Body weight, cholesterol, blood pressure (BP), glucose/insulin status and function, oxidative stress and inflammation are all cardiometabolic risk factors that can be influenced by an individual’s choice of dietary pattern. The Mediterranean diet (MedDiet) is considered one of the healthiest dietary patterns and is characterized by high consumption of vegetables, fruit, olive oil, nuts, seeds, fish and poultry.
Currently, the world is experiencing epidemic proportions of individuals diagnosed with type 2 diabetes. Type 2 diabetes is predominantly a lifestyle disease and a metabolic condition that is accompanied by many of the above metabolic factors, which greatly increases the risk of cardiovascular issues. According to the American Heart Association, “at least 68 percent of people age 65 or older with diabetes die from some form of heart disease; and 16 percent die of stroke.”
In recent years, an important advancement in nutritional science has recognized that an individual’s dietary pattern is more important than selective nutrients. A dietary pattern filled with many combinations of nutrients and compounds, such as the MedDiet pattern, can provide an overall synergistic effect that can greatly reduce health risks and provide beneficial health advantages.
A recent review in Endocrine, looked at the MedDiet pattern in relation to a variety of cardiometabolic factors for type 2 diabetes risk and treatment and, compared to control diets, has found the following:
For prevention of type 2 diabetes, a higher adherence to the MedDiet pattern can reduce the risk of type 2 diabetes by 18-40 percent. For those following a MedDiet, the probability of remission of the metabolic syndrome is 34-74 percent. In relation to glycemic control, compared to control diets the MedDiet reduced Hba1c by 0.30-0.47 percent. And following a MedDiet with carbohydrate content below 50 percent, patients saw a higher rate of complete remission 14.7 percent at year one, 5 percent at year six, compared to 4 and zero percent for a low-fat diet.
In relation to cardiovascular risk factors, overall the studies show a decreased waist circumference of 42 cm, decreased total cholesterol of 5.4 to 8.9 mg/dl, decreased triglycerides of 6.14 mg/dl, increased HDL cholesterol of 1.17 mg/dl, decreased systolic BP by 2.35 mmHg, and decreased diastolic BP by 1.5 mmHg. Following a MedDiet reduces overall body weight by 0.29 to 2.2 kg compared to control diets. Overall people who follow a MedDiet over an average period of 4.8 years have a 28-30 percent reduced risk of clinical cardiovascular events such as myocardial infarction, stroke and death.
The proposed mechanisms for the beneficial effects of the MedDiet on type 2 diabetes cardiometabolic risk factors are the anti-inflammatory and antioxidative nature of the dietary pattern. The switch from low-quality food sources such as refined sugars, starches, trans fats, and high-calorie foods; to high-quality food sources that contain fiber, vitamins, minerals, and polyphenols, influences the immune system in a beneficial way, reducing oxidative stress and the inflammatory cascade.
Inflammation is linked to increased insulin resistance, which is not only a precursor to type 2 diabetes diagnosis, but is an ongoing challenge facing those already diagnosed with diabetes as well. Many studies have shown that the circulation of proinflammatory molecules is reduced in those who consume a MedDiet pattern, which may, in turn, improve insulin sensitivity and endothelial function at the vascular level. Improvements in endothelial function have also been shown in diabetics that follow a MedDiet pattern.
Another interesting point is that the benefits achieved by those following a MedDiet pattern appear to be sustained benefits compared to those following control diets such as low-fat diets.