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Can the Mediterranean Diet curtail inflammation in Type 2 diabetes?

Evidence suggests that the Mediterranean diet can be beneficial for people with diabetes. Those benefits may also extend to inflammation.

Study under review: Mediterranean diet cools down the inflammatory milieu in type 2 diabetes: the MÉDITA randomized controlled trial

Introduction

Health and weight loss are two common motivators for people to turn their diet upside down. But what if there was a diet that could do both? In the 1950s, the hallmark Seven Countries Study[1] found that people living in the Mediterranean region had the lowest rates of cardiovascular disease and mortality worldwide. The diet of people in this region was characterized by several factors: a high consumption of plant foods (fruits, vegetables, legumes, and cereals); moderate consumption of fish, poultry, and dairy products; and limited consumption of red and processed meats. This combination, later to be named the Mediterranean diet (MedDiet), was shown to be both associated with good health[2] and effective for weight loss[3]. The essentials of the MedDiet are covered in Figure 1.

In 2015, the American Heart Association and the American Diabetes Association released a document[4] stating that the MedDiet is beneficial for preventing cardiovascular disease in people with diabetes by reducing cardiovascular disease risk factors and improving glycemic control. Type 2 diabetes (T2DM) is one of the most prevalent chronic diseases worldwide. It is a metabolic disease characterized by insulin resistance and chronically elevated blood sugar levels. Although pharmaceuticals exist to manage the disease, diet and exercise are still two potent measures[5] for both preventing and managing the disease.

C-reactive protein (CRP) and adiponectin are two blood biomarkers related to inflammation and T2DM risk. CRP, which is elevated in response to acute inflammation, has been associated with an increased risk[6] of developing T2DM, while adherence to a MedDiet has been associated[7] with reduced CRP levels. Adiponectin is an anti-inflammatory and insulin-sensitizing molecule[8] released from fat cells that appears to be inversely correlated[9] with T2DM risk and associated[10] with better adherence to the MedDiet. While the MedDiet appears to be effective[11] at reducing levels of proinflammatory molecules and increasing levels of anti-inflammatory molecules, there are limited controlled trials investigating the effects of the MedDiet on inflammatory biomarkers such as CRP and adiponectin in people with diabetes. Thus, the study under review used data from a previous randomized control trial (MEDITA) to assess how a MedDiet intervention compares to a low-fat diet in terms of its effects on CRP and adiponectin in people with T2DM.

Type 2 diabetes is associated with increased levels of the proinflammatory cytokine CRP and the anti-inflammatory cytokine adiponectin. The Mediterranean diet (MedDiet) has been associated with a improving inflammation and may be healthy for people with type 2 diabetes. However, limited experimental evidence exists for the beneficial effect of a MedDiet on CRP and adiponectin in people with diabetes. Therefore, the study under review compared a Mediterranean diet intervention to a low-fat diet in the context of their effects on these biomarkers.

Who and what was studied?

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Other Articles in Issue #35 (September 2017)