Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing

In the paper

“However, the human genome has not been significantly modified during these last decades and there is growing evidence that epigenetic alterations, mainly due to both intrauterine but also extrauterine insults, may significantly contribute to this increase.”

In the paper

“All these factors lead to obesity, hypertension, hyperlipidemia, and insulin resistance [1].”

What the sources say

• Not checked yetcites [1] Iriti, M., Varoni, E.M., and Vitalini, S. (2020). Healthy Diets and Modifiable Risk Factors for Non-Communicable Diseases-The European Perspective. Foods, 9. source

In the paper

“The important role of a healthy nutrition to combat insulin resistance, obesity, and their deleterious consequences, such as non-alcoholic fatty liver disease (NAFLD), polycystic ovarian syndrome (PCOS), sleep apnea, type 2 Diabetes (T2D) and cardiovascular events, all through the same pathogenetic mechanism of insulin resistance, has become evident through the beneficial effect of the so-called”

In the paper

“Moreover, the MD may further contribute to the improvement of reproductive health, modify the risk for neurodegenerative diseases, and protect against depression and psychosocial maladjustment.”

In the paper

“Furthermore, dietary fibers positively shape the composition of gut microbiota and immunity [2,3].”

What the sources say

• Not checked yetcites [2] Ramazzotti, 2017, Diet, Environments, and Gut Microbiota. A Preliminary Investigation in Children Living in Rural and Urban Burkina Faso and Italy, Front. Microbiol. source
• Not checked yetcites [3] Calabrese, 2020, Gut Microbiota and Type 1 Diabetes Mellitus: The Effect of Mediterranean Diet, Front. Nutr. source

In the paper

“Moreover, the MD may further contribute to the improvement of reproductive health, modify the risk for neurodegenerative diseases, and protect against depression and psychosocial maladjustment.”

In the paper

“The beneficial effects of the MD can be mainly attributed to its numerous components rich in anti-inflammatory and antioxidant properties.”

In the paper

“They contain biologically active nutrients, such as polyphenols which have a significant impact on the prevention and management of chronic non-communicable diseases due to their beneficial anti-oxidative, anti-bacterial or anti-inflammatory effects [10].”

What the sources say

• Not checked yetcites [10] Alkhatib, A., Tsang, C., Tiss, A., Bahorun, T., Arefanian, H., Barake, R., Khadir, A., and Tuomilehto, J. (2017). Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management. Nutrients, 9. source

In the paper

“Moreover, the MD may further contribute to the improvement of reproductive health, modify the risk for neurodegenerative diseases, and protect against depression and psychosocial maladjustment.”

In the paper

“When ingested, dietary fibers are not digested in the gastrointestinal tract, but they are fermented by the gut microbiota, leading to the generation of short-chain fatty acids (SCFAs) with anti-inflammatory and anti-aging actions.”

In the paper

“Western type diet is characterized by big meals rich in fat and carbohydrate content with a low content in fibers, while sweet beverages significantly contribute to the obesogenic environment, facilitating the development of visceral obesity and insulin resistance.”

In the paper

“As Calabrese et al. mentioned, olive oil also contains 3,3-dimethyl-1-butanol, which prevents the formation of trimethylamine-1-oxide.”

What the sources say

• Not checked yetcites [3] Calabrese, 2020, Gut Microbiota and Type 1 Diabetes Mellitus: The Effect of Mediterranean Diet, Front. Nutr. source

In the paper

“The beneficial effects of MD can be further enhanced by increased physical activity in the context of a well-balanced healthy lifestyle.”

In the paper

“The main factors contributing to the emergence of these diseases are related to people’s diet and behavior, such as the increase in food rich in saturated fat and carbohydrates, including sweetened beverages, lack of physical exercise and smoking.”

What the sources say

• Not checked yetcites [1] Iriti, M., Varoni, E.M., and Vitalini, S. (2020). Healthy Diets and Modifiable Risk Factors for Non-Communicable Diseases-The European Perspective. Foods, 9. source

In the paper

“According to Anderson et al., a diet rich in fibers, such as the MD, is associated with a lower prevalence of cardiovascular diseases, diabetes, metabolic syndrome, and gastrointestinal diseases like gastroesophageal reflux disease, gastric ulcer or diverticulitis [9].”

