Mediterranean Diet – Health Benefits and Advances

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: 5 October 2024 | Viewed by 27069

Special Issue Editors


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Guest Editor
1. School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
2. College of Science, Health, Engineering & Education, Murdoch University, Perth, Australia
Interests: mediterranean diet; heart disease; type 2 diabetes; fatty liver disease; childhood asthma; mood disorders; depression; dementia

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Guest Editor
Miriam Hospital, Providence, RI, USA
Interests: nutrition; extra virgin olive oil; risk factors for chronic diseases; cancer

Special Issue Information

Dear Colleagues

We invite you to publish your research on the Mediterranean diet in this Special Issue, which focuses on the latest advances in the health benefits of this dietary regime.

The traditional Mediterranean diet is a plant-based diet which is abundant in seasonal fruit and vegetables, legumes, and nuts, with extra virgin olive oil as the main source of added fat. Wholegrain cereals are often consumed as sourdough bread, with moderate portions of fish consumed two to three times a week. Fermented dairy is consumed most days, mainly in the form of yoghurt and feta cheese, and red meat and processed meats consumed sparingly with a preference for white (i.e., chicken) and game meats. Furthermore, free-range eggs are consumed three to four times per week, while fresh and dried herbs and spices, and fresh lemon juice are used to flavour salads and cooked meals. Water is the main beverage, and wine is consumed in moderation and always with meals.

For over 50 years, the health benefits of the Mediterranean diet have been known, beginning with the landmark Seven Countries study which demonstrated that the lower cardiovascular mortality of the Greek islander populations studied (Crete and Corfu) was associated with their dietary pattern.

Research has consistently reported that a greater adherence to a Mediterranean diet is associated with a lower risk of heart disease, stroke, type 2 diabetes, certain cancers, neurodegenerative diseases such as Alzheimer’s and other dementias, and reduced all-cause mortality. The mechanisms by which a traditional Mediterranean diet exerts protective effects across multiple chronic disease pathways are multi-factorial. More recently, the proposed protective mechanisms have been considered to be due to a reduction in oxidative stress and chronic inflammation attributable to the bioactive phytonutrients with antioxidant and anti-inflammatory properties that are found in this plant-based and biodiverse diet.

This Special Issue of Nutrients, titled “Mediterranean Diet – Latest Advances on Health Benefits”, aims to provide the latest scientific evidence on the impact of the Mediterranean diet on health. We are seeking articles from outstanding experts across all fields of research.

Prof. Dr. Catherine Itsiopoulos
Dr. Mary M. Flynn
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 submissions that pass pre-check are 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 semimonthly 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 2900 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
  • mediterranean cuisine
  • anti-inflammatory diet
  • bioactive phytonutrients
  • mediterranean diet adherence

Published Papers (6 papers)

