Search Results (926)

Type 2 diabetes (T2D) is a prevalent disease worldwide that increases the risk of cardiovascular (CV) complications, disability and mortality. While excessive alcohol consumption is harmful, the effects of moderate wine consumption remain debated. This review evaluates whether moderate wine intake affects the risk of developing T2D and its impact on subjects with T2D. Twenty-eight studies were analysed. Evidence suggests an association between moderate wine consumption and the risk of developing T2D, with a J-shaped relationship, and reduced risk observed at low levels. This effect appears more pronounced with red wine, likely related to its higher polyphenol content, and when consumed with meals. On the other side, in patients with T2D, moderate wine consumption has been associated with a reduced risk of CV complications, nephropathy and mortality. It has also been linked to improved lipid profiles and reduced inflammatory markers, without adversely affecting body weight or glycaemic control in well-managed patients. These effects may be enhanced within a Mediterranean dietary pattern, suggesting synergistic actions. However, alcohol intake may increase the risk of hypoglycemia, particularly in patients receiving glucose-lowering therapies. It should be avoided by vulnerable individuals, and those with comorbidities such as MASLD and other significant liver diseases, peripheral neuropathy or other severe conditions. In conclusion, moderate wine consumption may be associated with a reduction in the risk of developing T2D and with several CV benefits in patients with T2D. Vulnerable patients should abstain and individuals who currently do not drink alcohol should not start drinking. If wine is consumed, intake should always remain moderate (as low as possible), within healthy meals and only after individual clinical assessment. Full article

Background: Chronic pain and early cognitive vulnerability frequently co-occur in older women and may share inflammatory mechanisms. Objective: We examined whether dietary inflammatory load, assessed using the dietary inflammatory index (DII), and Mediterranean-derived dietary patterns (Mediterranean diet (MED), Dietary Approaches to Stop Hypertension (DASH), Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND) and anti-inflammatory Mediterranean Diet (AnMED)) are associated with pain and early cognitive outcomes. Methods: We conducted a cross-sectional study among women aged ≥50 years recruited from community pharmacies and healthcare centers in the Comunidad Valenciana (Spain). Dietary intake was assessed using the PREDIMED Food Frequency Questionnaire to derive DII and dietary pattern scores. Outcomes included pain intensity, subjective memory complaints (SMC) and semantic verbal fluency (SVF). Analyses were adjusted for sociodemographic, clinical and lifestyle covariates, with false discovery rate correction. Results: Complete case samples comprised 470 women for SMC and SVF, with 328 also included for pain. Higher DII was consistently associated with greater pain intensity, increased odds of SMC, and lower SVF scores. No dietary pattern was associated with pain after correction. AnMED was associated with lower odds of SMC and higher SVF, while DASH was also positively associated with SVF. Bridge analysis showed that lower DII was associated with both MIND and AnMED, with a stronger association for AnMED. Conclusions: Dietary inflammatory load showed the most consistent associations with pain and early cognitive vulnerability, whereas Mediterranean-derived patterns differed in their inflammatory and cognitive relevance. Full article

The Mediterranean diet (MedDiet) has emerged as a promising dietary strategy for the prevention and management of type 2 diabetes mellitus (T2DM). This narrative review provides a comprehensive synthesis linking the biological pathways of the MedDiet with established clinical evidence. Adherence to this traditional dietary pattern—characterized by a high intake of fiber, complex carbohydrates, antioxidants, and healthy fats—has demonstrated significant benefits in terms of glycemic control, enhanced insulin sensitivity, and overall metabolic health. Mechanistically, the review explains how the MedDiet improves health by modulating key physiological processes, including anti-inflammatory and antioxidant pathways, the regulation of branched-chain amino acid metabolism, the enhancement of short-chain fatty acid production via gut microbiota modulation, and upregulated incretin effects. Importantly, this review explains how the MedDiet complements modern medications, including glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter-2 (SGLT-2) inhibitors. By integrating molecular mechanisms with human clinical outcomes, this narrative review addresses multiple aspects of the MedDiet in both the prevention and management of T2DM including glycemic control, weight management, and cardiovascular risk reduction, rendering it a valuable dietary strategy for both the prevention and treatment of this chronic condition. Full article

