Health benefits induced by adherence to the Mediterranean lifestyle components diet and physical activity

  • Cécil J. W. Meulenberg Science and Research Centre of Koper, Institute for Kinesiology Research
Keywords: lifestyle, Mediterranean diet, physical activity, health benefit, interactions

Abstract

The purpose of this overview is to present the evidence that adherence to Mediterranean lifestyle components is beneficial for functional and cognitive health. Although Mediterranean diet is the principal component of this lifestyle, other components, like physical activity and socializing, form complex interactions and together they complete into the Mediterranean lifestyle. Individual components and their interactions have not been studied thoroughly, however, there is an increasing attention for these matters through scientific literature in original research, reviews and meta-analysis. This paper considers the recent knowledge and trends related to defining the indicators concerning these lifestyle components, as well as summarizes the health benefits induced by adherence to them and explains why Mediterranean lifestyle components are important for health.

References

Akbaraly, T., Sexton, C., Zsoldos, E., Mahmood, A., Filippini, N., Kerleau, C., ... Kivimaki, M. (2018). Association of long-term eiet quality with hippocampal volume: Longitudinal cohort study. American Journal of Medicine, 131(11), 1372-1381. https://doi.org/10.1016/j.amjmed.2018.07.001

Alvarez-Alvarez, I., Zazpe, I., Pérez de Rojas, J., Bes-Rastrollo, M., Ruiz-Canela, M., Fernandez-Montero, A., ... Martínez-González, M. A. (2018a). Mediterranean diet, physical activity and their combined effect on all-cause mortality: The Seguimiento Universidad de Navarra (SUN) cohort. Preventive medicine, 106, 45-52. https://doi.org/10.1016/j.ypmed.2017.09.021

Alvarez-Alvarez, I., Pérez de Rojas, J., Fernandez-Montero, A., Zazpe, I., Ruiz-Canela, M., Hidalgo-Santamaría, M., ... Martínez-González, M. A. (2018b). Strong inverse associations of Mediterranean diet, physical activity and their combination with cardiovascular disease: The Seguimiento Universidad de Navarra (SUN) cohort. European journal of preventive cardiology, 25(11), 1186-1197. https://doi.org/10.1177/2047487318783263

Bach, A., Serra-Majem, L., Carrasco, J. L., Roman, B., Ngo, J., Bertomeu, I., & Obrador, B. (2006). The use of indexes evaluating the adherence to the Mediterranean diet in epidemiological studies: a review. Public health nutrition, 9(1A), 132-146. https://doi.org/10.1079/PHN2005936

Bach-Faig, A., Berry, E. M., Lairon, D., Reguant, J., Trichopoulou, A., Dernini, S., et al. (2011). Mediterranean diet pyramid today. science and cultural updates. Public health nutrition, 14(12A), 2274-2284. https://doi.org/10.1017/S1368980011002515

Behrens, G., Fischer, B., Kohler, S., Park, Y., Hollenbeck, A. R., & Leitzman, M. F. (2013). Healthy lifestyle behaviors and decreased risk of mortality in a large prospective study of U.S. women and men. European journal of epidemiology, 28(5), 361-372. https://doi.org/10.1007/s10654-013-9796-9

Bonaccio, M., Di Castelnuovo, A., Costanzo, S., Gialluisi, A., Persichillo, M., Cerletti, C., ... Iacoviello, L. (2018). Mediterranean diet and mortality in the elderly: a prospective cohort study and a meta-analysis. British journal nutrition, 120(8), 841-854. https://doi.org/10.1017/S0007114518002179

Bredensen, D. (2017). The end of Alzheimer's: The first program to prevent and reverse cognitive decline. New York: Avery.

Calder, P. C., Carding, S. R., Christopher, G., Kuh, D., Langley-Evans, S. C., & McNulty, H. (2018). A holistic approach to healthy ageing: how can people live longer, healthier lives? Journal of human nutrition and dietetics. 31(4), 439-450. https://doi.org/10.1111/jhn.12566

Clare, L., Wu, Y. T., Teale, J. C., MacLeod, C., Matthews, F., Brayne, C., & Woods, B. (2017). Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: a cross-sectional study. PloS medicine, 14(3), e1002259. https://doi.org/10.1371/journal.pmed.1002259

Cornelissen, V. A., & Smart, N. A. (2013). Exercise training for blood pressure: A systematic review and meta-analysis. Journal of the American heart association, 2(1), e004473. https://doi.org/10.1161/JAHA.112.004473

