The Mediterranean diet — which gets its name from the traditional eating and cooking patterns of people in countries bordering the Mediterranean Sea — has long been studied for its heart health benefits. But research suggests this approach can also offer specific advantages for people living with type 2 diabetes. Among them: improved blood sugar, weight loss, and satisfying and flavorful ingredients.

How a Mediterranean Diet May Help You Manage Type 2 Diabetes

Overall, the Mediterranean diet offers more of the foods your body needs, such as vegetables, whole grains, and healthy fats, and less of what it doesn’t, including red meat, refined carbohydrates, and sugary fare, says Nicole M. Bereolos, PhD, MPH, a certified diabetes care and education specialist (CDCES) in Dallas.

In past research published in the American Journal of Clinical Nutrition, scientists in the United Kingdom compared the Mediterranean diet with vegetarian, vegan, low-carbohydrate, high-protein, high-fiber, and low-glycemic index diets, and found that the Mediterranean diet came out on top. Study participants following Mediterranean, low-glycemic index, low-carbohydrate, and high-protein diets all experienced better blood sugar control, as was indicated by their lower A1C scores. (A1C is a measure of average blood sugar levels over a three-month period.) But people following the Mediterranean diet saw significant additional benefits — they lost the most weight and saw improved cardiovascular health, including better cholesterol levels.

"The Mediterranean diet is rich in fruits and vegetables, and uses whole grains and lean protein, such as fish, as well as olive oil and nuts as the sources of fat," says Betul Hatipoglu, MD, an endocrinologist with University Hospitals in Cleveland. "These healthy choices make the diet very rich in monounsaturated fat and fiber, and both have been known to lower cholesterol and blood sugar in people with diabetes."

That’s why the Mediterranean diet is known as a heart-healthy style of eating. “In diabetes, it’s all about reducing your risk for having complications from the disease,” says Sharon Movsas, a registered dietitian with Montefiore Health System in the Bronx, New York. “One of the leading complications is cardiovascular disease, including heart attacks and strokes,” she says. If that wasn’t enough, diabetes also often comes with high blood pressure and cholesterol, both factors that increases the risk of heart disease.

A Mediterranean diet protects the heart by lowering and controlling blood pressure and cholesterol levels. According to a study published in February 2017 in Atherosclerosis, eating an olive oil-rich Mediterranean diet for 1.5 years improved arterial blood flow better than a standard low-fat diet in people with type 2 diabetes and prediabetes. That improvement in arterial function can help slow the development of atherosclerosis, or the buildup of plaque in artery walls. Other research indicates that the anti-inflammatory and antioxidant properties of the diet reduces odds of having a cardiovascular event (like a heart attack) by up to 30 percent.

The Mediterranean diet furthermore allows red wine, fat-free or low-fat dairy (such as yogurt), eggs, and lean meat all in moderation, says the Everyday Health nutritionist Kelly Kennedy, RD. Flavoring food with herbs and spices instead of salt is also encouraged. “It typically replaces saturated and trans fats with unsaturated fats, and this might explain the positive effect on insulin sensitivity," Kennedy says. Research also suggests that it may be the high concentration of polyphenols (antioxidant plant compounds) in the foods typically included in the Mediterranean diet that assists in decreasing insulin resistance, per a review published in August 2017 in Oxidative Medicine and Cellular Longevity.

How a Mediterranean Style of Eating May Help Prevent Type 2 Diabetes

It’s not just people who have diabetes who benefit from this style of eating. Those who are at risk for the disease (like those managing metabolic syndrome), may reduce their odds of developing diabetes by 23 percent, concluded a systematic review and meta-analysis published in August 2015 in BMJ Open. Mediterranean eating was also superior to low-fat diets for blood sugar control, the researchers reported.

One of the misconceptions about the Mediterranean diet stems from the word “diet” in its name. “This is a way of eating, approaching food, and making a lifestyle change. It’s not something that people do for six months and be done,” says Bereolos. In fact, it appears to be just as good as other diets, like low-fat, low-carb, and the American Diabetes Association diet for long-term (greater than one year) weight loss, according to a review of randomized clinical trials published in April 2016 in The American Journal of Medicine.

