MEDITERRANEAN DIET FOR DIABETES MELLITUS TYPE 2 PREVENTION, A LESSON FROM 751,161 SUBJECT

A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

OBJECTIVES
An unhealthy diet including excessive caloric intake and physical inactivity are strongly associated with future risk for type 2 diabetes (T2D). A meta-analysis by Esposito et al. showed that adoption of a healthy diet will decrease the risk of diabetes by 20%. An example of diet modification is the Mediterranean diet. Hence, we would like to determine the effect of the Mediterranean diet on the prevention of T2D.

METHODOLOGY
Electronic searches from several electronic databases for cohort and randomized controlled trial (RCT) was carried out in May 2022 with the following keywords: “Diabetes Mellitus Type 2” and “ Mediterranean diet” and “Prevention” and “Incidence.” Pooled effect was calculated using the statistical software Stata version 13. Primary analyses included the incidence of T2D and was limited to prospective studies in the healthy and/or highrisk population.

RESULTS
From 546 studies published from 2007 to 2020, 4 RCTs and 18 cohort studies (751,161 subjects) were included in our meta-analysis. Subgroup analysis was performed based on health status and sex. From pooled analysis, Mediterranean diet will decrease the risk for T2D by 17.6% (RR 0.824 (95%CI 0.803-0.845, I2: 70.05, P<0.0001). This effect was greater in the high-risk population (27%) and females (9.98%). The Egger regression test showed no evidence of substantial publication bias (P=0.12).

CONCLUSION
The present study has shown the benefits of adopting the Mediterranean diet among the healthy and high-risk population. Diet modification is essential, especially in those at risk for T2D and CVD.