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Following the Mediterranean Diet Could Lower Your Risk of Depression, Study Suggests

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It seems as though the Mediterranean diet makes headlines every other week. There’s a reason why this eating plan is touted as one of the world’s most popular meal plans, as researchers around the globe continue to discover more healthful benefits. From helping shed pounds to keeping your heart ticking, the positive news about this plan never seems to end. And the latest update about the Mediterranean diet is especially exciting.

A September 2018 paper published in Molecular Psychiatry found that following a Mediterranean diet is linked to a lower risk of developing depression. In a systematic review of 41 studies, researchers looked at the best available evidence that a person’s diet could affect his or her risk of depression. The studies examined a wide variety of healthy eating plans, such as the Dietary Approaches to Stop Hypertension (DASH). But among all the diets, the most compelling evidence for a reduced risk of depression was found with the folks who most closely followed the Mediterranean eating plan.

“We aggregated the results of several studies and found a clear pattern that following a healthier, plant-rich, anti-inflammatory diet can help prevent depression,” wrote study author Camille Lassale in an article for The Conversation. “Of the 41 studies in our review, four specifically looked at the link between a traditional Mediterranean diet and depression over time on 36,556 adults. We found that people with a more Mediterranean-like diet had a 33 percent lower risk of developing depression than people whose diet least resembled a Mediterranean diet.”

If you’re interested in reaping all the many benefits that the Mediterranean diet has to offer, here’s everything you’ve ever wanted to know about this colorful, delicious, and easy-to-follow plan:

What is the Mediterranean diet?

The answer is quite simple: The Mediterranean diet meal plan focuses on colorful foods found in nature. “It is a healthy way of eating that is based on plant-based foods with a focus on fruits, vegetables, whole grains, legumes, nuts, and seeds,” says Rachel Berman, RD, CDN, general manager at VeryWell.com, and author of Mediterranean Diet for Dummies ($13.59, Amazon). While lean meat, seafood, and dairy are also part of this plan, Berman explains that these favorites are sprinkled in sparingly. “They’re not the main event — they’re more like a side dish,” she adds.

In fact, the nothing-is-banned rule is one of the many reasons why she favors this way of eating. “In our society, we tend to demonize or glorify certain food groups,” continues Berman. “But one component of your diet does not make or break it. The truth is, all of the food groups need to be incorporated into your diet in healthful amounts.”

Another reason why Berman is so passionate about the Mediterranean diet plan — which is based on the dietary patterns of 22 countries bordering the Mediterranean Sea — is because it’s more than just about the foods you’re putting onto your plate. “It’s about the lifestyle that goes along with the Mediterranean diet,” she states. “A few of those components include being much more mindful of how you’re eating, slowing down, enjoying life without letting food control your life, and eating until you’re full and then going for a walk.”

Mediterranean diet food list
Getty Images

(Photo Credit: Getty Images) 

Berman is also an advocate of this plan due to its simplicity (“There’s not a lot of fancy food to buy since everything you need can be found in your local grocery store”), its versatility (“It’s easy to make food swaps for those with specific dietary needs”), and its multitude of healthful benefits, such as lowering your risk of cardiovascular disease — including a heart attack or stroke — weight-loss, cancer, and mortality. “So in other words, you’re less likely to die following the Mediterranean diet plan,” adds Berman.

Mediterranean Diet Benefits

Yes, there are plenty! “First and foremost, you’ll see that a lot of the studies that have been done show the Mediterranean diet plan has the potential to protect against heart disease,” says Berman.

For example, according to research presented at the American College of Cardiology’s Annual Scientific Session in 2014, adults who follow the Mediterranean diet plan were 47 percent less likely to develop heart disease over a 10-year period compared to those who didn’t follow this lifestyle. Study authors asked more than 2,500 adults from Athens, Greece, between the ages of 18 and 89 to complete surveys about their eating and lifestyle regimens, as well as their medical history at intervals over one decade. The investigators noted that not only was this diet beneficial to people in all groups, but also both genders, as well as those who were healthy and those with preexisting health conditions. Plus, the Mediterranean diet plan was found to have indirect benefits in managing hypertension, diabetes, and inflammation.

And then there’s the link to reducing risk of cancer. In 2017, researchers from Israel found that those who consumed the Mediterranean diet with a focus on fruits and fish were less likely to develop colon cancer. In one study that was comprised of more than 800 people between the ages of 40 and 70 who were not at high risk for this disease, authors asked the volunteers to fill out a food questionnaire and share their results from a colonoscopy. The investigators discovered that the adults who had advanced intestinal polyps — which could lead to colon cancer — didn’t adhere to many of the dietary habits in the Mediterranean diet plan.

