High variability of food and nutrient intake exists across the Mediterranean Dietary Pattern—A systematic review

Abstract

A Mediterranean style dietary pattern (MDP) is considered beneficial for health. The MD Score (MDS) definition has evolved, resulting in considerable variability in the foods and nutrients associated with MDS adherence. We systematically investigated food and nutrient composition of the MD between studies, countries, and methods of classifying the MDS. We searched Embase for MD systematic reviews and selected observational studies reporting intakes of foods, macronutrients, or micronutrients by categories of MDS adherence. The percentage differences in food and nutrient intakes between categories of high and low adherence to the MDS were calculated for each study. A total of 369 full‐text primary papers were reviewed from the included systematic reviews and 74 papers selected (66 adults, 8 children). We found considerable differences in MDS definitions and scoring criteria. Between‐study variation in food intake between high‐ and low‐adherence MDS adherence categories ranged from a mean of −23% for meat, to 119% for fruit, and 278% for fish. Greater variability was evident in non‐Mediterranean than Mediterranean regions. We conclude that few studies report food and nutrient intakes across the range of the MDP in adults and even fewer in children. The considerable variability in the foods and nutrients reported makes comparison of results from studies and translation into dietary guidelines difficult. We recommend that future publications of MD studies include full details of the range of food and nutrient intakes across the distribution of MD adherence in order to facilitate translation into health policy and practice.

Dietary Patterns and Weight Status in Italian Preschoolers with Autism Spectrum Disorder and Typically Developing Children

“…Evidence supports the idea that the Mediterranean dietary pattern (MDP) positively influences health and promotes the prevention of common non-communicable diseases (NCDs) [50,51]. The MDP is a dietary pattern that combines a high intake of vegetables and fruits, whole grains, legumes, nuts and seeds, and olive oil with a moderately high intake of fish and a low-to-moderate intake of dairy products, red meat, and saturated fats [52].…”

Nutrition and Frailty: Opportunities for Prevention and Treatment

“…The meta-analysis of diet quality and frailty showed that beneficial effects of greater compliance with high quality dietary patterns were most marked in the sub-group of studies from Mediterranean countries [ 29 ]. The Mediterranean dietary pattern is characterised by high consumption of fruit, vegetables, and plant-based foods (legumes, nuts, seeds), use of olive oil, and lower consumption of meat and dairy foods, providing higher intakes of micronutrients, including antioxidant nutrients, as well as polyphenols and other plant bioactive compounds [ 33 ]. Linked to a range of beneficial effects on health [ 34 , 35 ], compliance with this pattern may also be relevant to risk of frailty [ 36 ].…”

“…Two prospective studies from the US published since these reviews provide further confirmation of the benefits of the Mediterranean dietary pattern: greater compliance was associated with lower incident frailty among older women with type 2 diabetes in the Nurses’ Health Study [ 39 ], and among participants in the Osteoarthritis Initiative cohort [ 40 ], with both studies adjusting for age, sex, BMI, smoking status, energy intake, physical activity and co-mobidities. There are particular challenges in interpreting the differences in dietary exposures linked to the Mediterranean dietary pattern when collating evidence across studies [ 33 , 41 ]; for settings outside the Mediterranean, the findings from these recent US studies (based on adapted scoring methods) are therefore important.…”

Nutrition and Healthy Aging: Prevention and Treatment of Gastrointestinal Diseases

“…Literature studies show how the quality of the diet is very important with respect to the risk of frailty, and, in particular, the meta-analyzes have established that the Mediterranean dietary model has a high quality and greater beneficial effects, with a high intake of micronutrients and antioxidants, as polyphenols and bioactive compounds present in the diet, characterized by a high consumption of fruit, vegetables, and plant-based foods, use of olive oil, and lesser consumption of meat and dairy products [197][198][199][200].…”