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Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis.

Abstract

OBJECTIVE

Adherence to a Mediterranean diet is associated with significant improvements in health status. However, to date no systematic review and meta-analysis has summarized the effects of Mediterranean diet adherence on the risk of type 2 diabetes mellitus.

DESIGN

Electronic searches for randomized controlled trials and cohort studies were performed in MEDLINE, SCOPUS, EMBASE and the Cochrane Trial Register until 2 April 2014. Pooled effects were calculated by an inverse-variance random-effect meta-analysis using the statistical software Review Manager 5.2 by the Cochrane Collaboration.

SETTING

Meta-analysis of randomized controlled trials and cohort studies.

SUBJECTS

ELIGIBILITY CRITERIA

19+years of age.

RESULTS

One randomized controlled trial and eight prospective cohort studies (122 810 subjects) published between 2007 and 2014 were included for meta-analysis. For highest v. lowest adherence to the Mediterranean diet score, the pooled risk ratio was 0.81 (95 % CI 0.73, 0.90, P<0.0001, I 2=55 %). Sensitivity analysis including only long-term studies confirmed the results of the primary analysis (pooled risk ratio=0.75; 95 % CI 0.68, 0.83, P<0.00001, I 2=0 %). The Egger regression test provided no evidence of substantial publication bias (P=0.254).

CONCLUSIONS

Greater adherence to a Mediterranean diet is associated with a significant reduction in the risk of diabetes (19 %; moderate quality evidence). These results seem to be clinically relevant for public health, in particular for encouraging a Mediterranean-like dietary pattern for primary prevention of type 2 diabetes mellitus.

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  • Authors+Show Affiliations

    ,

    University of Vienna, Faculty of Life Sciences,Department of Nutritional Sciences,Althanstraβe 14 UZA II,A-1090 Vienna,Austria.

    ,

    University of Vienna, Faculty of Life Sciences,Department of Nutritional Sciences,Althanstraβe 14 UZA II,A-1090 Vienna,Austria.

    ,

    University of Vienna, Faculty of Life Sciences,Department of Nutritional Sciences,Althanstraβe 14 UZA II,A-1090 Vienna,Austria.

    University of Vienna, Faculty of Life Sciences,Department of Nutritional Sciences,Althanstraβe 14 UZA II,A-1090 Vienna,Austria.

    Source

    Public health nutrition 18:7 2015 May pg 1292-9

    MeSH

    Cohort Studies
    Diabetes Mellitus, Type 2
    Diet, Mediterranean
    Evidence-Based Medicine
    Humans
    Middle Aged
    Nutrition Policy
    Patient Compliance
    Randomized Controlled Trials as Topic
    Risk

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    25145972

    Citation

    Schwingshackl, Lukas, et al. "Adherence to a Mediterranean Diet and Risk of Diabetes: a Systematic Review and Meta-analysis." Public Health Nutrition, vol. 18, no. 7, 2015, pp. 1292-9.
    Schwingshackl L, Missbach B, König J, et al. Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis. Public Health Nutr. 2015;18(7):1292-9.
    Schwingshackl, L., Missbach, B., König, J., & Hoffmann, G. (2015). Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis. Public Health Nutrition, 18(7), pp. 1292-9. doi:10.1017/S1368980014001542.
    Schwingshackl L, et al. Adherence to a Mediterranean Diet and Risk of Diabetes: a Systematic Review and Meta-analysis. Public Health Nutr. 2015;18(7):1292-9. PubMed PMID: 25145972.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis. AU - Schwingshackl,Lukas, AU - Missbach,Benjamin, AU - König,Jürgen, AU - Hoffmann,Georg, Y1 - 2014/08/22/ PY - 2014/8/23/entrez PY - 2014/8/26/pubmed PY - 2016/2/26/medline KW - Systematic review SP - 1292 EP - 9 JF - Public health nutrition JO - Public Health Nutr VL - 18 IS - 7 N2 - OBJECTIVE: Adherence to a Mediterranean diet is associated with significant improvements in health status. However, to date no systematic review and meta-analysis has summarized the effects of Mediterranean diet adherence on the risk of type 2 diabetes mellitus. DESIGN: Electronic searches for randomized controlled trials and cohort studies were performed in MEDLINE, SCOPUS, EMBASE and the Cochrane Trial Register until 2 April 2014. Pooled effects were calculated by an inverse-variance random-effect meta-analysis using the statistical software Review Manager 5.2 by the Cochrane Collaboration. SETTING: Meta-analysis of randomized controlled trials and cohort studies. SUBJECTS: ELIGIBILITY CRITERIA: 19+years of age. RESULTS: One randomized controlled trial and eight prospective cohort studies (122 810 subjects) published between 2007 and 2014 were included for meta-analysis. For highest v. lowest adherence to the Mediterranean diet score, the pooled risk ratio was 0.81 (95 % CI 0.73, 0.90, P<0.0001, I 2=55 %). Sensitivity analysis including only long-term studies confirmed the results of the primary analysis (pooled risk ratio=0.75; 95 % CI 0.68, 0.83, P<0.00001, I 2=0 %). The Egger regression test provided no evidence of substantial publication bias (P=0.254). CONCLUSIONS: Greater adherence to a Mediterranean diet is associated with a significant reduction in the risk of diabetes (19 %; moderate quality evidence). These results seem to be clinically relevant for public health, in particular for encouraging a Mediterranean-like dietary pattern for primary prevention of type 2 diabetes mellitus. SN - 1475-2727 UR - https://www.unboundmedicine.com/medline/citation/25145972/Adherence_to_a_Mediterranean_diet_and_risk_of_diabetes:_a_systematic_review_and_meta_analysis_ L2 - https://www.cambridge.org/core/product/identifier/S1368980014001542/type/journal_article DB - PRIME DP - Unbound Medicine ER -