Special Issue "Health Benefits of Mediterranean Diet"

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

Deadline for manuscript submissions: closed (30 March 2019).

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A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. Giuseppe Grosso
Website
Guest Editor
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
Interests: evidence synthesis; nutritional epidemiology; polyphenols; Mediterranean diet; foods; nutrients; phytochemicals
Special Issues and Collections in MDPI journals
Dr. Daniela Martini

Guest Editor
Human Nutrition Unit, Department of Veterinary Science, University of Parma, Italy
Interests: food labeling; food regulation; bioactive compounds; oxidative stress
Special Issues and Collections in MDPI journals

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

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Keywords

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

Published Papers (17 papers)

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Editorial

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Open AccessEditorial
Health Benefits of Mediterranean Diet
Nutrients 2019, 11(8), 1802; https://doi.org/10.3390/nu11081802 - 05 Aug 2019
Cited by 3
Abstract
Growing evidence shows that a dietary pattern inspired by Mediterranean Diet (MD) principles is associated with numerous health benefits [...] Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet) Printed Edition available

Research

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Open AccessArticle
Adherence to a Mediterranean Dietary Pattern Is Associated with Higher Quality of Life in a Cohort of Italian Adults
Nutrients 2019, 11(5), 981; https://doi.org/10.3390/nu11050981 - 29 Apr 2019
Cited by 7
Abstract
Background: The observed rise in non-communicable diseases may be attributed to the ongoing changes of urban environment and society, as well as greater awareness of health-related issues and subsequent higher rates of diagnosis, which all contribute to the overall quality of life. The [...] Read more.
Background: The observed rise in non-communicable diseases may be attributed to the ongoing changes of urban environment and society, as well as greater awareness of health-related issues and subsequent higher rates of diagnosis, which all contribute to the overall quality of life. The aim of the study was to test the association between adherence to the Mediterranean dietary pattern and self-reported quality of life in a cohort of Italian adults. Methods: The demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Food frequency questionnaires (FFQs) and a Mediterranean diet adherence score were used to assess dietary intake. The Manchester Short Appraisal (MANSA) was used to assess self-rated quality of life. Multivariate logistic regression analyses were used to test the associations. Results: A significant linear trend of association was found for the overall quality of life and adherence to Mediterranean diet score. All of the components of the MANSA, with the exception of self-rated mental health, were individually associated with higher adherence to this dietary pattern. Conclusions: Adherence to a healthy dietary pattern is associated with the measures of better overall perceived quality of life. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet) Printed Edition available
Open AccessArticle
Adherence to the Mediterranean Diet is Associated with Better Sleep Quality in Italian Adults
Nutrients 2019, 11(5), 976; https://doi.org/10.3390/nu11050976 - 28 Apr 2019
Cited by 10
Abstract
Background: Sleep quality has been associated with human health and diseases, including cognitive decline and dementia; however major determinants of sleep disorders are largely unknown. The aim of this study was to evaluate the association between sleep quality and adherence to the Mediterranean [...] Read more.
Background: Sleep quality has been associated with human health and diseases, including cognitive decline and dementia; however major determinants of sleep disorders are largely unknown. The aim of this study was to evaluate the association between sleep quality and adherence to the Mediterranean dietary pattern in a sample of Italian adults. Methods: A total of 1936 individuals were recruited in the urban area of Catania during 2014–2015 through random sampling. A food frequency questionnaire and validated instruments were used to assess the adherence to the Mediterranean diet and sleep quality (Pittsburg sleep quality index). Multivariate logistic regressions were performed to determine the association between exposure and outcome. Results: A total of 1314 individuals (67.9% of the cohort) reported adequate sleep quality: for each point increase of the Mediterranean diet score, individuals were 10% more likely to have adequate sleep quality. In an additional analysis stratifying the sample by weight status, the association between sleep quality and high adherence to the Mediterranean diet was observed only among normal/overweight individuals but not in obese participants. Conclusions: high adherence to a Mediterranean diet is associated with better sleep quality either toward direct effect on health or indirect effects through improvement of weight status. Full article
(This article belongs to the Special Issue Health Benefits of Mediterranean Diet) Printed Edition available
Open AccessArticle
Mediterranean Diet and Motivation in Sport: A Comparative Study Between University Students from Spain and Romania
Nutrients 2019, 11(1), 30; https://doi.org/10.3390/nu11010030 - 22 Dec 2018
Cited by 8
Abstract
Background: The Mediterranean Diet (MD) is one of the healthiest dietary models worldwide, being an essential mean of preventing pathologies along with the practice of physical activity. Through a comparative study carried out across different countries, it has been demonstrated how this type [...] Read more.
Background: The Mediterranean Diet (MD) is one of the healthiest dietary models worldwide, being an essential mean of preventing pathologies along with the practice of physical activity. Through a comparative study carried out across different countries, it has been demonstrated how this type of habits vary depending on the geographical context. The aim of this research was to evaluate the adherence to MD and its relationships with motivational climate in sport on a sample of university students from Spain and Romania; Methods: A cross-sectional study was conducted on a sample of university students [specialization: Physical Education (n = 605; 20.71 ± 2.42 years old)], using as main instruments the Mediterranean Diet Quality Index (KIDMED) for students and adolescents and the Perceived Motivational Climate in Sport Questionnaire-2 (PMCSQ-2); Results: It was shown that students from Spain had a high adherence to the MD (6.65 ± 2.63 vs. 5.06 ± 1.31). Spanish university students got higher scores in task-oriented motivational climate (4.03 ± 0.62 vs. 3.11 ± 0.55) while ego-oriented climate was higher in university students from Romania (3.24 ± 0.54 vs. 2.07 ± 0.75). Finally, it was observed that the task-oriented motivational climate was related to a lower adherence to MD in Spanish students (4.49 ± 0.37 vs. 3.98 ± 0.62). In contrast, in Romanian youth, a medium adherence to the MD was associated with higher scores for the ego-oriented motivational climate (3.27 ± 0.53 vs. 3.00 ± 0.54); Conclusions: As main conclusions, it was shown that the students from Spain had a high adherence to the MD. In addition, it has been demonstrated that ego-oriented climates are linked to a better adherence to MD, especially due to the importance of following a proper diet in sport contexts, as demonstrated by young Romanians. Full article
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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 - 15 Nov 2018
Cited by 5
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) Printed Edition available
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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 - 06 Nov 2018
Cited by 1
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
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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 - 11 Oct 2018
Cited by 2
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) Printed Edition available
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 - 18 Sep 2018
Cited by 16
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
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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 - 10 Aug 2018
Cited by 17
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
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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 - 26 Jul 2018
Cited by 13
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
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Review

