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The Mediterranean Diet: A Time-Tested Path to Health and Wellness


For centuries, the concept that "prevention is better than cure" has been at the heart of the human quest for maintaining good health. Among the myriad of so-called "healthy" diets, the Mediterranean diet (MD) stands out as a beacon of health and longevity. Rooted in ancient traditions, this dietary pattern has captured the imagination of nutritionists, scientists, and health enthusiasts alike. Its unique blend of valuable macro and micronutrients has positioned the MD as a formidable contender in the battle against inflammation and non-communicable diseases (NCDs), also known as chronic diseases. Countless studies have delved into the role of MD components in reducing inflammation, lowering disease rates, and preventing NCDs, shedding light on their remarkable impact on human well-being.


In this comprehensive review, we will explore the profound influence of the Mediterranean diet on inflammation and its positive effects on various NCDs. While we've made significant strides in understanding the benefits of this diet, ongoing research continues to uncover its full potential, necessitating further high-quality experiments and trials to bridge any remaining gaps.


The Ancient Wisdom of Healthful Eating


Hippocrates, the father of modern medicine, famously proclaimed, "Let food be thy medicine and medicine be thy food." This age-old wisdom underscores the pivotal role of nutrition in maintaining good health. In the 21st century, scientific inquiry has honed in on the connection between dietary habits and chronic diseases such as cardiovascular diseases, metabolic syndrome, type II diabetes, and cancer. These diseases have intricate relationships with factors like lipid profiles, blood pressure, and endothelial function, all influenced by dietary choices.


When comparing dietary patterns worldwide, the Mediterranean and Western diets often take center stage. The Mediterranean diet, inspired by the culinary traditions of Mediterranean countries, emphasizes olive oil consumption, seasonal fresh vegetables, cereals, and a balanced meat intake. In stark contrast, the Western diet leans heavily towards high-fat dairy and processed red meats. However, discrepancies in the various MD patterns and food quantities consumed have raised questions about the true mechanisms behind its health benefits. Given these complexities, medical professionals, nutritionists, and dietitians have maintained a keen interest in unraveling the mysteries of the MD.


In this review, we aim to synthesize the accumulating evidence surrounding the Mediterranean diet, focusing on its anti-inflammatory properties.


Mediterranean Diet and Inflammation


The Mediterranean diet champions a healthful eating tradition characterized by consuming fruits, vegetables, and olive oil while minimizing meat intake. Previous studies have demonstrated that consistent adherence to the MD positively impacts cardiovascular diseases, diabetes, arthritis, cancer, and obstructive sleep apnea and is associated with significantly reducing total mortality. The advantages of adopting the MD have been known for nearly half a century, with the first observations of reduced cardiovascular disease risk among Mediterranean populations.


In recent decades, microbiology advances have illuminated the gut microbiome's critical role in human health. While we understand the significance of gut microbiota composition for overall well-being and its connection to the MD, the precise pathways to these interactions remain a subject of ongoing research. In light of the potential impact of inflammation on health, recent studies have provided strong evidence that people adhering to the MD experience reduced inflammation. These studies, focusing on gut microbiome metabolomics and metagenomics, emphasize the importance of food quality over quantity and highlight the benefits of the MD, even in older individuals.


For instance, two recent studies by Mesliel et al. and Ghosh TS et al., delving into the gut microbiome's role in metabolism and inflammation, underscore the significance of food quality, particularly in the elderly population. Bonaccio M et al. found an inverse relationship between MD adherence, White Blood Count, and platelet counts in a study involving 14,586 healthy subjects, indicating a potential anti-inflammatory effect. Furthermore, MD has been shown to down-regulate cellular and humoral immunological pathways related to disease activity and progression. Mena M. et al. presented evidence that MD inhibits the recruitment and adhesion of PBMCs to the endothelium, thus exerting a molecular anti-inflammatory action.


