Mediterranean diet

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The Mediterranean diet (sometimes referred to as MedDiet) is a diet rich in seafood, fruits, vegetables, whole grains, nuts, cheese and healthy fats, such as olive oil.[1] On average, the MedDiet contains three to nine serves of vegetables, half to two serves of fruit, one to 13 serves of cereals and up to eight serves of olive oil daily. It contains approximately 9300 kJ: 37% as total fat, 18% as monounsaturated and 9% as saturated, and 33g of fibre per day.[1]

The majority of studies emphasize the same key dietary components and principles for the benefits associated to the MedDiet: an increased intake of vegetables, wholegrains, and the preferential consumption of white meat as a substitute of red and processed meat, as well as abundant use of olive oil. However, the reporting of specific dietary recommendations for fruit, legumes, nuts, bread, red wine, and fermentable dairy products are generally less consistent or not reported.[2][3]

Heath benefits of the Mediterranean Diet

Mechanisms of Interplay between Mediterranean Diet and Aging (according to article.[2] Molecules that promote aging are shown in yellow, while molecules with anti-aging properties are shown in light green. Red lines indicate inhibited or slowed pathways and blue lines indicate activated pathways that together promote healthy aging. GH (growth hormone); IGF-1 (insulin-like growth factor-1); mTOR (protein mammalian target of rapamycin); AMPK (adenosine monophosphate-activated protein kinase); FOXO (Forkhead Box); PGC-1α (peroxisome proliferator-activated receptor gamma 1-alpha); SIRT-1 (sirtuine-1).

Irrespective of the discordance in the interpretation of a MedDiet, a number of studies have reported health benefits such as improved glycaemic control and favorable cardiovascular outcomes with adherence to a Mediterranean-style diet.[4][5][6] The Mediterranean diet (MedDiet) is recognised to reduce risk of coronary heart disease (CHD), in part, via its anti-inflammatory and antioxidant properties, which may be mediated via effects on body fat distribution.[7]

Several randomized controlled trials have showed the positive effects of the MedDiet style on several cardiovascular risk factors, such as body mass index, waist circumference, blood lipids, blood pressure, inflammatory markers and adhesion molecules, and diabetes and how these advantages of the MeDi are maintained in comparison of a low-fat diet. Some studies reported a positive effect of adherence to a Mediterranean Diet and heart failure incidence, whereas some studies showed that the incidence of major cardiovascular events was lower among those assigned to MedDiet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.[8]

Olive Oil in the Mediterranean Diet

One of the most examined oils for its health properties is olive oil, especially extra virgin olive oil (EVOO).[9][10] Olive oil is rich in monounsaturated oleic acid and phenolic compounds, as well as squalene. The capacity of olive oil to stop or slow down the inflammatory processes linked to chronic degenerative disorders also supports its role as an anti-atherosclerotic, therefore improving the lipid profile. The phenolic components of olive oil, such as luteolin, apigenin, ferulic, coumaric acid, or caffeic acid, have antibacterial effects and promote the regeneration of fibroblasts.[11]

Tomatoes in the Mediterranean Diet

Among the most consumed fruits and vegetables, tomatoes also deserve to be investigated as they are fundamental components of the Mediterranean diet, are available all year round, have an affordable price and have various benefits also in terms of cancer prevention.[12]

Tomatoes are a rich source of antioxidants, such as ascorbic acid, polyphenols, or carotenoids. Tomatoes contain minerals, vitamins, proteins, essential amino acids (leucine, threonine, valine, histidine, lysine, arginine), monounsaturated fatty acids (linoleic and linolenic acids), carotenoids (lycopene and β-carotenoids) and phytosterols (β-sitosterol, campesterol and stigmasterol). Lycopene is the main dietary carotenoid in tomato and tomato-based food products and lycopene consumption by humans has been reported to protect against cancer, cardiovascular diseases, cognitive function and osteoporosis.[13] Among the phenolic compounds present in tomato, quercetin, kaempferol, naringenin, caffeic acid and lutein are the most common. Many of these compounds have antioxidant activities and are effective in protecting the human body against various oxidative stress-related diseases.[14][15]

The anti-inflammatory and anti-allergic active compound, which strongly inhibited histamine release in tomato skin has been identified as naringenin chalcone (trans-2'4'6'4-tetrahydroxychalcone).[16][17] Naringenin chalcone is bioavailable in humans from cherry tomatoes as a dietary source.[18]