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Open AccessFeature PaperReview
Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet
Nutrients 2019, 11(6), 1306; https://doi.org/10.3390/nu11061306 - 09 Jun 2019
Cited by 4
Abstract
Several different socio-economic factors have caused a large portion of the population to adopt unhealthy eating habits that can undermine healthcare systems, unless current trends are inverted towards more sustainable lifestyle models. Even though a dietary plan inspired by the principles of the [...] Read more.
Several different socio-economic factors have caused a large portion of the population to adopt unhealthy eating habits that can undermine healthcare systems, unless current trends are inverted towards more sustainable lifestyle models. Even though a dietary plan inspired by the principles of the Mediterranean Diet is associated with numerous health benefits and has been demonstrated to exert a preventive effect towards numerous pathologies, including obesity, its use is decreasing and it is now being supplanted by different nutritional models that are often generated by cultural and social changes. Directing governments’ political actions towards spreading adherence to the Mediterranean Diet’s principles as much as possible among the population could help to tackle the obesity epidemic, especially in childhood. This document intends to reiterate the importance of acting in certain age groups to stop the spread of obesity and proceeds with a critical review of the regulatory instruments used so far, bearing in mind the importance of the scientific evidence that led to the consideration of the Mediterranean Diet as not just a food model, but also as the most appropriate regime for disease prevention, a sort of complete lifestyle plan for the pursuit of healthcare sustainability. Full article
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Open AccessReview
Mediterranean Diet Pyramid: A Proposal for Italian People. A Systematic Review of Prospective Studies to Derive Serving Sizes
Nutrients 2019, 11(6), 1296; https://doi.org/10.3390/nu11061296 - 07 Jun 2019
Cited by 5
Abstract
In the last decade, a number of meta-analyses of mostly observational studies evaluated the relation between the intake of food groups and the risk of noncommunicable diseases (NCDs). In this study, we systematically reviewed dose-response meta-analyses of prospective studies with the aim to [...] Read more.
In the last decade, a number of meta-analyses of mostly observational studies evaluated the relation between the intake of food groups and the risk of noncommunicable diseases (NCDs). In this study, we systematically reviewed dose-response meta-analyses of prospective studies with the aim to derive the quantities of food to consume to attain a protective (Mediterranean food) or a non-adverse (non-Mediterranean food) effect toward selected NCDs such as cardiovascular disease (CVD) including coronary heart disease (CHD) and stroke, type 2 diabetes (T2DM), colorectal (CRC) and breast cancer. These derived quantities, wherever possible, were suggested for a quantification of food servings of the Mediterranean Diet Pyramid proposed for Italian People (MDPPI). This pyramid came from the Modern Mediterranean Diet Pyramid developed in 2009 for Italian people. A weekly menu plan was built on the advice about frequency of intakes and serving sizes of such pyramid and the nutritional composition of this diet was compared with the Reference Italian Mediterranean Diet followed in 1960 in Nicotera. The diet built according the advice of MDPPI was very similar to that of Nicotera in the late 1950s that has been chosen as Italian Reference Mediterranean Diet with the exception of percentage of energy provided by cereals that was lower and of fruits and vegetables that was higher. Saturated fatty acids were only the 6% of daily energy intake. Also the Mediterranean Adequacy Index (MAI) was very similar to that of the aforementioned diet. Full article
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Open AccessReview
Effect of Adherence to Mediterranean Diet during Pregnancy on Children’s Health: A Systematic Review
Nutrients 2019, 11(5), 997; https://doi.org/10.3390/nu11050997 - 01 May 2019
Cited by 5
Abstract
The traditional Mediterranean diet has been shown to be a healthy eating pattern that protects against the development of many diseases in adults and children. Pregnancy is a critical period of plasticity during which foetal development may be significantly influenced by different environmental [...] Read more.