Croll, P. H., Voortman, T., Ikram, M. A., Franco, O. H., Schoufour, J. D., Bos, D., & Vernooij, M. W. (2018). Better diet quality relates to larger brain tissue volumes: The Rotterdam study. Neurology, 90(24), e2166-e2173. https://doi.org/10.1212/WNL.0000000000005691

Cryan, J. F., & Dinan, T. G. (2012). Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nature reviews neuroscience, 13(10), 701-712. https://doi.org/10.1038/nrn3346

Dash, S., Clarke, G., Berk, M., & Jacka, F. N. (2015). The gut microbiome and diet in psychiatry: focus on depression. Current opinion in psychiatry, 28(1), 1-6. https://doi.org/10.1097/YCO.0000000000000117

Davis, C., Bryan, J., Hodgson, J., & Murphy, K. (2015). Definition of the Mediterranean diet: A literature review. Nutrients, 7(11), 9139-9153. https://doi.org/10.3390/nu7115459

de Lorgeril, M., & Salen, P. (2006). The Mediterranean diet in secondary prevention of coronary heart disease. Clinical investigative medicine, 29(3), 154-158.

de Lorgeril, M., & Salen, P. (2011). The Mediterranean diet in secondary prevention of CHD. Public health nutrition, 14(12A), 2333-2337. https://doi.org/10.1017/S136898001100259X

Dernini, S., Berry, E. M., Serra-Majem, L., La Vecchia, C., Capone, R., Medina, F. X., ... Trichopoulou, A. (2017). Med Diet 4.0: the Mediterranean diet with four sustainable benefits. Public health nutrition, 20(7), 1322-1330. https://doi.org/10.1017/S1368980016003177

Droste, D. W., Iliescu, C., Vaillant, M., Gantenbein, M., De Bremaeker, N., Lieunard, C., ... Chioti, A. (2013). A daily glass of red wine associated with lifestyle changes independently improves blood lipids in patients with carotid arteriosclerosis: Results from a randomized controlled trial. Nutrition journal, 12(1), 147. https://doi.org/10.1186/1475-2891-12-147

Dunn, S. L., Siu, W., Freund, J., & Boutcher, S. H. (2014). The effect of a lifestyle intervention on metabolic health in young women. Diabetes, metabolic syndrome and obesity, 7, 437-444. https://doi.org/10.2147/DMSO.S67845

Esposito, K., Kastorini, C. M., Panagiotakos, D. B., & Giugliano, D. (2011). Mediterranean diet and weight loss: Meta-analysis of randomized controlled trials. Metabolic syndrome related disorders, 9(1), 1-12. https://doi.org/10.1089/met.2010.0031

Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., ... Martínez-González, M. A. (2018). Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. New England journal of medicine, 378(25), e34. https://doi.org/10.1056/NEJMoa1800389

Féart, C., Samieri, C., Rondeau, V., Amieva, H., Portet, F., Dartigues, J. F., ... Barberger-Gateau, P. (2009). Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA, 302(6), 638-648. https://doi.org/10.1001/jama.2009.1146

Garcia, M., Bihuniak, J. D., Shook, J., Kenny, A., Kerstetter, J., & Huedo-Medina, T. B. (2016). The effect of the traditional Mediterranean-style diet on metabolic risk factors: A meta-analysis. Nutrients, 8(3), 168. https://doi.org/10.3390/nu8030168

Gardener, S. L., Rainey-Smith, S. R., Barnes, M. B., Sohrabi, H. R., Weinborn, M., Lim, Y. Y., ... Martins, R. N. (2015). Dietary patterns and cognitive decline in an Australian study of ageing. Molecular psychiatry, 20(7), 860-866. https://doi.org/10.1038/mp.2014.79

Giacosa, A., Barale, R., Bavaresco, L., Gatenby, P., Gerbi, V., Janssens, J., ... Rondanelli, M. (2013). Cancer prevention in Europe: the Mediterranean diet as a protective choice. European journal of cancer prevention, 22(1), 90-95. https://doi.org/10.1097/CEJ.0b013e328354d2d7

Ibarrola-Jurado, N., Bulló, M., Guasch-Ferré, M., Ros, E., Martínez-González, M. A., Corella, D., ... Salas-Salvadó, J. (2013). Cross-sectional assessment of nut consumption and obesity, metabolic syndrome and other cardiometabolic risk factors: the PREDIMED study. PloS One, 8(2), e57367. https://doi.org/10.1371/journal.pone.0057367

Jacka, F. N., O'Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., ... Berk, M. (2017). A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC medicine, 15(23), 1-13. https://doi.org/10.1186/s12916-017-0791-y