Background/Objectives: The increasing burden of non-communicable diseases, together with accelerating environmental degradation, highlights the urgent need for sustainable dietary patterns that promote both human and planetary health. The Mediterranean diet (MedDiet), traditionally followed in countries bordering the Mediterranean basin, has gained recognition as a model of sustainable nutrition due to its well-documented health benefits and relatively low environmental impact. However, its broader role within sustainable food systems requires comprehensive and interdisciplinary evaluation. The aim of this review is to provide a state-of-the-art synthesis of the evidence on the MedDiet as a sustainable dietary pattern, integrating its health, environmental, economic, and socio-cultural dimensions. Methods: This state-of-the-art narrative review synthesizes evidence from peer-reviewed literature on the MedDiet and sustainability. Relevant studies were identified through major scientific databases, focusing on publications addressing nutritional, environmental, economic, and socio-cultural dimensions. Both observational and interventional studies, as well as modeling and life cycle assessment analyses, were included. Additional sources from international organizations and policy reports were incorporated to contextualize global trends and challenges. Results: High adherence to the MedDiet is consistently associated with a reduced risk of cardiovascular disease, type 2 diabetes, cancer, and all-cause mortality. From an environmental perspective, the MedDiet is associated with lower greenhouse gas emissions, reduced land and water use, and enhanced biodiversity conservation compared with Western dietary patterns. Economically, it may represent a cost-effective dietary model and support local food systems when grounded in traditional practices, although affordability varies across contexts. Socio-culturally, the MedDiet promotes food heritage, culinary skills, and social cohesion. Nevertheless, globalization, urbanization, and the increasing consumption of ultra-processed foods have contributed to declining adherence, posing significant challenges to its sustainability and scalability. Moreover, the sustainability benefits of the MedDiet seem to be context-dependent rather than intrinsic, raising several challenges and limitations for its adoption. Conclusions: The MedDiet should be viewed not as a definitive solution to global food-system challenges but as a valuable reference model that illustrates how dietary practices can contribute simultaneously to human health, environmental sustainability, and cultural continuity. Modern sustainable dietary strategies should build upon the strengths of the MedDiet while recognizing its limitations, embracing contextual adaptation, and addressing the structural determinants that shape food choices. Full article

Background/Objectives: The climacteric transition is a critical stage in women’s health characterized by significant endocrine, metabolic, cardiovascular, and autonomic changes that increase cardiometabolic vulnerability during midlife. This narrative review aimed to synthesize current evidence on body composition, heart rate variability and autonomic function, phytoestrogens & estrobolome interactions, and exercise-based lifestyle approaches during the climacteric transition. Methods: A structured literature search was conducted across four domains (body composition, heart rate variability, phytoestrogens, and exercise) using PubMed/MEDLINE, Web of Science, Scopus, Google Scholar, and the Cochrane Library. Studies were selected based on relevance, study design, and methodological rigor, and synthesized using a narrative approach. Additional thematic components, including dietary patterns and gut microbiota estrobolome interactions, were incorporated through targeted searches. Results: The climacteric transition is associated with increased visceral adiposity, reduced lean mass, insulin resistance, dyslipidemia, and a higher prevalence of metabolic syndrome, while body mass index may underestimate metabolically relevant adiposity. Altered autonomic regulation, reflected by reduced heart rate variability and sympathetic predominance, is linked to increased cardiovascular risk, although its independent contribution is influenced by aging and comorbidities. Mediterranean and plant-based dietary patterns may improve metabolic and inflammatory profiles and modulate estrogen metabolism through gut microbiota mechanisms. Phytoestrogens show potential benefits for vasomotor symptoms and selected metabolic markers, although evidence remains heterogeneous. Exercise interventions consistently improve body composition, cardiometabolic parameters, and autonomic function. Conclusions: A multidimensional lifestyle-based approach integrating exercise, dietary strategies, and modulation of estrogen-related pathways may help mitigate cardiometabolic risk and support healthier aging during the climacteric transition. Full article

Inflammatory bowel disease (IBD; Crohn’s disease and ulcerative colitis) arises from convergent dysfunction of the epithelial barrier, mucosal immunity, and gut microbiome on a background of genetic susceptibility and environmental exposures. Diet is among the most modifiable of these exposures, yet much of the diet–microbiome research in IBD remains descriptive and poorly aligned with the molecular pathways linking food to mucosal effects. This comprehensive review reframes the field around functional dysbiosis, in which altered microbial metabolic capacity (rather than taxonomic shifts alone) drives disease-relevant biology. We trace how dietary substrates and additives are converted by gut microbes into bioactive metabolites (short-chain fatty acids, secondary bile acids, tryptophan-derived indoles, sulfur compounds, and polyphenol-derived molecules) and map these to host receptors and signaling pathways governing barrier function, mucus and antimicrobial peptide production, and Treg/Th17 balance. Defined dietary therapies (exclusive enteral nutrition, the Crohn’s disease exclusion diet plus partial enteral nutrition, and Mediterranean-style patterns) are reinterpreted as interventions that reshape microbial metabolic output, and candidate biomarkers for microbiome-informed precision nutrition are evaluated. Microbiota-derived metabolites provide the molecular interface between diet and mucosal immunity in IBD; personalized dietary algorithms remain a research goal, not a validated clinical tool, and diet is best framed as adjunctive to pharmacotherapy and dietitian care. Full article