Committing to the change is worth it. In addition to being associated with a lower risk of diabetes, following the eating plan is also linked to a lower risk of overall mortality, certain cancers, and diseases like Alzheimer’s and Parkinson’s, notes a review published in January 2018 in the European Journal of Clinical Nutrition.

Complete Food List: Diabetes-Friendly Mediterranean Diet Foods to Eat and Avoid

Switching to a Mediterranean diet isn’t as radical or complicated as it might sound — and, though we wouldn't discourage you from visiting, you don’t have to move to southern Europe to adopt the region’s eating style. Like many healthy diets, it starts with choosing fresh fruits and vegetables whenever you can, and using lean protein sources such as fish, skinless chicken, and legumes rather than red meat, says Dr. Hatipoglu.

Fill your kitchen with a few staples to help you make the transition. As Kennedy says, “The key with the Mediterranean diet is that it emphasizes minimally processed foods." Here's a shopping list to help you stock up:

Foods to Eat on the Mediterranean Diet

Whole grains

Brown rice
Barley
Quinoa
Bulgur
Farro
Buckwheat
Wheat berries
Whole-grain bread, rolls, tortillas, and pasta

Nuts, seeds, beans, and legumes

Almonds
Walnuts
Pistachios
Cashews
Sunflower seeds
Sesame seeds
Beans (kidney beans, white beans, cannellini beans)
Chickpeas
Lentils
Peas
Peanuts

Vegetables

Avocados
Bell peppers
Brussels sprouts
Asparagus
Tomatoes
Leafy greens (spinach, lettuce, kale, collards)
Broccoli
Cabbage
Cucumbers
Eggplants
Leeks
Artichoke
Beets
Carrots
Celery
Fennel
Radish
Onions
Zucchini

Fruits

Melons
Figs
Dates
Grapes
Pomegranates
Citrus fruits (oranges, lemons, grapefruit)
Berries (raspberries, blueberries, blackberries)
Apples

Healthy fats

Olives
Olive oil

Drinks

Water
Coffee
Tea
Wine (in moderation)

Fresh fish and seafood

Salmon
Sardines
Halibut
Shrimp
Mussels
Albacore tuna
Trout
Mackerel
Herring

Healthy dairy, eggs, and poultry

Reduced-fat cheese
Low-fat or nonfat yogurt
Low-fat or nonfat milk
Eggs
Poultry (chicken, turkey, etc.)

Herbs and spices

Basil
Garlic
Cumin
Cloves
Cinnamon
Chili powder
Saffron
Mint
Ginger
Oregano
Nutmeg
Rosemary

Foods to Limit on the Mediterranean Diet

Beef
Lamb
Pork
Burgers
Butter
Sweets (cakes, cookies, candy)

Foods to Avoid on the Mediterranean Diet

Processed meats (hot dogs, sausage, deli meat, chicken nuggets)
Ultra-processed foods (chips, muffins, sugary cereals)
Fast food
Soda and other sweetened drinks

7-Day Meal Plan for a Diabetes-Friendly Mediterranean Diet

Here are some basic meal ideas that fit in a diabetes and Mediterranean diet, in part courtesy of Bereolos and Movsas.

DAY 1

Breakfast Greek yogurt topped with sliced almonds and raspberries

Lunch Green salad topped with chickpeas, quinoa, and a hard-boiled egg drizzled with vinaigrette.

Snack Walnuts and a sliced pear

Dinner Whole grain pasta with ground turkey, broccoli, and mushroom sauce

Dessert Small fig bar

DAY 2

Breakfast Veggie omelet with cheese

Lunch Lentil soup with side salad topped with olive oil and lemon

Snack Slice of whole-grain bread topped with ricotta and a sliced fig

Dinner Roasted chicken with zucchini and farro

Dessert Grilled peach

DAY 3

Breakfast Muesli with berries

Lunch Vegetarian chili with whole-grain crackers

Snack Hummus and sliced vegetables

Dinner Salmon with orzo and Brussels sprouts

Dessert Fruit sorbet with a sprinkle of nuts

DAY 4

Breakfast Slice of veggie frittata with fruit

Lunch Whole-grain pita with hummus, chopped vegetables, and olives

Snack A container of low-fat yogurt

Dinner Shrimp with artichokes and olives

Dessert A few candied walnuts

DAY 5

Breakfast Slice of whole-grain toast with cheese and fresh fruit

Lunch Green salad topped with roasted squash, pumpkin seeds, and salmon

Snack Mixed nuts

Dinner Sauteed kale with cannellini beans (aka beans and greens)

