Scientific Evidence of Interventions Using the Mediterranean Diet: A Systematic Review

Abstract

The Mediterranean Diet has been associated with greater longevity and quality of life in epidemiological studies, the majority being observational. The application of evidence-based medicine to the area of public health nutrition involves the necessity of developing clinical trials and systematic reviews to develop sound recommendations. The purpose of this study was to analyze and review the experimental studies on Mediterranean diet and disease prevention. A systematic review was made and a total of 43 articles corresponding to 35 different experimental studies were selected. Results were analyzed for the effects of the Mediterranean diet on lipoproteins, endothelial resistance, diabetes and antioxidative capacity, cardiovascular diseases, arthritis, cancer, body composition, and psychological function. The Mediterranean diet showed favorable effects on lipoprotein levels, endothelium vasodilatation, insulin resistance, metabolic syndrome, antioxidant capacity, myocardial and cardiovascular mortality, and cancer incidence in obese patients and in those with previous myocardial infarction. Results disclose the mechanisms of the Mediterranean diet in disease prevention, particularly in cardiovascular disease secondary prevention, but also emphasize the need to undertake experimental research and systematic reviews in the areas of primary prevention of cardiovascular disease, hypertension, diabetes, obesity, infectious diseases, age-related cognitive impairment, and cancer, among others. Interventions should use food scores or patterns to ascertain adherence to the Mediterranean diet. Further experimental research is needed to corroborate the benefits of the Mediterranean diet and the underlying mechanisms, and in this sense the methodology of the ongoing PREDIMED study is explained.

Long-term effects of non-surgical therapy for obesity on cardiovascular risk management: a weighted empirical review

“…No other comparable study was found with obese patients. However, similar findings have been described in several studies in patients with cardiovascular diseases (Serra-Majem et al 2006).…”

Recent Findings of Studies on the Mediterranean Diet

“…22 The most recent systematic reviews of cross-sectional, prospective cohort, and intervention studies have demonstrated further the favorable effects of a Mediterraneanstyle dietary pattern, 23 in terms of both a reduction in cardiovascular events 24 and improvements in many traditional CVD risk factors, including blood lipids/lipoproteins, body weight and BMI, SBP and DBP, fasting glucose and insulin resistance, and C-reactive protein. 25,26 In addition to the epidemiologic evidence, numerous short-term intervention trials have evaluated the effects of a Mediterranean-style diet on CVD risk factors ( Table 2). These trials provide additional evidence for the beneficial effects of a Mediterranean-style dietary pattern on the following CVD risk factors: plasma lipid/lipoprotein profiles, 27-31 apolipoproteins, 28 body weight/composition, 29,32,33 oxidative stress, 34 glycemic response, 27,29,32,33 inflammatory markers, 28,29 vascular function, 29,[35][36][37][38] and criteria for metabolic syndrome.…”

The Application of the Korean Dietary Pattern Score; KNHANES (Korean National Health and Nutrition Examination Survey) 2007

“…Nutrient studies, epidemiologic studies, and clinical trials indicate that the Mediterranean diet lowers the risk of chronic disease [8,9]. Accordingly, it is widely recommended as a healthy dietary pattern model to improve the quality of life [10,11].…”