Combat Stress Through A Mediterranean Diet

Combat stress through Mediterranean Diet

Fahd Farooq
Fellow in Internal Medicine
Member American College of Physician
Diploma in Sports Nutrition





Covid-19 pandemic has taken the entire world as hostage

Many countries were implementing lock-downs in order to reduce the spread of the virus, and many had to undergo quarantine as they were exposed to the virus but didn’t develop symptoms. All these measures were adopted to lessen the burden on medical resources. After so many days of the pandemic, it was affirmed that there is neither any confirmed treatment nor any vaccine to protect people from its harmful effects. An active immune system is our only weapon against the disease. During this time, it is important to adopt good nutritional habits, following a healthy and balanced nutritional diet containing all the essential micronutrients with a moderate quantity of fats. One should also wisely choose carbohydrates with a low glycemic index (which does not cause a rapid surge in blood sugar levels).

During lockdowns, the interruption of one’s daily routine along with continuous news regarding the pandemic is very stressful. Consequently, this stress forces people towards overeating, mostly looking for sugary “comfort foods”. This desire to consume a specific kind of food is defined as “food craving”. Food craving is a multidimensional concept including emotional (intense desire to eat), behavioral (seeking food), cognitive (thoughts about food), and physiological (salivation) processes. This practice has a higher prevalence in women than in men.

Carbohydrate craving encourages serotonin production that in turn has a positive effect on mood. Unfortunately, this unhealthy nutritional habit could increase the risk of obesity which itself is a risk factor in cardiovascular diseases, diabetes, and lung disorders.

Stress also results in sleep disturbances that in turn further worsen stress and decrease immunity. Increase in food intake thus gives rise to a dangerous vicious cycle.

Therefore, it is important to consume food containing or promoting the synthesis of serotonin and melatonin at dinner. Plants including roots, leaves, and fruits, alongside seeds such as almonds, bananas, cherries, and oats contain melatonin and/or serotonin.


What types of food should you consume?
Protein foods such as milk and milk products are the main source of melatonin.
Further beyond sleep-inducing properties, milk products such as yogurt could also be augmented as the natural killer of cell activity and reduce the risk of respiratory infection.

The increased intake of macronutrients could result in micronutrient deficiency, which occurs in obesity. This happens because some of these micronutrients such as vitamin E, vitamin C, Coenzyme Q10 and beta-carotene are antioxidants.
Beta Carotene is most abundant in sweet potatoes, carrots, and green leafy vegetables. CoQ10 is found in meat, fish and whole grains. The amount of CoQ10 found in these dietary sources, however, isn’t enough to significantly increase CoQ10 levels in your body so it has to be taken as a supplement to support your body to fight against infections.

The sources of vitamin C include red peppers, oranges, strawberries, broccoli, mangoes, lemons, and other fruits and vegetables.

The major dietary sources of E are vegetable oils such as wheat germ, walnuts, nuts, seeds, spinach, and broccoli.



How to get the optimal amount of Vitamin D?

Sunlight is the single most common source of Vitamin D but lockdowns could result in less time spent outdoors, and reduced production of vitamin D. Vitamin D deficiency in winter has been reported to be associated to viral epidemics. Unfortunately, many people do not know that Vitamin D is not sufficiently obtained from UV light in people with darker skin. Melanin pigment responsible for dark complexion is the main culprit which does not allow sufficient sunlight to be converted into active vitamin D. It is for this reason the prevalence of Vitamin D deficiency in Pakistan is 62.7%. Indeed, adequate vitamin D status reduces the risk of developing several chronic diseases such as cancers, cardiovascular disease and diabetes mellitus.

There is a significantly higher risk of deaths from respiratory tract infections in people who are Vitamin D deficient than otherwise healthy individuals. It is proven through research that in children once Vitamin D deficiency is corrected there is a 70% reduction in respiratory tract infections. Foods containing vitamin D include fish, liver, egg yolk and dairy foods (e.g. milk, yogurt). But the amount is so little that without fortification or supplementation its daily requirement cannot be met.

Another essential trace element that is crucial for the maintenance of immune function is zinc. Although oysters contain the most zinc per serving, the most common food to get zinc are represented from poultry, red meat, nuts, pumpkin seeds, sesame seeds, beans, and lentils.


What is the Mediterranean Diet?


All the above described nutrients are enclosed in the Mediterranean Diet pattern that could represent a healthy nutritional pattern to be followed in quarantine. Key ingredients of Mediterranean cuisine include:

  1. Fresh vegetables: Tomatoes, broccoli, spinach, onions, cauliflower, carrots, Brussels sprouts, cucumbers, etc. in every meal
    2. Fruits: Apples, bananas, oranges, pears, strawberries, grapes, dates, figs, melons, peaches, etc. in every meal
    3. Nuts and seeds: Almonds, peanuts , hazelnuts, cashews, sunflower seeds, pumpkin seeds, etc. daily
    4. Legumes: Beans, peas, lentils, pulses, chickpeas, etc. daily
    5.Whole grains: Whole oats, brown rice, rye, barley, corn, buckwheat, whole wheat, whole-grain bread and pasta in every meal
    6. Fish and seafood: Salmon, sardines, trout, tuna, shrimp, oysters, clams, crab, mussels two or more than two times per week
    7. Poultry: Eggs Chicken, duck, and turkey daily to weekly in moderate amount
    8. Dairy: Cheese, yogurt or milk etc daily to weekly in moderation
    9.Herbs and spices: Garlic, basil, mint, rosemary, sage, nutmeg, cinnamon and pepper daily
    10. Healthy Fats: Extra virgin olive oil, olives, avocados and avocado oil daily
    Coffee and tea are totally acceptable in Mediterranean Diet .

In Mediterranean diet following foods are in very low quantity and it is often advised to avoid them:

1.Added sugar: Soft drinks candies, ice cream, and table sugar
2. Refined grains: White bread, pasta made with refined wheat
3. Trans fats: Found in margarine and various processed foods.
4. Refined oils: Soybean oil, canola oil, cottonseed oil and others.
5. Processed meat: Mainly fast food which are energy deficient foods including sausages and hot dogs,
Under the prevailing situation leading to stress, nutrition should be the priority at this stage . Keeping foods that are good sources of immuno-supportive nutrients, proper time to eat meals, and having a cutoff time for eating is of great importance. But what is more important is having a mind with positive attitude. This time will pass but how we pass it is all what matters .



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