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Mediterranean Diet: Promoting Health and Sustainability

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A special issue of Foods (ISSN 2304-8158). This special issue belongs to the section "Nutraceuticals, Functional Foods, and Novel Foods".

Deadline for manuscript submissions: closed (10 June 2024) | Viewed by 30033

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Prof. Dr. Nikolaos K. Andrikopoulos

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Guest Editor

Laboratory of Chemistry-Biochemistry-Physical Chemistry of Foods, Department of Dietetics and Nutrition, School of Health Science and Education, Harokopio University, Kallithea, Athens, Greece
Interests: polyphenols; polar phenols; chemical changes of foods (cooking)

Dr. Andriana Kaliora

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Guest Editor

Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 70 El. Venizelou Ave., 17671 Kallithea, Athens, Greece
Interests: dietary interventions; foods; nutrients; food supplements; dietary patterns; chronic inflammatory conditions; inflammatory diseases; oxidative stress
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Dear Colleagues,

The Mediterranean Diet plays a well-established protective role against chronic diseases such as diabetes, obesity, cardiovascular diseases, different forms of cancer, Alzheimer disease, and even autoimmune disorders. Meanwhile, the Mediterranean diet is also linked with planetary health. It presents a better ecological footprint compared with other patterns due to the higher consumption of local in-season plant foods, the low ecological pressure by food production and consumption, as well as the lower intake of animal protein. Hence, encouraging people to increase adherence to Mediterranean diet would contribute substantially to decreased risk of chronic diseases as well as to sustainability of the food supply chain (from farm to fork), with a plethora of benefits for the environment.

In this Special Issue of Foods, we would like to bring together manuscripts dealing with the topic of “Mediterranean Diet: Promoting Health and Sustainability”. Different types of manuscripts on this topic, including original human and animal studies, dietary interventions, food analysis focusing mainly on the nutritional value of Mediterranean foods, systemic reviews, and metanalyses, are welcome.

Prof. Dr. Nikolaos K. Andrikopoulos
Prof. Dr. Andriana Kaliora
Guest Editors

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Keywords

mediterranean diet
health
chronic diseases
Mediterranean foods
Mediterranean cooking methods and chemical changes
sustainability
environmental impact
food selection determinants

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Published Papers (9 papers)

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Research

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14 pages, 2537 KiB

Open AccessArticle

Influence of Oleacein, an Olive Oil and Olive Mill Wastewater Phenolic Compound, on Caenorhabditis elegans Longevity and Stress Resistance

by Morgane Carrara, Myriam Richaud, Pierre Cuq, Simon Galas and Delphine Margout-Jantac

Foods 2024, 13(13), 2146; https://doi.org/10.3390/foods13132146 - 5 Jul 2024

Cited by 1 | Viewed by 940

Abstract

Oleacein, a bioactive compound of olive oil and olive mill wastewater, has one of the strongest antioxidant activities among olive phenolics. However, few reports explore the in vivo antioxidant activity of oleacein, with no clear identification of the biological pathway involved. Earlier studies have demonstrated a link between stress resistance, such as oxidative stress, and longevity. This study presents the effects of oleacein on Caenorhabditis elegans mean lifespan and stress resistance. A significant lifespan extension was observed with an increase of 20% mean lifespan at 5 µg/mL with a hormetic-like dose-dependent effect. DAF-16 and SIR-2.1 were involved in the effects of oleacein on the longevity of C. elegans, while the DAF-2 receptor was not involved. This study also shows the capacity of oleacein to significantly enhance C. elegans resistance to oxidative and thermal stress and allows a better understanding of the positive effects of olive phenolics on health. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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17 pages, 294 KiB

Open AccessArticle

Association between Dietary Patterns and Metabolic Syndrome Risk Factors: A Cross-Sectional Study of Christian Orthodox Church Fasters and Non-Fasters in Greece

by Anna Kokkinopoulou, Niki Katsiki, Ioannis Pagkalos, Nikolaos E. Rodopaios, Alexandra-Aikaterini Koulouri, Eleni Vasara, Sousana K. Papadopoulou, Petros Skepastianos, Maria Hassapidou and Anthony G. Kafatos