Background: Dietary behaviours in young athletes are shaped by multiple behavioural, social, and environmental influences, which may contribute to the coexistence of healthy and unhealthy eating patterns. This study aimed to explore factors associated with fast-food consumption frequency and adherence to the Mediterranean diet (MD) among young football athletes. Methods: A cross-sectional study was conducted among 94 male football players aged 10–16 years from a Portuguese football club. Adherence to the MD was assessed using the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) index. Fast-food consumption patterns and food-choice motivations were evaluated through a structured questionnaire. Anthropometric measurements were obtained using standardised procedures. Correlation, linear regression, and ordinal regression analyses were performed. Results: Most participants demonstrated high adherence to the MD (96.8%), with a median KIDMED score of 12.0 (IQR: 10.0–13.0). Although 88.3% of participants reported consuming fast food, intake frequency was generally low, with 67.0% reporting consumption never or only once per month. Higher fast-food consumption frequency was associated with lower fruit and vegetable intake and higher consumption of sweets and pastries. No significant associations were observed between fast-food consumption frequency and overall MD adherence, Body Mass Index z-score, or fat mass percentage. Higher health-related motivation scores were associated with lower odds of more frequent fast-food consumption (OR = 0.248; p = 0.021), whereas greater decision autonomy regarding restaurant choice was associated with higher consumption frequency (OR = 4.036; p = 0.010). Conclusions: Young football athletes showed high adherence to the Mediterranean diet despite the presence of fast-food consumption, suggesting that healthy and unhealthy dietary behaviours may coexist within the same population. Behavioural factors, particularly health motivations and food-choice autonomy, appear to influence fast-food consumption independently of overall diet quality and anthropometric status. Full article

Background: Adolescence is a critical developmental period for emotional health, and anxiety disorders are a major public health concern. Adherence to the Mediterranean diet has been associated with improved mental health outcomes in adults; however, evidence in adolescents remains limited. Methods: We analyzed data from 86 adolescents participating in the KLOTHO birth cohort. Dietary quality was assessed using the KIDMED index, whereas maternal adherence to the Mediterranean diet during pregnancy was evaluated using a Mediterranean diet score. Psychological outcomes included behavioral difficulties (Strengths and Difficulties Questionnaire), anxiety symptoms (Spence Children’s Anxiety Scale), and mood-related outcomes (Mood and Feelings Questionnaire). Associations were examined using Spearman’s correlation analyses and multivariate linear regression models adjusted for sex, body mass index (BMI), sleep duration, and physical activity. Results: Higher adherence to the Mediterranean diet in adolescents was inversely associated with anxiety levels in correlation analyses (ρ = −0.294, p = 0.029). However, after adjustment for sex, body mass index, sleep duration, and physical activity, the association with total anxiety score was attenuated and no longer statistically significant associated with lower anxiety levels in correlation analyses (ρ = −0.294, p = 0.029). In adjusted models, the KIDMED score was not associated with total anxiety score but was independently associated with lower scores in specific anxiety domains, including social phobia and separation anxiety. Maternal adherence to the Mediterranean diet was associated with lower overall anxiety in offspring but not with specific anxiety subdomains. Conclusions: Adherence to the Mediterranean diet during adolescence is modestly associated with lower levels of specific anxiety symptoms, suggesting a modest domain-specific association between dietary patterns and emotional health. Full article

Background: Diet is a key modifiable factor influencing oral health and may shape the oral microbiota. While individual nutrients, especially free sugars, have been widely studied, the role of overall dietary patterns remains unclear. This systematic review aimed to evaluate the association between dietary patterns and oral microbiota in humans. Methods: PubMed/MEDLINE, Embase, and Web of Science were searched up to 18 March 2026. Studies assessing defined dietary patterns (Mediterranean, vegan, vegetarian, omnivorous) and oral microbiota using sequencing-based methods in healthy individuals were included. Due to heterogeneity in study design, dietary assessment, and microbiome analysis, a narrative synthesis was conducted. Results: Six studies (n = 448 participants) were included. Dietary patterns showed limited impact on overall microbiota structure, with no consistent changes in alpha and beta diversity. However, differences were observed at the taxonomic level. The Mediterranean diet was generally associated with a lower abundance of periodontopathogenic taxa. Plant-based and omnivorous diets showed distinct microbial profiles, particularly involving Neisseria, Haemophilus, Prevotella, and Streptococcus. Functional activity and metabolomic profiles appeared more sensitive to dietary variation than taxonomic composition alone. Conclusions: The oral microbiota appears relatively stable across dietary patterns, although diet may influence specific taxa and functional pathways relevant to oral health. The Mediterranean diet shows the most consistent association with beneficial microbial shifts. However, evidence is limited by heterogeneity and cross-sectional designs, highlighting the need for longitudinal and interventional studies. Full article

