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BMJ Open. 2015 Aug 10;5(8):e008222. doi: 10.1136/bmjopen-2015-008222.

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

Author information

1
Diabetes Unit, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
2
Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Naples, Italy.
3
Medical Statistics Unit, Second University of Naples, Naples, Italy.
4
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.

Abstract

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.

KEYWORDS:

DIABETES & ENDOCRINOLOGY; NUTRITION & DIETETICS; PREVENTIVE MEDICINE

PMID:
26260349
PMCID:
PMC4538272
DOI:
10.1136/bmjopen-2015-008222
[Indexed for MEDLINE]
Free PMC Article

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