A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses

Abstract

ObjectivesTo summarise the evidence about the efficacy of a Mediterranean diet on the management of type 2 diabetes and prediabetic states.DesignA systematic review of all meta-analyses and randomised controlled trials (RCTs) that compared the Mediterranean diet with a control diet on the treatment of type 2 diabetes and prediabetic states was conducted. Electronic searches were carried out up to January 2015. Trials were included for meta-analyses if they had a control group treated with another diet, if they were of sufficient duration (at least 6 months), and if they had at least 30 participants in each arm. A random-effect model was used to pool data.ParticipantsAdults with or at risk for type 2 diabetes.InterventionsDietary patterns that described themselves as using a ‘Mediterranean’ dietary pattern.Outcome measuresThe outcomes were glycaemic control, cardiovascular risk factors and remission from the metabolic syndrome.ResultsFrom 2824 studies, 8 meta-analyses and 5 RCTs were eligible. A ‘de novo’ meta-analysis of 3 long-term (>6 months) RCTs of the Mediterranean diet and glycaemic control of diabetes favoured the Mediterranean diet as compared with lower fat diets. Another ‘de novo’ meta-analysis of two long-term RCTs showed a 49% increased probability of remission from the metabolic syndrome. 5 meta-analyses showed a favourable effect of the Mediterranean diet, as compared with other diets, on body weight, total cholesterol and high-density lipoprotein cholesterol. 2 meta-analyses demonstrated that higher adherence to the Mediterranean diet reduced the risk of future diabetes by 19–23%.ConclusionsThe Mediterranean diet was associated with better glycaemic control and cardiovascular risk factors than control diets, including a lower fat diet, suggesting that it is suitable for the overall management of type 2 diabetes.

Mediterranean Diet and 10-year (2002-2012) Incidence of Diabetes and Cardiovascular Disease in Participants with Prediabetes: The ATTICA study

“…The protective effect of the Mediterranean diet against the development of diabetes has been consistently demonstrated and various mechanisms have been implicated, including improvement of insulin sensitivity, reduction of endothelial dysfunction and inflammatory markers, and increase in antioxidant markers [5,16]. The antidiabetic effect of the Mediterranean diet in the non-diabetic population of the ATTICA cohort was mediated by attenuation of inflammation and enhancement of total antioxidant capacity [6].…”

“…-Moderate consumption of wine, fish, and dairy products. -Low consumption of poultry, meat, highly processed foods, refined grains, and sugars [5].…”

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

“…Many of these proposed mechanisms are, at least partially, modifiable with dietary interventions involving the MedDiet. For example, recent meta-analyses of RCTs have shown that when comparing with a variety of control diets, a Mediterranean style diet has beneficial effects on glycemic control, weight loss and cardiovascular risk factors among individuals with T2DM [160,161]. Furthermore, recent results from the long term MÉDITA trial showed that when compared with a standard low-fat diet, a Mediterranean diet ameliorates the inflammatory response and improves endothelial functioning in persons with T2DM [162,163].…”

Dietary Fatty Acids: Is it Time to Change the Recommendations?

“…Most studies of the Mediterranean diet in the context of type 2 diabetes and CVD have shown favorable effects on glycemic control and CVD risks, although there is some controversy about obesity [86,87] . A recent 4-year prospective cohort study examined the relationship between the Mediterranean diet and mortality in individuals with type 2 diabetes.…”