This regimen may also reduce your risk of breast cancer. According to a 2015 article published online by JAMA Internal Medicine, researchers from Spain gathered nearly 4,300 women between the ages of 60 and 80 and directed them to consume one out of three eating patterns over the course of six years. The results? The women who followed a Mediterranean diet plan supplemented with extra-virgin olive oil showed a 68 percent lower risk of malignant breast cancer.

The Mediterranean diet might be particularly beneficial for women over the age of 40. September 2018 research published in the American Heart Association’s journal Stroke found that following the Mediterranean diet might lower the risk of a stroke for women over 40. Researchers looked at more than 23,000 adults aged 40 to 77 and examined their diets for a period of 17 years. As it turned out, the female participants who adhered most closely to the Mediterranean diet reduced their stroke risk by 22 percent. Even better? This was the case regardless of whether or not the women had entered menopause yet. The results also remained the same when taking hormonal therapy into account.

And men can benefit, too. In January 2018, a study published in The Journal of Urology concluded that this diet can reduce the risk of aggressive prostate cancer. After analyzing the data of approximately 2,000 men from Spain with an average age of 66, the participants who regularly consumed fish, fruits, vegetables, legumes, and olive oil showed a “statistically significant protective effect” in developing tumors compared to the males who ate either a Western diet (refined grains, processed meats, sweets, and fatty foods) or Prudent diet (low-fat dairy products, whole grains, fruits, vegetables, and juices).

Older adults who want to stay active and independent should take note as well. An analysis of four studies conducted in four countries (France, Spain, Italy, and China) found that senior citizens who follow the Mediterranean diet plan may cut their risk of frailty by nearly half. These findings, which were published in a January 2018 edition of the Journal of the American Geriatrics Society, suggests that a plant-based meal plan can possibly lead to fewer falls, fractures, hospital stays, and operations (along with premature death) among the elderly.

In fact, the most current research to date — six articles published in the March 2018 issue of The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences — further suggests that the Mediterranean diet continues to be linked to a healthier aging. While different scales were used to measure this regimen’s effects, the numerous study authors found an association between the Mediterranean diet meal plan and strong physical and cognitive function, along with lower levels of inflammation in the body and improved metabolic health — a cluster of health factors, including weight, cholesterol levels, and sugar levels that can lead to chronic and fatal diseases.

If someone is considering fertility treatment options, the Mediterranean diet may be the best plan for conception. Researchers from Greece asked more than 240 women who were about to undergo their first round of IVF (in vitro fertilization) to complete a survey about their dietary habits. According to their report, the females who ate more fresh vegetables, fruit, whole grains, legumes, fish and olive oil, as well as a limited amount of red meat six months before this procedure were 64 to 68 percent more likely to achieve a successful pregnancy and birth.

Then there’s the most complex organ in the body — the brain! More than 400 Scottish adults around the age of 70 who did not have dementia submitted their eating habits to study authors before receiving two MRI brain scans that were administered three years apart. The investigators reported in a 2017 issue of the online journal Neurology that those who followed the Mediterranean diet plan maintained more brain volume — which means they were less likely to suffer from memory and learning issues.

How to Start the Mediterranean Diet

“Let me start off by saying that I don’t like to go by calorie count,” admits Berman. “I think healthy eating is all about balancing the plate and having all of the components at each meal that are nutritionally filling.” She’s also adamant about eating the foods that work best with your body. “Focus your energy on the foods that make you feel good,” she continues. “If for some reason a food doesn’t make you feel well, then there may be a legitimate reason, like you’re having an allergy to it, a sensitivity — then, of course, customize your diet.”

And the same goes for your palate. “Some people will say, ‘OK, I’m never going to eat meat or dairy,’ but it’s not just realistic,” states Berman. “In America, we tend to be on these very restrictive diets where we’re feeling bad or shameful. But the Mediterranean diet plan is about enjoying the food on your plate and indulging in smaller amounts.” A few of those indulgences include meat, dairy, desserts (“Every once in a while enjoy one scoop of full-fat ice cream”), and red wine.

Mediterranean diet information

(Photo Credit: Getty Images) 

Berman suggests starting with small changes that can realistically be incorporated into your diet today, then adding more changes down the road. For example, consider freezing grapes (“One of my favorites for a snack or dessert!”), adding fruit to your favorite breakfast meal, mixing whole-grain pasta with white pasta, baking falafel (a patty made from chickpeas and beans) instead of frying it, going with whole-grain bread, or including Greek yogurt instead of mayo. And begin to experiment with different flavors of vinegars — wine vinegars are rich and fruity in flavor, malt vinegars are mild and sweet, while rice vinegar is the sweetest of them all — as well as natural additives that may be hidden in your cupboard.

“Something else that is part of the Mediterranean way is using herbs and spices,” adds Berman. Not only do they enhance dishes with flavor, but the majority of herbs and spices (such as turmeric, ginger, and garlic) contain anti-inflammatory benefits.

