Diet and lifestyle choices go a long way towards managing chronic inflammation. But can the Med Diet fight inflammation? And if so, how?

An ‘anti-inflammatory diet’ is widely considered to be an eating pattern that emphasises plant-based foods, such as fruit, vegetables, nuts, seeds, legumes and whole grains. The Mediterranean Diet (Med Diet) is one variation of this theme – and is also one of the most researched dietary patterns in the world!

What is inflammation?

Acute inflammation is a natural part of the body’s every day defence mechanisms. Without it, we’d struggle to fight off infections, like viruses, or recover from injuries.

But when inflammation persists at a low level, over a long time, the story changes. Chronic inflammation can be harmful to health. In fact, it’s thought to be at the core of conditions like heart disease, type 2 diabetes, arthritis and some forms of cancer.

Unlike acute inflammation, it’s hard to see chronic inflammation, so there are proxy measures for it – inflammatory markers.

Did you know? Constant, low-grade inflammation can weaken the immune system.

What causes inflammation?

Many factors can increase the risk of chronic inflammation, including older age, smoking, obesity, stress, sleep problems and diet.

Specifically, a Western-style diet – typically rich in highly-processed foods and added sugars, and low in plant foods – has been linked with chronic inflammation.

But the good news is that adopting a healthy dietary pattern, which puts plant foods front and centre, can go a long way towards managing inflammation.

Med Diet 101

A Mediterranean dietary pattern varies in composition among the 21 countries which make up the Mediterranean region (5).

But it is typically largely plant-based with a high intake of whole grains, legumes, nuts, seeds, fruits and vegetables (particularly leafy greens, tomatoes, onion, garlic and herbs/spices) and the liberal use of extra virgin olive oil (2).

Animal foods include fish and seafood, moderate amounts of poultry, eggs and dairy foods (particularly yoghurt and cheese), and limited red meat. Herbs and spices are used as condiments, rather than salt. Processed foods are limited, home cooking, social eating and physical activity are encouraged, and wine (for those who drink alcohol) is consumed in moderation with meals.

Although in many ways similar to other global healthy plant-based dietary patterns, it is the higher intakes of olive oil, nuts and red wine, which make the Mediterranean dietary pattern unique (5).

The Mediterranean dietary pattern is rich in unsaturated fats, fibre, minerals, vitamins, and antioxidants, like polyphenols and flavonoids, which all have anti-inflammatory properties (1).

Research shows that the Med Diet may reduce the risk of developing (3):

• Heart disease, including heart attack
• Type 2 diabetes, or its complications
• Some cancers, including bowel cancer
• Fatty liver disease
• Depression, or improving its symptoms
• Cognitive decline, including dementia.

The long-term effect of the Med Diet on inflammation

The well-regarded PREDIMED study tracked almost 7,400 adults, aged 55–80 years, with a high risk of cardiovascular disease, over an average of five years. Many ‘sub-studies’, involving small groups of PREDIMED study participants, have been published over time.

A new sub-study, published in 2021, investigated the three-year effect of the Med Diet, compared to a low-fat diet, on changes to 14 inflammatory biomarkers (4). Study participants were randomly assigned into three study groups: Med Diet with extra-virgin olive oil, Med Diet with nuts, or low-fat diet.

After three years, both Med Diet groups had significantly lower blood levels of inflammatory biomarkers. And levels of certain biomarkers (including interleukin-6 and tumor necrosis factor receptor) after the Med Diet were significantly different from those in the low-fat diet.

Lean in to the Mediterranean dietary pattern

Breakfast ideas:

• Natural Greek yogurt topped with in-season fruit, a handful of nuts and seeds
• Whole grain bread, with cooked eggs, spinach and tomato, with a sprinkling of chopped nuts
• Overnight oats with chopped dates, cinnamon and nuts

Lunch ideas:

• Nourish bowl of quinoa, black beans, tomato and avocado, with a drizzle of olive oil and a handful of nuts
• Greek salad packed with tomato, cucumber, red onion, feta cheese and canned fish
• A Med-style wrap filled with lentils, zucchini, capsicum and mushrooms, plus tzatziki sauce and chopped nuts

Dinner ideas:

• Cauliflower ‘schnitzel’ with ribbon salad
• Wholemeal pasta with nutty basil pesto sauce and a Greek-style side salad
• Baked eggplant stuffed with feta, chickpeas, semi-dried tomatoes, chopped nuts and herbs, served with cous cous  

Snack ideas:

• Handful (30g) of nuts
• Fresh, canned or dried fruit
• Vegetable sticks with pesto, hummus or tzatziki dip
• Natural Greek yogurt
• Avocado on wholegrain crackers