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Research

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13 pages, 1040 KiB  
Article
Association between Diet Quality and Risk of Type 2 Diabetes Mellitus in Patients with Coronary Heart Disease: Findings from the CORDIOPREV Study
by Lorenzo Rivas-Garcia, Gracia M. Quintana-Navarro, Juan F. Alcala-Díaz, Jose D. Torres-Peña, Antonio P. Arenas-de Larriva, Oriol Alberto Rangel-Zuñiga, Alejandro López-Moreno, Maria M. Malagon, Niki Katsiki, Pablo Perez-Martinez, Jose Lopez-Miranda and Javier Delgado-Lista
Nutrients 2024, 16(8), 1249; https://doi.org/10.3390/nu16081249 - 22 Apr 2024
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Abstract
The incidence of type 2 diabetes mellitus (T2DM) is growing in Western countries. Nutritional interventions that promote high-quality dietary patterns could help reverse this trend. We aimed to evaluate whether changes in Nutrient-Rich Food Index 9.3 (NRF9.3) were related to the risk of [...] Read more.
The incidence of type 2 diabetes mellitus (T2DM) is growing in Western countries. Nutritional interventions that promote high-quality dietary patterns could help reverse this trend. We aimed to evaluate whether changes in Nutrient-Rich Food Index 9.3 (NRF9.3) were related to the risk of developing T2DM in patients with coronary heart disease (CHD). The study was carried out in the context of two healthy dietary interventions (a Mediterranean and a low-fat diet). For this purpose, we evaluated all the patients in the CORDIOPREV study without T2DM at baseline. Data were obtained during the first 5 years of dietary intervention. The score was calculated using the Food Frequency Questionnaires at baseline and after 1 year of intervention. After 5 years of follow-up, 106 patients developed T2DM (incident-T2DM), while 316 subjects did not (non-T2DM). Total NRF9.3 score and changes during the first year of intervention were compared between incident-T2DM and non-T2DM. Incident-T2DM showed less improvement in NRF9.3 than non-T2DM (p = 0.010). In the multi-adjusted Cox proportional hazard study, patients with greater improvement in NRF9.3 had over 50% less risk of developing T2DM compared with the lowest tertile (HR 2.10, 95%, CI = 1.12–3.56). In conclusion, improved diet quality in terms of nutrient density after the dietary intervention was associated with a lower risk of T2DM in patients with CHD. Full article
(This article belongs to the Special Issue Mediterranean Diet – Health Benefits and Advances)
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14 pages, 318 KiB  
Article
Exploring the Relationship between Mediterranean Diet Adherence and Subjective Well-Being among Greek and Cypriot Adults
by Georgia-Eirini Deligiannidou, Elena Philippou, Eirini Vasiari, Vanda Lopes de Andrade, Marika Massaro, Mihail Chervenkov, Teodora Ivanova, Rui Jorge, Dessislava Dimitrova, Tatjana Ruskovska, Lence Miloseva, Viktorija Maksimova, Katarina Smilkov, Darinka Gjorgieva Ackova, María-Teresa García-Conesa, Paula Pinto and Christos A. Kontogiorgis
Nutrients 2024, 16(8), 1238; https://doi.org/10.3390/nu16081238 - 21 Apr 2024
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Abstract
Associations between subjective well-being (SWB) and dietary habits, employment status, and habitual activities are increasingly capturing the focus of researchers as well as policymakers worldwide. This study aimed to explore these associations in a sample of the population in Greece and Cyprus via [...] Read more.
Associations between subjective well-being (SWB) and dietary habits, employment status, and habitual activities are increasingly capturing the focus of researchers as well as policymakers worldwide. This study aimed to explore these associations in a sample of the population in Greece and Cyprus via an online survey. In total, 936 questionnaires (470: Cyprus, 466: Greece) were analyzed to study the associations between the Mediterranean Diet (MD) (using the 14-item MEDAS score, (14-MEDAS)), subjective well-being (SWB), and several socioeconomic factors. Key remarks of this survey highlight the positive impact of MD adherence on some well-being items. Namely, statistically significant differences were found on the following items: Satisfied with life (p < 0.001), Life worthwhile (p < 0.001), Feeling happy (p < 0.001), worried (p = 0.005), and depressed (p = 0.001), when comparing Low MD adherence (14-MEDAS < 5) to High MD adherence (14-MEDAS > 10). Other lifestyle habits such as spending time with friends and family, spending time in nature, and habitual physical activity were associated with aspects of SWB such as Life satisfaction, Life worthwhile, Feeling happy, and energetic. The findings support adherence to the MD, since it is associated with higher life satisfaction and self-reported happiness in this sample and should be considered when developing health policies on well-being. Full article
(This article belongs to the Special Issue Mediterranean Diet – Health Benefits and Advances)

