Mediterranean diet for diabetics: what you need to know

Medically reviewed on April 23, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What is the mediterranean diet?
• The mediterranean diet: a detailed breakdown
• Is the mediterranean diet right for you?
• Create a customized eating plan with help from Everlywell
• Related content

Numerous national health organizations—like the US Centers for Disease Control and Prevention—recognize the potential benefits of a Mediterranean diet for diabetics. [1] Now, it’s important to note that the Mediterranean diet is more of a general framework for eating habits rather than a strict nutritional regimen. And it’s not a diet specifically designed for weight loss, diabetes management, illness prevention, or any other medical benchmark.

That said, there is emerging evidence to suggest that a Mediterranean diet can help people with diabetes manage their weight and sugar intake. [2]

So, how could the Mediterranean diet fit into your lifestyle?

In this guide, all you need to know about the Mediterranean diet for diabetics—how it works, which foods you should include in your eating plan, and more are covered.

What is the mediterranean diet?

The Mediterranean diet isn’t based on any official dietetic recommendations. Instead, it’s a loose framework for eating that closely mimics the dietary choices of Mediterranean residents in the mid-20th century. [2]

There are numerous countries in the Mediterranean region with distinct cultures and palates, but the Mediterranean diet mostly focuses on eating habits in the regions of: [2]

• Crete
• Greece
• Southern Italy

Why the emphasis on these specific places, and why hone in on the mid-to-late 1900s? At that time, people living in these areas experienced a relatively low rate of chronic disease and a higher-than-average life expectancy—even though they had less access to healthcare than their American counterparts. [2]

A modified food pyramid

Nearly 30 years ago, the Harvard University School of Public Health, Oldways Preservation and Exchange Trust, and the European Office of the World Health Organization released their Mediterranean Diet Pyramid: a loose visual guide of the eating framework. [3]

Here’s a breakdown of the pyramid from the base to the top: [3]

• Physical activity and social meals – At the base of the pyramid—representing the foundation of the diet—are physical activity and enjoying meals as a group. From the outset, this emphasizes the holistic aspect of diet and how it pertains to health as a part of lifestyle.
• The biggest group – The largest food group on the pyramid is quite diverse, featuring fruits, vegetables, whole grains, olive oil, beans, nuts, seeds, legumes, and spices. The pyramid recommends basing every meal around these foods.
• Fish and seafood – The largest protein group in the pyramid is fish, and this diet recommends eating fish and seafood as a primary protein source or incorporating them into a meal at least twice each week.
• Poultry, cheese, yogurt, and eggs – The pyramid recommends moderate portions of all of these foods—anywhere from daily to weekly servings.
• The top of the pyramid – The top of any food pyramid (though it seems misleading) typically represents the foods you should eat the least often. In the case of the Mediterranean diet, red meat and sweets are at the top of the pyramid.
• The side of the pyramid – Along with the foods listed in the pyramid, the publishing organizations recommend consuming red wine in moderation and drinking plenty of water.

Possible advantages for diabetics

While research is still ongoing, current data suggest that a Mediterranean diet for diabetics could support: [1]

• Cardiovascular health – People living with diabetes are at a higher risk for heart health complications. [4] Diabetics can experience high blood sugar levels, which can lead to high blood pressure, elevated low density lipoprotein (LDL) cholesterol, or high triglycerides. For diabetics with heart problems, healthcare experts recommend limiting intake of saturated fat and sodium—the Mediterranean diet being low in both of these types of foods. [1]
• Weight loss – Obesity and diabetes can be closely related. Because people living with diabetes struggle with insulin sensitivity and sugar regulation, they often experience weight gain. [5] While weight maintenance should always be based on guidance from a healthcare provider, two key elements of the Mediterranean diet could help you maintain a healthy body weight: eating more dietary fiber and increasing your physical activity. [1]
• Healthy immunity – Since the Mediterranean diet calls for lots of vitamin-packed fruits and vegetables, it might help diabetics maintain a healthy immune system. [1]

The mediterranean diet: a detailed breakdown

Let’s dig deeper into the Mediterranean diet—the recommended foods and the potential benefits of these foods for people living with diabetes.

