The Mediterranean diet is known for its tasty cuisine and many health benefits, but with a changing food landscape, the Mediterranean diet has taken a back seat to processed foods and beverages with artificial flavorings, sweeteners, preservatives, and colorings. Local farms are disappearing as factory farming and mass production are taking dominance. These changes in the food system can have dramatic effects on the health and well-being of society. Not so coincidentally, the incidence of many chronic diseases has increased, one of the most prominent being type 2 diabetes.

As defined by the Mayo Clinic, diabetes is "A group of diseases that affect how your body uses blood sugar (glucose).”_¹ Although sugar is a major component of this condition, there are many components that can help cause, prevent, treat, or worsen type 2 diabetes. One of those is fat. In the typical American diet it is quite common to consume saturated and trans fat, which include butter, margarine, and animal fats. These types of fats have a chemical structure that can be easily stacked and forms a solid fat at room temperature._² The Mediterranean diet on the other hand provides unsaturated fats such as the omega 3 fatty acids (often found in the fat of fish), monounsaturated fat, and polyunsaturated fat_² as primary fat sources. These unsaturated fats have a chemical structure that is not easily stacked, and forms a liquid at room temperature._² Consuming mostly saturated or unsaturated types of fats will have different impacts on the body.

Consuming foods that contain saturated and trans fat are typically high-calorie foods, which contribute to weight gain, and being overweight causes a susceptibility to becoming insulin resistant. Insulin resistance is a contributing factor in developing type 2 diabetes_³ and can occur as fat molecules are released into the blood supply. This impacts cells that work in response to blood sugar, and diminishes the sensitivity of these cells. Unsaturated fats on the other hand, do not tend to stay in one’s bloodstream, and actually aid in the transport of digesting saturated fats.₃ Therefore, the types of fat being consumed in the Mediterranean diet could be one tool to aid in the prevention of type 2 diabetes.

The amount of fat consumed in the Mediterranean diet is not necessarily lower compared to other diets, however the type of fat is what makes all the difference. Olive oil is a source of monounsaturated fat and nuts/seeds are a source of polyunsaturated fat. In the study, Fish oil prevents insulin resistance induced by high-fat feeding in rats, it was found that the omega 3 fatty acids in the fat of fish proved to reduce and prevent insulin resistance. These findings indicate that the fat in fish, which is a main source of fat in the Mediterranean diet, works to lessen insulin resistance, causing a reduced risk for high levels of insulin in the bloodstream.₄

Saturated and trans fats raise one’s blood cholesterol and puts one at risk for developing heart disease.₅ These fats work similarly, and both raise a type of cholesterol that is referred to as LDL cholesterol, often referred to as “bad cholesterol.”₅ This cholesterol can be lowered by mono and polyunsaturated fats, like those found in in the Mediterranean diet.₅ Omega 3 fatty acids found in seafood prevent the formation of plaque in arteries, and can therefore help prevent heart disease as well.₅ The importance in reducing the risk for heart disease is very relevant to type 2 diabetes as diabetes leads to an increased risk of heart disease.₅ Heart disease is one of the most common ways for individuals with type 2 diabetes to have complications as blood vessels can become damaged in the presence of high blood sugar over time.₅

It should be noted that following a Mediterranean diet has been shown to reduce fasting blood sugar and A1C values.₂ In the research study Prevention and control of type 2 diabetes by Mediterranean diet: a systematic review, it was shown that both fasting blood sugar and A1C values were reduced more significantly when following a Mediterranean diet than when following a low-fat diet. This demonstrates that one should not simply cut out fat from their diet, but rather improve their fat sources in order to retain glucose sensitivity. By adhering to the Mediterranean diet, one will consume primarily healthy fats. Eating healthy fats is important for everyone, but especially in the case of diabetes. In order to prevent, treat, and take precautions against the risks that come with diabetes, following the Mediterranean diet is an effective approach to consuming fats in a healthy way.

References

1. Mayo Clinic Staff. Diseases and Conditions. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-20033091. Published July 31, 2014. Accessed June 7, 2015.

2. Benson G, Pereira RF, Boucher JL. Rationale for the Use of a Mediterranean Diet in Diabetes Management. Diabetes Spectrum. 2011;24(1):38-39.

3. Lovejoy JC, Smith SR, Champagne CM, et al. Effects of Diets Enriched in Saturated, Monounsaturated, or Trans Fatty Acids in Insulin Sensitivity and Substrate Oxidation in Healthy Adults. Diabetes Care. 2002;25(8):1286-1288.

4. Storlien LH, Kraegen EW, Chisholm DJ et al. Fish Oil Prevents Insulin Resistance induced by high-fat feeding in rats. Science 21. 2015;14(2):411-417.

5. Risérus U, Willett WC, Hu FB. Dietary Fats and Prevention of Type 2 Diabetes. Prog Lipid Res 2009;48(1):44–51

The Mediterranean Diet and Type 2 Diabetes

Tiana Lavin, Dietetic Intern

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