Naringenin can suppress cancer development in various body parts, alleviating the conditions of cancer patients by acting as effective alternative supplementary remedies. Their anticancer activities are pleiotropic, and they can modulate different cellular signaling pathways, suppress cytokine and growth factor production and arrest the cell cycle.[19] Naringenin improved memory and learning ability in aging mice by influencing TNF-α, which is involved in aging-associated cognitive impairment, protected cardiac muscle from aging. Naringenin promotes the synthesis of the extracellular matrix (ECM) in cartilage and, in turn, improves aging in both lipopolysaccharide- and reactive oxygen species (ROS)-induced skin senescence. This appears to occur through the sirtuin SIRT1-mediated inhibition of NF-κΒ, NADPH oxidase, and matrix metalloproteinases (MMPs) as seen in human dermal fibroblasts, suggesting a regenerative and anti-aging effect on the dermal cell structure.[20]

Like metformin, naringenin displays in vitro and in vivo antidiabetic effects by sensitizing insulin signaling in insulin-sensitive cells and tissues, inhibiting gluconeogenesis in hepatocytes, suppressing adipocyte proliferation and adipogenesis, and protecting pancreas β-cells from apoptosis.[21] Antioxidant activity of naringenin may be related to its upregulation through a transcriptional mechanism of intracellular heat shock protein 70 (HSP70), by which naringenin improves diabetic- or hyperglycemia-induced impairment of endothelial function.[22]

