need to lose weight and keep it off, and a Mediterranean diet helps you do it, you’ll almost certainly tilt the odds in your favor. Research also suggests following a healthy Mediterranean-style diet may reverse or reduce the risk of developing metabolic syndrome, which can lead to type 2 diabetes and heart disease.

A study published in the journal Diabetologia in August 2013 suggests that people who follow a Mediterranean diet have a lower risk of developing type 2 diabetes, compared with those who don’t follow the eating style. The study was based on dietary and diabetes data from more than 22,295 people who were followed for more than 11 years. Researchers found that those who most closely adhered to a Mediterranean-style diet were 12 percent less likely to develop diabetes than those who followed it the least.

Control: A Mediterranean diet can be in line with the American Diabetes Association’s nutrition guidance. And because there are no rigid meal plans or prepackaged meals, you can ensure that what you’re eating doesn’t go against your doctor’s advice. Some research has shown that diabetics on a Mediterranean diet may improve their levels of hemoglobin A1C, a measure of blood sugar over time.

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