The anti-inflammatory effects of a Mediterranean diet: a review

Abstract

Purpose of reviewChronic noncommunicable diseases remain the leading cause of morbidity and mortality worldwide and the majority are preventable with a healthy diet and lifestyle, but controversy remains as to the best approach. Greater adherence to a traditional Mediterranean diet has consistently been associated with lower morbidity and mortality from cardiovascular disease, diabetes and many cancers, and lower all-cause mortality. Despite the well known benefits on chronic disease risk there remains some scepticism as to the effects of this dietary pattern across populations outside the Mediterranean and the mechanisms of action of this traditional plant-based dietary pattern.This narrative review aims to summarize the latest evidence on the health protective effects of a traditional Mediterranean diet on chronic noncommunicable diseases, specifically focussing on the anti-inflammatory effects of this highly published dietary pattern.Recent findingsRecent high-quality evidence now supports a Mediterranean diet in secondary prevention of cardiovascular disease with impacts on atherosclerosis progression, likely through reduction of systemic inflammation and irrespective of changes in cholesterol or weight. The Mediterranean diet has a low Dietary Inflammatory Index illustrating its anti-inflammatory potential. This dietary pattern beneficially modulates the gut microbiota and immune system, including emerging evidence for efficacy against severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019). Emerging evidence shows clinicians are not routinely recommending a Mediterranean diet despite well known evidence due to barriers such as lack of training, patient materials and concerns about potential patient adherence.SummaryThe physiological mechanisms of action of this healthy diet pattern are becoming better understood to be multisystem and involving the gut. Larger controlled trials investigating mechanistic effects in broader non-Mediterranean populations are warranted. Although reflected in therapeutic guidelines for chronic disease management worldwide there are individual, clinical practice and health system barriers to its implementation that need a multisectoral approach to address.

Low Adherence to Mediterranean Diet Is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Results from the Longevity Check-Up (Lookup) 7+ Project

“…Multiple components of the Mediterranean diet may contrast factors associated with age-related muscle strength decline, including malnutrition, oxidative stress, inflammation, endothelial dysfunction, and insulin resistance ( Figure 2 ) [ 65 , 66 , 67 , 68 , 69 ].…”

“…The Mediterranean diet supplies a plethora of vitamins (e.g., β-carotene, vitamin C, vitamin E), minerals, and polyphenols, with antioxidant, anti-inflammatory, and pro-autophagic properties [ 67 , 70 , 71 , 72 ]. For instance, the PREvencion con DIeta MEDiterranea (PREDIMED) study found a decrease in inflammatory biomarkers, such as interleukin 6, C-reactive protein, and leukocyte adhesion molecules, in participants with higher Mediterranean diet adherence [ 73 ].…”

Healthy lifestyles and wellbeing reduce neuroinflammation and prevent neurodegenerative and psychiatric disorders

“…Naturally occurring common anti-inflammatories are found in pomegranates, medicinal plants, vitamin D, vitamin C, a Mediterranean diet and extra-virgin olive oil, flavonoids found in fruits, curcumin, resveratrol, aged garlic extract, walnuts, marine carotenoid astaxanthin found in seafood, omega-3 fatty acids, caffeine, and manuka honey ( Almasaudi et al, 2017 ). Ingestion of these foods reduce chronic inflammation and neuroinflammation ( Rekatsina et al, 2020 ; Di Majo et al, 2022 ; Itsiopoulos et al, 2022 ). These (neuro)inflammation reducing foods could be part of the prevention and treatment of neurodegenerative and psychiatric disorders, however, clinical studies are needed.…”

Small Intestinal Bacterial Overgrowth and Non-Alcoholic Fatty Liver Disease: What Do We Know in 2023?

“…High intake of dietary fiber and antioxidant compounds shows synergistic beneficial anti-inflammatory effects, especially within the microscopic intestinal barrier and the gut microbiome [ 112 , 113 ]. The Mediterranean diet has in general a strong anti-inflammatory effect [ 114 ]. The dominant anti-inflammatory ingredients in this diet are omega-3 fatty acids, olive oil and phenolic compounds, as well as fiber and a low degree of food processing [ 112 , 114 , 115 ].…”

“…The Mediterranean diet has in general a strong anti-inflammatory effect [ 114 ]. The dominant anti-inflammatory ingredients in this diet are omega-3 fatty acids, olive oil and phenolic compounds, as well as fiber and a low degree of food processing [ 112 , 114 , 115 ].…”