Abstract
A Mediterranean diet (MedDiet) has been widely investigated and promoted as one of the ‘healthiest’ dietary patterns with respect to reductions in chronic disease risk and longevity. Moreover, it also emphasizes a plant-based dietary pattern consistent with an environmentally sustainable healthy reference diet conveyed by the EAT-Lancet Commission report. Nevertheless, the MedDiet does not exclude, but rather moderates consumption of animal-based foods, and therefore has emerged as a dietary pattern that could address both health and environmental concerns. However, whether non-Mediterranean countries such as Australia can adhere to such dietary principles is less clear. In this narrative review, we present evidence from eight randomized control trials conducted in Australia which demonstrates impressive and sustained adherence to a MedDiet intervention. However, we also report heterogeneity in the dietary protocols and prescriptive interpretation of a MedDiet across all studies presented in this review, making interpretations of the efficacy and adherence challenging. Based on the observable health benefits, translating key dietary elements of a Mediterranean-style diet within the Australian population remains attractive. However, adapting or modernizing traditional dietary patterns to satisfy the population’s nutritional requirements and/or acceptability warrants further exploration.
Highlights
The Australian Dietary Guidelines (ADGs) provides information on the types and amounts of food to eat from a range of core food groups and emphasizes a dietary pattern to promote health and wellbeing and reduce overall risk of non-communicable diseases (NCDs)
We report on a total of eight randomized control trials (RCTs) conducted in Australia, published between 2011 and 2019 with sample sizes ranging from 27 to 166 participants against primary outcomes related to cardiometabolic risk factors, glycaemic control, cognition, hepatic steatosis and depressive symptomology
We reviewed the efficacy and adherence to a Mediterranean diet (MedDiet) adopted as a dietary intervention in clinical trials conducted in Australia on middle-aged to older adults against primary outcomes related to cardiometabolic risk factors, glycaemic control, cognition, hepatic steatosis and depressive symptomology
Summary
The Australian Dietary Guidelines (ADGs) provides information on the types and amounts of food to eat from a range of core food groups and emphasizes a dietary pattern to promote health and wellbeing and reduce overall risk of non-communicable diseases (NCDs). Nutrients 2019, 11, 2507 dietary guidelines attempt to translate a vast evidence base regarding the relationship between foods, dietary patterns, and health related outcomes into specific, culturally acceptable and actionable dietary recommendations [7]. The majority of evidence from clinical trials assessing the efficacy of the MedDiet on health-related outcomes has been conducted in Mediterranean populations, where the dietary pattern and other non-dietary customs are familiar [12,13]. Given the multiethnic landscape of Australia, coupled with the high prevalence of NCDs and the scientific evidence base of the MedDiet, assessing whether the Australian population can adhere to principles of a MedDiet is warranted. All studies included in this review were randomized control trials (RCTs), conducted in Australia, investigating the efficacy of a MedDiet against any disease outcome, in men and/or women aged ≥18 years
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