Mediterranean Diet and IBS, Low Fodmap | Epicured

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A Mediterranean Diet and IBS include foods from the traditional diets of the Greeks and others bordering the Mediterranean Sea.

No doubt you’ve heard the Mediterranean diet is one of the best diets to follow for overall health. That’s why it’s consistently ranked as “#1 Best Diet Overall” by a panel of nutrition experts. 

Now, you might wonder “can a Mediterranean diet help my IBS?” The answer is yes! 

What is the Mediterranean Diet?

The Mediterranean Diet is more than a diet per se, it’s a lifestyle based upon cooking and eating nutritious foods, enjoying yummy meals with friends and family, and being physically active. 

Dr. Marion Nestle, a world-renowned nutrition expert, describes it this way, “What’s called the Mediterranean diet is just a version that follows sensible principles of healthy diets: eat plenty of plant foods, balance calories, and don’t eat too much junk food. Really, it’s that simple.“ 

 

Foods to eat every day on a Mediterranean Diet

  • Vegetables
  • Fruits
  • Whole grains, such as oats, barley, farro, quinoa, brown rice, wild rice 
  • Legumes and beans
  • Healthy oils and fats from nuts, seeds, avocados, and olives 
  • Herbs and spices 

 

Foods to eat in moderation on a Mediterranean Diet

  • Fatty fish (at least 2x per week)
  • Poultry (chicken, turkey)
  • Eggs
  • Dairy: unprocessed aged cheeses, plain yogurt (used to complement meals)
  • Wine (if desired and tolerated) 

 

Foods to limit or avoid on a Mediterranean Diet

  • Red meat
  • Added sugar
  • Saturated fats
  • Refined grains 
  • Ultra-processed foods

 

A Mediterranean Diet and Health

We can learn a lot by observing how some of the world’s healthiest populations live and eat. 

Perhaps you’ve heard of the “Blue Zones?” These are five areas throughout the world where people live the longest and healthiest lives, where they grow old without chronic disease. What’s their secret? Among many things, they eat a mostly plant-based diet with fresh or minimally processed foods. They do not eat our standard American diet, low in fiber but full of added sugar, ultra-processed foods, and animal protein. 

Take note: Two of these Blue Zones are in the Mediterranean. 

 

General Health Benefits 

Thanks to its focus on plants over animals, a Mediterranean diet is full of key disease-fighting components, including healthy fatty acids, antioxidants, and fiber.

Extensive research has linked the Mediterranean Diet to a variety of health benefits, including a reduced risk of developing the following conditions: 

  • Cancer
  • Heart disease
  • Diabetes
  • Depression
  • Parkinson’s disease, Alzheimer’s disease, and other neurodegenerative disorders 
  • Obesity 
  • Inflammation
  • Frailty (newer, less extensive research to support this connection)

What’s super exciting, especially for a gut-health geek like myself, is now we’re learning how some of these protective findings of the Mediterranean diet are linked to diet-derived changes in the gut microbiota!

For example, research has connected a high adherence to a Mediterranean-style diet to increased levels of fecal short-chain fatty acids (SCFAs) and healthy bacteria, and low adherence to elevated urinary trimethylamine oxide (TMAO), which is associated with increased cardiovascular disease. 

In general, diets high in fiber and low in animal protein support the growth of our beneficial gut microbes. So, it’s no wonder a Mediterranean-style diet would benefit gut health via the gut microbiota.  

Gut-Specific Health Benefits 

OK, so we’re learning how the Mediterranean diet might affect the gut microbiota to contribute to its overall protective benefits. That’s great news! However, how does this impact the day-to-day life of someone with IBS? 

A 2019 study compared the success of a low FODMAP diet, a gluten-free diet, and a balanced Mediterranean diet to improve common IBS symptoms. All three diets included three main meals (breakfast, lunch, dinner) and two light snacks between meals.

Here are some key findings: 

  • The balanced Mediterranean diet improved mental quality of life, abdominal bloating, and abdominal pain in people with IBS.
  • A balanced Mediterranean diet was easier to follow than a low FODMAP or gluten-free diet. 
  • By aiming for regular meal and snack times, the balanced Mediterranean diet avoided excessive FODMAP overload without eliminating high FODMAP foods.

What’s the main takeaway? A balanced Mediterranean diet might be a terrific first-line approach to managing IBS symptoms. If it is unsuccessful, then someone can move on to a more restrictive approach, such as a low FODMAP diet, with the help of a knowledgeable GI dietitian. 

What’s more? Besides helping with IBS, the Mediterranean Diet can also be an effective long-term approach for managing other GI conditions, including inflammatory bowel disease (IBD).

 

Tips for How to Eat a Mediterranean Diet 

Curious about what you might eat on a Mediterranean-type diet? Here’s what a day of eating might look like: 

  • Breakfast: Oatmeal topped with fresh fruit and walnuts 
  • Snack: 2-3 dates with a couple of oz of Greek yogurt 
  • Lunch: Whole wheat pita spread with hummus and stuffed with leafy greens, sliced olives, tomatoes, bell peppers, and cucumbers
  • Dinner: Baked salmon (topped with dill and lemon) served with asparagus roasted in olive oil, and lemon herbed quinoa 
  • Snack: Fresh fruit 

See how simple this is? A Mediterranean-style diet doesn’t require fancy ingredients or tons of prep time. You can make simple, delicious meals out of regular, everyday items. 

 

Here are five tips to help you follow a Mediterranean-style diet: 

  1. Choose fruit for dessert.
  2. Eat lots of vegetables. Instead of thinking about veggies as a side dish, think about them as the main course.
  3. Treat meat as a flavor enhancer versus the main course. Limit meat to 3 ounces per meal. 
  4. Aim to cook at least one vegetarian (plant-based) meal per week. 
  5. Eat more fatty fish, such as tuna, herring, salmon, and sardines. These fish are excellent sources of anti-inflammatory omega-3 fatty acids.
  6. Don’t fear fat. Seek out healthy fats, including those from olive oil, avocados, nuts, and seeds.

Finally, please remember the Mediterranean Diet isn’t a specific diet. It’s a lifestyle. Besides eating well, those who thrive on a Mediterranean-style diet focus on being physically active, sleeping well, managing stress, and interacting with loved ones. 


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