Role of Mediterranean Diet Components on Inflammatory Response


Trace Elements and Minerals Contribution


Adherence to the Mediterranean diet has been associated directly with dietary intake of trace elements (such as Fe, Cu, Zn, Mo, Na, K, Ca, Mg) and factors that affect mineral absorption. Interestingly, low serum micronutrient levels have been observed in patients with Major Depressive Disorder, opening the door to further research on the potential benefits of the MD in addressing various disease states.


Salt Intake


The high salt content in the Western diet has been linked to hyperosmotic stress and inflammatory responses. Osmotic stress can trigger the release of proinflammatory cytokines. At the same time, over-salting has been shown to disrupt macrophage activation, weaken tissue inflammation processes, and interfere with Treg (regulatory T cell) function. In contrast, higher adherence to the MD, with its lower salt intake, has been associated with a reduced risk of hypertension.


The Olive Oil Treasure


Olive oil is the cornerstone of the Mediterranean diet and contains a minor constituent called oleocanthal, which boasts potent anti-inflammatory properties. Experimental studies in mice have shown that olive oil consumption can attenuate adipose tissue hypertrophy, reduce inflammation, and exert anti-atherosclerotic effects. Oleocanthal's anti-inflammatory actions extend to its influence on neutrophil activity, suppressing the expression of certain surface markers and inhibiting the release of specific inflammatory mediators.


Polyphenols and Neutrophil Activity


Polyphenols, including oleacein, play a role in preventing cardiovascular diseases. Neutrophil activity, a critical factor in acute myocardial infarction, can be affected by oleacein concentrations, inhibiting various neutrophil functions. Additionally, polyphenols such as lycopene found in tomatoes, watermelon, and guava have been associated with reduced oxidative stress, making them valuable in the context of the MD.


Lycopene's Value


Lycopene, a carotenoid found in various fruits and vegetables, has demonstrated its anti-inflammatory and protective properties. It has been linked to reduced disease activity, pain, and stiffness in patients with inflammatory arthritis. Lycopene's antioxidant properties can alleviate oxidative stress and suppress inflammation, potentially reducing mortality in individuals with systemic lupus erythematosus (SLE). Furthermore, lycopene has shown promise in mitigating the effects of contrast-induced nephropathy (CIN), acting as an anti-inflammatory, anti-autophagic, and anti-apoptotic agent.


The beneficial impact of lycopene extends to chronic diseases such as age-related macular degeneration (AMD), obesity, chronic obstructive pulmonary disease (COPD), osteoporosis, neuropathic pain, and colorectal cancer. Its antioxidative properties protect against oxidative damage to mitochondrial enzymes and prevent apoptosis. In the context of AMD, lycopene inhibits inflammatory responses, and in obesity, it modulates immune-mediated inflammatory responses. Altogether, lycopene represents a potent ally in the fight against various chronic diseases.


Concluding Remarks


The Mediterranean diet continues to be a beacon of health and well-being in nutrition. Its time-tested principles, rooted in ancient traditions, have evolved into a robust dietary pattern supported by extensive scientific research. The anti-inflammatory effects of the Mediterranean diet, influenced by its various components, offer substantial protection against chronic diseases, emphasizing the importance of food quality over quantity.


As our understanding of the diet's intricate mechanisms deepens, we find new avenues for health promotion and disease prevention. Emerging research underscores the role of trace elements, olive oil, polyphenols, and lycopene in modulating inflammation and its associated diseases. These findings present opportunities for personalized nutrition and dietary interventions tailored to individuals at risk for chronic diseases.


Despite the remarkable progress in understanding the Mediterranean diet's health benefits, ongoing research is essential to unlocking its full potential. Further investigations should explore the diet's impact on diverse populations, consider the influence of genetics, and delve into the microbiome's role in mediating its effects. The Mediterranean diet is a timeless ally in the quest for better health and longevity, guiding us toward the ancient wisdom of healthful eating.


References


https://pubmed.ncbi.nlm.nih.gov/32650619/


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Please note that this is a general structure for a comprehensive review article. Depending on the specific requirements and guidelines of the journal you plan to submit to, you may need to make adjustments and follow their formatting guidelines. Additionally, you should include specific academic references to support the information presented in the article.

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