title: Protective Effects of the Mediterranean Diet on Type 2 Diabetes and Metabolic Syndrome.
abstract: Several studies provide evidence supporting a beneficial effect from the traditional Mediterranean diet (MedDiet) on the risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). This review summarizes the current scientific evidence from epidemiologic studies and clinical trials on the relation between the MedDiet and T2DM and MetS and the possible mechanisms underlying the reported associations. A recent meta-analysis of prospective cohort studies showed that greater adherence to the MedDiet was associated with a significant reduction in the risk of diabetes. The MedDiet has also been found to be beneficial in the prevention of gestational diabetes. Four large prospective studies have observed inverse associations between the MedDiet and MetS or its components. Few randomized controlled trials (RCTs) have evaluated the effect of the MedDiet on T2DM and MetS. Results from the landmark PREvención con DIeta MEDiterránea (PREDIMED) nutrition intervention trial showed that participants assigned to the MedDiet had a significant 30% reduction in the risk of T2DM and that it also promoted the reversion of MetS and its components, hyperglycemia and central obesity. In addition, 5 RCTs showed the beneficial effects of the MedDiet compared with other dietary patterns on glycemic control in patients with T2DM. A recent meta-analysis of RCTs revealed that, compared with a variety of control diets, the MedDiet was associated with beneficial effects on all MetS components. Bioactive components of the MedDiet synergize to affect various metabolic pathways, leading to a reduced cardiometabolic disease risk. The abundance of healthy, nutrient-dense foods that make up the plant-based MedDiet predicts its bioactivity and potential to beneficially influence metabolic pathways that lead to MetS and T2DM, as well as other chronic conditions. Abundant epidemiologic and clinical trial evidence supports the role of the MedDiet on the prevention and management of T2DM and MetS.
authors.affiliation: Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Rovira i Virgili University, Reus, Spain.|Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.affiliation: Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Rovira i Virgili University, Reus, Spain.|Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Guasch-Ferré
authors.affiliation: Department of Genetics and Complex Diseases, Division of Biological Sciences, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.|Department of Internal Medicine, August Pi i Sunyer Biomedical Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Estruch
authors.affiliation: Broad Institute of MIT and Harvard, Cambridge, MA.
authors.forename: Clary B
authors.initials: CB
authors.lastname: Clish
authors.affiliation: Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.|Lipid Clinic, Endocrinology and Nutrition Service, August Pi i Sunyer Biomedical Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
keywords: Mediterranean diet; cardiovascular disease; diabetes; metabolic syndrome; metabolic syndrome components; review