Background/Objectives: This study aimed to evaluate the effect of adherence to the DASH and Mediterranean diets on cognitive performance in adults. Methods: In this study, the Mediterranean Diet Adherence Screener (MEDAS), DASH Diet Quality Scale (DASH-Q), Oktem Verbal Memory Processes Test (Oktem-VMPT), and Trail Making Test (TMT) were administered face-to-face to adult individuals living in Afyonkarahisar, Türkiye, together with a form assessing sociodemographic characteristics and dietary habits. The collected data were analyzed using SPSS v27 software. Results: As participants’ ages increased, DASH scores decreased (p < 0.05). As participants’ BMI and waist/hip width increased, a decrease in DASH and MEDAS scores was observed (p < 0.05). As participants’ ages increased, the IST-A, IST-B, and IST-Total scores increased (p < 0.05), but as their education level increased, the IST-A, IST-B, and IST-Total scores decreased (p < 0.05). As participants’ education level increased, the total recall score on the Oktem-SBST scale tended to increase (p < 0.05). As participants’ DASH scores increased, the “Immediate Memory” and “Spontaneous Recall” sub-components of the Oktem-SBST increased, while the “Learning Mistake Score,” “USB Mistake Score,” and “IST-A,” “IST-B,” and “IST Total” scores decreased (p < 0.05). As participants’ MEDAS scores increased, the sub-components of Oktem-SBST, namely “Criteria Achievement,” “Maximum Learning,” “Spontaneous Recall,” “Recognition,” and “Total Recall,” also increased, while the “Learning Mistake Score” decreased. (p < 0.05). Conclusions: Age, educational status, DASH, and MEDAS scores are associated with cognitive performance. The DASH and MEDAS diets have a positive impact on cognitive performance, highlighting the importance of healthy eating in public health strategies for maintaining cognitive health. Full article

Background: Residential lifestyle medicine programs have documented immediate and long-term improvements in cardiometabolic risk factors. Despite this, adherence among participants varies in such programs, limiting the positive outcomes that can be achieved. This study aimed to assess how adherence to positive lifestyle behaviors correlates with cardiometabolic risk factors at the end of a residential lifestyle medicine program and at three or more months of follow-up. Methods: Patients enrolled in a NEWSTART^® lifestyle medicine program were invited to participate in this prospective chart review. Outcomes included changes in BMI, blood pressure, medication and supplement use, cardiometabolic disease biomarkers, Mediterranean eating pattern, meat intake, and other lifestyle behaviors. Results: Among 109 adults (78% female; 62% overweight or obese) enrolled in a 6- to 39-day (mean 14.5-day) residential intervention, meat intake reduced by 3.2 servings/week, MEPA III scores increased by 2.3, water intake increased by 2.1 glasses/day, and exercise increased by 193 min/week (all p < 0.01). From baseline to end of program, reductions were noted in blood glucose (−5.3 mg/dL, p = 0.01), total cholesterol (−16.0 mg/dL, p < 0.01), LDL cholesterol (−11.0 mg/dL, p < 0.01), HDL cholesterol (−2.0 mg/dL, p < 0.01), triglycerides (−13 mg/dL, p < 0.01), serum creatinine (−0.03 mg/dL, p = 0.049), systolic blood pressure (−6.0 mmHg, p < 0.01), diastolic blood pressure (−3.0 mmHg, p = 0.01), and weight (−3.2 kg, p < 0.01). At a mean of 8.6 months follow-up, reductions in triglycerides (14.9 mg/dL, p = 0.03) and weight (2.8 kg, p < 0.01) from baseline were sustained, and water intake increased 20% from baseline (1.1 glasses/day, p = 0.01). Improved adherence to a Mediterranean eating pattern score, increase in water intake and reductions in meat intake and BMI predicted favorable health outcomes. Conclusions: Participation in the lifestyle medicine program was associated with improvements in cardiometabolic risk factors during intervention and at follow-up. These outcomes correlated with adherence to positive lifestyle behaviors. Sustained weight reduction as well as dietary and cardiometabolic improvements in our participants suggest the NEWSTART^® intervention may hold promise for maintaining cardiometabolic health. Full article

