Abstract

The Mediterranean diet (MedDiet) has been recommended to the general population by many scientific organizations as a healthy dietary pattern, based on strong evidence of association with improved cardiometabolic health, including lower risk of cardiovascular disease, diabetes, and obesity. However, most studies have been conducted in Mediterranean or European countries or among white populations in the United States (US), while few exist for non-Mediterranean countries or racial/ethnic minority populations in the US. Because most existing studies evaluating adherence to the MedDiet use population-specific definitions or scores, the reported associations may not necessarily apply to other racial/ethnic populations that may have different distributions of intake. Moreover, racial/ethnic groups may have diets that do not comprise the typical Mediterranean foods captured by these scores. Thus, there is a need to determine if similar positive effects from following a MedDiet are observed in diverse populations, as well as to identify culturally-relevant foods reflected within Mediterranean-like patterns, that can facilitate implementation and promotion of such among broader racial/ethnic groups. In this narrative review, we summarize and discuss the evidence from observational and intervention studies on the MedDiet and cardiometabolic diseases in racial/ethnic minority populations in the US, and offer recommendations to enhance research on MedDiet for such populations.

Highlights

  • The Mediterranean diet (MedDiet) has been recommended to the general population by many scientific organizations as a healthy dietary pattern [1,2] based on strong evidence that it improves cardiometabolic health [3,4,5]

  • Most of the studies assessing the health benefits of the MedDiet have been conducted in Mediterranean or European countries [4,13,14,15,16] or among white populations in the United States (US) [17,18,19], while few exist for non-Mediterranean countries or racial/ethnic minority populations in the US [20]; that is, individuals identifying as Black or African American, American

  • The Multi-Ethnic Study of Atherosclerosis (MESA) was one of the first population-based prospective cohort studies reporting associations between MedDiet and diabetes-related outcomes in a multi-ethnic sample of men and women aged 45–84 years living in US [32]

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Summary

Introduction

The Mediterranean diet (MedDiet) has been recommended to the general population by many scientific organizations as a healthy dietary pattern [1,2] based on strong evidence that it improves cardiometabolic health [3,4,5]. One study conducted in a multi-ethnic population in the US with 63% Hispanic and 20% Black participants reported lower consumption of MedDiet components (fruit, vegetables, legumes, fish, cereals, and MUFA) in comparison with other studies in European and American populations [25]. Intervention studies on the MedDiet and major cardiometabolic diseases (i.e., diabetes, obesity, cardiovascular disease, and their biological risk factors) in racial/ethnic minority populations living in the US, describe the cultural adaptations of the original MedDiet from the intervention studies reported (Table 2), discuss the implications of following a MedDiet and offer recommendations to enhance research on MedDiet for such populations. Sum of population sex-specific median of 9 groups: vegetables; whole grains; nuts; legumes; fruits; MUFA:SFA; red and processed meat; dairy; fish; alcohol. Native Hawaiians, and Japanese Americans living in Hawaii and California

Key Findings
Background
Population-Based Studies
Randomized Clinical Trials and Interventions
Randomized Control Trials and Interventions
Findings
Conclusions and Recommendations

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