What the sources say

• Not checked yetcites [9] Anderson, 2009, Health benefits of dietary fiber, Nutr. Rev. source

In the paper

“Furthermore, the consumption of fiber-rich food alters the gut microbiome and enriches the microbiome diversity, which is important for the immune system, possessing anti-inflammatory capacities [7,8].”

What the sources say

• Not checked yetcites [7] Hooper, 2012, Interactions between the microbiota and the immune system, Science source
• Not checked yetcites [8] Bailey, 2018, Microbiome-Mediated Effects of the Mediterranean Diet on Inflammation, Adv. Nutr. source

In the paper

“Moreover, the MD consists of many components rich in mono-unsaturated fatty acid such as oleic acid, in olive oil, omega-3-polyunsaturated fatty acid, such as alpha- linolenic acid in tree nuts, like walnuts, high amounts of flavonoids and antioxidants found in fruits and vegetables and high amounts of dietary fibers that have a great impact on the composition of gut microbiota—all considered to”

What the sources say

• Not checked yetcites [12] Widmer, 2015, The Mediterranean diet, its components, and cardiovascular disease, Am. J. Med. source
• Not checked yetcites [13] Renaud, 1994, Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease, Lancet source

In the paper

“It has also been shown to inhibit the NADPH-induced oxidative stress and activate the anti-inflammatory molecule peroxisome proliferator-activated receptor gamma (PPARγ) [4].”

What the sources say

• Not checked yetcites [4] Nani, A., Murtaza, B., Sayed Khan, A., Khan, N.A., and Hichami, A. (2021). Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules, 26. source

In the paper

“Curcumin, for example, is known for its protective properties against DNA-mutations [19].”

What the sources say

• Not checked yetcites [19] Griffiths, K., Aggarwal, B.B., Singh, R.B., Buttar, H.S., Wilson, D., and De Meester, F. (2016). Food Antioxidants and Their Anti-Inflammatory Properties: A Potential Role in Cardiovascular Diseases and Cancer Prevention. Diseases, 4. source

In the paper

“Increased monounsaturated fatty acids and reduced saturated fatty acids in the diet have been associated with increased insulin sensitivity and improved beta cell function [26,27].”

What the sources say

• Not checked yetcites [26] Martín-Peláez, S., Fito, M., and Castaner, O. (2020). Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review. Nutrients, 12. source
• Not checked yetcites [27] Bhaswant, 2015, Mechanisms of enhanced insulin secretion and sensitivity with n-3 unsaturated fatty acids, J. Nutr. Biochem. source

In the paper

“It has been shown that polyphenols have an anti-inflammatory function. They inhibit proinflammatory molecules and modulate the inflammatory pathways like NF-κB, MAPK and the arachidonic acid pathway [17].”

What the sources say

• Not checked yetcites [17] Yahfoufi, N., Alsadi, N., Jambi, M., and Matar, C. (2018). The Immunomodulatory and Anti-Inflammatory Role of Polyphenols. Nutrients, 10. source

In the paper

“Moreover, the ingestion of herbal components such as green tea, rich in polyphenols such as epigallocatechin-3-O-gallate (EGCG), contributes to diabetes management and has a lipid-lowering effect, while increasing energy expenditure and decreasing inflammation and oxidative stress through the inhibition of the NF-κB pathway [4].”

What the sources say

• Not checked yetcites [4] Nani, A., Murtaza, B., Sayed Khan, A., Khan, N.A., and Hichami, A. (2021). Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules, 26. source

In the paper

“In the MD, more unsaturated fatty acids are consumed, especially as a component of olive oil or table olives, and less saturated fatty acids from animal fat. This has an inhibitory effect on the pathogenesis of diabetes mellitus.”

In the paper

“In addition, there is evidence that polyphenols increase glucose uptake in muscle cells, reduce gluconeogenesis in the liver, and prevent the inflammation-induced destruction of the pancreatic β-cells [31].”

What the sources say

• Not checked yetcites [31] Kim, Y., Keogh, J.B., and Clifton, P.M. (2016). Polyphenols and Glycemic Control. Nutrients, 8. source

In the paper

“Spices are a rich source of polyphenols as well and have anti-inflammatory, anti-carcinogenic and antioxidant capacities.”

In the paper

“Faster shortening of the telomeres and an inhibition of the telomerase activity has therefore been observed in unhealthy obesity [22,23].”

