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MEDITERRANEAN

This section outlines some key research findings associated with the Mediterranean Diet.

 

This nutritional lifestyle does not have a specified macronutrient ratio. It is based more on eating habits, rather than trying to eat the various groups within a certain range. The diet:

  • Emphasises whole foods, especially fruits, vegetable and whole grains

  • Encourages consumption of fish, poultry and eggs

  • Allows for moderate portions of dairy products

  • Limits red meat

 

KEY RESEARCH FINDINGS

WEIGHT LOSS AND INSULIN RESISTANCE / DIABETES

The Mediterranean diet seems to be effective in causing weight loss in that it has been associated with reductions in both body weight (a) and waist circumference (b). It also seems to improve diabetes-related health, being associated with reduced fasting glucose (c) and risk of diabetes (d).

 

The above findings (that the Mediterranean diet seems to improve diabetes-related health and cause weight loss) presents a problem for promoters of low carb diets for diabetes and insulin resistance treatment, as well as weight loss. The Mediterranean diet is a moderate to high carbohydrate diet and there’s evidence that it can improve insulin sensitivity. Therefore, insulin resistance (and its effects like weight gain) cannot be as simple as how much carbohydrates a person consumes.

 

HEART HEALTH

The Mediterranean diet also seems to improve heart health as it is associated with…

e. Increased high-density lipoprotein cholesterol (HDL) levels

 

Reduced: 

f. triglyceride levels

g. blood pressure

h. coronary events

i. mortality from cardiovascular events

 

OTHER

The Mediterranean diet is also associated with reduced: 

j. risk of metabolic syndrome

k. risk of cancer

l. neurodegenerative disease

m. mortality

 

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REFERENCES

The Mediterranean diet has been associated with:

 

a. reduced body weight

  • Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229-241. McManus K, Antinoro L, Sacks F. A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord. 2001;25:1503-1511. 

  • Esposito K, Maiorino MI, Ciotola M, et al. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Ann intern Med. 2009; 151: 306-314

  • Elhayany A, Lustman A, Abel R, Attal-Singer J, Vinker S. A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study. Diabetes
    Obes Metab. 2010;12:204-209.

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b. reduced waist circumference

  • Christina-Maria Kastorini, Haralampos J. Milionis, Katherine Esposito, Dario Giugliano, John A. Goudevenos, Demosthenes B. Panagiotakos. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components A Meta-Analysis of 50 Studies and 534,906 Individuals Vol. 57, No. 11, 2011

  • Mantzoros CS, Williams CJ, Manson JE, Meigs JB, Hu FB. Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women. Am J Clin Nutr 2006;84:328 –35. 

  • Romaguera D, Norat T, Mouw T, et al. Adherence to the Mediter- ranean diet is associated with lower abdominal adiposity in European men and women. J Nutr 2009;139:1728 –37. 

  • Tzima N, Pitsavos C, Panagiotakos DB, et al. Mediterranean diet and insulin sensitivity, lipid profile and blood pressure levels, in overweight and obese people; the Attica study. Lipids Health Dis 2007;6:22. 

 

c. reduced fasting glucose levels

  • Christina-Maria Kastorini, Haralampos J. Milionis, Katherine Esposito, Dario Giugliano, John A. Goudevenos, Demosthenes B. Panagiotakos. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components A Meta-Analysis of 50 Studies and 534,906 Individuals Vol. 57, No. 11, 2011

 

d. reduced insulin

  • Mancini et al. Systematic Review of the Mediterranean Diet for Long-Term Weight Loss The American Journal of Medicine (2016) 129, 407-415

 

e. reduced risk of diabetes

  • Gonzalez et al. Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study BMJ 2008

 

f. increased HDL levels

  • Christina-Maria Kastorini, Haralampos J. Milionis, Katherine Esposito, Dario Giugliano, John A. Goudevenos, Demosthenes B. Panagiotakos. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components A Meta-Analysis of 50 Studies and 534,906 Individuals Vol. 57, No. 11, 2011

 

g. reduced triglyceride levels

  • Christina-Maria Kastorini, Haralampos J. Milionis, Katherine Esposito, Dario Giugliano, John A. Goudevenos, Demosthenes B. Panagiotakos. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components A Meta-Analysis of 50 Studies and 534,906 Individuals Vol. 57, No. 11, 2011

 

h. reduced blood pressure

  • Christina-Maria Kastorini, Haralampos J. Milionis, Katherine Esposito, Dario Giugliano, John A. Goudevenos, Demosthenes B. Panagiotakos. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components A Meta-Analysis of 50 Studies and 534,906 Individuals Vol. 57, No. 11, 2011

  • Psaltopoulou et al. Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr 2004;80:1012–18 

 

i. reduced coronary events

  • de Lorgeril M, Renaud S, Mamelle N, et al. Mediterranean alpha- linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994;343:1454-9. [Erratum, Lancet 1995;345:738.] 

  • Singh RB, Dubnov G, Niaz MA, et al. Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial. Lancet 2002;360:1455-61. 