Plant-based foods

Plant-based foods are a cornerstone of the Mediterranean diet. [6] Experts suggest that people following this framework should plan their meals around one or more of the following: [6]

• Fruits
• Vegetables
• Whole grains
• Legumes
• Nuts
• Herbs and spices

Each of these foods offers potential health benefits, some of which you might already know. Let’s take a closer look at:

• Fruits – Fruits do not contain cholesterol, and they’re generally low in fat and sodium. In addition, they feature critical vitamins, nutrients, and minerals like fiber, potassium, folate (vitamin B), and vitamin C. [7]
• Vegetables – Vegetables (especially leafy greens) are also packed with key vitamins and minerals. They can help you maintain a healthy blood pressure, manage your heart health, and support your immune system. [8]
• Whole grains – [Whole grains versus refined grains](https://www.everlywell.com/blog/virtual-care/whole-grains-vs-refined-grains/) are different, so make sure you get the right types. Refined grains are processed to optimize shelf life and texture, but whole grains feature all three nutritious parts of the grain: the germ, the endosperm, and the bran. [9] Refined grains typically only contain the endosperm, but the germ and the bran feature critical vitamins and nutrients that can support healthy body function. [9]

Olive oil as a fat source

Instead of butter and other types of oils, olive oil is the primary fat source recommended in the Mediterranean diet.

This is partially due to historical context: since olives were so widely grown in Greece, Crete, and Southern Italy, people living in these areas have been using olive oil (for culinary and other purposes) for more than 4,000 years. [10]

In terms of health benefits, research on olive oil is still ongoing. But current evidence supports a variety of possible advantages to using extra virgin olive oil in cooking: it’s low in saturated fat, may protect blood lipids from oxidation, and could help prevent coronary heart diseases (CHDs). [11]

Dairy

The Mediterranean diet framework generally calls for moderate intake of cheese, Greek yogurt or other types of yogurt, eggs, and other dairy products. [6]

Since this diet isn’t based on any formal guidelines from dieticians, “moderate intake” can look a little different for each person. You might choose to:

• Eat eggs for breakfast one or two days each week
• Have cheese as an afternoon snack every other day
• Use milk or cream in sauces
• Eat Greek yogurt parfaits for dessert instead of ice cream or baked goods

Perhaps the most important benefit of including dairy in your diet is support for healthy bones: dairy contains calcium, potassium, Vitamin D, and protein. [12]

Fish and poultry

Fish and poultry are the Mediterranean diet’s primary protein sources, and Harvard’s food pyramid generally recommends eating more fish than poultry. [3]

Fish is generally recognized as a highly nutritious food that can also support heart health and provide a healthy source of iron and omega-3 fatty acids. [13] But experts recommend that people who are pregnant or breastfeeding avoid fish species that are high in mercury, like: [13]

• Marlin
• King mackerel (sometimes called “kingfish”) and Spanish mackerel
• Swordfish
• Bigeye tuna (not to be confused with blackfin tuna, though they look very similar)
• Tilefish

If you’re ever looking to mix up your Mediterranean diet, consider poultry sources other than chicken, like:

• Turkey
• Quail
• Dove
• Duck
• Grouse

Red wine

While it’s not explicitly included in Harvard’s pyramid, Mediterranean diet advocates generally recommend drinking red wine in moderation as an alcohol source. [2]

It’s important to note that alcohol isn’t right for everyone: if you rarely drink, consider asking your healthcare provider whether or not alcohol will interfere with any of your prescription medications.

That said, emerging evidence suggests that red wine might offer health benefits when consumed in moderation: [14]

• Red wine is high in antioxidants, which can help neutralize free radicals.
• While research on free radicals is still ongoing, free radicals can possibly contribute to chronic illnesses like cancer and heart disease.
• One of the antioxidants in red wine—resveratrol—could help prevent cardiovascular disease by neutralizing reactive oxygen species and nitrogen radicals and by reducing platelet aggregation (which can cause blood clots).

