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The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants.

Abstract

OBJECTIVE

The purpose of this work was to meta-analyze prospective studies that have evaluated the effect of a Mediterranean diet on the development of type 2 diabetes.

MATERIALS/METHODS

PubMed, Embase and the Cochrane Central Register of Controlled Trials databases were searched up to 20 November 2013. English language publications were allocated; 17 original research studies (1 clinical trial, 9 prospective and 7 cross-sectional) were identified. Primary analyses were limited to prospective studies and clinical trials, yielding to a sample of 136,846 participants. A systematic review and a random effects meta-analysis were conducted.

RESULTS

Higher adherence to the Mediterranean diet was associated with 23% reduced risk of developing type 2 diabetes (combined relative risk for upper versus lowest available centile: 0.77; 95% CI: 0.66, 0.89). Subgroup analyses based on region, health status of participants and number of confounders controlling for, showed similar results. Limitations include variations in Mediterranean diet adherence assessment tools, confounders' adjustment, duration of follow up and number of events with diabetes.

CONCLUSIONS

The presented results are of major public health importance, since no consensus exists concerning the best anti-diabetic diet. Mediterranean diet could, if appropriately adjusted to reflect local food availability and individual's needs, constitute a beneficial nutritional choice for the primary prevention of diabetes.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.

    ,

    Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.

    ,

    Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.

    School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece. Electronic address: d.b.panagiotakos@usa.net.

    Source

    MeSH

    Adult
    Diabetes Mellitus, Type 2
    Diet, Mediterranean
    Europe
    Evidence-Based Medicine
    Health Promotion
    Humans
    Incidence
    Nutrition Policy
    Patient Compliance
    Prospective Studies
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    24931280

    Citation

    Koloverou, Efi, et al. "The Effect of Mediterranean Diet On the Development of Type 2 Diabetes Mellitus: a Meta-analysis of 10 Prospective Studies and 136,846 Participants." Metabolism: Clinical and Experimental, vol. 63, no. 7, 2014, pp. 903-11.
    Koloverou E, Esposito K, Giugliano D, et al. The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants. Metab Clin Exp. 2014;63(7):903-11.
    Koloverou, E., Esposito, K., Giugliano, D., & Panagiotakos, D. (2014). The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants. Metabolism: Clinical and Experimental, 63(7), pp. 903-11. doi:10.1016/j.metabol.2014.04.010.
    Koloverou E, et al. The Effect of Mediterranean Diet On the Development of Type 2 Diabetes Mellitus: a Meta-analysis of 10 Prospective Studies and 136,846 Participants. Metab Clin Exp. 2014;63(7):903-11. PubMed PMID: 24931280.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants. AU - Koloverou,Efi, AU - Esposito,Katherine, AU - Giugliano,Dario, AU - Panagiotakos,Demosthenes, Y1 - 2014/04/24/ PY - 2014/02/16/received PY - 2014/04/10/revised PY - 2014/04/16/accepted PY - 2014/6/17/entrez PY - 2014/6/17/pubmed PY - 2014/9/3/medline KW - Chronic disease KW - Diabetes KW - Dietary pattern KW - Incidence KW - Mediterranean KW - Meta-analysis KW - Review SP - 903 EP - 11 JF - Metabolism: clinical and experimental JO - Metab. Clin. Exp. VL - 63 IS - 7 N2 - OBJECTIVE: The purpose of this work was to meta-analyze prospective studies that have evaluated the effect of a Mediterranean diet on the development of type 2 diabetes. MATERIALS/METHODS: PubMed, Embase and the Cochrane Central Register of Controlled Trials databases were searched up to 20 November 2013. English language publications were allocated; 17 original research studies (1 clinical trial, 9 prospective and 7 cross-sectional) were identified. Primary analyses were limited to prospective studies and clinical trials, yielding to a sample of 136,846 participants. A systematic review and a random effects meta-analysis were conducted. RESULTS: Higher adherence to the Mediterranean diet was associated with 23% reduced risk of developing type 2 diabetes (combined relative risk for upper versus lowest available centile: 0.77; 95% CI: 0.66, 0.89). Subgroup analyses based on region, health status of participants and number of confounders controlling for, showed similar results. Limitations include variations in Mediterranean diet adherence assessment tools, confounders' adjustment, duration of follow up and number of events with diabetes. CONCLUSIONS: The presented results are of major public health importance, since no consensus exists concerning the best anti-diabetic diet. Mediterranean diet could, if appropriately adjusted to reflect local food availability and individual's needs, constitute a beneficial nutritional choice for the primary prevention of diabetes. SN - 1532-8600 UR - https://www.unboundmedicine.com/medline/citation/24931280/The_effect_of_Mediterranean_diet_on_the_development_of_type_2_diabetes_mellitus:_a_meta_analysis_of_10_prospective_studies_and_136846_participants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0026-0495(14)00118-8 DB - PRIME DP - Unbound Medicine ER -