Foods 2023, 12(18), 3488; https://doi.org/10.3390/foods12183488 - 19 Sep 2023

Cited by 1 | Viewed by 1773

Abstract

It is well known that the Mediterranean diet contributes to healthy living, prevention of non-communicable diseases, and longevity. A cross-sectional study was conducted with participants from Greece who follow the Mediterranean diet and were further divided into two categories: (i) Christian Orthodox Church (COC) religious fasters and (ii) non-fasters. Four-hundred individuals underwent anthropometric measurements, whereas information regarding dietary intake was collected via three 24 h diet recalls and a monthly food frequency questionnaire. Principal component analysis was performed to derive dietary patterns, whereas associations between dietary patterns and metabolic syndrome (MetS) risk factors were investigated with the general linear model. Non-fasters (n = 200) were found to consume significantly more beef, chicken, turkey, sausage, broth, fried potatoes, ketchup, and mustard, while consuming less seafood, snails, soya, tarama salads, fresh fruits, margarine, olives, and decaf coffee. Two distinct dietary patterns were identified in fasters: (i) the “Mixed Diet” and (ii) the “Plant-based/Fasting Diet” pattern. Moreover, three patterns were identified in non-fasters, and were identified as follows: (i) the “Western Diet”, (ii) the “Mixed Diet”, and (iii) the “Mediterranean-like Diet” pattern. No significant association was observed between dietary patterns and the prevalence of MetS in our population. Further epidemiological studies should evaluate the links between dietary patterns and MetS prevalence within the adult Greek population. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

18 pages, 1003 KiB

Open AccessEditor’s ChoiceArticle

Ultra-Processed Foods in the Mediterranean Diet according to the NOVA Classification System; A Food Level Analysis of Branded Foods in Greece

by Alexandra Katidi, Antonis Vlassopoulos, Stamoulis Noutsos and Maria Kapsokefalou

Foods 2023, 12(7), 1520; https://doi.org/10.3390/foods12071520 - 3 Apr 2023

Cited by 14 | Viewed by 4244

Abstract

While the Mediterranean diet (MD) is championed as a healthy and sustainable dietary pattern, the NOVA classification is discussed as a tool to identify ultra-processed foods and further specify healthy food choices. We tested whether the NOVA System aligns with the MD recommendations as presented in the MD pyramids. Foods from the Greek branded food composition database, HelTH, (n = 4581) were scored according to NOVA and assigned to the tiers of the traditional and/or sustainable MD pyramids. Nutritional quality was measured as nutrient content and Nutri-Score grades. NOVA identified 70.2% of all foods as UPFs, and 58.7% or 41.0% of foods included in the sustainable and the traditional MD, respectively. Although foods at the top of the pyramids were mostly (>80%) UPFs, NOVA identified > 50% of foods in the MD base as UPFs. Only 22–39% of foods in the MD base were not UPFs and of high nutritional quality (Nutri-Score A-B). NOVA has low discriminatory capacity across the MD tiers, and it restricts food choices to <30% of foods currently available in supermarkets and <60% within the recommended MD tiers. Therefore, the NOVA classification cannot always identify suitable food choices under the MD pyramid in the modern packaged food environment. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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18 pages, 1078 KiB

Open AccessArticle

Pleurotus eryngii Chips—Chemical Characterization and Nutritional Value of an Innovative Healthy Snack

by Charalampia Amerikanou, Dimitra Tagkouli, Thalia Tsiaka, Dimitra Z. Lantzouraki, Sotirios Karavoltsos, Aikaterini Sakellari, Stamatia-Angeliki Kleftaki, Georgios Koutrotsios, Virginia Giannou, Georgios I. Zervakis, Panagiotis Zoumpoulakis, Nick Kalogeropoulos and Andriana C. Kaliora

Foods 2023, 12(2), 353; https://doi.org/10.3390/foods12020353 - 11 Jan 2023

Cited by 10 | Viewed by 3452

Abstract

Nowadays, as the pandemic has reshaped snacking behaviors, and consumers have become more health-conscious, the need for the incorporation of “healthy snacking” in our diets has emerged. Although there is no agreed-upon definition of “healthy snacking”, dietary guidelines refer to snack foods with high nutritional and biological value. The aim of this study was to chemically characterize and determine the nutritional value of an innovative UVB-irradiated and baked snack from Pleurotus eryngii mushrooms. P. eryngii is an edible mushroom native to the Mediterranean basin. We applied proximate composition, amino acids, fatty acids, vitamins, and macro and trace elements analyses. Also, we computed indices to assess the nutritional quality of food, and we evaluated the sensory characteristics of the mushroom snack. We found high nutritional, consumer, and biological values for the snack. More specifically it was low in calories, high in fibre and protein, low in lipids, without added sugars, and high in ergosterol and beta-glucans. Additionally, it had some vitamins and trace elements in significant quantities. Its NRF9.3 score was considerably high compared to most popular snacks, and the snack exhibited high hypocholesterolemic and low atherogenic and thrombogenic potentials. In conclusion, as a result of UVB-irradiation and baking of P. eryngii mushrooms, the snack’s nutritional and biological value were not affected; instead, it provided a “healthy snacking” option. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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16 pages, 309 KiB

Open AccessArticle

Longitudinal Trends, Determinants, and Cardiometabolic Impact of Adherence to the Mediterranean Diet among Greek Adults

by Michael Georgoulis, Ekavi N. Georgousopoulou, Christina Chrysohoou, Christos Pitsavos and Demosthenes B. Panagiotakos

Foods 2022, 11(16), 2389; https://doi.org/10.3390/foods11162389 - 9 Aug 2022

Cited by 12 | Viewed by 2269

Abstract

Despite the well-established health benefits of the Mediterranean diet, there are signs that Mediterranean populations are deviating from this traditional pattern. We aimed to evaluate longitudinal changes in adherence to the Mediterranean diet, its determinants and health effects in a representative sample of the adult Greek population. This was a secondary analysis of the ATTICA epidemiological cohort study conducted in 2001/2002 and 2011/2012. The study sample consisted of 3042 men and women free of cardiovascular diseases living in Attica, Greece; of them, 2583 were followed-up for 10 years. Participants were evaluated in terms of sociodemographic, lifestyle and clinical parameters at baseline, and incidence of cardiometabolic diseases was recorded at follow-up. Dietary habits were assessed both at baseline and 10 years through a validated food frequency questionnaire and adherence to the Mediterranean diet was evaluated through the MedDietScore, based on which four trajectories were identified, i.e., low–low, low–high, high–low and high–high. During the study period, 45.6% of participants moved away from the Mediterranean diet (high–low), 9.0% moved closer (low–high), while 18.7% sustained a high adherence (high–high). Participants in the high–high trajectory were younger, mostly women, more physically active, had a higher socioeconomic status, and a more favorable body composition and cardiometabolic profile at baseline, and exhibited lower 10-year incidence rates of hyperlipidemia, hypertension, diabetes mellitus and cardiovascular disease compared to other trajectories (all p-values < 0.050). Adherence to the Mediterranean diet is declining among Greek adults. Staying close to the Mediterranean diet is associated with significant health benefits and should be a major target of public health strategies. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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34 pages, 860 KiB

Open AccessReview

Nutritional Barriers to the Adherence to the Mediterranean Diet in Non-Mediterranean Populations

by Tobili Y. Sam-Yellowe

Foods 2024, 13(11), 1750; https://doi.org/10.3390/foods13111750 - 2 Jun 2024

Cited by 1 | Viewed by 1419

Abstract

Adherence to the Mediterranean diet has been shown to lower the risk of developing chronic non-communicable diseases like cardiovascular and neurodegenerative diseases and cancer. Improvements in depression, participation in daily activities in older individuals, weight loss and a reduction in adverse pregnancy outcomes are associated with adherence to the Mediterranean diet. The number of studies that have evaluated barriers to adherence to the Mediterranean diet in the US and, in particular, in racial and ethnic minority populations within the US are few. Among Native American and Alaskan Native populations, studies evaluating traditional or alternative Mediterranean diet adherence for chronic non-infectious diseases is unavailable. Mediterranean diet scoring instruments used in studies in European and Mediterranean countries and among white participants in the US fail to capture the dietary patterns of racial and ethnic minority populations. In this narrative review, the food components of the traditional Mediterranean diet are discussed, adherence to the Mediterranean diet is examined in Mediterranean and non-Mediterranean countries and barriers preventing adherence to the Mediterranean diet in the US and among racial and ethnic minority populations is reviewed. Recommendations for improving nutrition education and intervention and for increasing adherence and cultural adaptions to the Mediterranean diet are provided. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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31 pages, 1463 KiB

Open AccessReview

Effects of Agricultural Intensification on Mediterranean Diets: A Narrative Review

by Gultekin Hasanaliyeva, Enas Khalid Sufar, Juan Wang, Leonidas Rempelos, Nikolaos Volakakis, Per Ole Iversen and Carlo Leifert

Foods 2023, 12(20), 3779; https://doi.org/10.3390/foods12203779 - 14 Oct 2023

Cited by 5 | Viewed by 1911

Abstract

Introduction: Mediterranean diets (MedDiets) are linked to substantial health benefits. However, there is also growing evidence that the intensification of food production over the last 60 years has resulted in nutritionally relevant changes in the composition of foods that may augment the health benefits of MedDiets. Objective: To synthesize, summarize, and critically evaluate the currently available evidence for changes in food composition resulting from agricultural intensification practices and their potential impact on the health benefits of MedDiets. Methods: We summarized/synthesized information from (i) systematic literature reviews/meta-analyses and more recently published articles on composition differences between conventional and organic foods, (ii) desk studies which compared food composition data from before and after agricultural intensification, (iii) recent retail and farm surveys and/or factorial field experiments that identified specific agronomic practices responsible for nutritionally relevant changes in food composition, and (iv) a recent systematic literature review and a small number of subsequently published observational and dietary intervention studies that investigated the potential health impacts of changes in food composition resulting from agricultural intensification. Results and Discussion: There has been growing evidence that the intensification of food production has resulted in (i) lower concentrations of nutritionally desirable compounds (e.g., phenolics, certain vitamins, mineral micronutrients including Se, Zn, and omega-3 fatty acids, α-tocopherol) and/or (ii) higher concentrations of nutritionally undesirable or toxic compounds (pesticide residues, cadmium, omega-6 fatty acids) in many of the foods (including wholegrain cereals, fruit and vegetables, olive oil, dairy products and meat from small ruminants, and fish) that are thought to contribute to the health benefits associated with MedDiets. The evidence for negative health impacts of consuming foods from intensified conventional production systems has also increased but is still limited and based primarily on evidence from observational studies. Limitations and gaps in the current evidence base are discussed. Conclusions: There is now substantial evidence that the intensification of agricultural food production has resulted in a decline in the nutritional quality of many of the foods that are recognized to contribute to the positive health impacts associated with adhering to traditional MedDiets. Further research is needed to quantify to what extent this decline augments the positive health impacts of adhering to a traditional MedDiet. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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16 pages, 1843 KiB

Open AccessEditor’s ChoiceReview

Mediterranean Diet: The Role of Phenolic Compounds from Aromatic Plant Foods

by Amélia Delgado, Sandra Gonçalves and Anabela Romano

Foods 2023, 12(4), 840; https://doi.org/10.3390/foods12040840 - 16 Feb 2023

Cited by 25 | Viewed by 3209

Abstract

Today’s global food system aggravates climate change while failing in meeting SDG2 and more. Yet, some sustainable food cultures, such as the Mediterranean Diet (MD), are simultaneously safe, healthy, and rooted in biodiversity. Their wide range of fruits, herbs, and vegetables convey many bioactive compounds, often associated with colour, texture, and aroma. Phenolic compounds are largely responsible for such features of MD’s foods. These plant secondary metabolites all share in vitro bioactivities (e.g., antioxidants), and some are evidenced in vivo (e.g., plant sterols lower cholesterol levels in blood). The present work examines the role of polyphenols in the MD, with respect to human and planetary health. Since the commercial interest in polyphenols is increasing, a strategy for the sustainable exploitation of Mediterranean plants is essential in preserving species at risk while valuing local cultivars (e.g., through the geographical indication mechanism). Finally, the linkage of food habits with cultural landscapes, a cornerstone of the MD, should enable awareness-raising about seasonality, endemism, and other natural constraints to ensure the sustainable exploitation of Mediterranean plants. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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17 pages, 1260 KiB

Open AccessReview

Carob: A Sustainable Opportunity for Metabolic Health

by Aristea Gioxari, Charalampia Amerikanou, Irini Nestoridi, Eleni Gourgari, Harris Pratsinis, Nick Kalogeropoulos, Nikolaos K. Andrikopoulos and Andriana C. Kaliora

Foods 2022, 11(14), 2154; https://doi.org/10.3390/foods11142154 - 20 Jul 2022

Cited by 31 | Viewed by 9297

Abstract

Carob (Ceratonia siliqua L.) is an evergreen tree that belongs to the Leguminosae family and grows in the arid and semi-arid regions of the Mediterranean basin. The carob tree is resistant to droughts and salinity, while its deep root systems allow CO₂ to sink, mitigating global warming effects. Traditionally, carob has been used to produce animal feed, but for many years, it was excluded from the human diet. Nowadays, agricultural and industrial sectors exploit carob fruit, also referred to as carob pod, and its primary products (i.e., flour, powder and syrup) to develop a variety of foods and beverages. The nutritional composition varies depending on the carob part but also on genetic, cultivar, seasonal and environmental factors. Despite the high sugar content, the carob pod is rich in insoluble fiber and microconstituents including phenolic compounds, inositols (mainly d-pinitol) and vitamins. In the present review article, we aimed to (a) highlight the role of carob cultivation in addressing climate change challenges and the need for sustainability, and (b) summarize the effects of carob consumption on obesity and related metabolic disorders. Full article

(This article belongs to the Special Issue Mediterranean Diet: Promoting Health and Sustainability)

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