Preventing DiabetesMarch 2009
How Does the Miami Mediterranean Diet Fight Diabetes?
Adherence to a Mediterranean-type diet, along with exercise, is a proven approach to lowering your risk of developing type 2 diabetes. All you need is healthy food, a knife and fork, and a good pair of walking shoes. In my book, The Miami Mediterranean Diet, you can read all the specifics of a Mediterranean diet that consists of fresh fruits and vegetables, whole grains, olive oil, cold water fish, red wine, nuts, and beans. If you’ve been regularly following the diet, I’m sure you’ve made use of the book’s hundreds of delicious recipes and suggested meal plans that can decrease your risk of developing type 2 diabetes, as well as hypertension and cardiovascular disease.
The Miami Mediterranean diet works in two ways to lower the risk of diabetes by: 1) including healthy foods that fight the causes of diabetes, and 2) eliminating toxic foods that increase the risks of the disease. The diet limits refined sugar, which clearly increases the risk of high blood glucose and diabetes. The worst player that is completely absent from the diet is high-fructose corn syrup, which increases inflammation in the body. Unfortunately, high-fructose corn syrup is now pervasive in the standard American diet. It is used as a preservative and to sweeten foods and drinks like sodas. The food industry has had a love affair with high-fructose corn syrup for decades because it is cheap and it allows foods to be preserved on the shelf. But we’ve paid a price for that, as high-fructose corn syrup increases inflammation in the body, as well as the amount of the lipoprotein called very low-density lipoprotein (VLDL), which is a major transporter of triglycerides.6 When high-fructose corn syrup is consumed, blood sugar goes directly to the liver instead of to muscle and fat cells. The liver utilizes the sugar to produce triglycerides. There simply aren’t any health benefits to be gained from high-fructose corn syrup like there would be if you ate a piece of fresh fruit such as an apple. Many physicians, myself included, believe that the significant increase in high-fructose corn syrup in the American diet has greatly contributed to the epidemic of insulin resistance and type 2 diabetes.7,8
Red meat and trans fats are two more unhealthy culprits that you will not find in the Miami Mediterranean diet. Both can increase inflammation in the body. The Harvard Nurses’ Health Study showed that even a slight increase in the amount of dietary trans fat translated into a significant increase in the development of type 2 diabetes.9 Trans fats are the biggest food processing disaster in history. They’ve been banned in some countries for years, and only now are we waking up in this country to the point where trans fats are being banned in some areas.
Foods included in the Miami Mediterranean diet fight inflammation and thus reduce the risk of developing type 2 diabetes.10 Olive oil, particularly extra-virgin, cold-pressed olive oil, has anti-inflammatory and antioxidant properties and has been shown in several trials to protect against insulin resistance and the metabolic syndrome. Indices of insulin resistance were significantly improved in people following a Mediterranean-type diet that included moderate consumption of olive oil and cold water fish. Cold water fish like salmon, sardines, and trout bring omega-3 fatty acids to the table, which exert anti-inflammatory effects. I regularly recommend moderate consumption of cold water fish or fish oil supplements for my patients who are at increased risk of cardiovascular disease. Red wine, consumed in moderation, and other components of the diet such as whole grains and fresh fruits and vegetables have all been shown in various studies to lower blood sugar and decrease insulin resistance.
Weight management is an important component of a diabetes prevention program, because obesity contributes to the development of type 2 diabetes. Fat cells secrete inflammatory proteins that interfere with insulin receptors, leading to insulin resistance and pancreatic beta-cell dysfunction.11 A Mediterranean-type diet, coupled with a program of regular exercise, supports healthy weight loss and weight management. When you consider the lifestyle of people in the Mediterranean region, you see that they eat healthy foods, avoiding highly processed foods that pack on the pounds and are found too often in the American diet. They are active during the day, walking as a matter of routine, and doing other activities like working in the garden. So along with the diet, be sure to incorporate activity into your daily life. Walking is the easiest way to do this. And a good walk after a delicious Mediterranean-style meal is a perfect way to reduce the stresses in your life.
Diabetes can be prevented and even reversed by following a Mediterranean-type diet and incorporating exercise into your lifestyle. I saw in my own practice that patients who followed these recommendations had less chance of developing type 2 diabetes. In fact, I have had patients with type 2 diabetes who went on the Miami Mediterranean diet and began a walking program see their blood sugar return to normal. Hippocrates said, “Let food be your medicine.” He was right all those years ago. By following the Miami Mediterranean diet, you are right on track for reducing your risk of both cardiovascular disease and type 2 diabetes.
Michael Ozner, MD is the author of The Great American Heart Hoax (Benbella Books, 2008) and The Miami Mediterranean Diet (Benbella Books, 2008).
1. Martinez-Gonzalez MA, de la Fuente-Arrillaga C, Nunez-Cordoba JM, et al. Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ. 2008 Jun 14;336(7657):1348-51.
2. Available at: http://www.diabetes.org/diabetes-statistics.jsp. Accessed December 10, 2008.
3. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998 Jul 23;339(4):229-34.
4. Baena-Diez J, Arboix A, Merino-Audi M, et al. Impaired fasting glucose as a risk factor for atherothrombotic or lacunar cerebral infarction. A case-control study. Neurologia. 2008 Nov 6.
5. Winkelmayer WC, Setoguchi S, Levin R, Solomon DH. Comparison of cardiovascular outcomes in elderly patients with diabetes who initiated rosiglitazone vs pioglitazone therapy. Arch Intern Med. 2008 Nov 24;168(21):2368-75.
6. Gaby AR. Adverse effects of dietary fructose. Altern Med Rev. 2005 Dec;10(4):294-306.
7. Elliott SS, Keim NL, Stern JS, Teff K, Havel PJ. Fructose, weight gain, and the insulin resistance syndrome. Am J Clin Nutr. 2002 Nov;76(5):911-22.
8. Johnson RJ, Segal MS, Sautin Y, et al. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr. 2007 Oct;86(4):899-906.
9. Salmeron J, Hu FB, Manson JE, et al. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr. 2001 Jun;73(6):1019-26.
10. Lairon D. Intervention studies on Mediterranean diet and cardiovascular risk. Mol Nutr Food Res. 2007 Oct;51(10):1209-14.
11. Bonora E, Brangani C, Pichiri I. Abdominal obesity and diabetes. G Ital Cardiol (Rome). 2008 Apr;9(4 Suppl 1):40S-53S.