The SCVC Blog

Cardiovascular care news and articles from our expert team

Why the Mediterranean Diet Works: It’s More Than Just What You Eat

Posted on Saturday August 30, 2025 in Metabolic Health

An article written by Dr Edward Leatham, Consultant Cardiologist

Tags: VAT, Diabetes, Nutrition, metabolic Health, LDL, Heart attack, CHD prevention, wellness search website using Tags to find related stories.

For years, the Mediterranean diet has been praised as one of the healthiest ways to eat. Rich in vegetables, olive oil, fish, nuts, and whole grains, it’s been linked to lower rates of heart disease, diabetes, and obesity. But why does it work so well?

It turns out that it’s not just about the food—how and when you eat, how long you chew, whether you drink water before meals, and even who you eat with, may be just as important as the ingredients on your plate.

1. Fibre First: Slowing the Metabolic Response

One of the lesser-known principles of Mediterranean eating is the order of eating. When you begin a meal with a salad or vegetables, especially those high in fibre, you naturally slow the absorption of sugars and carbohydrates that follow. Fibre acts like a sponge in the gut, dampening the glucose spike and reducing the demand on insulin¹.

This small shift—eating fibre first—has been shown in studies to improve blood sugar control, especially in people with prediabetes or type 2 diabetes. Over time, this helps reduce metabolic stress and insulin resistance.

2. More Healthy Fats: Unsaturated and Satisfying

Mediterranean meals are rich in unsaturated fats, especially from olive oil, nuts, and oily fish. These fats aren’t just heart-healthy—they also increase satiety, meaning you feel fuller for longer.

Including healthy fats in meals slows gastric emptying, moderates the post-meal glucose response, and prevents the crash that often leads to snacking ². Importantly, these fats don’t trigger insulin in the same way that refined carbohydrates do, keeping your metabolic pathways stable.

3. Chew More, Absorb Less

It may sound simple, but chewing your food for longer can significantly improve metabolic health. Chewing thoroughly allows digestive enzymes more time to act and improves satiety by stimulating the release of gut hormones like GLP-1 and peptide YY ³.

A slower eating pace is associated with lower total food intake, better post-meal glucose control, and reduced risk of developing insulin resistance ⁴. Simply taking time to chew each bite 20–30 times can lower the glycaemic impact of a meal and help with weight regulation.

4. Hydration Before a Meal: A Natural Appetite Regulator

Another proven technique is drinking water before meals. Having a glass or pint of water 30 minutes before eatinghas been shown to reduce hunger, lower overall caloric intake, and promote weight loss in both overweight and older adults ⁵.

Water helps fill the stomach, activates stretch receptors that signal satiety, and may blunt the speed of glucose absorption by diluting the digestive contents. This supports a more controlled insulin response and less postprandial fat storage.

5. Time Matters: Eating Slowly and Socially

One of the most underrated aspects of Mediterranean culture is how long meals take. Meals often last 60–90 minutes, shared with family or friends, eaten slowly and mindfully.

Contrast this with modern fast food culture—grabbing a sandwich, eating in the car, or bolting lunch between meetings. When we eat quickly, especially carb-heavy meals, we tend to overshoot the insulin response. Satiety signals lag behind food intake, leading to overeating and excessive glucose and insulin spikes ⁶.

Fast eating also blunts the effect of key hormones like GLP-1, which helps regulate both blood sugar and appetite. This repeated metabolic stress contributes to insulin resistance, which then drives visceral fat accumulation—the kind most associated with metabolic disease.

6. The Vicious Cycle: From Insulin Resistance to Fat Gain

When insulin levels are constantly elevated, particularly due to high-glycaemic and fast-eaten meals, the body shifts toward fat storage—particularly around the organs (visceral fat).

Visceral fat isn’t just stored energy—it’s metabolically active, releasing free fatty acids and inflammatory signals that worsen insulin resistance, especially in muscle tissue ⁷. This means muscles absorb less glucose, blood sugar remains high, and more insulin is secreted—further fuelling fat gain. It’s a self-reinforcing cycle.

Takeaway: Mediterranean Isn’t Just a Diet, It’s a Way of Eating

To truly benefit from Mediterranean-style eating, it’s worth embracing more than just the ingredients:

Start with fibre-rich vegetables at the beginning of the meal
Include healthy unsaturated fats to slow digestion and improve satiety
Drink water before meals to support portion control and metabolic efficiency
Chew slowly and thoroughly—don’t rush your meals
Take your time—60 to 90 minutes per meal when possible
Eat socially when you can—conversation slows you down and promotes wellbeing
Avoid fast food culture—don’t bolt your meals, even if they’re healthy

These habits—small on the surface—add up to a major metabolic advantage, helping you prevent insulin resistance, support healthy weight, and protect long-term cardiovascular health.

References

Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food order has a significant impact on postprandial glucose and insulin excursions. Diabetes Care. 2015 Mar;38(3):e34–5. doi:10.2337/dc14-2215
Zhu Y, Bo Y, Liu Y. Dietary total fat, fatty acids intake, and risk of type 2 diabetes: a meta-analysis of prospective cohort studies. Nutrients. 2019 May;11(5):1185. doi:10.3390/nu11051185
Li J, Zhang N, Hu L, Li Z, Li R, Li C. Improvement in chewing activity reduces energy intake in one meal and modulates plasma gut hormone concentrations in obese and lean young Chinese men. Am J Clin Nutr. 2011 Aug;94(3):709–16. doi:10.3945/ajcn.111.015270
Ohkuma T, Hirakawa Y, Nakamura U, et al. Eating rate and obesity: a systematic review and meta-analysis. Int J Obes (Lond). 2015 Nov;39(11):1589–96. doi:10.1038/ijo.2014.186
Dennis EA, Dengo AL, Comber DL, et al. Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults. Obesity (Silver Spring). 2010 Feb;18(2):300–7. doi:10.1038/oby.2009.235
Kahleova H, McCann J, Alwarith J, et al. Eating rate and the risk of type 2 diabetes: findings from the Adventist Health Study 2. Nutrients. 2020 Jan;12(1):105. doi:10.3390/nu12010105
Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev. 2000 Dec;21(6):697–738. doi:10.1210/edrv.21.6.0415

Protected: Mounjaro

There is no excerpt because this is a protected post.

Effective Annual Health Screening for Your Directors and Employees

Annual health screenings represent a valuable investment in employee well-being, offering significant benefits for both employees and employers. If you are a company or HR director you may be interested in the UK tax breaks around annual health check, which may give you and your employees access to our cutting edge health screening programs without its costs being viewed by HMRC as benefit in kind.

GLP-1 agonists – too good to be true?

By Juliette Martin, Nutritional Therapist: Over the past year, a family of medications called GLP-1 agonists, often referred to as the ‘skinny jab’ has captured widespread media attention.