I thought I was doing a pretty good job at following the Mediterranean diet, but boy was I ever wrong. I experienced culture shock when I moved from Colombia to Canada, going from purchasing fresh produce daily to grocery shopping weekly. The small markets were no longer within walking distance. I saw more canned and preserved foods, as well as frozen fruits and vegetables as an alternative to fresh produce.
I became ill. Everything tasted saltier and sweeter. I remember living off Ensure and crackers for almost a year, as the stress of living in a different country and culture had a terrible impact on my digestive health.
As a dietitian, I was aware of the Mediterranean diet principles, such as being a predominantly plant-based diet, where the primary sources of protein come from legumes, nuts, seeds and eggs. The Mediterranean diet promotes the consumption of fish at least twice a week and sporadic use of red meats and poultry. Dairy products are present mostly as a complement to a meal in the form of yogurt or cheese. Extra virgin olive oil is the primary source of fat. Refined sugars and processed foods are almost non-existent. Let alone, the promotion of physical activity, supporting local farmers and enjoyment of meals with family and friends.
In practice, I used the Mediterranean diet principles in my day-to-day life as it was very similar to my grandparents’ way of living. I grew up in Amaga, a small town in Colombia, and even though our resources were limited, we had access to fresh, wholesome foods such as tangerines, guava, oranges, mangoes, passion fruit, bananas, plantains, avocados and tomatoes daily.
I once asked my grandfather, why do we have such a variety of trees and crops in the backyard? He said he had to diversify the crops to enrich the soil after harvesting the coffee beans. We also had free-range chickens, which blessed us with fresh eggs every day. My grandma used to make fresh cheese, wrapped up in plantain leaves and kept it in the coldest place in the house, as liquid milk would spoil without refrigeration. Olive oil was unknown to me until I learned about it during my nutrition studies in Colombia, but it was virtually inaccessible due to its high price.
Now, living in Canada for 13 years. It took a lot of trial and error in trying to replicate my eating habits from back home. I had to get used to “in season” produce that was new to my taste buds. These included a variety of squash, zucchini, berries, sweet potatoes, rhubarb, nectarines, Brussels sprouts and green leafy vegetables like kale, collard greens, beet greens and Swiss chard. I grew up in a corn-based culture, so arepas (a type of food made with ground corn dough) is highly prevalent in the region. Until recently, arepas were still almost non-existent in Canada. Whole-grain wheat products, quinoa, amaranth, millet, buckwheat, sorghum, wild rice were all foreign grains to me.
Diet and Autoimmune Conditions
I started to pay more attention to the Mediterranean diet a few years ago when I wanted to change my lifestyle to complement the therapies to manage my autoimmune conditions (rheumatoid arthritis, Sjögren’s syndrome and celiac disease).
I wanted to give the diet a try, but honestly, I didn’t know how to start. My most challenging part of this way of eating was cooking with olive oil for most recipes and with seasonings such as turmeric, paprika, red chili peppers, ginger and cayenne pepper, as well as nuts and seeds and gluten-free whole grains. All ingredients that have shown evidence to reduce overall inflammation.
In December, as I was setting up my health goals for 2020, I saw the Oldways Mediterranean diet challenge on my Instagram feed. Maybe it was meant to be. I felt intrigued and joined their Make Every Day Mediterranean Facebook group. Then I purchased the four-week meal plan and discovered a whole new world, new flavors, a new community and a simple way of cooking meals the Mediterranean diet way.
Some of the meals that stood up for me from the Med diet challenge were the spicy salmon, artichoke and spinach frittata, apricot tahini oatmeal – I would have never imagined adding tahini to oatmeal or yogurt – tabbouleh, home-made hummus and fattoush. Now, there are my standby staples, as well as quinoa, oats, amaranth, tahini, Greek yogurt, fresh herbs such as basil, parsley and mint, and of course extra virgin olive oil.
I chose the Mediterranean diet due to the growing evidence on the health benefits of a plant-based diet. Unlike other popular diets, the Mediterranean diet is flexible, flavorful and sustainable. Even though the existing evidence about the Mediterranean diet on reducing inflammation in people with rheumatoid arthritis is mixed, I believe the principles make this way of living realistic and attainable in the long run.