Dessert Berries with a dollop of Greek yogurt

DAY 6

Breakfast Shakshuka (eggs cooked in spicy tomato sauce)

Lunch Chickpea, quinoa, and veggie bowl

Snack Sunflower seeds

Dinner Lamb with potatoes and green beans

Dessert Poached pear

DAY 7

Breakfast Yogurt with fruit and low-fat, low-sugar granola

Lunch Avocado whole grain toast with pumpkin seeds and a dash of lemon juice on top

Snack Roasted chickpeas

Dinner Halibut with sautéed spinach and ratatouille

Dessert Fig stuffed with ricotta

Where to Find Diabetes-Friendly Mediterranean Diet Recipes

It’s not hard to find recipes that are compliant with the Mediterranean diet. Here are some standout resources for meal inspiration.

American Diabetes Association (ADA)

Check out the ADA’s Diabetes Food Hub. Movsas likes this site because it helps you plan your meals ahead of time — a recipe for success. You can search depending on your wants (a vegetarian meal, budget-friendly) and you’ll get a list of recipes that fit. It will also help you create a shopping list.

Cookbooks

Poring over a cookbook is a great way to learn new skills, understand the style of cooking, and whet your appetite. Try The Mediterranean Diet Cookbook for Beginners by Elena Parvantes, RDN, or The Mediterranean DASH Diet Cookbook by Abbie Gellman, RD, CDN, or The Mediterranean Diabetes Cookbook by Amy Riolo.

Blogs

Try out new culinary skills, get step-by-step instructions, and sign up for meal plans through blogs like The Mediterranean Dish.

5 Expert Tips for Maintaining a Mediterranean Diet While Managing Diabetes

Even though the Mediterranean diet is inherently healthy for people managing type 2 diabetes, you’ll still need to watch your carbs. Here are some quick tips to keep in mind overall as you make the switch.

1. Watch the Legumes

“Beans, peas, chickpeas, and lentils all have phenomenal nutrients and fiber, but fundamentally, they’re still a carbohydrate, and that will affect your blood sugar,” says Bereolos. That does not mean you should actively avoid them, but be aware of the amount of carbs they’re contributing to your diet, especially if you’re taking insulin.

2. Talk to Your Doctor About Alcohol

Alcohol in moderation, particularly red wine, is allowed on the Mediterranean diet. But that doesn’t mean it’s right for you and your health. “Ask your physician about alcohol and possible interactions with the medications you’re taking,” says Bereolos.

3. Make Small Changes to Your Plate

A registered dietitian or a CDCES can help you develop a strategy for making a Mediterranean eating plan work for your food preferences and lifestyle. “I encourage people to be as honest as they can with their healthcare team — that’s the only way you’ll be able to get the information you need,” says Bereolos. For example, if you’ve been eating a fast-food breakfast five days a week, tell your provider. “We will work with where you’re at and help you make a change that works for you,” she says.

4. Keep in Mind That Portion Size Still Matters

Weight management in diabetes is important for controlling blood sugar, blood pressure, and cholesterol, says Movsas. For that reason, even if you’re eating healthy foods, “portions matter. Excessive calories can come from overeating healthy foods like olive oil, whole grains, and beans,” she says. Drizzle vegetables in 1 tablespoon of olive oil (120 calories, 0 grams [g] carbs) or stick with a half cup of brown rice (119 calories, 25 g carbs) rather than eating unlimited amounts.

5. Know the Meaning of ‘Occasional’

Red meat (and even some of your favorite processed foods) is still an option when you go Mediterranean, but these foods are to be eaten “on occasion.” “My definition of ‘occasion’ is not three or four times per week. It’s one to two times per month,” says Bereolos. If you eat more in the beginning — that’s okay. She doesn’t want you to feel guilty or regretful, just move forward and take steps toward the goal of eating in a more Mediterranean way.

A Summary on Going Mediterranean for Diabetes Prevention and Management

Begin to mesh the Mediterranean diet into your life — swapping high-fat meats for beans, lentils, and fish, adding more fruits and vegetables to your plate, and making most of your grains whole — and you should see big improvements in diabetes control and your health.

Additional reporting by Diana Rodriguez.

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