The traditional Mediterranean diet has been shown to be a healthy eating pattern that protects against the development of many diseases in adults and children. Pregnancy is a critical period of plasticity during which foetal development may be significantly influenced by different environmental factors, including maternal nutrition. In this context, several studies have examined the potential benefits of adherence to a Mediterranean diet during pregnancy on birth outcomes, considering the Mediterranean diet as a whole rather than focusing on the effect of its individual components. In this review, we systematically summarized and discussed results of studies investigating the protective role of Mediterranean diet against foetal growth, prematurity, neural tube defects and other congenital pathologies, asthma and allergy, body weight and metabolic markers. Although current data are insufficient and randomized control trials are needed, growing evidence suggests the beneficial effect of the Mediterranean diet during pregnancy on children’s health. In this sense, strategies aiming to promote adherence to this dietary pattern might be of considerable importance to public health. Full article
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Open AccessReview
Overview of Human Intervention Studies Evaluating the Impact of the Mediterranean Diet on Markers of DNA Damage
Nutrients 2019, 11(2), 391; https://doi.org/10.3390/nu11020391 - 13 Feb 2019
Cited by 8
Abstract
The Mediterranean diet (MD) is characterized by high consumption of fruits, vegetables, cereals, potatoes, poultry, beans, nuts, lean fish, dairy products, small quantities of red meat, moderate alcohol consumption, and olive oil. Most of these foods are rich sources of bioactive compounds which [...] Read more.
The Mediterranean diet (MD) is characterized by high consumption of fruits, vegetables, cereals, potatoes, poultry, beans, nuts, lean fish, dairy products, small quantities of red meat, moderate alcohol consumption, and olive oil. Most of these foods are rich sources of bioactive compounds which may play a role in the protection of oxidative stress including DNA damage. The present review provides a summary of the evidence deriving from human intervention studies aimed at evaluating the impact of Mediterranean diet on markers of DNA damage, DNA repair, and telomere length. The few results available show a general protective effect of MD alone, or in combination with bioactive-rich foods, on DNA damage. In particular, the studies reported a reduction in the levels of 8-hydroxy-2′–deoxyguanosine and a modulation of DNA repair gene expression and telomere length. In conclusion, despite the limited literature available, the results obtained seem to support the beneficial effects of MD dietary pattern in the protection against DNA damage susceptibility. However, further well-controlled interventions are desirable in order to confirm the results obtained and provide evidence-based conclusions. Full article
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Open AccessReview
Metabolomics and Microbiomes as Potential Tools to Evaluate the Effects of the Mediterranean Diet
Nutrients 2019, 11(1), 207; https://doi.org/10.3390/nu11010207 - 21 Jan 2019
Cited by 17
Abstract
The approach to studying diet–health relationships has progressively shifted from individual dietary components to overall dietary patterns that affect the interaction and balance of low-molecular-weight metabolites (metabolome) and host-enteric microbial ecology (microbiome). Even though the Mediterranean diet (MedDiet) has been recognized as a [...] Read more.
The approach to studying diet–health relationships has progressively shifted from individual dietary components to overall dietary patterns that affect the interaction and balance of low-molecular-weight metabolites (metabolome) and host-enteric microbial ecology (microbiome). Even though the Mediterranean diet (MedDiet) has been recognized as a powerful strategy to improve health, the accurate assessment of exposure to the MedDiet has been a major challenge in epidemiological and clinical studies. Interestingly, while the effects of individual dietary components on the metabolome have been described, studies investigating metabolomic profiles in response to overall dietary patterns (including the MedDiet), although limited, have been gaining attention. Similarly, the beneficial effects of the MedDiet on cardiometabolic outcomes may be mediated through gut microbial changes. Accumulating evidence linking food ingestion and enteric microbiome alterations merits the evaluation of the microbiome-mediated effects of the MedDiet on metabolic pathways implicated in disease. In this narrative review, we aimed to summarize the current evidence from observational and clinical trials involving the MedDiet by (1) assessing changes in the metabolome and microbiome for the measurement of diet pattern adherence and (2) assessing health outcomes related to the MedDiet through alterations to human metabolomics and/or the microbiome. Full article
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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 - 17 Oct 2018
Cited by 24
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
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Other

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 - 09 Apr 2018
Cited by 16
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
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