Experts weigh in on Mediterranean diet for improved health

Published on Wednesday, March 1, 2023

By: Andrea Wright Dilworth, awdilworth@umc.edu

For a solid decade, Dr. Laquita Cooper couldn’t get the scale to move below 210 pounds. Considered overweight by body mass index (BMI) charts, she tried a number of popular diets, including keto and Atkins, both of which limit carbs, and would lose a few pounds and inches, only to gain them back.   

To make matters worse, most diets made Cooper, a project manager with the University of Mississippi Medical Center’s Cancer Center and Research Institute, feel sick, weak and brain fogged. And still hungry. 

Fed up with yo-yo dieting, she made an appointment with Dr. Kimberly Bibb, an assistant professor at UMMC Weight Management Clinic who’s board-certified in family medicine and obesity medicine.  

Bibb suggested Cooper try the Mediterranean diet, named the best overall diet in January by U.S. News & World Report based on a panel of 33 experts comprised of physicians, registered dietitian nutritionists, nutritional epidemiologists and weight loss researchers recognized as leaders in their fields.   

Scientific research has consistently shown the Mediterranean diet provides multiple health benefits, including improved mortality and brain function, and reduced risks of heart disease, diabetes, certain cancers, depression, Alzheimer’s and Parkinson’s diseases, said Bibb, who has recommended it to many of her patients, with success.  

The added benefit is weight loss that is maintained over time. 

Based on traditional foods from countries bordering the Mediterranean Sea, the diet’s foundation consists of plant-based foods including whole grains, legumes, fruits, vegetables, nuts, seeds, herbs and spices, and olive oil the primary added fat, with seafood, poultry and dairy allowed in moderation, according to the Mayo Clinic. Water is the beverage of choice. Wine, too, can be consumed in moderation, and red meats and sweets are allowed occasionally.  

Diagnosed with late onset type 1 diabetes at 30, Cooper likes that the foods are unprocessed, don’t have added sugars and are easy to prepare. A bonus: her meals consist of foods she’s always eaten, including steamed broccoli, kale, turnip greens, bananas, grapes, melons, nut butters, beans, peas, brown rice, salmon, crab, tuna and shrimp.

“The food is tasty and rich in flavor, so there is no loss there. It’s fulfilling and gives a sense of not missing out on foods that are not good for my health.” 

Cooper, who lost 30 pounds on the diet and is back to her college weight, wearing sizes 6/8, has maintained the weight loss over two years by continuing to follow the plan for maintenance.  

People usually think of dieting as a temporary, restrictive way of eating that lacks a balance of healthy foods and isn’t sustainable long term, said Bibb. 

“The Mediterranean diet is effective because, by including a variety of healthy foods, it is not restrictive, is more flexible, and more sustainable over time compared to other diets. It can also help save money by buying less processed and fast food.”

Dr. Elizabeth Fryoux, an assistant professor board certified in internal medicine and obesity medicine, also at UMMC Weight Management Clinic, is cautious about labeling any diet “best” because she prefers to focus on lifestyle changes and moderation instead of strict diet regimens. 

“That being said, focusing on natural, whole foods and discouraging processed foods similar to the Mediterranean diet is what I recommend to patients.” 

Its variety makes it an attractive and inexpensive family-friendly plan because meals can be adjusted and items swapped for those with health restrictions, including vegan, vegetarian, gluten-free and kosher.  

 “We often discuss the Mediterranean diet with our patients, especially those with heart disease, high blood pressure and type 2 diabetes because clinical trials have shown it reduces the risk of cardiovascular disease, stroke and improves glucose control,” said Fryoux. 

Though the diet doesn’t specify a restricted caloric intake, Bibb tells patients to decrease and spread their daily consumption across three healthy meals and snacks, using U.S. Department of Agriculture guidelines for serving sizes. Those considered overweight or obese should also decrease calories to 1,200 to 1,500 daily (women) and 1,500 to 1,800 (men).  

Bibb also stresses to patients the importance of changing their relationship with food. That includes reading (and understanding) labels, using a fitness app for food journaling, and consulting with a registered dietician to help develop a personalized nutritional plan based on their specific needs.  

Instead of counting calories, Cooper practices portion control, using saucers instead of plates, and eating kid-sized meals and cup-sized portions when eating out.  

“Getting started and maintaining doesn’t happen overnight,” she said. “It does take time, effort and self-control.” 

Paul Robertson, a weight management dietitian who also recommends the diet when he believes a patient’s health will benefit from its principles, like Fryoux, doesn’t like to call it the “best.”

“I’m not personally a fan of the word ‘diet’ necessarily, so I tend to phrase it as making a lifestyle change that amends eating habits in a way that are generally heart-healthy and personalized for the patient’s taste preferences,” he said. “That said, those who truly commit to a lifestyle change do well.” 

The best approach to sustained weight loss is one personalized for the patient, he said.  

“My recommendation to follow the Mediterranean approach would be to research the diet itself and determine if it is something you would like to apply,” said Robertson. “If you select Mediterranean as the dietary approach for weight loss and need assistance, reach out to your local dietitian.” 

Bibb offers these recommendations to jump start the Mediterranean diet: 

• Make changes that are easy to incorporate into your daily routine, and gradually make one change each week.  
• Prepare a healthy Mediterranean meal by filling half the plate with non-starchy vegetables, one-fourth with whole grains and starchy vegetables, and one-fourth with protein such as fish, seafood or dried beans.  
• Use olive oil instead of butter, eat a handful of nuts instead of processed snacks, replace sugary beverages with water, and eat fresh fruit in place of high-fat sugary desserts.  
• Use a Mediterranean-based grocery shopping list, recipes and meal plans.  
• Visit local farmer’s markets for a good selection of seasonal fresh, locally grown produce. 
• Have meals as shared experiences with others, such as family or friends.

Regardless of your lifestyle regimen, Robertson suggests these tips for healthy weight loss and management: 

• Define your goal and keep it SMART: specific, measurable, attainable, relevant and time-bound. 
• Create a detailed, personalized plan that will help you reach your goal.   
• Keep the costs (time, energy, social, etc.) minimal to stay motivated.  
• Be flexible because life happens, and you may need to make some adjustments to stay on track.
• Weigh no more than once weekly, unless your doctor recommends otherwise.
• Tell someone about your goals for encouragement and accountability. 

Cooper said following the Mediterranean diet was easy, and though at her goal weight, she plans to follow the plan indefinitely. “I don’t feel like I had to give up anything to have a better quality of life when it comes to food selection and my health. 

“With older age comes stubborn weight loss, and I am a foody with type 1 diabetes, so I had to learn how to eat to live and not live to eat.”

The above article appears in CONSULT, UMMC’s monthly e-newsletter sharing news about cutting-edge clinical and health science education advances and innovative biomedical research at the Medical Center and giving you tips and suggestions on how you and the people you love can live a healthier life. Click here and enter your email address to receive CONSULT free of charge. You may cancel at any time.