Johnson, K. V., & Foster K. R. (2018). Why does the microbiome affect behaviour? Nature reviews microbiology, 16(10), 647-655. https://doi.org/10.1038/s41579-018-0014-3

Kastorini, C. M., Milionis, H. J., Esposito, K., Giugliano, D., Goudevenos, J. A., & Panagiotakos, D. B. (2011). The effect of Mediterranean diet on metabolic syndrome and its components: A meta-analysis of 50 studies and 534,906 individuals. Journal of the American college of cardiology, 57(11), 1299-1313. https://doi.org/10.1016/j.jacc.2010.09.073

Katz, D. L., & Meller, S. (2014). Can we say what diet is best for health? Annual review of public health, 35, 83-103. https://doi.org/10.1146/annurev-publhealth-032013-182351

Kelly, J. R., Minuto, C., Cryan, J. F., Clarke, G., & Dinan, T. D. (2017). Cross-talk: The microbiota and neurodevelopmental disorders. Frontiers in neuroscience, 11, 490. https://doi.org/10.3389/fnins.2017.00490

Keys, A., Fidanza, F., Karvonen, M. J., Kimura, N., & Taylor, H. L. (1972). Indices of relative weight and obesity. Journal of chronic diseases, 25(6-7), 329-343. https://doi.org/10.1016/0021-9681(72)90027-6

Keys, A., Mienotti, A., Karvonen, M. J., Aravanis, C., Blackburn, H., Buzina, R., ... Toshima, H. (1986). The diet and 15 year death rate in the Seven Countries Study. American journal of epidemiology, 124(6), 903-915. https://doi.org/10.1093/oxfordjournals.aje.a114480

Killinger, B. A., Madaj, Z., Sikora, J. W., Rey, N., Haas, A. J., Vepa, Y., ... Labrie, V. (2018). The vermiform appendix impacts the risk of developing Parkinson’s disease. Science translational medicine, 10(465), eaar5280. https://doi.org/10.1126/scitranslmed.aar5280

Kivipelto, M., Mangialasche, F., & Ngandu, T. (2018). Lifestyle interventions to prevent cognitive impairment, dementia and Alzheimer disease. Nature reviews neurology, 14(11), 653-666. https://doi.org/10.1038/s41582-018-0070-3

Kodama, S., Tanaka, S., Saito, K., Shu, M., Sone, Y., Onitake, F., ... Sone, H. (2007). Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: A meta-analysis. Archives of internal medicine, 167(10), 999-1008. https://doi.org/10.1001/archinte.167.10.999

Lassale, C., Batty, G. D., Baghdadli, A., Jacka, F., Sánchez-Villegas, A., Kivimäki, M., & Akbaraly, T. (2018). Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular psychiatry. https://doi.org/10.1038/s41380-018-0237-8.

Lin, X., Zhang, X., Guo, J., Roberts, C. K., McKenzie, S., Wu, W. C., ... Song, Y. (2015). Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Journal of the American heart association., 4(7), e002014. https://doi.org/10.1161/JAHA.115.002014

Luciano, M., Corley, J., Cox, S. R., Valdés Hernández, M. C., Craig, L. C., Dickie, D. A., ... Deary, I. J. (2017). Mediterranean-type diet and brain structural change from 73 to 76 years in a Scottish cohort. Neurology, 88(5), 449-455. https://doi.org/10.1212/WNL.0000000000003559

Malakou, E., Linardakis, M., Armstrong, M.E.G., Zannidi, D., Foster, C., Johnson, L., & Papadaki, A. (2018). The combined effect of promoting the Mediterranean diet and physical activity on metabolic risk factors in adults: a systematic review and meta-analysis of randomised controlled trials. Nutrients, 10(11), E1577. https://doi.org/10.3390/nu10111577

Martin, A., Booth, J. N., Laird, .Y, Sproule, J., Reilly, J. J., & Saunders, D. H. (2018). Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD009728. https://doi.org/10.1002/14651858.CD009728.pub4

Martinez-Lacoba, R., Pardo-Garcia, I., Amo-Saus, E., & Escribano-Sotos, F. (2018). Mediterranean diet and health outcomes: a systematic meta-review. European journal of public health, 28(5), 955-961. https://doi.org/10.1093/eurpub/cky113

Martínez-Lapiscina, E. H., Clavero, P., Toledo, E., Estruch, R., Salas-Salvadó, J., San Julián, B., ... Martinez-Gonzalez, M. A. (2013). Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial. Journal of neurolology, neurosurgery and psychiatry, 84(12), 1318-1325. https://doi.org/10.1136/jnnp-2012-304792

Nordmann, A. J., Suter-Zimmermann, K., Bucher, H. C., Shai, I., