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Special Issue "Health Benefits of Mediterranean Diet"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: 30 December 2018

Special Issue Editors

Guest Editor
Dr. Giuseppe Grosso

1. Department of Biomedical and Biotechnological Sciences, University of Catania,Via S. Sofia, Catania 95100, Italy
2. NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge CB4 0WS, UK
Website | E-Mail
Interests: public health nutrition; evidence synthesis; nutritional epidemiology; dietary antioxidants; chronic disease prevention
Guest Editor
Dr. Daniela Martini

Department of Food & Drugs, Università degli Studi di Parma (UNIPR), Parma, Italy
Website | E-Mail
Interests: antioxidants; nutrients; diet; functional foods; biomarkers; bioactive compounds

Special Issue Information

Dear Colleagues,

Growing evidence shows that a dietary pattern inspired by Mediterranean diet principles is associated with numerous health benefits. A Mediterranean-type diet has been demonstrated to exert a preventive effect toward cardiovascular diseases, in both Mediterranean and non-Mediterranean populations. Part of these properties may depend on a positive action toward healthier metabolism, decreasing the risk of diabetes and metabolic-syndrome-related conditions. Some studies also suggested a potential role in preventing certain cancers. Finally, newer research has showed that a higher adherence to the Mediterranean diet is associated with a lower risk of cognitive decline, depression, and other mental disorders. Overall, a better understanding of the key elements of this dietary pattern, the underlying mechanisms, and targets, are needed to corroborate current evidence and provide insights on new and potential outcomes.

This Special Issue welcomes original research and reviews of literature concerning the Mediterranean diet and various health outcomes:

  • Observational studies on established nutritional cohorts (preferred), case-control studies, or population sample on the association with non-communicable diseases;
  • Level of evidence on the association with human health, including systematic reviews and meta-analyses;
  • Evaluation of application of Mediterranean diet principles in non-Mediterranean countries;
  • Description of mechanisms of action, pathways, and targets at the molecular level, including interaction with gut microbiota.
Dr. Giuseppe Grosso
Dr. Daniela Martini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mediterranean diet
  • non-communicable diseases
  • global
  • evidence

Published Papers (8 papers)

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Research

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Open AccessArticle Does the Mediterranean Diet Protect against Stress-Induced Inflammatory Activation in European Adolescents? The HELENA Study
Nutrients 2018, 10(11), 1770; https://doi.org/10.3390/nu10111770
Received: 28 September 2018 / Revised: 1 November 2018 / Accepted: 10 November 2018 / Published: 15 November 2018
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Abstract
Stress increases inflammation but whether adherence to Mediterranean diet counteracts this association and how early can these effects be observed is not well known. We tested whether (1) cortisol is associated to inflammation, (2) cortisol is associated to the adolescent Mediterranean diet score
[...] Read more.
Stress increases inflammation but whether adherence to Mediterranean diet counteracts this association and how early can these effects be observed is not well known. We tested whether (1) cortisol is associated to inflammation, (2) cortisol is associated to the adolescent Mediterranean diet score (aMDS), (3) aMDS lessens inflammation, (4) aMDS associates with cortisol levels and inflammation. Two hundred and forty-two adolescents (137 females; 12.5–17.5 years old) provided salivary cortisol, blood and 2-day 24-h dietary recall from which aMDS was derived. Cortisol levels were associated with increased tumor necrosis factor (TNF-α B = 11.887, p = 0.001) when adjusted for age, gender, parental education and body mass index (BMI). Moreover, cortisol levels were inversely associated to adherence to the Mediterranean Diet (B = −1.023, p = 0.002). Adolescents with higher adherence to aMDS had lower levels of interleukins (IL) IL-1, IL-2, IL-6 and TNF-α, compared to those who did not adhere. The association between cortisol and TNF-α was no longer significant when aMDS was included in the model (B = 6.118, p = 0.139). In addition, comparing lower and higher aMDS groups, the association between cortisol and TNF-α was only observed in those with lower aMDS adherence. Our study suggests that adherence to the Mediterranean Diet may counteract the effect of stress on inflammatory biomarkers which may contribute to decreasing the risk of future mental health. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)
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Open AccessArticle Exploring the Perceived Barriers to Following a Mediterranean Style Diet in Childbearing Age: A Qualitative Study
Nutrients 2018, 10(11), 1694; https://doi.org/10.3390/nu10111694
Received: 29 September 2018 / Revised: 1 November 2018 / Accepted: 2 November 2018 / Published: 6 November 2018
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Abstract
A considerable amount of research has focused on interventions in pregnancy to promote health in current and future generations. This has yielded inconsistent results and focus has turned towards improving health in the preconception period. Promotion of healthy dietary patterns similar to a
[...] Read more.
A considerable amount of research has focused on interventions in pregnancy to promote health in current and future generations. This has yielded inconsistent results and focus has turned towards improving health in the preconception period. Promotion of healthy dietary patterns similar to a Mediterranean diet in the preconception years has been suggested as a dietary strategy to prevent maternal obesity and optimize offspring health. However, it is uncertain whether adoption is acceptable in women of childbearing age. This qualitative study aims to investigate the perceived barriers to following a Mediterranean diet in women of childbearing age. Semi-structured focus groups were used to generate deep insights to be used to guide the development of a future intervention. Nulliparous women aged between 20 and 47 years were recruited (n = 20). Six focus groups were digitally audio recorded and transcribed verbatim by the researcher. Thematic analysis was used to analyze data, which occurred in parallel with data collection to ascertain when data saturation was reached. Five core themes were identified: Mediterranean diet features, perceived benefits, existing dietary behavior and knowledge, practical factors, and information source. The present study highlights that a Mediterranean diet is acceptable to childbearing-aged women, and the insights generated will be helpful in developing an intervention to promote Mediterranean diet adoption. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)
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Open AccessArticle Differences in Mediterranean Diet Adherence between Cyclists and Triathletes in a Sample of Spanish Athletes
Nutrients 2018, 10(10), 1480; https://doi.org/10.3390/nu10101480
Received: 11 September 2018 / Revised: 6 October 2018 / Accepted: 8 October 2018 / Published: 11 October 2018
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Abstract
Adherence to the Mediterranean diet (MD) has rapidly declined in Mediterranean countries due to the increasing introduction of the Western diet. The aim of this study was to describe adherence to the MD within a sample of athletes from Spain. A second aim
[...] Read more.
Adherence to the Mediterranean diet (MD) has rapidly declined in Mediterranean countries due to the increasing introduction of the Western diet. The aim of this study was to describe adherence to the MD within a sample of athletes from Spain. A second aim was to predict adherence to various components of the MD according to region, sex, and sport discipline. A cross-sectional study was conducted with a sample of 4037 (34.14 ± 9.28 years old) cyclists and triathletes (men: 90.1%). Participants self-reported their sex, date of birth, the number of years they had been practicing their sport, height, weight, sport discipline (cyclist, triathlon), and region. Mediterranean Diet Adherence Screener (MEDAS) was used to determine level of adherence to the MD. Women reported a higher MEDAS score and body mass index (BMI) (p ˂ 0.000) than men. Cyclists reported a lower MEDAS score (7.44, SD 2.12 vs. 7.85, SD 2.08), and older age (37.72, SD 9.67 vs. 34.54, SD 8.58) and BMI (23.74, SD 2.69) vs. 22.85, SD 2.28) than triathletes. The study showed that a large proportion of the surveyed athletic population were not meeting the MD guidelines, with particularly low consumption amongst men and cyclists. There were no regional effects. Nutritional guidelines for athletes should be individual rather than general and follow specifications identified by the present research. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)
Open AccessFeature PaperArticle Adherence to the Mediterranean Diet among School Children and Adolescents Living in Northern Italy and Unhealthy Food Behaviors Associated to Overweight
Nutrients 2018, 10(9), 1322; https://doi.org/10.3390/nu10091322
Received: 9 August 2018 / Revised: 11 September 2018 / Accepted: 12 September 2018 / Published: 18 September 2018
Cited by 1 | PDF Full-text (263 KB) | HTML Full-text | XML Full-text
Abstract
The purposes of this study were to evaluate the differences in Mediterranean diet and its components among primary and secondary school children and adolescents living in northern Italy, and the associations with the weight status. Adherence was assessed by the KIDMED (Mediterranean Diet
[...] Read more.
The purposes of this study were to evaluate the differences in Mediterranean diet and its components among primary and secondary school children and adolescents living in northern Italy, and the associations with the weight status. Adherence was assessed by the KIDMED (Mediterranean Diet Quality Index) questionnaire on 669 subjects (6–16 years) attending five schools of Novara. The adherence was poor in 16.7%, average in 63.7%, and high in 19.6% of the students. Poor adherence was more frequent in primary than in secondary schools (20.7% vs. 13.7%, p < 0.04). Some unhealthy behaviors were more prevalent in younger children. Children of other ethnic origins had a mixed behavior, choosing both traditional healthy and unhealthy foods. Besides male gender and primary school, in Italian children, the risk of overweight was directly associated with eating at fast-food restaurants (OR: 1.890, CI 95% 1.002–3.563), and inversely with consumption of vegetables more than once a day (OR: 0.588, CI 95% 0.349–0.991), and olive oil at home (OR: 0.382, CI 95% 0.176–0.826). In children of other ethnic origins, this risk was associated with skipping breakfast (OR: 16.046, CI 95% 1.933–133.266), or consuming commercial baked good or pastries for breakfast (OR: 10.255, CI 95% 1.052–99.927). The overall KIDMED score correlated with height (β: 0.108; p < 0.005). Poor food quality is replacing the Mediterranean dietary pattern in children and adolescents, in particular among younger children. Because the risk of overweight was associated with different components of the Mediterranean diet depending on ethnic origins, tailored nutritional programs remain a need. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)
Open AccessArticle Impact of a Mediterranean Dietary Pattern and Its Components on Cardiovascular Risk Factors, Glucose Control, and Body Weight in People with Type 2 Diabetes: A Real-Life Study
Nutrients 2018, 10(8), 1067; https://doi.org/10.3390/nu10081067
Received: 24 July 2018 / Revised: 3 August 2018 / Accepted: 7 August 2018 / Published: 10 August 2018
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Abstract
This study evaluates the relation of a Mediterranean dietary pattern and its individual components with the cardiovascular risk factors profile, plasma glucose and body mass index (BMI) in people with type 2 diabetes. We studied 2568 participants at 57 diabetes clinics. Diet was
[...] Read more.
This study evaluates the relation of a Mediterranean dietary pattern and its individual components with the cardiovascular risk factors profile, plasma glucose and body mass index (BMI) in people with type 2 diabetes. We studied 2568 participants at 57 diabetes clinics. Diet was assessed with the EPIC (European Prospective Investigation into Cancer and Nutrition) questionnaire, adherence to the Mediterranean diet was evaluated with the relative Mediterranean diet score (rMED). A high compared to a low score was associated with a better quality of diet and a greater adherence to the nutritional recommendations for diabetes. However, even in the group achieving a high score, only a small proportion of participants met the recommendations for fiber and saturated fat (respectively 17% and 30%). Nonetheless, a high score was associated with lower values of plasma lipids, blood pressure, glycated hemoglobin, and BMI. The relationship of the single food items components of the rMED score with the achievement of treatment targets for plasma lipids, blood pressure, glucose, and BMI were also explored. The study findings support the Mediterranean dietary model as a suitable model for type 2 diabetes and the concept that the beneficial health effects of the Mediterranean diet lie primarily in its synergy among various nutrients and foods rather than on any individual component. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)
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Open AccessArticle Adherence to the Mediterranean Diet Is Associated with Physical Activity, Self-Concept and Sociodemographic Factors in University Student
Nutrients 2018, 10(8), 966; https://doi.org/10.3390/nu10080966
Received: 21 June 2018 / Revised: 20 July 2018 / Accepted: 23 July 2018 / Published: 26 July 2018
Cited by 1 | PDF Full-text (288 KB) | HTML Full-text | XML Full-text
Abstract
(1) Background: The aim of this study was to assess adherence to the Mediterranean diet (MD) and to examine the relationship between MD adherence, physical activity, self-concept, and other sociodemographic factors; (2) Methods: A cross-sectional study (N = 597; 18.99 ± 0.64
[...] Read more.
(1) Background: The aim of this study was to assess adherence to the Mediterranean diet (MD) and to examine the relationship between MD adherence, physical activity, self-concept, and other sociodemographic factors; (2) Methods: A cross-sectional study (N = 597; 18.99 ± 0.64 years) was conducted in a sample of university students from Ceuta, Melilla, and Granada (Spain). Religious beliefs and place of residence were directly reported, while physical activity and adherence to the MD were self-reported using the Physical Activity Questionnaire for Adolescents (PAQ-A) and the Mediterranean Diet Quality Index (KIDMED) respectively. Self-concept was evaluated using the Five-Factor Self-Concept Scale; (3) Results: Of those students reporting high levels of habitual physical activity, 82.3% also reported high adherence to the MD, with 17.7% reporting a medium adherence. Of students reporting no physical activity, 25.7% also reported medium adherence to the MD. No significant associations were found between the MD and religious beliefs. It was observed that the university campus was associated with the level of adherence to the MD (p = 0.030), with adherence being lowest in Ceuta and Melilla. Finally, the MD was associated with academic (p = 0.001) and physical self-concept (p = 0.005); 4) Conclusions: The MD should be promoted to university students, particularly those studying at Ceuta and Melilla, given the present findings of lower MD adherence. In addition, as higher MD adherence was also highlighted with more positive self-concept, its promotion would be beneficial in wider educational contexts. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)

Review

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Open AccessReview Relationship between Mediterranean Dietary Polyphenol Intake and Obesity
Nutrients 2018, 10(10), 1523; https://doi.org/10.3390/nu10101523
Received: 21 September 2018 / Revised: 13 October 2018 / Accepted: 14 October 2018 / Published: 17 October 2018
Cited by 1 | PDF Full-text (770 KB) | HTML Full-text | XML Full-text
Abstract
Obesity is a multifactorial and complex disease defined by excess of adipose mass and constitutes a serious health problem. Adipose tissue acts as an endocrine organ secreting a wide range of inflammatory adipocytokines, which leads to systemic inflammation, insulin resistance, and metabolic disorders.
[...] Read more.
Obesity is a multifactorial and complex disease defined by excess of adipose mass and constitutes a serious health problem. Adipose tissue acts as an endocrine organ secreting a wide range of inflammatory adipocytokines, which leads to systemic inflammation, insulin resistance, and metabolic disorders. The traditional Mediterranean diet is characterized by a high phenolic-rich foods intake, including extra-virgin olive oil, nuts, red wine, vegetables, fruits, legumes, and whole-grain cereals. Evidence for polyphenols’ effect on obesity and weight control in humans is inconsistent and the health effects of polyphenols depend on the amount consumed and their bioavailability. The mechanisms involved in weight loss in which polyphenols may have a role are: activating β-oxidation; a prebiotic effect for gut microbiota; inducing satiety; stimulating energy expenditure by inducing thermogenesis in brown adipose tissue; modulating adipose tissue inhibiting adipocyte differentiation; promoting adipocyte apoptosis and increasing lipolysis. Even though the intake of some specific polyphenols has been associated with body weight changes, there is still no evidence for the effects of total polyphenols or some polyphenol subclasses in humans on adiposity. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)
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Other

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Open AccessOpinion A Mediterranean Diet Model in Australia: Strategies for Translating the Traditional Mediterranean Diet into a Multicultural Setting
Nutrients 2018, 10(4), 465; https://doi.org/10.3390/nu10040465
Received: 2 March 2018 / Revised: 4 April 2018 / Accepted: 8 April 2018 / Published: 9 April 2018
Cited by 7 | PDF Full-text (4562 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Substantial evidence supports the effect of the Mediterranean Diet (MD) for managing chronic diseases, although trials have been primarily conducted in Mediterranean populations. The efficacy and feasibility of the Mediterranean dietary pattern for the management of chronic diseases has not been extensively evaluated
[...] Read more.
Substantial evidence supports the effect of the Mediterranean Diet (MD) for managing chronic diseases, although trials have been primarily conducted in Mediterranean populations. The efficacy and feasibility of the Mediterranean dietary pattern for the management of chronic diseases has not been extensively evaluated in non-Mediterranean settings. This paper aims to describe the development of a MD model that complies with principles of the traditional MD applied in a multiethnic context. Optimal macronutrient and food-based composition was defined, and a two-week menu was devised incorporating traditional ingredients with evidence based on improvements in chronic disease management. Strategies were developed for the implementation of the diet model in a multiethnic population. Consistent with the principles of a traditional MD, the MD model was plant-based and high in dietary fat, predominantly monounsaturated fatty acids from extra virgin olive oil. Fruits, vegetables and wholegrains were a mainstay, and moderate amounts of nuts and seeds, fish, dairy and red wine were recommended. The diet encompassed key features of the MD including cuisine, biodiversity and sustainability. The MD model preserved traditional dietary components likely to elicit health benefits for individuals with chronic diseases, even with the adaptation to an Australian multiethnic population. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet)
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