Mediterrane Ernährung: was den Effekt tatsächlich trägt

<h4>Background</h4>Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. Given the conflicting evidence regarding the impact of adherence to the Mediterranean diet (MedDiet) on MS development and the lack of a systematic review on this topic, this study aimed to examine this association.<h4>Methods</h4>Following the PRISMA and JBI methods, a search of electronic databases was conducted through PubMed, Embase, Web of Science, and Scopus up to March 2024. Clinical original studies assessing the association between the MedDiet adherence and MS development were included. Risk of bias was evaluated using JBI critical appraisal tools. Meta-analyses were performed using CMA4 software.<h4>Results</h4>Out of 202 screened records, eight studies, including five case-control and three cohort studies, met the inclusion criteria. Retrospective evidence from three case-control studies suggested that MedDiet adherence is associated with decreased odds of MS, whereas cohort studies showed no significant relationship. Based on the meta-analysis, there was a significant association between high adherence to the MedDiet and reduced odds of MS (fixed-effect OR: 0.275, 95% CI: 0.11-0.72, p-value <0.01, least MedDiet adherence as the reference).<h4>Discussion</h4>Although the meta-analysis showed a significant inverse association between higher adherence to the MedDiet and the odds of MS, the overall body of evidence does not provide strong support f

The Mediterranean Diet (MD) is globally recognized not only for its well-established benefits to human health but also for its potential as a sustainable dietary model from environmental perspectives. Primarily based on plant-based foods, olive oil, fish, and seasonal and local products, the MD stands out for its ability to reduce overall mortality and the incidence of chronic diseases. At the same time, it is a low environmental impact dietary approach, contributing to the reduction in greenhouse gas emissions, water savings, biodiversity conservation, and soil regeneration. This narrative review was conducted by searching the Scopus and PubMed databases, covering all publications up to 2011, applying predefined inclusion and exclusion criteria, and ultimately including 33 studies. The paper provides a synthesis of the key elements that make the MD a paradigm of sustainability, analyzing critical indicators such as carbon, water, and energy footprints, land use, food waste generation, and carbon sequestration. It also addresses the decline in adherence to the MD, even in Mediterranean countries, highlighting the socio-economic, cultural, and behavioral causes, as well as the necessary strategies to promote its rediscovery and adaptation to contemporary contexts.

Since the 1950s, when Ancel Keys popularized the traditional Mediterranean diet, an immense accrual of large and valid studies, including prospective cohort studies, randomized controlled trials (RCT), and systematic reviews, have been conducted to investigate the potential health benefits related to this dietary pattern. The available evidence shows that the traditional Mediterranean diet represents a sustainable, healthy, and highly palatable pattern with a wide array of associated health benefits. In particular, its protective effects on cardiovascular disease have been supported by several consistent large RCTs, namely, the Lyon Diet-Heart Study, PREDIMED, PREDIMED-Plus and CORDIOPREV. The traditional Mediterranean diet is not a vegetarian diet, but it emphasizes the preferential consumption of minimally processed plant-based foods: fruits, vegetables, whole-grain cereals, legumes, and tree nuts. Its unique components-different from other healthy, plant-based, food patterns-are extra-virgin olive oil as the main source of fat (keeping a high monounsaturated-to-saturated fat ratio), a high consumption of tree nuts, and low-to-moderate consumption of red wine with meals. However, the inclusion of an alcoholic beverage in a healthy diet is becoming increasingly controversial. An ongoing RCT, the University of Navarra Alumni Trialist Initiative (UNATI), aims to answer this question in 10 000 drinkers. In addition to conventional epidemiologic studies, metabolomics techniques