Mediterranean diet and type 2 diabetes
Abstract
Consumption of selected dietary components is favourably associated with prevention of type 2 diabetes, but discordant results for some foods or single nutrients continue to appear. The study of complete dietary patterns represents the most adequate approach to assess the role of diet on the risk of diabetes. The term 'Mediterranean diet' essentially refers to a primarily plant-based dietary pattern whose greater consumption has been associated with higher survival for lower all-cause mortality. At least five large prospective studies report a substantially lower risk of type 2 diabetes in healthy people or at risk patients with the highest adherence to a Mediterranean diet. Five randomized controlled trials have evaluated the effects of a Mediterranean diet, as compared with other commonly used diets, on glycaemic control in subjects with type 2 diabetes. Improvement of HbA1c levels was greater with a Mediterranean diet and ranged from 0.1% to 0.6% for HbA1c . No trial reported worsening of glycaemic control with a Mediterranean diet. Although no controlled trial specifically assessed the role of a Mediterranean diet in reducing cardiovascular events in type 2 diabetes, there is evidence that post-infarct or high-risk patients, including diabetic patients, may have cardiovascular benefits from a Mediterranean diet. The evidence so far accumulated suggests that adopting a Mediterranean diet may help prevent type 2 diabetes; moreover, a lower carbohydrate, Mediterranean-style diet seems good for HbA1c reduction in persons with established diabetes.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
People following a Mediterranean diet had lower hemoglobin A1c levels compared to the control group.
“It has been demonstrated that people following MD had lower hemoglobin A1c (HbA1c) levels compared to the control group.”
From Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing (2021) · cites this paper as [25]
According to Esposito et al., adherence to a Mediterranean diet has beneficial effects in both the prevention and treatment of diabetes.
“According to Esposito et al., the adherence to a MD has beneficial effects in both the prevention and treatment of diabetes.”
From Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing (2021) · cites this paper as [25]
Fasting glucose can be reduced by the Mediterranean diet.
“Furthermore, it was observed that fasting glucose could also be reduced by the MD [25].”
From Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing (2021) · cites this paper as [25]
Cites
2 retracted
RETRACTED: Primary Prevention of Cardiovascular Disease with a Mediterranean Diet
Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1200303 · Cited by 4,257 · see citing works
RetractedDietary advice for the prevention of type 2 diabetes mellitus in adults
Nield, L., Summerbell, C. D., Hooper, L., Whittaker, V., & Moore, H. J. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005102.pub2 · Cited by 85 · see citing works
RetractedAdherence to a Mediterranean diet and survival in a Greek population
Trichopoulou, A., Costacou, T., Bamia, C., & Trichopoulos, D. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa025039 · Cited by 4,397 · see citing works
Dietary pattern analysis: a new direction in nutritional epidemiology
Hu, F. B. (2002) · Current Opinion in Lipidology · doi:10.1097/00041433-200202000-00002 · Cited by 4,029 · see citing works
IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030
Whiting, D. R., Guariguata, L., Weil, C., & Shaw, J. E. (2011) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2011.10.029 · Cited by 3,994 · see citing works
Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A. L., Tsapas, A., Wender, R., & Matthews, D. R. (2012) · Diabetes Care · doi:10.2337/dc12-0413 · Cited by 3,207 · see citing works
Mediterranean diet pyramid: a cultural model for healthy eating
Willett, W., Sacks, F., Trichopoulou, A., Drescher, G., Ferro-Luzzi, A., Helsing, E., & Trichopoulos, D. (1995) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/61.6.1402s · Cited by 2,461 · see citing works
Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet
Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D. R., Witkow, S., Greenberg, I., Golan, R., Fraser, D., Bolotin, A., Vardi, H., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0708681 · Cited by 2,143 · see citing works
Lindström, J., Ilanne-Parikka, P., Peltonen, M., Aunola, S., Eriksson, J. G., Hemiö, K., Hämäläinen, H., Härkönen, P., Keinänen-Kiukaanniemi, S., Laakso, M., et al. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69701-8 · Cited by 1,799 · see citing works
Bantle (2008) · doi:10.2337/dc08-s061 · Cited by 1,795 · see citing works
Adherence to Mediterranean diet and health status: meta-analysis
Sofi, F., Cesari, F., Abbate, R., Gensini, G. F., & Casini, A. (2008) · BMJ · doi:10.1136/bmj.a1344 · Cited by 1,717 · see citing works
Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors: A Randomized Trial
Estruch, R., Martínez-González, M. Á., Corella, D., Salas-Salvadó, J., Ruiz-Gutiérrez, V., Covas, M. I., Fiol, M., Gómez-Gracia, E., López-Sabater, M. C., Vinyoles, E., et al. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-145-1-200607040-00004 · Cited by 1,704 · see citing works
Li, G., Zhang, P., Wang, J., Gregg, E. W., Yang, W., Gong, Q., Li, H., Li, H., Jiang, Y., An, Y., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60766-7 · Cited by 1,600 · see citing works
Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire
Hu, F. B., Rimm, E., Smith-Warner, S. A., Feskanich, D., Stampfer, M. J., Ascherio, A., Sampson, L., & Willett, W. C. (1999) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/69.2.243 · Cited by 1,165 · see citing works
Dietary factors and low-grade inflammation in relation to overweight and obesity
Calder, P. C., Ahluwalia, N., Brouns, F., Buetler, T., Clement, K., Cunningham, K., Esposito, K., Jönsson, L. S., Kolb, H., Lansink, M., et al. (2011) · British Journal of Nutrition · doi:10.1017/s0007114511005460 · Cited by 1,098 · see citing works
Self-citationAjala, O., English, P., & Pinkney, J. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.042457 · Cited by 821 · cited 1× · see citing works
“Another systematic review with meta-analysis included 21 randomized controlled trials with interventions lasting 6 or more months and compared low carbohydrate, vegetarian, vegan, low glycaemic index, high fibre, Mediterranean and high protein diets with control diets in type 2 diabetes [42].”
BackgroundInflammatory Markers and Risk of Type 2 Diabetes
Wang, X., Bao, W., Liu, J., OuYang, Y.-Y., Wang, D., Rong, S., Xiao, X., Shan, Z.-L., Zhang, Y., Yao, P., et al. (2013) · Diabetes Care · doi:10.2337/dc12-0702 · Cited by 820 · see citing works
Carter, P., Gray, L. J., Troughton, J., Khunti, K., & Davies, M. J. (2010) · BMJ · doi:10.1136/bmj.c4229 · Cited by 728 · see citing works
Food synergy: an operational concept for understanding nutrition
Jacobs, D. R., Gross, M. D., & Tapsell, L. C. (2009) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.26736b · Cited by 665 · see citing works
Mediterranean diet and public health: personal reflections
Keys, A. (1995) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/61.6.1321s · Cited by 528 · see citing works
Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study
Martínez-González, M. Á., Fuente-Arrillaga, C. D. L., Nunez-Cordoba, J. M., Basterra-Gortari, F. J., Beunza, J. J., Vazquez, Z., Benito, S., Tortosa, A., & Bes-Rastrollo, M. (2008) · BMJ · doi:10.1136/bmj.39561.501007.be · Cited by 517 · see citing works
Type 2 Diabetes as a “Coronary Heart Disease Equivalent”
Juutilainen, A., Lehto, S., Rönnemaa, T., Pyörälä, K., & Laakso, M. (2005) · Diabetes Care · doi:10.2337/diacare.28.12.2901 · Cited by 452 · see citing works
Macronutrients, Food Groups, and Eating Patterns in the Management of Diabetes
Wheeler, M. L., Dunbar, S. A., Jaacks, L. M., Karmally, W., Mayer-Davis, E. J., Wylie-Rosett, J., & Yancy, W. S. (2012) · Diabetes Care · doi:10.2337/dc11-2216 · Cited by 357 · see citing works
The role of diet in the prevention of type 2 diabetes