What the sources say

• Not checked yetcites [22] Cheng, 2021, Diabetes, metabolic disease, and telomere length, Lancet Diabetes Endocrinol. source
• Not checked yetcites [23] Canudas, 2020, Mediterranean Diet and Telomere Length: A Systematic Review and Meta-Analysis, Adv. Nutr. source

In the paper

“MD can thus be considered as a natural antioxidant, able to reduce mortality, by reducing the incidence of cardiovascular, metabolic, endocrine, and neurodegenerative diseases through the beneficial effects of its components, mainly polyphenols [24].”

What the sources say

• Not checked yetcites [24] Noce, 2017, Impact of Mediterranean diet on metabolic syndrome, cancer and longevity, Oncotarget source

In the paper

“Oxidative stress at the cellular level originates from an imbalance between endogenous reactive oxygen species (ROS) production and the natural anti-oxidation system [4].”

What the sources say

• Not checked yetcites [4] Nani, A., Murtaza, B., Sayed Khan, A., Khan, N.A., and Hichami, A. (2021). Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules, 26. source

In the paper

“One of the reasons for the increase in the incidence of diabetes is the high-fat, high-carbohydrate, and low-fiber diet.”

In the paper

“Special interest has been laid to resveratrol, a component of grapes, that has been shown to promote intracellular glucose transport and reduce insulin secretion.”

What the sources say

• Not checked yetcites [4] Nani, A., Murtaza, B., Sayed Khan, A., Khan, N.A., and Hichami, A. (2021). Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules, 26. source

In the paper

“GLP1 stimulates insulin secretion and inhibits glucagon secretion.”

In the paper

“As MD is rich in dietary fiber, and the fermentation of this fiber leads to the formation of SCFAs, these then, in turn, stimulate GLP1 expression [26].”

What the sources say

• Not checked yetcites [26] Martín-Peláez, S., Fito, M., and Castaner, O. (2020). Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review. Nutrients, 12. source

In the paper

“Moreover, further studies have demonstrated that the consumption of tea is associated with a reduced waist-to-hip ratio and lower levels of blood pressure [10].”

What the sources say

• Not checked yetcites [10] Alkhatib, A., Tsang, C., Tiss, A., Bahorun, T., Arefanian, H., Barake, R., Khadir, A., and Tuomilehto, J. (2017). Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management. Nutrients, 9. source

In the paper

“The increased expression of proinflammatory cytokines leads to downregulation of the anti-inflammatory molecule, AMP-activated protein kinase (AMPK), and the induction of the acute-phase-protein C-reactive protein (CRP) [4].”

What the sources say

• Not checked yetcites [4] Nani, A., Murtaza, B., Sayed Khan, A., Khan, N.A., and Hichami, A. (2021). Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules, 26. source

In the paper

“The inflammatory reaction can be further attenuated by the polyphenol quercetin since it induces the secretion of the anti-inflammatory factor, adiponectin, in adipocytes. This leads to a reduction in body weight in obese mice in vivo.”

In the paper

“These molecules show important antidiabetic effects. They inhibit a-glucosidase and thus intestinal glucose uptake. They also inhibit dipeptidyl peptidase 4, which inactivates the enzyme GLP1. In addition, they inhibit hepatic gluconeogenesis and increase glucose uptake in muscle cells, thus counteracting hyperglycemia.”

What the sources say

• Not checked yetcites [34] Naimi, M., Vlavcheski, F., Shamshoum, H., and Tsiani, E. (2017). Rosemary Extract as a Potential Anti-Hyperglycemic Agent: Current Evidence and Future Perspectives. Nutrients, 9. source

In the paper

“In addition, it increases the expression of anti-inflammatory molecules like PPARγ and reduces the expression of proinflammatory molecules such as IL1β and cyclooxygenase (COX) 2 [4].”

What the sources say

• Not checked yetcites [4] Nani, A., Murtaza, B., Sayed Khan, A., Khan, N.A., and Hichami, A. (2021). Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules, 26. source

In the paper

“These plaques can either lead to vascular stenosis and occlusion or break off with the blood flow inducing the formation of a thrombus. Both events subsequently lead to tissue blood underperfusion, tissue ischemia and final necrosis.”

In the paper

“In a randomized control trial (RCT), Yaskolka et al. were able to demonstrate that an MD enriched in green plants with reduced red meat intake was able to enhance intrahepatic fat loss in comparison to the control diet, proving the beneficial effects of MD on reducing hepatic steatosis [37].”