Review

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13 pages, 458 KiB  
Review
Mediterranean Diet and Sleep Features: A Systematic Review of Current Evidence
by Justyna Godos, Raffaele Ferri, Giuseppe Lanza, Filippo Caraci, Angel Olider Rojas Vistorte, Vanessa Yelamos Torres, Giuseppe Grosso and Sabrina Castellano
Nutrients 2024, 16(2), 282; https://doi.org/10.3390/nu16020282 - 17 Jan 2024
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Abstract
The prevalence of sleep disorders, characterized by issues with quality, timing, and sleep duration is increasing globally. Among modifiable risk factors, diet quality has been suggested to influence sleep features. The Mediterranean diet is considered a landmark dietary pattern in terms of quality [...] Read more.
The prevalence of sleep disorders, characterized by issues with quality, timing, and sleep duration is increasing globally. Among modifiable risk factors, diet quality has been suggested to influence sleep features. The Mediterranean diet is considered a landmark dietary pattern in terms of quality and effects on human health. However, dietary habits characterized by this cultural heritage should also be considered in the context of overall lifestyle behaviors, including sleep habits. This study aimed to systematically revise the literature relating to adherence to the Mediterranean diet and sleep features in observational studies. The systematic review comprised 23 reports describing the relation between adherence to the Mediterranean diet and different sleep features, including sleep quality, sleep duration, daytime sleepiness, and insomnia symptoms. The majority of the included studies were conducted in the Mediterranean basin and reported a significant association between a higher adherence to the Mediterranean diet and a lower likelihood of having poor sleep quality, inadequate sleep duration, excessive daytime sleepiness or symptoms of insomnia. Interestingly, additional studies conducted outside the Mediterranean basin showed a relationship between the adoption of a Mediterranean-type diet and sleep quality, suggesting that biological mechanisms sustaining such an association may exist. In conclusion, current evidence suggests a relationship between adhering to the Mediterranean diet and overall sleep quality and different sleep parameters. The plausible bidirectional association should be further investigated to understand whether the promotion of a healthy diet could be used as a tool to improve sleep quality. Full article
(This article belongs to the Special Issue Mediterranean Diet – Health Benefits and Advances)
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26 pages, 748 KiB  
Review
Is Extra Virgin Olive Oil the Critical Ingredient Driving the Health Benefits of a Mediterranean Diet? A Narrative Review
by Mary M. Flynn, Audrey Tierney and Catherine Itsiopoulos
Nutrients 2023, 15(13), 2916; https://doi.org/10.3390/nu15132916 - 27 Jun 2023
Cited by 6 | Viewed by 12634
Abstract
Most chronic diseases are preventable with a healthy diet, although there is debate about the optimal dietary approach. Increasingly more countries are focusing on food-based guidelines rather than the traditional nutrient-based approach. Although there is good agreement on plant foods, controversy remains about [...] Read more.
Most chronic diseases are preventable with a healthy diet, although there is debate about the optimal dietary approach. Increasingly more countries are focusing on food-based guidelines rather than the traditional nutrient-based approach. Although there is good agreement on plant foods, controversy remains about the types and amounts of fats and oils. This narrative review aims to systematically summarize and evaluate the latest evidence on the protective effects of extra virgin olive oil (EVOO) on disease risk factors. A systematic search of the relevant literature using PubMed, Cochrane Library, and Embase databases was conducted for the years 2000 through December 2022. A narrative synthesis was then undertaken. Of 281 retrieved articles, 34 articles fulfilled our inclusion criteria and were included. Compared with other dietary fats and low-fat diets, EVOO is superior in the management of clinical biomarkers including lowering blood pressure and LDL-c, increasing protective HDL-c, improving glycemic control, and weight management. The protective effects of EVOO are likely due to its polyphenol content rather than the monounsaturated fat content. It is therefore important to promote the regular use of EVOO in the context of healthy dietary patterns such as the Mediterranean diet for maximal health benefit. Full article
(This article belongs to the Special Issue Mediterranean Diet – Health Benefits and Advances)
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Other

