Differences in the interpretation of a modernized Mediterranean diet prescribed in intervention studies for the management of type 2 diabetes: how closely does this align with a traditional Mediterranean diet?

Abstract

Synthesis of the reviewed literature demonstrates considerable variation in the qualitative interpretation of a MedDiet. We also identified inadequate reporting of MedDiet interventions, despite a number of studies referring to their intervention as a 'traditional' MedDiet. The majority of studies emphasized the same key dietary components and principles: an increased intake of vegetables, wholegrains, and the preferential consumption of white meat in substitute of red and processed meat and abundant use of olive oil. However, the reporting of specific dietary recommendations for fruit, legumes, nuts, bread, red wine, and fermentable dairy products were less consistent or not reported. Irrespective of the discordance in the interpretation of a MedDiet, a number of studies included in the present review reported improved glycaemic control and favorable cardiovascular outcomes with adherence to a Mediterranean-style diet. Nevertheless, greater clarity and depth of reporting amongst intervention studies is warranted for the refinement of a modernized MedDiet definition that is distinct from a prudent dietary pattern.

Daily Use of Extra Virgin Olive Oil with High Oleocanthal Concentration Reduced Body Weight, Waist Circumference, Alanine Transaminase, Inflammatory Cytokines and Hepatic Steatosis in Subjects with the Metabolic Syndrome: A 2-Month Intervention Study

“…In this context, the Epicor study, investigating the association between consumption of fruits, vegetables, and olive oil and the incidence of coronary heart disease (CHD), has shown that the consumption of olive oil in the diet leads to a reduction in CVD risk in middle-aged Italian women without a diagnosis of stroke, myocardial infarction, diabetes or hyperlipidemia [ 47 ]. EVOO is able to counteract postprandial oxidative stress through down-regulation of nicotinamide adenine dinucleotide phosphate oxidase (NOX2) [ 48 ] and reduces the risk of diabetes among people at a high CVD risk [ 20 , 49 , 50 ]. The Primary Prevention of Cardiovascular Disease with Mediterranean Diet (PREDIMED) study, with a total of 7447 persons enrolled [ 51 ], has also shown that the addition of EVOO to an MD reduces the risk the incidence of major CV events.…”

Adherence to the Mediterranean Diet is Associated with Better Sleep Quality in Italian Adults

“…The Mediterranean dietary pattern has gained popularity over recent decades due to its palatable taste and a strong evidence of benefits for health [10]. Despite a single definition of Mediterranean diet cannot be achieved, it refers to the traditional diet of Southern Italian people explored in the 60s by Ancel Keys, characterized by certain peculiarities including high consumption of plant-based foods (such as fruit, vegetable, legumes and nuts), preference for whole-grain cereals, fish (whenever available) and dairy products instead of other sources of refined carbohydrates and animal proteins, respectively; other characteristics were the daily consumption of olive oil and moderate intake of alcohol (mostly red wine) during meals [11]. A combination of these features has been further investigated in several studies, leading to the development of a number of adherence scores ideally optimized for type of population (i.e., geographical localization), diet parameters availability (i.e., completeness of dietary questionnaires), and generalizability of results (i.e., use of comparable scores) [12].…”

Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study

“…Briefly, the MedDiet is a food pattern rich in fruits, vegetables, olive oil, whole grains, legumes, nuts, fish and a preference of white over read meat. Less consistent are the recommendations for fermentable dairy products and red wine in the literature [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. From a holistic point of view, the MedDiet has been considered one of the key elements of the so-called Mediterranean lifestyle, which moreover adds to the diet qualities of eco-friendly and sustainability by the preference for locally produced, traditional and seasonal foods.…”