What the sources say

• Not checked yetcites [37] Yaskolka Meir, A., Rinott, E., Tsaban, G., Zelicha, H., Kaplan, A., Rosen, P., Shelef, I., Youngster, I., Shalev, A., and Blüher, M. (2021). Effect of green-Mediterranean diet on intrahepatic fat: The DIRECT PLUS randomised controlled trial. Gut. source

In the paper

“Although the exact role of the different components of the MD on the prevention and management of NAFLD is not fully elucidated, it became clear that many components have lipid-lowering properties and reduce insulin resistance at the hepatic level, while they have anti-inflammatory and antioxidant properties, further reducing endoplasmic stress.”

In the paper

“As shown in the review by Naimi et al. [34], rosemary also has lipid-lowering and anti-inflammatory effects [34].”

What the sources say

• Not checked yetcites [34] Naimi, M., Vlavcheski, F., Shamshoum, H., and Tsiani, E. (2017). Rosemary Extract as a Potential Anti-Hyperglycemic Agent: Current Evidence and Future Perspectives. Nutrients, 9. source

In the paper

“As mentioned previously, MD contains many biologically active molecules called polyphenols with anti-inflammatory and antioxidant effects [19].”

What the sources say

• Not checked yetcites [19] Griffiths, K., Aggarwal, B.B., Singh, R.B., Buttar, H.S., Wilson, D., and De Meester, F. (2016). Food Antioxidants and Their Anti-Inflammatory Properties: A Potential Role in Cardiovascular Diseases and Cancer Prevention. Diseases, 4. source

In the paper

“Cardiovascular events are mainly due to atherosclerosis and intravascular plaques formation.”

In the paper

“In addition to the high LDL levels, conferring an atherosclerotic cardiovascular risk, it has recently become evident that the susceptibility of LDL particles to aggregate constitutes a further prothrombotic factor and a risk factor for future cardiovascular death.”

In the paper

“Kastorini et al. investigated the effects of the MD on metabolism through a meta-analysis. They found that adherence to the MD has a positive effect on metabolism. MD is associated with a lower rate of MetS and its components such as abdominal obesity, low HDL levels and hypertension [44].”

What the sources say

• Not checked yetcites [44] Kastorini, 2011, The effect of Mediterranean diet on metabolic syndrome and its components: A meta-analysis of 50 studies and 534,906 individuals, J. Am. Coll. Cardiol. source

In the paper

“Nowadays, the incidence of MetS is steadily increasing, mainly as a cause of modern lifestyle with increasing obesity rates, and the combination of increased sedentary activities and non-adherence to healthy nutrition.”

In the paper

“Furthermore, this lowers the blood pressure and inhibits platelet aggregation by inhibiting cyclooxygenase (COX) activity [53].”

What the sources say

• Not checked yetcites [53] Rahman, 2006, Garlic and cardiovascular disease: A critical review, J. Nutr. source

In the paper

“Furthermore, the MetS is associated with numerous other complications as well as with an increased risk of neoplasia [42,43].”

What the sources say

• Not checked yetcites [42] Esposito, 2012, Metabolic syndrome and risk of cancer: A systematic review and meta-analysis, Diabetes Care source
• Not checked yetcites [43] Uzunlulu, 2016, Association between Metabolic Syndrome and Cancer, Ann. Nutr. Metab. source

In the paper

“An antihypertensive and cardioprotective effect has also been associated with the consumption of olive oil [54].”

What the sources say

• Not checked yetcites [54] Gorzynik-Debicka, M., Przychodzen, P., Cappello, F., Kuban-Jankowska, A., Marino Gammazza, A., Knap, N., Wozniak, M., and Gorska-Ponikowska, M. (2018). Potential Health Benefits of Olive Oil and Plant Polyphenols. Int. J. Mol. Sci., 19. source

In the paper

“According to Ghavipour et al., the tomato has anti-inflammatory and antioxidant effects [45].”

What the sources say

• Not checked yetcites [45] Ghavipour, 2013, Tomato juice consumption reduces systemic inflammation in overweight and obese females, Br. J. Nutr. source

In the paper

“An example of these beneficial molecules is the polyphenol quercetin, which reduces the metabolic stress in mitochondria and acts like the widely used antidiabetic drug metformin [32].”