Salas‐Salvadó, J., Martínez‐González, M. Á., Bulló, M., & Ros, E. (2011) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2011.03.009 · Cited by 341 · see citing works
Harding, A.-H. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.14.1493 · Cited by 322 · see citing works
Elhayany, A., Lustman, A., Abel, R., Attal‐Singer, J., & Vinker, S. (2010) · Diabetes, Obesity and Metabolism · doi:10.1111/j.1463-1326.2009.01151.x · Cited by 298 · see citing works
Efficacy of Lifestyle Education to Prevent Type 2 Diabetes
Yamaoka, K., & Tango, T. (2005) · Diabetes Care · doi:10.2337/diacare.28.11.2780 · Cited by 264 · see citing works
Diet-Quality Scores and the Risk of Type 2 Diabetes in Men
de Koning, L., Chiuve, S. E., Fung, T. T., Willett, W. C., Rimm, E. B., & Hu, F. B. (2011) · Diabetes Care · doi:10.2337/dc10-2352 · Cited by 252 · see citing works
Biologic and Quality-of-Life Outcomes From the Mediterranean Lifestyle Program
Toobert, D. J., Glasgow, R. E., Strycker, L. A., Barrera, M., Radcliffe, J. L., Wander, R. C., & Bagdade, J. D. (2003) · Diabetes Care · doi:10.2337/diacare.26.8.2288 · Cited by 238 · see citing works
Tobias, D. K., Hu, F. B., Chavarro, J., Rosner, B., Mozaffarian, D., & Zhang, C. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.3747 · Cited by 219 · see citing works
Uusitupa, M. I. J., Peltonen, M., Lindström, J., Aunola, S., Ilanne‐Parikka, P., Keinanen-Kiukaanniemi, S. M., Valle, T. T., Eriksson, J. G., Tuomilehto, J. O., & for the Finnish Diabetes Prevention Study Group (2009) · PLoS ONE · doi:10.1371/journal.pone.0005656 · Cited by 212 · see citing works
Barzi, F., Woodward, M., Marfisi, R. M., Tavazzi, L., Valagussa, F., Marchioli, R., & on behalf of GISSI-Prevenzione Investigators (2003) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601575 · Cited by 209 · see citing works
Prevention and control of type 2 diabetes by Mediterranean diet: A systematic review
Esposito, K., Maiorino, M. I., Ceriello, A., & Giugliano, D. (2010) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2010.04.019 · Cited by 208 · see citing works
Self-citationLong-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus
Kaushik, M., Mozaffarian, D., Spiegelman, D. L., Manson, J. E., Willett, W. C., & Hu, F. B. (2009) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.27424 · Cited by 208 · see citing works
The InterAct Consortium (2011) · Diabetes Care · doi:10.2337/dc11-0891 · Cited by 202 · see citing works
Vegetable but Not Fruit Consumption Reduces the Risk of Type 2 Diabetes in Chinese Women
Villegas, R., Shu, X. O., Gao, Y., Yang, G., Elasy, T. A., Li, H., & Zheng, W. (2008) · Journal of Nutrition · doi:10.1093/jn/138.3.574 · Cited by 184 · see citing works
Mozaffarian, D., Marfisi, R., Levantesi, G., Silletta, M. G., Tavazzi, L., Tognoni, G., Valagussa, F., & Marchioli, R. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61343-9 · Cited by 179 · see citing works
Knoops, K. T. B., de Groot, L. C. P. G. M., Kromhout, D., Perrin, A.-E., Moreiras-Varela, O., Menotti, A., & van Staveren, W. A. (2004) · JAMA · doi:10.1001/jama.292.12.1433 · Cited by 146 · see citing works
Whole grain foods for the prevention of type 2 diabetes mellitus
Priebe, M. G., van Binsbergen, J., de Vos, R., & Vonk, R. J. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006061.pub2 · Cited by 142 · see citing works
Esposito, K., Kastorini, C.-M., Panagiotakos, D. B., & Giugliano, D. (2010) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2010.0009 · Cited by 127 · see citing works
Self-citationAdherence to a Mediterranean diet and glycaemic control in type 2 diabetes mellitus
Esposito, K., Maiorino, M. I., Di Palo, C., Giugliano, D., & for the Campanian Postprandial Hyperglycemia Study Group (2009) · Diabetic Medicine · doi:10.1111/j.1464-5491.2009.02798.x · Cited by 102 · see citing works
Self-citationHodge, A. M., English, D. R., Itsiopoulos, C., O’Dea, K., & Giles, G. G. (2010) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2010.10.014 · Cited by 86 · see citing works
Sawyer, L., & Gale, E. A. M. (2008) · Diabetologia · doi:10.1007/s00125-008-1203-9 · Cited by 38 · see citing works
Mediterranean diet and diabetes prevention: Myth or fact?
