Research has shown that a greater adherence to the Mediterraneandiet is associated with a reduced risk of major chronic disease. However, the existing literature leads to debate for different issues, such as the measurement of the adherence to the Mediterraneandiet, the use of a wide variety of dietary indices with various food components and the large heterogeneity across the studies.
In order to summarise the evidence and evaluate the validity of the association between the adherence to the Mediterranean diet and multiplehealthoutcomes, an umbrellareview of the evidence across meta-analyses of observtional studies and randomised clinical trials (RCTs) was performed. Thirteen meta-analyses of observationalstudies and 16 meta-analyses of RCTs investigating the association between the adherence to the Mediterraneandiet and 37 different healthoutcomes, for a total population of over than 12 800 000 subjects, were identified.
A robust evidence, supported by a P-value<0.001, a large simple size, and not a considerable heterogeneity between studies, for a greater adherence to the Mediterraneandiet and a reduced the risk of overall mortality, cardiovascular diseases, coronary heart disease, myocardial infarction, overall cancer incidence, neurodegenerative diseases and diabetes was found.
For most of the site-specific cancers, as well as for inflammatory and metabolic parameters, the evidence was only suggestive or weak and further studies are needed to draw firmer conclusions. No evidence, on the other hand, was reported for bladder, endometrial and ovarian cancers, as well as for LDL (low density lipoprotein)-cholesterol levels.
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