Mediterranean Diet Sample Menu: What Does the Mediterranean Diet Consist Of?

A typical breakfast: Oatmeal topped with strawberries and a handful of chopped walnuts

Berman explains: “With the oatmeal, you’re getting complex carbohydrates and fiber; the walnuts provide protein and heart-healthy omega-3 fatty acids, and the strawberries offer a boost of antioxidants.”

A typical lunch: A traditional Greek salad with tomatoes, cucumbers, green peppers, some feta cheese sprinkled in, and a side of lentil soup

Berman explains: “The salad is loaded with nutrient-dense veggies, and the lentils are loaded with soluble fiber.” Plus, the feta cheese contains B vitamins and calcium, as well as fatty acids.

A typical snack: Plain regular or Greek yogurt with berries, sprinkled with cinnamon

Berman explains: The yogurt provides calcium and protein (note: Greek yogurt is higher in protein), the berries offer a big dose of antioxidants, including vitamin C, anthocyanins and quercetin — both which help reduce inflammation. Cinnamon is also an antioxidant and has been shown to help fight obesity. “The most important thing to say about yogurt is choosing one without added sugar and preservatives, or it could be like a dessert.”

A typical dinner: 5 oz. of salmon, broccoli, and a side of rice pilaf

Berman explains: Protein-packed salmon is also rich in omega-3 fatty acids, as well as potassium and B vitamins. Broccoli, a leafy green, is loaded with fiber and numerous vitamins and minerals, including vitamin A, C, E, folate, and phosphorus. Rice pilaf helps boost digestion, weight loss, and heart health, thanks to the fiber content.

A typical dessert: Something fruit-based, like a fruit tart.

Berman explains: “I love dessert, but I don’t know if there’s a typical Mediterranean diet dessert,” she states. “But making anything with fruit is always a good idea.”

Mediterranean Diet Food and Shopping Lists

Produce:

  • favorite fruits and vegetables of all colors (i.e. oranges, blueberries, green apples, tomatoes, spinach, beets, cauliflower)
  • fresh herbs, like basil, cilantro, parsley
  • onions, garlic, shallots
  • hummus (which is made from chickpeas)

Meats:

  • chicken
  • wild salmon
  • lean pork

Dairy:

  • grated Parmesan cheese
  • eggs
  • plain or Greek yogurt

Canned goods:

  • garbanzo beans (chickpeas)
  • black beans
  • lentils
  • canned tomatoes

Whole grains:

  • wild rice
  • whole-grain pita bread
  • Ezekiel bread
  • whole-grain pasta
  • quinoa

Healthy fats:

  • extra virgin olive oil
  • avocado
  • nuts (i.e. almonds, walnuts, hazelnuts)
  • seeds (i.e. chia seeds, flax seeds)

Vegetarian Mediterranean Diet Options

“If you’re not eating the meat, poultry, and seafood, you can still get plenty of protein from the beans and legumes, which are very present in this eating plan,” says Berman. This diet is actually easily adaptable for vegetarians since the key foods — fruits, vegetables, whole grains, nuts, and seeds — are vegetarian-friendly.

For example, Vegetarian Times offers a variety of Mediterranean-styles recipes, such as gyros that contain jackfruit  (a vegan meat replacement) and pita quesadillas with cilantro hummus  (sans cheese and chicken).

Is the Mediterranean diet low-carb?

Not exactly. “Carbohydrates are found in the vegetables, fruits, nuts, and grains,” states Berman. “The meat and dairy foods don’t have carbohydrates, yet these are the items that you should be eating more sparingly.”

However, she explains that one way to reduce the total number of carbs in this plan is to limit your intake of starchy vegetables — such as peas, sweet potatoes, corn, pumpkin, butternut squash, plantains, and parsnips — and opt for more non-starchy veggies, including broccoli, leafy greens, green beans, tomatoes, cucumbers, peppers, and cauliflower. “Honestly, I think the low-carb diet is the most difficult plan to adhere to,” adds Berman.

Is the Mediterranean diet gluten-free?

Yes, this eating regimen can be followed by those with celiac disease or gluten sensitivity. “There are plenty of grains that are gluten-free whole grains, including quinoa and rice, that can be incorporated for breads, cereals, and pastas,” states Berman. Other gluten-free whole grains include corn, oat, wild rice, and buckwheat.

Fresh fruits, veggies, healthy fats, and lean meats are naturally gluten-free. The majority of nuts and seeds are as well, but make sure to read the labels on packaged nuts for added flavors that may contain gluten. Most dairy foods are also gluten-free, yet some milk substitutes (like soy milk) may contain additives with gluten.

Also, consider livening up dishes with gluten-free condiments, such as mustard, horseradish, and salsa. (Again, double-check the labels for ingredients that contain gluten.)