Kastorini, C.-M. (2010) · World Journal of Diabetes · doi:10.4239/wjd.v1.i3.65 · Cited by 35 · see citing works
Adherence to the Mediterranean Diet in Patients with Type 2 Diabetes Mellitus and HbA1c Level
Díez‐Espino, J., Buil‐Cosiales, P., Serrano-Martínez, M., Toledo, E., Salas‐Salvadó, J., & Martínez‐González, M. Á. (2011) · Annals of Nutrition and Metabolism · doi:10.1159/000324718 · Cited by 33 · see citing works
Auchincloss, A. H. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.302 · Cited by 18 · see citing works
Esposito, K., & Giugliano, D. (2011) · BMJ Evidence-Based Medicine · doi:10.1136/ebm1152 · Cited by 16 · see citing works
Self-citationEsposito, K., Maiorino, M. I., Ciotola, M., Di Palo, C., Scognamiglio, P., Gicchino, M., Petrizzo, M., Saccomanno, F., Beneduce, F., Ceriello, A., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-5-200909010-00004 · Cited by 13 · see citing works
Self-citationEsposito, K., & Giugliano, D. (2012) · Diabetes Care · doi:10.2337/dc12-0247 · Cited by 7 · see citing works
Self-citationWhich diet is best for diabetes?
Esposito, K., Maiorino, M. I., & Giugliano, D. (2009) · Diabetologia · doi:10.1007/s00125-009-1292-0 · Cited by 6 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Huo, R., Du, T., Xu, Y., Xu, W., Chen, X., Sun, K., & Yu, X. (2015) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.243 · Cited by 296 · see citing works
Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing
Gantenbein, K. V., & Kanaka-Gantenbein, C. (2021) · Nutrients · doi:10.3390/nu13061951 · Cited by 288 · see citing works
Santangelo, C., Filesi, C., Varì, R., Scazzocchio, B., Filardi, T., Fogliano, V., D’Archivio, M., Giovannini, C., Lenzi, A., Morano, S., et al. (2016) · Journal of Endocrinological Investigation · doi:10.1007/s40618-016-0506-9 · Cited by 109 · see citing works
Association of the Mediterranean Diet With Onset of Diabetes in the Women’s Health Study
Ahmad, S., Demler, O. V., Sun, Q., Moorthy, M. V., Li, C., Lee, I.-M., Ridker, P. M., Manson, J. E., Hu, F. B., Fall, T., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.25466 · Cited by 54 · see citing works
Tranidou, A., Dagklis, T., Magriplis, E., Apostolopoulou, A., Tsakiridis, I., Chroni, V., Tsekitsidi, E., Kalaitzopoulou, I., Pazaras, N., & Chourdakis, M. (2023) · Nutrients · doi:10.3390/nu15040848 · Cited by 21 · see citing works
- Authors
- Esposito, K., & Giugliano, D.
- Affiliations
- University of Campania "Luigi Vanvitelli" (IT)
- Corresponding author
- Esposito, Katherine
- Venue
- Diabetes/Metabolism Research and Reviews
- Publisher
- Wiley
- Published
- 2014-02-14
- Volume
- 30
- Issue
- S1
- Pages
- 34-40
- ISSN
- 1520-7552 (ISSN-L)
- 1520-7560
- OpenAlex
- W2101002009
- Cited by
- 96
- References
- 50
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 8 · 2023: 10 · 2022: 7 · 2021: 11 · 2020: 14 · 2019: 6 · 2018: 6 · 2017: 2 · 2016: 6 · 2015: 6 · 2014: 6
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes/Metabolism Research and Reviews (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- Mediterranean diet, type 2 diabetes, diabetes prevention, dietary habits, plant-based diet, glycemic control, HbA1c, cardiovascular risk, low-carbohydrate diet, all-cause mortality
- MeSH terms
- Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Humans, Diet, Mediterranean
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
