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Mediterranean diet in the targeted prevention and personalized treatment of chronic diseases: evidence, potential mechanisms, and prospects

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Abstract

The prevalence of chronic diseases is currently a major public health issue worldwide and is exploding with the population growth and aging. Dietary patterns are well known to play a important role in our overall health and well-being, and therefore, poor diet and malnutrition are among the most critical risk factors for chronic disease. Thus, dietary recommendation and nutritional supplementation have significant clinical implications for the targeted treatment of some of these diseases. Multiple dietary patterns have been proposed to prevent chronic disease incidence, like Dietary Approaches to Stop Hypertension (DASH) and Diabetes Risk Reduction Diet (DRRD). Among them, the MedDiet, which is one of the most well-known and studied dietary patterns in the world, has been related to a wide extent of health benefits. Substantial evidence has supported an important reverse association between higher compliance to MedDiet and the risk of chronic disease. Innovative strategies within the healthcare framework of predictive, preventive, and personalized medicine (PPPM/3PM) view personalized dietary customization as a predictive medical approach, cost-effective preventive measures, and the optimal dietary treatment tailored to the characteristics of patients with chronic diseases in primary and secondary care. Through a comprehensive collection and review of available evidence, this review summarizes health benefits of MedDiet in the context of PPPM/3PM for chronic diseases, including cardiovascular disease, hypertension, type 2 diabetes, obesity, metabolic syndrome, osteoporosis, and cancer, thereby a working hypothesis that MedDiet can personalize the prevention and treatment of chronic diseases was derived.

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Abbreviations

AGA:

America Gastroenterological Association

BP:

Blood pressure

BMI:

Body mass index

BMD:

Bone mineral density

CI:

Confidence interval

CVD:

Cardiovascular disease

CRC:

Colorectal cancer

CAD:

Coronary artery disease

DASH:

Dietary Approaches to Stop Hypertension

DRRD:

Diabetes Risk Reduction Diet

DM:

Diabetes mellitus

DBP:

Diastolic BP

EVOO:

Extra virgin olive oil

ESC:

European Society of Cardiology

ESH:

European Society of Hypertension

EPIC:

European Prospective Survey of Cancer and Nutrition

GC:

Gastric cancer

HT:

Hydroxytyrosol

HR:

Hazard ratio

HCC:

Human hepatocellular carcinoma

IDF:

International Diabetes Federation

MUFA:

Monounsaturated fatty acids

MetS:

Metabolic syndrome

MAFLD:

Metabolic dysfunction-associated fatty liver disease

MCF-7:

Michigan Cancer Foundation-7

NCDs:

Non-communicable diseases

OA:

Oleic acid

OL:

Oleuropein

OP:

Osteoporosis

OR:

Odds ratio

PPPM/3PM:

Predictive, preventive, and personalized medicine

PCa:

Prostate cancer

RCTs:

Randomized controlled trials

ROS:

Reactive oxygen species

RR:

Relative risk

SBP:

Systolic BP

SUN:

Seguimiento Universidad de Navarra

TG:

Triglyceride

T2DM:

Type 2 diabetes mellitus

VOO:

Virgin olive oil

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Funding

This work is supported by National Natural Science Foundation of China (Grant No. 82003476) and Dalian Medical University Interdisciplinary Research Cooperation Project Team Funding (Grant No. JCHZ2023012).

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  1. Yuji Xiao and Xuefei Xiao contributed equally to this study.

Authors and Affiliations

  1. School of Public Health, Dalian Medical University, Dalian, Liaoning, People’s Republic of China

    Yuji Xiao, Xue Zhang, Dongxin Yi, Qiangqiang Hao & Feng Zhang

  2. Bishan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China

    Yuji Xiao & Xuefei Xiao

  3. The Second People’s Hospital of Dalian, Dalian, Liaoning, People’s Republic of China

    Xue Zhang

  4. Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of China

    Tao Li

  5. Department of Clinical Nutrition, the Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of China

    Xu Li

  6. Department of Nutrition and Food Hygiene, School of Public Health, Global Health Research Center, Dalian Medical University, Dalian, Liaoning, People’s Republic of China

    Ningning Wang

  7. Global Health Research Center, Dalian Medical University, Dalian, Liaoning, People’s Republic of China

    Ningning Wang

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Contributions

YX and XX collaborated on writing the original manuscript and the figure design. XZ, DY, TL, QH, and FZ reviewed the manuscript. NW and XL designed the study and revised the manuscript. All authors have made a substantial, direct, and intellectual contribution to the work and approved it for publication.

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Xiao, Y., Xiao, X., Zhang, X. et al. Mediterranean diet in the targeted prevention and personalized treatment of chronic diseases: evidence, potential mechanisms, and prospects. EPMA Journal (2024). https://doi.org/10.1007/s13167-024-00360-w

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