The Mediterranean diet and lifestyle is a flexible eating pattern containing seasonal, locally sourced foods abundant in the Mediterranean region, which we can access worldwide, and have cultural foods here in Aotearoa, New Zealand, with similar health benefits. It is a way of living and eating that features daily exercise, social connectivity, and living well.

by Tracey Kellett, Registered Nutritionist

Tips to Follow the Mediterranean Diet and Lifestyle: 

  • Get 7-9 hours sleep. Having adequate sleep is the first step to making healthy food choices.  
  • Eat mainly plants. Have 2 or more servings of vegetables every meal and 1-2 pieces of fruit. A serving is about a handful. Eat a variety of different coloured and textured fruits and vegetables. The more diverse types of plant foods you can eat in a week, the better, particularly for gut health. 
  • Make leafy greens a daily staple. The darker coloured the better! If you are taking blood thinning medication, talk to your doctor before making a huge change to your leafy green intake. 
  • Include whole grains with every meal. This includes oats (e.g. porridge or add to smoothies), brown rice, quinoa, millet, barley, buckwheat, and popcorn as well as whole grain products like wholemeal bread, Weetbix and wholemeal pasta. 
  • Eat legumes and legume products. This includes lentils, chickpeas, kidney beans, black beans, and tofu at least three times a week. These foods are high in plant protein and great for filling up on. Baked beans and chilli beans count and are one way to get started eating legumes but be aware that both contain added sugar and salt. The Heart Foundation’s Full O’Beans cookbook has information and recipes for legumes. 
  • Eat fish and seafood. More than 2 servings a week is recommended. Avoid deep-fried and battered fish. Oily fish, like salmon and mackerel, and shellfish like mussels, are high in anti-inflammatory omega-3 fats so aim to have these at least once a week. Seafood is so good for all types of arthritis! If you have gout, make sure you are taking your daily medication and enjoy seafood as one part of a healthy meal, but not your entire meal. Fresh or canned fish are both good choices.  
  • Swap butter for olive oil. Extra virgin olive oil has more antioxidants than other types of olive oil and is the main type of fat consumed in the Mediterranean diet. If you don’t like olive oil, canola oil is another good option and is higher in Omega 3s than other budget-friendly vegetable oils. 
  • Drink plenty of fluids. Drink at least eight cups of fluids a day. Water is best. Green and herbal teas are also great options. 
  • Have lean white meat and eggs. If you eat chicken or other birds, make it skinless and not deep-fried. Keep those fatty Tītī for special occasions and be wary if you have high cholesterol. The Mediterranean diet has about 4 eggs per week and about 2 servings of chicken a week. 
  • Limit red and processed meat. In the Mediterranean diet, red meat is eaten rarely, less than 2 servings per week. It’s eaten in a similar way that we use condiments to flavour meals, it’s not the main star of a meal. The Mediterranean diet limits the consumption of processed meats including bacon, ham, salami, and corned beef (sorry, we don’t make the rules). On the other hand, corned beef is low in purines so will affect those with gout less than eating chicken! (read about gout and purines).
  • Choose low-fat milk and milk products or soy milk and soy products. The Mediterranean diet prioritises low-fat yoghurt, cheese, and fermented dairy products. We drink a lot of milk in New Zealand so use low-fat animal milk or go with enriched soy milk such as with added calcium if you choose plant-based milk.
  • Cook and flavour food with herbs and spices instead of salt. Experiment with herbs and spices to find flavours you love. There’s no such thing as “getting it wrong,” so choose a new herb, and try it with your favourite foods to find your perfect match. If you eat salt, always choose iodised salt and have it on the table to be added to the meal only if needed and leave it out of cooking. 
  • Limit sugar and sugary foods and drinks. Choose foods that are naturally sweet and naturally have lots of nutrients, like fruit. Keep sugary foods and drinks as occasional foods. 
  • Eat unsalted nuts, seeds, and olives. Have a small handful (30g) of nuts or seeds as a snack daily. Add diced olives to salads/wraps/burgers, and sprinkle chopped nuts or seeds over your breakfast cereal, salad, or stir-fry. 
  • Grow, gather, and swap at least some of your food. Traditionally this was the main way all people obtained food. Grow and eat from at least one plant, year-round. Give away food you have in excess or swap with others. Gathering food from the ocean is another way to keep you healthy through physical activity, connecting to the local environment and spending time with family or friends. The Mediterranean Diet highlights seasonality, local, and eco-friendly foods. 
  • Eat together. Communal eating is a big part of the Mediterranean lifestyle. 
  • Spend time with friends and family: Having good and meaningful relationships decreases feelings of loneliness and keeps your brain active and healthy.  
  • If you drink alcohol, drink red wine in moderation: No alcohol is the best amount to drink for overall health, but if you do drink alcohol, let it be in moderation and in social situations. The Mediterranean diet allows for low to moderate amounts of red wine, usually with meals but The World Cancer Research Foundation says no amount of alcohol is safe. 
  • Know your purpose: Wake up every morning knowing what you bring to the world, to your community, and your worth. A sense of purpose is a key characteristic of not only the Mediterranean lifestyle, but also other blue zone lifestyles around the globe. Blue zones are areas in the world where people experience the best quality and longevity of life, this includes the Mediterranean. 
  • Have good boundaries with work and make time to relax: Making healthy choices is easier when you have adequate downtime from your responsibilities, and you feel relaxed. If you have a side hustle, make sure it’s relaxing, something you enjoy, or physically active if you have a sedentary job so you aren’t increasing stress or time sitting during your week. 
  • Have fun! When you have things in your day or week that make you happy or have something planned to look forward to, you may be less likely to turn to sugary or oily comfort food to get your feel-good hormones going.  