I interpret the Mediterranean diet as the “anti-diet.” This way of eating is more than just counting calories, fat and carbs; it’s about the enjoying meals with family. It’s about savoring foods that are in season regardless of the country you live in.
New Ingredients and Blending of Heritage Foods
Some of the changes I’ve made were to stock up on new seasonings such as thyme, rosemary, tarragon and red chili peppers. Adding spices reduced the need to use salt in our meals dramatically. I also incorporated extra virgin olive oil into my cooking. Until then, I used olive oil sporadically, so incorporating it into my regular cooking more than once a day was a first for me. I used palm oil back home as it was cheaper, then upgraded it to sunflower and canola oils. Unfortunately, those type of oils are high in omega-6 fatty acids, which can be pro-inflammatory.
I never thought that olive oil was so versatile and added such an incredible taste to every dish. Olive oil is now an essential ingredient of salads, roasted veggies, spreads, soups and even baked goods.
I became hooked on the Mediterranean diet when I discovered how I could combine my heritage foods with the Mediterranean diet condiments. For example, when I prepared the Oldways edamame and sweet peas recipe, I spread it on arepa. It was an incredible experience, an explosion of flavors in my mouth. I recently made up a rice bowl with black lentils, beets and egg salad, along with ripe plantain cooked in olive oil and seasoned with cinnamon. I am finding more ways to mix my heritage foods with the Mediterranean seasonings.
Avocados were also a surprise compliment to my diet. Yes, I grew up eating plain avocados accompanying my soups and rice, but I found them boring and tasteless. The Mediterranean diet recipes challenged me to enjoy this incredible fruit in many new ways. It also helped me reduce the amount of processed cheese, cream cheese and even butter I used to spread on my toast and crackers. Now I used avocado for that same creamy taste.
Living with Sjogren’s syndrome since childhood, I often had problems enjoying my food because of the severe dry mouth caused by this autoimmune disease. I tended to favor bland meals to avoid burning my mouth. Therefore, olives, capers, sun-dried tomatoes, artichokes, tahini, red chili peppers, feta cheese and balsamic vinegar were ingredients that I would typically avoid. However, what I found surprising is that using such ingredients helped me reduce the amount of salt added to my recipes and, most importantly, minimize the burning sensation in my mouth.
Following the Mediterranean diet made me more diligent with my meal planning and meal prep. Meal planning makes me more aware of my food choices for the week ahead. I look for easy-to-prepare recipes, as having rheumatoid arthritis can make it challenging to stand in the kitchen for an extended period of time. I pick the recipes with my husband, make up a grocery shopping list and set up 2 or 3 hours on Sundays to prep for the week.
This process revived my love for home cooking and the social experience of mealtimes. This was so important for me during the COVID-19 pandemic; it is easy to lose track of your health when you’re home. In fact, a few weeks I stayed away from planning my meals, I could feel the impact on my overall energy levels and control of my autoimmune conditions.
I can confidently say that this way of eating has contributed to reducing pain and fatigue caused by my arthritis. As a registered dietitian, I experience the benefits of including anti-inflammatory ingredients in my daily meals. The standard American diet is often high in animal protein, processed foods, salt and refined sugars, which are known as pro-inflammatory foods that can even impact the effectiveness of the therapies used to treat inflammatory arthritis.
It hasn’t been all rainbows and unicorns, though. The first time purchasing all the ingredients for the week was a bit overwhelming and costly. My grocery bill went up, but it became more comfortable once I had the main staples at home, such as extra virgin olive oil, seasonings, quinoa, oats, whole-grain gluten-free flours. It still takes me time to plan for the week ahead, as I need to consider the Mediterranean diet, my food intolerances and a way to include some traditional Colombian foods – such as beans, whole corn, plantain, cassava and parsnips.
What’s next? I’ll continue to implement the Mediterranean diet principles in my daily living, as well as promote its benefits with my clients.