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21 pages, 9995 KiB  
Systematic Review
The Effects of Olive Oil Consumption on Biochemical Parameters and Body Mass Index of People with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Georgios Tsamos, Georgios Kalopitas, Kleo Evripidou, Dimitra Vasdeki, Theocharis Koufakis, Vasileios Kanavas, Christina Antza, Georgios Germanidis and Michail Chourdakis
Nutrients 2024, 16(6), 857; https://doi.org/10.3390/nu16060857 - 15 Mar 2024
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Abstract
Nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disorder, is closely associated with insulin resistance, obesity, and metabolic syndromes. A body of research has proposed that olive oil, a basic component of the Mediterranean diet with antioxidant and anti-inflammatory properties, may [...] Read more.
Nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disorder, is closely associated with insulin resistance, obesity, and metabolic syndromes. A body of research has proposed that olive oil, a basic component of the Mediterranean diet with antioxidant and anti-inflammatory properties, may alleviate metabolic disturbances and retard the progression of NAFLD. We conducted a systematic review and meta-analysis to assess the effectiveness of olive oil intake in people with NAFLD. We systematically searched the major electronic databases (PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials), as well as grey literature sources, to identify randomized controlled trials (RCTs) investigating the effects of olive oil consumption on biochemical and anthropometric parameters of individuals with NAFLD. The quality of the studies was evaluated using the risk-of-bias tool 2.0 (RoB 2). The mean difference (MD) and the 95% confidence interval (CI) were calculated using fixed-effects and random-effects models. Seven RCTs involving 515 subjects were included in the analysis. In the random-effects model, no statistically significant differences were identified with respect to alanine transaminase (MD = −1.83 IU/L, 95% CI: −5.85, 2.19 IU/L, p = 0.37, I2 = 69%) and aspartate transaminase (MD = −1.65 IU/L, 95% CI: −4.48, 1.17 IU/L, p = 0.25, I2 = 72%) levels or waist circumference values (MD = −0.23 cm, 95% CI: −1.23, 0.76 cm, p = 0.65, I2 = 0%). However, a significant effect on body mass index was observed (MD = −0.57 kg/m2, 95% CI: −1.08, −0.06 kg/m2, p = 0.03, I2 = 51%) for subjects who received olive oil compared to those who received an alternative diet or placebo. The findings of the present meta-analysis suggest a modestly positive impact of olive oil intake on body weight in people with NAFLD. Full article
(This article belongs to the Special Issue Mediterranean Diet – Health Benefits and Advances)
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16 pages, 655 KiB  
Systematic Review
Mediterranean Diet for Primary and Secondary Prevention of Cardiovascular Disease and Mortality: An Updated Systematic Review
by Ana Laffond, Cristina Rivera-Picón, Pedro Manuel Rodríguez-Muñoz, Raúl Juárez-Vela, Regina Ruiz de Viñaspre-Hernández, Noelia Navas-Echazarreta and Juan Luis Sánchez-González
Nutrients 2023, 15(15), 3356; https://doi.org/10.3390/nu15153356 - 28 Jul 2023
Cited by 18 | Viewed by 3933
Abstract
Cardiovascular diseases (CVDs) are currently the leading cause of mortality worldwide, with coronary heart disease being the primary cause. The Mediterranean Diet (MD) has been highlighted for its potential in providing greater protection against CVDs. This study aims to present an updated systematic [...] Read more.
Cardiovascular diseases (CVDs) are currently the leading cause of mortality worldwide, with coronary heart disease being the primary cause. The Mediterranean Diet (MD) has been highlighted for its potential in providing greater protection against CVDs. This study aims to present an updated systematic review that examines the impact of MD on mortality and CVDs, both in the general population and in patients with a prior CVD, while also considering the potential influence of gender. We conducted a systematic review. After the selection process, 24 studies met the inclusion criteria. The findings from these studies consistently demonstrate that higher adherence to the MD is associated with a reduced risk of overall mortality, both in the general population and in patients with previous CVDs. Moreover, evidence suggests that following this dietary pattern likely decreases the risk of CVDs such as heart attacks, various types of coronary artery disease, stroke, and cardiovascular mortality. While some studies have identified differences in the benefits of the MD between men and women, it is important to note that these disparities may be attributed to lower event rates and a generally lower cardiovascular risk profile in women. Thus, the observed variations in outcomes should be interpreted in the context of these factors. Adherence to the MD has the potential to improve survival rates and reduce the risk of CVDs in both the general population and individuals with a prior CVD. Further research is needed to explore the specific mechanisms underlying the protective effects of this dietary pattern and to better understand the role gender-related differences in its outcomes. Nevertheless, promoting the adoption of the MD could be an effective strategy for mitigating the burden of CVDs globally. Full article
(This article belongs to the Special Issue Mediterranean Diet – Health Benefits and Advances)
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