Foods to avoid: red meat and sweets

At the top of the Harvard Mediterranean diet pyramid are red meat (beef and pork) and sugary desserts. [3] Instead of sweets (like ice cream, baked goods, or candy), advocates for the Mediterranean diet recommend sweet alternatives like:

• Fruit and yogurt parfaits
• Honey, agave, and/or other natural sugar sources

Instead of red meat, Mediterranean diet devotees typically choose fish, poultry, and eggs as primary protein sources. But, remember that the Mediterranean diet is a loose framework; enjoying these foods in moderation (one serving per week or less) isn’t against the rules.

Is the mediterranean diet right for you?

For people living with diabetes, a Mediterranean-style diet could help them reap some of the rewards of a balanced diet, generally low in fat and sugar. But is this diet right for you?

Before you make any major dietary changes, we recommend talking to your healthcare provider. They can help you create a customized eating framework that meets your dietary needs and accommodates any ongoing health issues.

Since the Mediterranean diet isn’t a strict regimen, like stipulating calorie counts or complete elimination of any foods, testing it out is unlikely to produce negative health results.

Create a customized eating plan with help from Everlywell

A Mediterranean diet for diabetics might help manage blood glucose and support other health outcomes while living with chronic health challenges. Remember to speak to a healthcare provider (ideally a Registered Dietician) before making any major changes to your current nutrition plan.

If you’re looking for a personalized diet plan to help you achieve your health goals and balance your blood glucose levels, Everlywell is here to help. Our community is over one million strong, and we’re passionate about connecting people with licensed providers and expanding access to quality medical care. Our online weight management offering can help you connect with licensed clinicians to support your journey to health and wellness.

Whether you’re looking for general care, energy support, or nutrition advice, learn more about our products and services.

Related content

Foods that give you energy

Benefits of leafy greens

Obesity and diabetes: what's the link?

Whole grains vs. refined grains: what's the difference?

References

1. CDC. Healthy Eating for People With Diabetes. Centers for Disease Control and Prevention. Published December 6, 2022. URL. Accessed April 20, 2023.
2. Harvard School of Public Health. Diet Review: Mediterranean Diet. The Nutrition Source. Published December 12, 2018. URL. Accessed April 20, 2023.
3. Oldways. Mediterranean Diet | Oldways. Oldways. Published 2019. URL. Accessed April 20, 2023.
4. Centers for Disease Control and Prevention. Diabetes and Your Heart. Centers for Disease Control and Prevention. Published 2021. URL. Accessed April 20, 2023.
5. Naeem N, Basit A, Shiraz A, et al. Insulin-associated Weight Gain in Type 2 Diabetes and Its Relation with Caloric Intake. Cureus. Published online July 30, 2019. URL. Accessed April 20, 2023.
6. McManus K. A practical guide to the Mediterranean diet - Harvard Health Blog. Harvard Health Blog. Published March 11, 2019. URL. Accessed April 20, 2023.
7. MyPlate. Fruits | MyPlate. www.myplate.gov. Published 2020. URL. Accessed April 20, 2023.
8. U.S Department of Agriculture. Vegetables | MyPlate. www.myplate.gov. Published 2020. URL. Accessed April 20, 2023.
9. U.S. Department of Agriculture. Grains | MyPlate. www.myplate.gov. Published 2020. URL. Accessed April 20, 2023.
10. Vossen P. Olive Oil: History, Production, and Characteristics of the World’s Classic Oils. HortScience. 2007;42(5):1093-1100. URL. Accessed April 20, 2023.
11. Mazzocchi A, Leone L, Agostoni C, Pali-Schöll I. The Secrets of the Mediterranean Diet. Does [Only] Olive Oil Matter? Nutrients. 2019;11(12):2941. URL. Accessed April 20, 2023.
12. USDA. Dairy | MyPlate. www.myplate.gov. Published 2020. URL. Accessed April 20, 2023.
13. Nutrition C for FS and A. Advice about Eating Fish. FDA. Published online February 17, 2022. URL. Accessed April 20, 2023.
14. Snopek L, Mlcek J, Sochorova L, et al. Contribution of Red Wine Consumption to Human Health Protection. Molecules : A Journal of Synthetic Chemistry and Natural Product Chemistry. 2018;23(7). URL. Accessed April 20, 2023.