What the sources say

• Not checked yetcites [32] Eid, 2010, Stimulation of AMP-activated protein kinase and enhancement of basal glucose uptake in muscle cells by quercetin and quercetin glycosides, active principles of the antidiabetic medicinal plant Vaccinium vitis-idaea, Mol. Nutr. Food Res. source

In the paper

“This inflammatory state is characterized by the ectopic deposition of lipids, which leads to insulin resistance in muscle cells, liver steatosis with altered metabolism in the liver and beta-cell dysfunction in pancreatic cells and consequently decreased insulin secretory activity that progressively cannot compensate for the increased insulin demands necessary to counteract the peripheral insulin”

What the sources say

• Not checked yetcites [24] Noce, 2017, Impact of Mediterranean diet on metabolic syndrome, cancer and longevity, Oncotarget source

In the paper

“This increase in incidence occurs in parallel with the increasing incidence of obesity and insulin resistance [35].”

What the sources say

• Not checked yetcites [35] Angelico, F., Ferro, D., and Baratta, F. (2021). Is the Mediterranean Diet the Best Approach to NAFLD Treatment Today?. Nutrients, 13. source

In the paper

“Moreover, in vitro and in vivo studies have shown that the consumption of garlic can improve the lipid status, by lowering the level of LDL and increasing the level of HDL. This is achieved by inhibiting enzymes in the pathway of cholesterol synthesis, for example, monooxygenase and 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMG-CoA-reductase).”

What the sources say

• Not checked yetcites [53] Rahman, 2006, Garlic and cardiovascular disease: A critical review, J. Nutr. source

In the paper

“A diet rich in olive oil consumption, especially of extra-virgin olive oil, allows the intake of phytosterols and polyphenols that have a protective function on the endothelium preventing arteriosclerosis and cardiovascular events.”

In the paper

“AGEs bind to their receptors (receptor of advanced glycation end products, RAGE), which are also expressed in the ovarian tissue. By binding to RAGE, they induce an inflammatory response that stimulates oxidative stress. AGEs thus accumulate in the ovarian tissue, leading to ovarian dysfunction [74].”

What the sources say

• Not checked yetcites [74] Garg, 2015, Advanced Glycation End Products: Link between Diet and Ovulatory Dysfunction in PCOS?, Nutrients source

In the paper

“Another parameter associated with impaired male fertility is the presence of xenoestrogens, which are found nowadays in increased amounts in meat products [90]. Xenoestrogents are shown to reduce the ejaculate volume, the sperm motility and vitality [91].”

What the sources say

• Not checked yetcites [90] 2017, Dietary patterns, foods and nutrients in male fertility parameters and fecundability: A systematic review of observational studies, Hum. Reprod. Update source
• Not checked yetcites [91] Rozati, 2002, Role of environmental estrogens in the deterioration of male factor fertility, Fertil. Steril. source

In the paper

“Furthermore, it has been observed that increased consumption of trans lipids is associated with reduced sperm quality and lower testosterone levels.”

What the sources say

• Not checked yetcites [92] Nassan, 2018, Diet and men’s fertility: Does diet affect sperm quality?, Fertil. Steril. source

In the paper

“Oxidative stress is induced by both internal and external factors. Internal factors can be the result of cryptorchidism or testicular inflammation. External factors that lead to enhanced oxidative stress include obesity, smoking and an unhealthy diet [88].”

What the sources say

• Not checked yetcites [88] Rahman, S.U., Huang, Y., Zhu, L., Feng, S., Khan, I.M., Wu, J., Li, Y., and Wang, X. (2018). Therapeutic Role of Green Tea Polyphenols in Improving Fertility: A Review. Nutrients, 10. source

In the paper

“It has also been shown that resveratrol decelerates ovarian ageing in rodent experiments and thus increases fertility [85].”

What the sources say

• Not checked yetcites [85] Chen, 2010, Effects of plant polyphenols on ovarian follicular reserve in aging rats, Biochem. Cell Biol. source

In the paper

“Studies have shown that cinnamon, for example, reduces insulin resistance and fasting insulin levels.”

What the sources say

• Not checked yetcites [80] Ashkar, 2020, The Role of medicinal herbs in treatment of insulin resistance in patients with Polycystic Ovary Syndrome: A literature review, Biomol. Concepts source

In the paper

“The constellation of these diets contributes to the inflammatory state and induces oxidative stress [76].”

What the sources say

• Not checked yetcites [76] Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., Pugliese, G., Colao, A., and Savastano, S. (2019). Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients, 11. source

In the paper

“It was observed that resolvin leads to a downregulation of proinflammatory mediators and thus to a limitation of the inflammatory response [79].”

