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Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials

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Dinu, M, Pagliai, G, Casini, A, Sofi, F·2018·European Journal of Clinical Nutrition

DOI 10.1038/ejcn.2017.58

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Abstract

Research has shown that a greater adherence to the Mediterranean diet is associated with a reduced risk of major chronic disease. However, the existing literature leads to debate for different issues, such as the measurement of the adherence to the Mediterranean diet, the use of a wide variety of dietary indices with various food components and the large heterogeneity across the studies. In order to summarise the evidence and evaluate the validity of the association between the adherence to the Mediterranean diet and multiple health outcomes, an umbrella review of the evidence across meta-analyses of observational studies and randomised clinical trials (RCTs) was performed. Thirteen meta-analyses of observational studies and 16 meta-analyses of RCTs investigating the association between the adherence to the Mediterranean diet and 37 different health outcomes, for a total population of over than 12 800 000 subjects, were identified. A robust evidence, supported by a P-value<0.001, a large simple size, and not a considerable heterogeneity between studies, for a greater adherence to the Mediterranean diet and a reduced the risk of overall mortality, cardiovascular diseases, coronary heart disease, myocardial infarction, overall cancer incidence, neurodegenerative diseases and diabetes was found. For most of the site-specific cancers, as well as for inflammatory and metabolic parameters, the evidence was only suggestive or weak and further studies are needed to draw firmer conclusions. No evidence, on the other hand, was reported for bladder, endometrial and ovarian cancers, as well as for LDL (low density lipoprotein)-cholesterol levels.

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Authors: Dinu, M., Pagliai, G., Casini, A., & Sofi, F.
Affiliations: University of Florence (IT)
Azienda Ospedaliero-Universitaria Careggi (IT)
Corresponding author: Dinu, M
ORCID: Dinu, M
Pagliai, G
Casini, A
Sofi, F
Venue: European Journal of Clinical Nutrition
Publisher: Springer Science and Business Media LLC
Published: 2017-05-10
Volume: 72
Issue: 1
Pages: 30-43
ISSN: 0954-3007 (ISSN-L)
1476-5640
DOI: 10.1038/ejcn.2017.58
OpenAlex: W2612135195
Cited by: 1,016
References: 46
Citations by year: 2026: 91 · 2025: 108 · 2024: 148 · 2023: 116 · 2022: 126 · 2021: 148 · 2020: 115 · 2019: 74 · 2018: 73 · 2017: 16
FWCI: 12.35
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: other-oa
www.springer.com/tdm (tdm)
Locations: European Journal of Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Florence Research (University of Florence) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
Keywords: Mediterranean diet, dietary adherence, health outcomes, all-cause mortality, cardiovascular disease, coronary artery disease, myocardial infarction, cancer incidence, neurodegenerative diseases, diabetes mellitus, dietary indices, LDL cholesterol, inflammatory markers, metabolic biomarkers
MeSH terms: Systematic Reviews as Topic, Cardiovascular Diseases, Coronary Disease, Diabetes Mellitus, Humans, Mortality, Myocardial Infarction, Neoplasms, Patient Compliance, Meta-Analysis as Topic, Reproducibility of Results, Incidence, Randomized Controlled Trials as Topic, Evidence-Based Medicine, Neurodegenerative Diseases, Diet, Mediterranean, Observational Studies as Topic

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Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials

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