Is the Mediterranean diet good for diabetics?

Absolutely! “Many of the foods on the traditional Mediterranean diet menu — fruits, vegetables, and whole grains — are very high in fiber, which helps control blood glucose levels,” says Berman.

In fact, research reported by the American College of Cardiology in 2014 stated that following the Mediterranean diet was associated with a lower risk of diabetes — especially among those who are at risk for heart disease. And these findings, which looked at 19 studies that consisted of more than 162,000 men and women, were the same regardless of someone’s age, sex, race, or culture.

“Plus, the other lifestyle components that are part of the Mediterranean diet plan, such as being mindful about eating at regular intervals throughout the day and getting exercise, greatly benefit anyone with diabetes, since these habits keep sugar levels at bay,” adds Berman.

Is the Mediterranean diet anti-inflammatory?

Of course, says Berman. “The things that cause inflammation in the body are refined carbohydrates (white breads, white pasta, baked goods), sodas, fast food, processed meats — anything that isn’t wholesome,” she explains. “But the foods that fight inflammation are the leafy green vegetables, fatty fishes, fruits, nuts, and olive oil — so basically all of the plant-based foods in this plan have anti-inflammatory effects!”

A 2017 article published online by Harvard Health Publishing, which is part of Harvard Medical School, recommends the Mediterranean diet meal plan for combatting illnesses that are linked to chronic inflammation, such as arthritis, depression, and Alzheimer’s, as well as cancer, diabetes, and heart disease. The foods highlighted in their report include tomatoes, olive oil, spinach, kale, almonds, walnuts, salmon, tuna, sardines, berries, cherries, and oranges.

Mediterranean diet cookbook

(Photo Credit: Getty Images) 

Does the Mediterranean diet lower blood pressure?

Once again, the answer is yes! Researchers from the University of Birmingham in the UK studied the impact almonds would have on young and middle-aged men, both healthy and with various cardiovascular risk factors, including high blood pressure. Their findings revealed that the high-fiber, high-fat food is also rich in vitamin E. This boosts the antioxidants in the bloodstream, which in turn lowers blood pressure levels and improves blood flow. The study authors deemed almonds a “superfood” and stated their work added “weight to the theory that Mediterranean diets with lots of nuts have big health benefits.”

Can the Mediterranean diet lower cholesterol?

Well, it can certainly improve it. Research from a 2017 edition of Circulation, a journal published by the American Heart Association, concluded that a Mediterranean diet rich in virgin olive oil can boost “good” HDL cholesterol. After blood samples were taken from nearly 300 random people with an average age of 66, study authors directed them to follow one of three eating regimens for one year: a traditional Mediterranean diet plan that included consuming four tablespoons of virgin olive oil each day, a traditional Mediterranean diet plan that included consuming a fistful of nuts each day, or a “controlled diet” that reduced red meat, processed food, high-fat dairy products, and sweets.

Participants from the olive oil group showed an improvement in HDL function, including relaxed blood vessels, which keeps the blood flowing. Plus, there was greater antioxidant protection, which lowers the risk of developing plaque in the arteries. Interestingly, the more olive oil someone included in their diet, the better the function.

Which Mediterranean diet book is the best?

Along with Berman’s book, Mediterranean Diet for Dummies, which offers more detailed information on the various health benefits of this lifestyle, along with shopping tips (like how to choose the best oils), we also recommend the following books:

The Complete Mediterranean Diet Cookbook: 500 Vibrant, Kitchen-Tested Recipes for Living and Eating Well Everyday ($18.56, Amazon) by The Editors at America’s Test Kitchen

Put on your apron, because it’s time to start cooking! Written by a team of more than 60 chefs who create foolproof recipes for PBS television shows, this book uses the guidelines of the Mediterranean diet pyramid and offers the home cook hundreds of recipes for every meal (sweets included), as well as nutritional information, conversion charts, and recipe variations.

The Mediterranean Diet Weight Loss Solution: The 28-Day Kickstart Plan for Lasting Weight Loss ($14.86, Amazon) by Julene Stassou, MS, RD

If your number one goal is to reduce belly fat (along with the number on the scale), this book offers weekly meal plans for nearly one month and 90-plus recipes that will help shed those unwanted pounds. The author also includes guidelines on portion control and exercise routines that will boost your chances for success.

Mediterranean Slow Cooker Cookbook: A Mediterranean Cookbook with 101 Easy Slow Cooker Recipes ($12.10, Amazon) by Salinas Press

If cooking meals hours ahead of time fits best with your schedule, consider this cookbook, which shows how versatile a slow cooker can be. Along with providing healthful recipes made with fresh ingredients for dishes like Mediterranean Beef Stew, Eggplant Parmigiana, and Chocolate Hazelnut Bread Pudding, the authors also provide tips on how to stock your pantry for slow cooker meals.

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