What the sources say

• Not checked yetcites [79] Zhang, 2020, The Anti-inflammatory Mediator Resolvin E1 Protects Mice Against Lipopolysaccharide-Induced Heart Injury, Front. Pharmacol. source

In the paper

“It is claimed that low-grade inflammation is present in PCOS, which drives the clinical picture [73].”

What the sources say

• Not checked yetcites [73] 2012, Inflammation in Polycystic Ovary Syndrome: Underpinning of insulin resistance and ovarian dysfunction, Steroids source

In the paper

“According to Wong, the polyphenol resveratrol has proapoptotic properties on the theca cells and can thus antagonize the insulin effect [82].”

What the sources say

• Not checked yetcites [82] Wong, 2010, Effects of resveratrol on proliferation and apoptosis in rat ovarian theca-interstitial cells, Mol. Hum. Reprod. source

In the paper

“Green tea stimulates metabolism and has a lipolytic effect.”

What the sources say

• Not checked yetcites [80] Ashkar, 2020, The Role of medicinal herbs in treatment of insulin resistance in patients with Polycystic Ovary Syndrome: A literature review, Biomol. Concepts source

In the paper

“Oxidative stress, for example, can contribute to male infertility. A high amount of reactive oxygen species is associated with reduced sperm quality, vitality, and concentration as well as DNA damage in spermatocytes.”

What the sources say

• Not checked yetcites [88] Rahman, S.U., Huang, Y., Zhu, L., Feng, S., Khan, I.M., Wu, J., Li, Y., and Wang, X. (2018). Therapeutic Role of Green Tea Polyphenols in Improving Fertility: A Review. Nutrients, 10. source

In the paper

“In addition, this leads to an induction of the expression of SIRT1, which also seems to have protective effects against oxidative stress in the ovarian tissue [84].”

What the sources say

• Not checked yetcites [84] Ochiai, 2020, Preconception resveratrol intake against infertility: Friend or foe?, Reprod. Med. Biol. source

In the paper

“As Amini et al. have described, polyunsaturated fatty acids have positive effects on insulin sensitivity and can limit hyperandrogenism [78].”

What the sources say

• Not checked yetcites [78] Amini, 2015, Antioxidants and management of polycystic ovary syndrome in Iran: A systematic review of clinical trials, Iran J. Reprod. Med.

In the paper

“They are mainly the result of the ingestion of high sugar diet and may also be found in animal fat- and protein-rich products and less represented in fruits and vegetables [75].”

What the sources say

• Not checked yetcites [75] Uribarri, 2010, Advanced glycation end products in foods and a practical guide to their reduction in the diet, J. Am. Diet. Assoc. source

In the paper

“Chamomile has positive effects on weight control and lowers insulin levels.”

What the sources say

• Not checked yetcites [80] Ashkar, 2020, The Role of medicinal herbs in treatment of insulin resistance in patients with Polycystic Ovary Syndrome: A literature review, Biomol. Concepts source

In the paper

“Finally, Marrubium vulgare lowers cholesterol, glucose, and oxidative stress [80].”

What the sources say

• Not checked yetcites [80] Ashkar, 2020, The Role of medicinal herbs in treatment of insulin resistance in patients with Polycystic Ovary Syndrome: A literature review, Biomol. Concepts source

In the paper

“Another parameter that is important in the pathogenesis of PCOS is the presence of advanced glycation end products (AGEs). These substances are either endogenously produced or exogenously supplied through food ingestion [74].”

What the sources say

• Not checked yetcites [74] Garg, 2015, Advanced Glycation End Products: Link between Diet and Ovulatory Dysfunction in PCOS?, Nutrients source

In the paper

“The results showed that the high cholesterol diet led to the formation of abnormal sperm and reduced sperm motility [93].”

What the sources say

• Not checked yetcites [93] Saez Lancellotti, T.E., Boarelli, P.V., Monclus, M.A., Cabrillana, M.E., Clementi, M.A., Espínola, L.S., Cid Barría, J.L., Vincenti, A.E., Santi, A.G., and Fornés, M.W. (2010). Hypercholesterolemia impaired sperm functionality in rabbits. PLoS ONE, 5. source

In the paper

“Polyphenols instead lead to an improvement in cognition, which can be shown by both cognitive tests and functional MRI (fMRI) studies.”

What the sources say

• Not checked yetcites [113] Rajaram, 2019, Plant-Based Dietary Patterns, Plant Foods, and Age-Related Cognitive Decline, Adv. Nutr. source

In the paper

“In contrast, Bacteroides-dominant gut flora results in the formation of proprionate, succinate and acetate, which have proinflammatory effects and promote autoimmunity by increasing the epithelial permeability of the gut [102].”

What the sources say

• Not checked yetcites [102] Barca, 2015, Diet, Microbiota and Immune System in Type 1 Diabetes Development and Evolution, Nutrients source

In the paper

“The polyphenols, mainly catechins, contained in green tea also have a protective effect on sperm quality. They protect against spontaneous mutations and chromosomal aberrations.”

What the sources say

• Not checked yetcites [88] Rahman, S.U., Huang, Y., Zhu, L., Feng, S., Khan, I.M., Wu, J., Li, Y., and Wang, X. (2018). Therapeutic Role of Green Tea Polyphenols in Improving Fertility: A Review. Nutrients, 10. source

In the paper

“Isocyanates found in cruciferous vegetables and olecanthal act as natural COX inhibitors and thus limit inflammatory responses [117,118,119].”

What the sources say

• Not checked yetcites [117] Grodzicki, W., and Dziendzikowska, K. (2020). The Role of Selected Bioactive Compounds in the Prevention of Alzheimer’s Disease. Antioxidants, 9. source
• Not checked yetcites [118] Li, 2009, Inhibition of tau fibrillization by oleocanthal via reaction with the amino groups of tau, J. Neurochem. source
• Not checked yetcites [119] Radan, 2018, Isothiocyanates: Cholinesterase inhibiting, antioxidant, and anti-inflammatory activity, J. Enzyme Inhib. Med. Chem. source

In the paper

“According to Yang et al., the consumption of a polyphenol-rich diet, such as the MD, increases the amount of beneficial bacterial species and suppresses the growth of pathogenic bacterial species [107].”

What the sources say

• Not checked yetcites [107] Yang, Q., Liang, Q., Balakrishnan, B., Belobrajdic, D.P., Feng, Q.J., and Zhang, W. (2020). Role of Dietary Nutrients in the Modulation of Gut Microbiota: A Narrative Review. Nutrients, 12. source

In the paper

“Hesperidin, for example, which is found in citrus fruits, scavenges free oxygen radicals. Furthermore, it suppresses the formation of proinflammatory cytokines and thus also has an anti-inflammatory effect. In addition, according to several studies, it has been shown that hesperidin increases cerebral blood flow, which further prevents cognitive decline.”

What the sources say

• Not checked yetcites [115] Hajialyani, M., Hosein Farzaei, M., Echeverría, J., Nabavi, S.M., Uriarte, E., and Sobarzo-Sánchez, E. (2019). Hesperidin as a Neuroprotective Agent: A Review of Animal and Clinical Evidence. Molecules, 24. source

In the paper

“Further studies have shown that anthocyanins and the compound of olive oil, olecanthal, prevent the aggregation of Aβ amyloids and tau protein [116].”

What the sources say

• Not checked yetcites [116] Li, 2017, Health benefits of anthocyanins and molecular mechanisms: Update from recent decade, Crit. Rev. Food Sci. Nutr. source

In the paper

“In summary, it can be said that polyphenols, and thus also the MD, have a preventive effect against neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease.”

In the paper

“It has been shown that children whose mothers had a high adherence to the MD are less likely to develop atopic diseases and behavioral problems [97].”

What the sources say

• Not checked yetcites [97] Amati, F., Hassounah, S., and Swaka, A. (2019). The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health. Nutrients, 11. source

In the paper

“Polyphenols regulate the composition of gut bacteria by stimulating the growth of beneficial bacteria and inhibiting the growth of harmful bacteria.”

What the sources say

• Not checked yetcites [11] Zhou, 2020, Gut Microbiota: A Pivotal Hub for Polyphenols as Antidepressants, J. Agric. Food. Chem. source

In the paper

“Furthermore, the high body weight of the mother is associated with lower fertilization rate and miscarriage [99].”

What the sources say

• Not checked yetcites [99] Mehta, 2008, Nutrition and pregnancy, Clin. Obstet. Gynecol. source

In the paper

“Depression is nowadays one of the leading causes of disability [122].”

