The Mediterranean Diet for your GUT

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Patients often ask me what diet to follow and whether or not to count calories, carbs, etc. Especially after watching documentaries like WHAT THE HEALTH, I’ve seen a growing interest in more of a plant-based diet, which is amazing! (I highly recommend for everyone to watch it!). Instead of following a specific diet or going through fads though, I think its best for people to concentrate on developing more of a lifestyle than a diet, such as a lifestyle that revolves around food as healthy, natural nourishment that brings you together with your friends and family. And one of the best lifestyles to follow is the Mediterranean one. In fact, the “Mediterranean diet” has a TON of science to prove its worth including the fact that 2 of the 5 “Blue Zones” — communities around the world where residents live particularly long and healthy lives — are in the Mediterranean region.  Adherence to the diet has been associated with: reduced metabolic syndrome, obesity, type 2 diabetes, reductions in overall mortality, cardiovascular mortality, cancer incidence and mortality, and incidence of Parkinson disease and Alzheimer disease and is effective in primary and secondary prevention of cardiovascular disease. Phew! I’d say that’s impressive!


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So, what exactly is the Med diet?

·      A TON OF: fruits, vegetables, whole grains, beans/legumes, nuts, seeds, fish, olive oil (important source of monounsaturated fat vs saturated)

·      MEDIUM: wine consumption, poultry, dairy

·      SPARINGLY: red meat, processed foods including added sugar, white bread

adapted from the  NYPost

adapted from the NYPost


When I say it s not a hip trendy diet…

·      The Med Diet was first described in the 1960s by Ancel Keys after results of the epidemiological “Seven Countries Study,” which demonstrated that the populations bordering the Mediterranean Sea had a lower incidence of cardiovascular disease and cancer.


It’s more than a diet. It's a lifestyle.

adapted from the  NYPost

adapted from the NYPost

·      In 2010, UNESCO described it as “the set of skills, knowledge, rituals, symbols, and traditions raging from the landscape to the table, which in the Mediterranean basin concerns the crops, harvesting, picking, fishing, animal husbandry, conservation, processing, cooking, and particularly sharing and consuming of food.


What are the specific evidence-based health benefits?

·      CANCER PREVENTION: Studies have found that a Med diet is associated with decreased risk for COLORECTAL, prostate, oropharyngeal, and breast cancer. In Mediterranean countries there is a lower incidence of breast, endometrial, colorectal, and prostate cancer compared with Western countries. These cancers have been hypothesized to have a relationship to diet, in that a low consumption of fruits/vegetables and a high consumption of red meat correlate with cancer incidence. By statistical modeling, some epidemiologists estimate that up to 25% of colorectal cancer could be prevented in Western countries if diets were changed to reflect Mediterranean practices

·      NAFLD (non-alcoholic fatty liver disease) is one of the most common chronic liver diseases worldwide and the spread of it in the West is strongly associated with the increasing prevalence of obesity and type 2 diabetes due to lifestyle and dietary habits. One large study found that adherence to the Med-Diet was inversely associated with insulin resistance, the main driver of NAFLD. Those with higher adherence had a progressive reduction of risk of having NAFLD and a more favorable metabolic profile including lower triglycerides and blood glucose. Another study of 4,700 adults from the NHANES cohort, showed that relationship between Med-Diet and insulin resistance may be mediated by abdominal fat. It is also a high antioxidant diet as it contains polyphenols and vitamin E, important in fatty liver as oxidative stress is one important factor implicated in NAFLD onset.

adapted from the  NEJM

adapted from the NEJM

·      WEIGHT LOSS : A 2-year study published in New England Journal of Medicine  compared a Med diet, Atkins diet, and a low-fat diet. At the end of 2 years, the weight loss was −4.4 kg for the Med diet group. In 24 months they lost 2 BMI points and  …

o   Decreased: waist circumference, blood pressure, CRP, leptin, fasting plasma glucose and HOMA-IR, liver tests.

o   Increased: HDL, adiponectin

o   The Med diet group had a higher ratio of monounsaturated to saturated fat than the other groups (P<0.001) and a higher intake of dietary fiber (P = 0.002)

The Lancet also published about an unrestricted-calorie, high-vegetable-fat Med diet associated with decreased weight and less gain in central fat compared with a control diet. These results lend support to advice not restricting intake of healthy fats for weight maintenance.

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My gut-friendly suggestion would be to make sure any seafood/meat you eat is antibiotic-free and don't eat much of it! And try to avoid dairy. Otherwise the Med diet is as gut-friendly as they get! #gutlove