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

Objectives To summarise the evidence about the efficacy of a Mediterranean diet on the management of type 2 diabetes and prediabetic states.Design A systematic review of all meta-analyses and randomised controlled trials (RCTs) that compared the Mediterranean diet with a control diet on the treatmen...

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Main Authors: Demosthenes Panagiotakos, Katherine Esposito, Paolo Chiodini, Maria Ida Maiorino, Giuseppe Bellastella, Dario Giugliano
Format: Article
Language:English
Published: BMJ Publishing Group 2015-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/5/8/e008222.full
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Summary:Objectives To summarise the evidence about the efficacy of a Mediterranean diet on the management of type 2 diabetes and prediabetic states.Design A 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.Participants Adults with or at risk for type 2 diabetes.Interventions Dietary patterns that described themselves as using a ‘Mediterranean’ dietary pattern.Outcome measures The outcomes were glycaemic control, cardiovascular risk factors and remission from the metabolic syndrome.Results From 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%.Conclusions The 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.
ISSN:2044-6055