The Mediterranean diet is widely recognized as one of the most robust dietary patterns for the prevention of chronic diseases, yet its health effects cannot be fully understood without considering the culinary practices and cultural contexts that shape food preparation and consumption. In this context, we propose the concept of Mediterranean Culinary Medicine, defined as the application of culinary medicine principles within the Mediterranean dietary model, integrating evidence-based nutrition with traditional ingredients, cooking techniques, and meal patterns. This narrative review synthesizes evidence from epidemiological, experimental, and clinical studies to examine how culinary practices may influence the nutritional quality, bioavailability of bioactive compounds, and overall health effects of the Mediterranean diet, although the strength of evidence varies across domains, with particular attention to home cooking, traditional cooking techniques, and extra virgin olive oil. We also explore the biological pathways, suggested by a combination of experimental findings and observational evidence, through which culinary practices may modulate metabolic health, including inflammation, glycemic response, and gut microbiota, as well as their potential application in addressing disease-related eating limitations such as sensory alterations, dysphagia, malnutrition, and food allergies, for example, through texture modification or flavor enhancement strategies. Finally, we highlight the social, cultural, and environmental dimensions of Mediterranean Culinary Medicine, emphasizing its role as a holistic and culturally grounded approach that facilitates the translation of Mediterranean dietary principles into sustainable and practical dietary behaviors. Overall, available evidence suggests that culinary practices are a relevant but still underexplored component of the Mediterranean diet, with the potential to improve dietary adherence and nutritional quality. However, current evidence remains heterogeneous and largely based on experimental and observational studies, highlighting the need for longitudinal and intervention studies to clarify their long-term health impact. Full article

Food insecurity has been associated with poorer diet quality; however, limited evidence exists on the association between food insecurity and adherence to the Mediterranean diet in Saudi Arabia. This cross-sectional study, conducted among 577 Saudi adults between February and June 2025, examined the association between food security status and adherence to the Mediterranean diet in this region. Data were collected through a self-administered questionnaire that included sociodemographic characteristics, the Food Insecurity Experience Scale, and the Mediterranean diet adherence score. Most participants were food secure (73.0%), and only 12.7% demonstrated high adherence to the Mediterranean diet. The food insecurity score was inversely related to Mediterranean diet adherence (B = −0.107, 95% CI −0.191 to −0.024; p = 0.012); however, the magnitude of the association was small. Age, marital status, and monthly income were also significantly associated with food security status (p < 0.005). Although most of the participants were food secure, overall adherence to the Mediterranean diet was low, with only a small proportion demonstrating high adherence. These findings suggest that socioeconomic factors, particularly income, may be associated with both food access and diet quality. Further research is needed to inform strategies aimed at improving access to affordable healthy foods and promoting healthier dietary patterns, especially among young adults and low-income individuals. Full article

Type 2 diabetes mellitus is a relevant cardio–renal–metabolic disorder in which chronic low-grade inflammation and oxidative stress have a crucial function in linking insulin resistance, endothelial dysfunction, β-cell impairment, and progressive organ injury. In this context, nutrition has emerged as a key modifiable determinant of metabolic homeostasis, capable of influencing inflammatory signalling, redox balance, mitochondrial function, and gut microbiota–host interactions. The objective of this review is to critically summarise the mechanistic connections among inflammation, oxidative stress, and diabetes progression, and to investigate how dietary factors and patterns, as well as nutrition-responsive biomarkers, influence these pathways and their cardiorenal consequences. We discuss the effects of macronutrient quality, dietary fibre, fatty acids, polyphenols, and specific micronutrients, including vitamin C, vitamin E, selenium, zinc, and magnesium, as well as the role of Mediterranean, DASH, and plant-based diets in improving glycaemic control, endothelial function, and cardio-renal risk profiles. We also summarise established and emerging biomarkers of inflammation and oxidative stress that may improve risk stratification and the evaluation of nutrition-based interventions. Overall, current evidence supports a shift from a purely glucose-centred approach toward an integrated model in which dietary modulation of inflammatory and oxidative pathways helps reduce cardiovascular and renal risk. However, heterogeneity of interventions, variability in biomarker assessment, and interindividual differences in dietary response represent major limitations. Future research should focus on biomarker-informed, precision-oriented nutritional approaches integrated within contemporary cardio–renal–metabolic care. Full article