Abstract
This study evaluates the relation of a Mediterranean dietary pattern and its individual components with the cardiovascular risk factors profile, plasma glucose and body mass index (BMI) in people with type 2 diabetes. We studied 2568 participants at 57 diabetes clinics. Diet was assessed with the EPIC (European Prospective Investigation into Cancer and Nutrition) questionnaire, adherence to the Mediterranean diet was evaluated with the relative Mediterranean diet score (rMED). A high compared to a low score was associated with a better quality of diet and a greater adherence to the nutritional recommendations for diabetes. However, even in the group achieving a high score, only a small proportion of participants met the recommendations for fiber and saturated fat (respectively 17% and 30%). Nonetheless, a high score was associated with lower values of plasma lipids, blood pressure, glycated hemoglobin, and BMI. The relationship of the single food items components of the rMED score with the achievement of treatment targets for plasma lipids, blood pressure, glucose, and BMI were also explored. The study findings support the Mediterranean dietary model as a suitable model for type 2 diabetes and the concept that the beneficial health effects of the Mediterranean diet lie primarily in its synergy among various nutrients and foods rather than on any individual component.
Highlights
Diet remains the cornerstone of effective type 2 diabetes management; the aim of promoting nutritional changes in people with diabetes is to optimize metabolic control and overall health.Nutritional recommendations have been issued by several scientific societies to support clinicians in the choice of the most suitable dietary intervention(s) in people with diabetes [1]
We evaluated the adherence to the current nutritional recommendation for people with diabetes in the participants with low, intermediate or high relative Mediterranean diet score (rMED) score (Figure 1)
A dietary pattern mimicking the Mediterranean model in people with type 2 diabetes is associated with more favorable cardiovascular risk factors profile, better glucose control and lower
Summary
Diet remains the cornerstone of effective type 2 diabetes management; the aim of promoting nutritional changes in people with diabetes is to optimize metabolic control and overall health.Nutritional recommendations have been issued by several scientific societies to support clinicians in the choice of the most suitable dietary intervention(s) in people with diabetes [1]. Human nutrition science has shifted from a reductionist approach focused on specific nutrients to a broader view emphasizing the concepts of overall dietary quality and patterns that promote metabolic health [8]. This paradigm change is supported by convincing evidence that food exposure is complex and its impact on health is influenced by single nutrients, and by their interplay and by the interactions of the bioactive non-nutrients present in food (i.e., fiber, antioxidants, minerals, etc.). The relationship between nutrition and health may not be fully appreciated unless evaluated within the context of the whole diet
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