What the sources say

• Not checked yetcites [122] James, 2018, Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017, Lancet source

In the paper

“Adherence to the MD is further associated with a reduced likelihood of gestational diabetes and hypertensive pregnancy diseases [100].”

What the sources say

• Not checked yetcites [100] Mulligan, 2017, Maternal modifiers of the infant gut microbiota: Metabolic consequences, J. Endocrinol. source

In the paper

“It has been further suggested that flavonoids have a remyelination-promoting effect [110,111].”

What the sources say

• Not checked yetcites [110] Zhang, 2017, Icariin enhances remyelination process after acute demyelination induced by cuprizone exposure, Brain. Res. Bull. source
• Not checked yetcites [111] 2018, The Role of Diet in Multiple Sclerosis: Mechanistic Connections and Current Evidence, Curr. Nutr. Rep. source

In the paper

“They showed that the group that followed MD had less stress and negative emotions and scored better on depression scores.”

What the sources say

• Not checked yetcites [124] Parletta, 2019, A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED), Nutr. Neurosci. source

In the paper

“As described in the review by Amati et al., maternal nutrition before and during pregnancy has a major impact on fetal health greatly contributing to the gut microbiota diversity of the offspring [97,100].”

What the sources say

• Not checked yetcites [97] Amati, F., Hassounah, S., and Swaka, A. (2019). The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health. Nutrients, 11. source
• Not checked yetcites [100] Mulligan, 2017, Maternal modifiers of the infant gut microbiota: Metabolic consequences, J. Endocrinol. source

In the paper

“As Riera-Sampol et al. have shown, both adherence to MD and a low BMI are beneficial against depression.”

What the sources say

• Not checked yetcites [123] Riera-Sampol, A., Bennasar-Veny, M., Tauler, P., Nafría, M., Colom, M., and Aguilo, A. (2021). Association between Depression, Lifestyles, Sleep Quality and Sense of Coherence in a Population with Cardiovascular Risk. Nutrients, 13. source

In the paper

“It has been observed that the consumption of saturated fatty acids and especially long-chain fatty acids is associated with an aggravation of the symptomatology and an increase in immune cell recruitment [108].”

What the sources say

• Not checked yetcites [108] Timmermans, 2014, High fat diet exacerbates neuroinflammation in an animal model of multiple sclerosis by activation of the Renin Angiotensin system, J. Neuroimmune Pharmacol. source

In the paper

“In contrast, the risk of developing gestational diabetes is increased in overweight women, which also entails many complications for the newborn, including both adverse metabolic health [100] and future neurodevelopment [99,101].”

What the sources say

• Not checked yetcites [100] Mulligan, 2017, Maternal modifiers of the infant gut microbiota: Metabolic consequences, J. Endocrinol. source
• Not checked yetcites [99] Mehta, 2008, Nutrition and pregnancy, Clin. Obstet. Gynecol. source
• Not checked yetcites [101] Friedman, 2018, Developmental Programming of Obesity and Diabetes in Mouse, Monkey, and Man in 2018: Where Are We Headed?, Diabetes source

In the paper

“The lack of dietary fiber leads to an excess of lipopolysaccharide-producing bacteria in the microbiome, resulting in damage to the intestinal barrier and mitochondrial function [112].”

What the sources say

• Not checked yetcites [112] Jackson, 2019, Diet in Parkinson’s Disease: Critical Role for the Microbiome, Front. Neurol. source

In the paper

“Moreover, healthy nutrition may modify the risk for neurodegenerative diseases such as Alzheimer disease, or Parkinson’s disease, or even protect against depression and psychosocial maladjustment.”

In the paper

“Moreover, it seems that MD may further contribute to reproductive health in both men and women, since higher rates of subfertility have been noted nowadays in westernized societies and may further contribute to the overall health of future generations.”

In the paper

“There is a lot of evidence highlighting the impact of healthy nutrition of the woman on the composition of gut microbiota and metabolic health of her offspring and may further protect from congenital malformations or even adverse neurodevelopment in the offspring.”

In the paper

“EGCG present in tea has also been associated with adverse effects when administered at high concentrations. A hepatotoxic effect with an increase in hepatic transaminase has been reported in animal experiments as well as in humans.”

What the sources say

• Not checked yetcites [130] Hayat, 2015, Tea and its consumption: Benefits and risks, Crit. Rev. Food Sci. Nutr. source