Why the Mediterranean Diet? 

It’s less of a strict or limiting diet, and more of a holistic healthy way of living. It’s one of the few diets that has been well studied and has evidence for overall health benefits for everyone. According to research, people following the Mediterranean Diet are more likely to live longer and less likely to die from heart disease, stroke, or cancer.  

For arthritis, research suggests that the Mediterranean Diet promotes overall health, and is an uncomplicated way of eating for everyday life to maintain a healthy weight. A healthy weight protects joints from being overloaded and reduces symptoms of osteoarthritis and inflammatory arthritis. The American College of Rheumatology Guidelines are followed by Aotearoa New Zealand health professionals and the updated 2022 guidelines recommend the Mediterranean Diet for Rheumatoid Arthritis and are against any other type of defined diet or nutritional supplements. 

Read more about what the Mediterranean Diet is: What is the Mediterranean diet? (arthritis.org.nz)

References

-A practical guide to the Mediterranean diet – Harvard Health 

-Eating and Activity Guidelines for New Zealand Adults, updated 2020. 

-Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, Medina FX, Battino M, Belahsen R, Miranda G, Serra-Majem L; Mediterranean Diet Foundation Expert Group. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011 Dec;14(12A):2274-84. doi: 10.1017/S1368980011002515. PMID: 22166184. 

-Al-Amer, Saleh & Bekhit, Alaa & Gooneratne, Ravi & Mason, Sue. (2015). Nutritional composition of Mutton bird (Puffinus griseus) meat. Journal of Food Composition and Analysis. 46. 10.1016/j.jfca.2015.10.006.  

-Limit alcohol consumption | Cancer Prevention | WCRF International 

-Cynthia Felix, Caterina Rosano, Xiaonan Zhu, Jason D Flatt, Andrea L Rosso, Greater Social Engagement and Greater Gray Matter Microstructural Integrity in Brain Regions Relevant to Dementia, The Journals of Gerontology: Series B, Volume 76, Issue 6, July 2021, Pages 1027–1035, https://doi.org/10.1093/geronb/gbaa173 

-Gardner, Meryl & Wansink, Brian & Kim, Junyong & Park, Se-Bum. (2014). Better Moods for Better Eating?: How Mood Influences Food Choice. Journal of Consumer Psychology. 24. 10.1016/j.jcps.2014.01.002. 

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