References

  1. ↑ 1.0 1.1 Davis, C., Bryan, J., Hodgson, J., & Murphy, K. (2015). Definition of the Mediterranean diet: a literature review. Nutrients, 7(11), 9139-9153. PMID: 26556369 PMCID: PMC4663587 DOI: 10.3390/nu7115459
  2. ↑ 2.0 2.1 Andreo-López, M. C., Contreras-Bolívar, V., Muñoz-Torres, M., García-Fontana, B., & García-Fontana, C. (2023). Influence of the Mediterranean Diet on Healthy Aging. International Journal of Molecular Sciences, 24(5), 4491. https://doi.org/10.3390/ijms24054491
  3. ↑ McClure, R., & Villani, A. (2019). Greater adherence to a Mediterranean Diet is associated with better gait speed in older adults with type 2 diabetes mellitus. Clinical nutrition ESPEN, 32, 33-39. PMID: 31221287 DOI: 10.1016/j.clnesp.2019.05.009
  4. ↑ Villani, A., Sultana, J., Doecke, J., & Mantzioris, E. (2019). Differences in the interpretation of a modernized Mediterranean diet prescribed in intervention studies for the management of type 2 diabetes: how closely does this align with a traditional Mediterranean diet?. European journal of nutrition, 58, 1369-1380. PMID: 29943276 DOI: 10.1007/s00394-018-1757-3
  5. ↑ Allcock, L., Mantzioris, E., & Villani, A. (2022). Adherence to a Mediterranean Diet is associated with physical and cognitive health: A cross-sectional analysis of community-dwelling older Australians. Frontiers in Public Health, 10, 4360. PMID: 36466491 PMCID: PMC9709195 DOI: 10.3389/fpubh.2022.1017078
  6. ↑ Devranis, P., Vassilopoulou, Ε., Tsironis, V., Sotiriadis, P. M., Chourdakis, M., Aivaliotis, M., & Tsolaki, M. (2023). Mediterranean Diet, Ketogenic Diet or MIND Diet for Aging Populations with Cognitive Decline: A Systematic Review. Life, 13(1), 173. https://doi.org/10.3390/life13010173
  7. ↑ Bayerle, P., Beyer, S., Tegtbur, U., Kück, M., Adel, J., Kwast, S., ... & Busse, M. (2023). Exercise Capacity, Iron Status, Body Composition, and Mediterranean Diet in Patients with Chronic Heart Failure. Nutrients, 15(1), 36. PMID: 36615693 PMCID: PMC9824214 DOI: 10.3390/nu15010036
  8. ↑ Tuttolomondo, A., Simonetta, I., Daidone, M., Mogavero, A., Ortello, A., & Pinto, A. (2019). Metabolic and vascular effect of the Mediterranean diet. International journal of molecular sciences, 20(19), 4716. PMID: 31547615 PMCID: PMC6801699 DOI: 10.3390/ijms20194716
  9. ↑ Riolo, R., De Rosa, R., Simonetta, I., & Tuttolomondo, A. (2022). Olive Oil in the Mediterranean Diet and Its Biochemical and Molecular Effects on Cardiovascular Health through an Analysis of Genetics and Epigenetics. International Journal of Molecular Sciences, 23(24), 16002. PMID: 36555645 PMCID: PMC9782563 DOI: 10.3390/ijms232416002
  10. ↑ Fernández del Río, L., Gutiérrez-Casado, E., Varela-López, A., & Villalba, J. M. (2016). Olive oil and the hallmarks of aging. Molecules, 21(2), 163. PMID: 26840281 PMCID: PMC6273542 DOI: 10.3390/molecules21020163
  11. ↑ Melguizo-Rodríguez, L., Illescas-Montes, R., Costela-Ruiz, V. J., Ramos-Torrecillas, J., de Luna-Bertos, E., García-Martínez, O., & Ruiz, C. (2021). Antimicrobial properties of olive oil phenolic compounds and their regenerative capacity towards fibroblast cells. Journal of Tissue Viability, 30(3), 372-378. PMID: 33810929 DOI: 10.1016/j.jtv.2021.03.003
  12. ↑ Shannon, O. M., Ashor, A. W., Scialo, F., Saretzki, G., Martin-Ruiz, C., Lara, J., ... & Mathers, J. C. (2021). Mediterranean diet and the hallmarks of ageing. European Journal of Clinical Nutrition, 75(8), 1176-1192. PMID: 33514872 DOI: 10.1038/s41430-020-00841-x
  13. ↑ Imran, M., Ghorat, F., Ul-Haq, I., Ur-Rehman, H., Aslam, F., Heydari, M., ... & Rebezov, M. (2020). Lycopene as a natural antioxidant used to prevent human health disorders. Antioxidants, 9(8), 706. PMID: 32759751 PMCID: PMC7464847 DOI: 10.3390/antiox9080706
  14. ↑ Ali, M. Y., Sina, A. A. I., Khandker, S. S., Neesa, L., Tanvir, E. M., Kabir, A., ... & Gan, S. H. (2020). Nutritional Composition and Bioactive Compounds in Tomatoes and Their Impact on Human Health and Disease: A Review. Foods (Basel, Switzerland), 10(1), 45. PMID: 33375293 PMCID: PMC7823427 DOI: 10.3390/foods10010045
  15. ↑ Yang, Z., Li, W., Li, D., & Chan, A. S. (2023). Evaluation of Nutritional Compositions, Bioactive Components, and Antioxidant Activity of Three Cherry Tomato Varieties. Agronomy, 13(3), 637. https://doi.org/10.3390/agronomy13030637
  16. ↑ Yamamoto, T., Yoshimura, M., Yamaguchi, F., Kouchi, T., Tsuji, R., Saito, M., ... & Kikuchi, M. (2004). Anti-allergic activity of naringenin chalcone from a tomato skin extract. Bioscience, biotechnology, and biochemistry, 68(8), 1706-1711. PMID: 15322354 DOI: 10.1271/bbb.68.1706
  17. ↑ Escribano-Ferrer, E., Queralt Regue, J., Garcia-Sala, X., Boix Montanes, A., & Lamuela-Raventos, R. M. (2019). In vivo anti-inflammatory and antiallergic activity of pure naringenin, naringenin chalcone, and quercetin in mice. Journal of natural products, 82(2), 177-182. PMID: 30688453 DOI: 10.1021/acs.jnatprod.8b00366
  18. ↑ Kolot, C., Rodriguez-Mateos, A., Feliciano, R., Bottermann, K., & Stahl, W. (2019). Bioavailability of naringenin chalcone in humans after ingestion of cherry tomatoes. International Journal for Vitamin and Nutrition Research. PMID: 30961461 DOI: 10.1024/0300-9831/a000574
  19. ↑ Stabrauskiene, J., Kopustinskiene, D. M., Lazauskas, R., & Bernatoniene, J. (2022). Naringin and naringenin: Their mechanisms of action and the potential anticancer activities. Biomedicines, 10(7), 1686. PMID: 35884991 PMCID: PMC9313440 DOI: 10.3390/biomedicines10071686
  20. ↑ Lim, K. H., & Kim, G. R. (2018). Inhibitory effect of naringenin on LPS-induced skin senescence by SIRT1 regulation in HDFs. Biomedical Dermatology, 2(1), 26-34. doi: 10.1186/s41702-018-0035-6.
  21. ↑ Nyane, N. A., Tlaila, T. B., Malefane, T. G., Ndwandwe, D. E., & Owira, P. M. O. (2017). Metformin-like antidiabetic, cardio-protective and non-glycemic effects of naringenin: Molecular and pharmacological insights. European Journal of Pharmacology, 803, 103-111. PMID: 28322845 DOI: 10.1016/j.ejphar.2017.03.042
  22. ↑ Zhang, Z., Liu, H., Hu, X., He, Y., Li, L., Yang, X., ... & Tao, S. (2022). Heat Shock Protein 70 Mediates the Protective Effect of Naringenin on High-Glucose-Induced Alterations of Endothelial Function. International Journal of Endocrinology, 2022:7275765 PMID: 35958293 PMCID: PMC9359828 DOI: 10.1155/2022/7275765
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