We’ve all been bombarded with mixed healthy eating messages over the past few decades, and we continue to be, particularly from the tabloid press and some misguided social media sites. This often leads to misinformation and confusion about which style of eating to follow for optimum health. However, there’s no need to be confused any longer because the research is all pointing towards one very sensible, balanced style of eating; the one known as ‘the Mediterranean diet'.  

Reducing inflammation and overall disease risk

As it happens, the very diet that scientists recommend in helping to reduce inflammation, and thereby help to manage an arthritis condition, is the very same one that has also been shown to reduce the risk of coronary heart disease and cognitive decline, in addition to helping to stabilise blood sugar control, meaning a reduced risk of type II diabetes and an improved ability to manage our weight (which, in turn, impacts again on our symptoms of arthritis among other things). So, it’s a win-win for us all because it simplifies the message into a very easy-to-follow, delicious healthy eating plan in the form of the Mediterranean diet.

What are the main components of the Mediterranean diet?

It’s not complicated. The Mediterranean diet, rather than a restriction diet, is one that is just based around basic healthy eating principles that we have known for years. It is abundant in fruits, vegetables, wholegrains, pulses (like chickpeas, lentils and baked or kidney beans) and healthy fats (nuts, nut butters, olives and avocadoes), with very little saturated fat (ie. butter and processed meats like sausages). It features fish and poultry more often as lean protein sources, rather than lots of red meat. It also tends to be low in processed foods (anything with lots of ingredients and additives) and sugar, including refined carbohydrates (think sugary drinks, sweets, bagels, white bread and pastries) and includes a moderate amount of alcohol (see box below ‘watch the alcohol’).

The body loves more fibre!

Eating a high fibre diet like the Mediterranean diet may help to lower inflammation and helps to keep us full for longer (thereby helping with weight loss and maintenance). Despite this, it is believed that 80 per cent of Irish people don’t get the recommended amount of fibre. The current recommendation is that adults should eat at least 30 grams of fibre a day, and most of us consume more like 20 grams each day. However, some experts believe that we should double the amount of fibre we’re eating, getting that level closer to 50 grams per day, in terms of helping to improve our ‘gut microbiome’ (the community of trillions of microbes that live in our digestive tract). Fibre works as a ‘prebiotic’, in that it feels the good bacteria in our gut, leading to a healthier gut microbiome. New research is linking the health of our gut microbiome to our susceptibility to Alzheimer’s, inflammatory bowel disease, cancer and chronic inflammatory disease, including arthritis). 

How to achieve it

In order to reach that level, it’s important to boost your intake of fruits and vegetables, in addition to things like porridge oats, nuts and seeds. Also, some people find it helpful to focus on increasing the diversity of colour on their plate – so aiming for as many reds, oranges, greens and purples as possible in order to reap the maximum health benefits as these are also full of antioxidants, which are believed to have protective effects on our health. Different types and colours of fruits and vegetables contain different combinations of important nutrients, which our bodies need to stay healthy. 

Fish is also a big part of the Mediterranean diet. In particular, the diet emphasizes fatty fish, like salmon, sardines, tuna and mackerel. These fish are rich in heart- and brain-healthy omega-3 fatty acids. Even fish that are leaner and have less fat (such as cod or tilapia) are still worth eating, as they provide a good source of protein. You can even have fish at breakfast, by having smoked salmon or mackerel with your eggs. If you currently don't get a lot of fish in your diet, an easy point of entry is to designate one day each week as fish night.

In addition, the benefits of switching your bread, rice and noodles to wholegrain versions – wholemeal bread and brown rice and noodles – are many. Not only will you be getting more fibre in, but you’ll also likely eat less as wholegrain foots are more filling and satisfying, giving you an even supply of energy throughout the day. Experiment with other wholegrain foods such as quinoa, millet and bulgar. Also, remember that air popped popcorn is a wholegrain so it’s a healthy snack that’s handy on the go. 

‘Always Be Counting’ your portions

A helpful way to approach your fruit and veg intake is to stick to the motto, ABC (‘Always Be Counting’). The aim is to reach 30 portions of fruits and vegetables a week (or this can be distilled into your ‘5 a day’ – use whichever figure works best for you). You can do this by using a tick chart at home or on your phone, or simply making a mental note of the number of portions of fruits and vegetables you’re having each day. Make sure you eat fruit and veg at every meal and choose them as snacks (such as carrot batons with hummus) and desserts too (melon/pineapple and poached pears/apples make delicious after-dinner sweet treats, as do strawberries and yoghurt or a small amount of cream). 

Watch the alcohol The Mediterranean diet tends to incorporate only ‘moderate’ amounts of alcohol, and this is usually red wine as opposed to spirits or beer. The ‘moderate’ amount refers to no more than one drink a day for women, and two for men. Remember, though, that a standard drink is large so, in this way, if you are a woman drinking two large glasses of wine, that’s actually four standard drinks you’ve had in one day, as opposed to the one drink that is recommended for women, so these moderate amounts are really smaller than you might initially think. Another important thing to realise about alcohol is that it provides ‘empty calories’. There are around 150-200 calories in a large glass of white or red wine and about 180 calories in a pint of lager, which can easily rack up if you’re having more than two drinks. Often the biggest problem comes that evening, or the next day, when people tend to overeat after alcohol consumption. A great option, if you’re trying to move away from alcohol, is to try a low-calorie beer or a zero-alcohol wine, which make you feel like you’re having a beer or glass of wine.

An easy way to sum it up!

In summary, to start enjoying all the benefits of the Mediterranean diet, try to eat;

More:

• Fish (particularly oily fish like salmon and tuna – tinned is allowed!)
• Healthy fats (avocadoes, nuts, nut butters, olives and olive oil instead of butter)
• Pulses (lentils, chickpeas, beans and red kidney beans)
• Fibre (think 30 portions of fruit and veg per week and switching to wholegrain versions of bread, rice and pasta, as well as sprinkling nuts and seeds, like chia or flaxseeds on Greek yoghurt or on your porridge)
• Colourful fruits and vegetables.

and Less:

• Sugar and processed foods
• Processed meats (sausages, bacon, salami) and less red meat
• Alcohol (many people consume more than the ‘moderate’ amounts consumed in the Mediterranean diet, which is around 1 standard drink a day for women and 2 for men, but their serving size for a ‘standard drink’ is smaller than what is served typically in Ireland). 

Feel that you’ve still got more to learn?

For more information about diet and arthritis, please listen to our informative podcast with registered dietitian Louse Reynolds. Also, as part of the National Arthritis Week webinar series this year, Louise also gave a wonderful webinar all about arthritis and food that is well worth watching.  Lastly, don’t miss our video session with registered dietitian Richell Flanagan, all about healthy eating for osteoarthritis.

The Mindful Monday blog has been funded by Amgen Limited. The content has been provided and approved by Arthritis Ireland. Amgen Limited has had no influence over the content.