 

j. reduced mortality from cardiovascular events

  • TrichopoulouA,CostacouT,BamiaC,TrichopoulosD.Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003;348(26):2599 – 608. 

  • Knoops et al. Mediterranean Diet, Lifestyle Factors, and 10-Year Mortality in Elderly European Men and Women The HALE Project JAMA. 2004;292:1433-1439 

 

k. reduced risk of metabolic syndrome

  • Christina-Maria Kastorini, Haralampos J. Milionis, Katherine Esposito, Dario Giugliano, John A. Goudevenos, Demosthenes B. Panagiotakos. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components A Meta-Analysis of 50 Studies and 534,906 Individuals Vol. 57, No. 11, 2011

  • Tortosa A, Bes-Rastrollo M, Sanchez-Villegas A, Basterra-Gortari FJ, Nunez-Cordoba JM, Martinez-Gonzalez MA. Mediterranean diet inversely associated with the incidence of metabolic syndrome: the SUN prospective cohort. Diabetes Care 2007;30:2957–9. 

  • Babio N, Bullo M, Basora J, et al. Adherence to the Mediterranean diet and risk of metabolic syndrome and its components. Nutr Metab Cardiovasc Dis 2009;19:563–70. 

  • Salas-Salvado J, Fernandez-Ballart J, Ros E, et al. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med 2008;168:2449 –58. 

  • Panagiotakos DB, Pitsavos C, Chrysohoou C, et al. Impact of lifestyle habits on the prevalence of the metabolic syndrome among Greek adults from the ATTICA study. Am Heart J 2004;147:106–12. 

  • Esposito K, Marfella R, Ciotola M, et al. Effect of a Mediterranean- style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004; 292:1440 – 6. 

  • Gonzalez et al. Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study BMJ 2008

 

l. reduced risk of cancer

  • Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ 2008;337: a1344. 

  • Knoops et al. Mediterranean Diet, Lifestyle Factors, and 10-Year Mortality in Elderly European Men and Women The HALE Project JAMA. 2004;292:1433-1439 

  • Sofi F et al. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis Am J Clin Nutr 2010;92:1189–96. 

 

m. reduced neurodegenerative disease

  • Sofi F et al. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis Am J Clin Nutr 2010;92:1189–96.

 

n. reduced mortality

  • de Lorgeril M, Renaud S, Mamelle N, et al. Mediterranean alpha- linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994;343:1454-9. [Erratum, Lancet 1995;345:738.] 

  • Singh RB, Dubnov G, Niaz MA, et al. Effect of an Indo-Mediter- ranean diet on progression of coronary artery disease in high-risk patients (Indo-Mediterranean Diet Heart Study): a randomised sin- gle-blind trial. Lancet 2002;360:1455-61. 

  • Panagiota N. Mitrou, PhD; Victor Kipnis, PhD; Anne C. M. Thie ́baut, PhD; Jill Reedy, PhD; Amy F. Subar, PhD; Elisabet Wirfa ̈lt, PhD; Andrew Flood, PhD; Traci Mouw, MPH;Albert R. Hollenbeck, PhD; Michael F. Leitzmann, MD, DrPH; Arthur Schatzkin, MD, DrPH Mediterranean Dietary Pattern and Prediction of All-Cause Mortality in a US Population Mediterranean Dietary Pattern and Prediction of All-Cause Mortality in a US Population Results From the NIH-AARP Diet and Health Study Arch Intern Med. 2007;167(22):2461-2468 

  • Lagiou P, Trichopoulos D, Sandin S, et al. Mediterranean dietary pattern and mor- tality among young women. Br J Nutr. 2006;96(2):384-392. 

  • Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediter- ranean diet and survival in a Greek population. N Engl J Med. 2003;348(26): 2599-2608.
    Haveman-Nies A, de Groot LP, Burema J, Cruz JA, Osler M, van Staveren WA. Dietary quality and lifestyle factors in relation to 10-year mortality in older Eu- ropeans: the SENECA study. Am J Epidemiol. 2002;156(10):962-968. 

  • KnoopsKT,deGrootLC,KromhoutD,etal.Mediterraneandiet,lifestylefactors, and 10-year mortality in elderly European men and women: the HALE project. JAMA. 2004;292(12):1433-1439. 

  • Kouris-BlazosA,GnardellisC,WahlqvistML,TrichopoulosD,LukitoW,Tricho- poulou A. Are the advantages of the Mediterranean diet transferable to other popu- lations? a cohort study in Melbourne, Australia. Br J Nutr. 1999;82(1):57-61. 

  • Lasheras C, Fernandez S, Patterson AM. Mediterranean diet and age with re- spect to overall survival in institutionalized, nonsmoking elderly people. Am J Clin Nutr. 2000;71(4):987-992. 

  • Osler M, Schroll M. Diet and mortality in a cohort of elderly people in a north European community. Int J Epidemiol. 1997;26(1):155-159. 

  • Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, et al. Diet and overall survival in elderly people. BMJ. 1995;311(7018):1457-1460. 

  • Sofi F et al. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis Am J Clin Nutr 2010;92:1189–96. 

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