With type 1 diabetes (T1D), knowing what foods to eat and how much of them can be confusing. What’s more, there are so many different diets, and it can be challenging to know if they meet your nutritional needs. 

While there isn’t a “best” diet for everyone, the Mediterranean diet has grown in popularity as a flexible, healthy eating pattern originating from areas bordering the Mediterranean Sea. It also has a stamp of approval from the American Heart Association to help reduce the risk of cardiovascular disease. 

As a diet that’s rich in extra virgin olive oil, legumes, whole grains, nuts and fruits, vegetables, and fish, it’s widely encouraged and recognized for its health benefits. But is it good for people living with diabetes, and does it offer similar results in different cultures? Let’s look at what science has to say.  

 

Health benefits of the Mediterranean diet with T1D 

Researchers have linked the Mediterranean diet to a longer lifespan and a lower risk of cardiovascular disease, metabolic issues, and even certain types of cancer. 

Findings from a study of youth (<20 years old) living with T1D suggest a correlation between the Mediterranean diet and improvements in glucose levels and cardiovascular health.  

Results from another study of young adults with T1D (average age of 18) following a Mediterranean diet for six months showed improvements in glucose values and overall nutrition.  

A six-year longitudinal study suggests DASH (Dietary Approaches to Stop Hypertension) and Mediterranean eating patterns reduce the risk of atherosclerosis in people with and without T1D.  

 

How do I know what dietary changes to make? 

Start by looking at the Mediterranean food pyramid. Even small changes matter. Increasing whole, minimally processed, and plant-based foods in your everyday diet is key. This includes whole grains, legumes, vegetables, fruits and nuts. 

For example, if you’re not eating many vegetables, consider adding more to your meals and snacks. Think of the vegetables you enjoy and try new recipes. Set one goal at a time until you gradually increase your score.  

With T1D, a diet rich in vegetables and whole grains adds dietary fiber and can impact after-meal glucose levels, boosting overall energy and health. 

 

What is a Mediterranean Diet Score? 

The Mediterranean Diet Score (MDS) is a tool that a registered dietitian uses to assess Mediterranean diet choices and make recommendations.  

Scores range from 0 to 9 (diets rich in recommended foods give the highest scores). The scale focuses on consuming vegetables, fruits and nuts, legumes, cereals, fish, and healthy fat choices (olive oil).  

If you live with T1D, an MDS can help you track healthy diet changes. For example, if your baseline score is 5, you’ll know there’s room for improvement. A registered dietitian can help to shape your goals. 

 

Start with this easy self-assessment tool.  

  • Focus on one or two areas to improve your score 
  • If you are lacking in beans and vegetables, try using canned, low-sodium beans as a dip for your vegetables 
  • Increase your nut intake by snacking on walnuts and almonds — or have them with sliced fruit for a crunchy afternoon snack 

Raising your score by just two points can reduce the risk of heart disease, cancer, Alzheimer’s, and depression.  

 

Eating for health and longevity 

The Mediterranean diet has become known for its outstanding health benefits and simplicity for long-term maintenance. But what makes it so special?  

I sat down with Maggie Moon, a Registered Dietitian and best-selling author of the MIND Diet: A Scientific Approach to Enhancing Brain Function and Helping Prevent Alzheimer’s and Dementia, to find out.  

The foundations of Moon’s book are a mix of the Mediterranean and DASH diets. Research suggests both diets are associated with a lower cardiovascular risk in people living with T1D.  

Moon has found that success comes when clients have the agency to choose healthy food changes that suit their preferences. Studies show that diets consisting of accessible, affordable, and culturally familiar foods are more effective and acceptable. 

 

Who is the Mediterranean diet best for? 

Moon doesn’t believe everyone should “Mediterraneanize” a non-Mediterranean diet. Rather, she suggests balancing traditional food choices alone or in combination with Mediterranean foods to maximize health benefits. 

She explained that Mediterranean diet research has led to an increased understanding of common health-promoting foods and habits that translate well within different communities.  

Take Korean foods, for example. Traditional foods include seafood, leafy greens, and fruits that tie into Mediterranean foods. “Korean food is characteristically communal,” explained Maggie Moon, who grew up in Southern California, where she experienced a rich blend of her South Korean heritage at home and American culture outside of it. 

Rather than switching to a Mediterranean diet, Moon suggests using cultural foods with similar health benefits. Korean and Mediterranean foods emphasize plant-based foods, seafood, and limited animal products.  

“Traditional Korean food is already healthy and doesn’t need to be ‘Mediterraneanized’ to be healthy,” said Moon. It also limits the intake of added sugars, and individuals often indulge in fruit as a snack or dessert. Besides this, the Korean diet offers unique health benefits from fermented foods and the social practice of sharing meals and social connections. 

 

Can the Mediterranean diet be adapted to fit other cultures?  

Multiple research studies say yes.  

You can get started by swapping similar foods within your own culture. As the research suggests below, you can enjoy your traditional foods while incorporating the health benefits of Mediterranean-style choices. 

The Puerto Rican Optimized Mediterranean-Like Diet (PROMED) replaced Mediterranean foods with Puerto Rican foods. PROMED successfully reduced cardiometabolic risk in month four through cultural foods and messaging.  

In another study, Puerto Ricans who scored high on the Mediterranean diet had lower waist circumference, BMI, lower insulin resistance, and lower inflammation.  

Similarly, Chileans successfully integrated Mediterranean principles into their traditional cuisine to manage overweight, obesity, and metabolic syndrome.  

Studies on African Americans and Japanese Americans have also highlighted the effectiveness of Mediterranean-style adaptations in reducing cardiovascular risk mortality. 

 

Five ways to enhance your cultural diet with T1D 

Use your traditional foods for a healthier diet. Here’s how: 

  1. Add healthy foods, like fruits, vegetables, legumes, nuts and seeds, and whole grains. 
  2. Limit/avoid foods to improve your health, such as sweetened beverages, processed meats, and ultra-processed foods with little or no nutritional value, like candy or donuts.
  3. Swap foods for healthier options, such as olive or avocado oil instead of butter or lard.
  4. Select the right portions by eating enough food regularly to stay satisfied and healthy. This can help you to avoid overeating and undereating. A registered dietitian can help.
  5. Eat vegetables daily in side dishes, added to stews, garnishes, or as main dish ingredients.

 

Wrapping it up 

Clearly, embracing a balanced diet with real, whole foods is one of the healthiest ways to eat. It may take some time to adjust, but you’ll quickly begin to reap its health benefits. Despite its challenges when applied outside the Mediterranean region, it is adaptable to culture-specific foods containing similar nutritional profiles. 

Your diet is only one-factor influencing overall health. Other habits, such as adequate sleep, regular movement, and stress management, also matter.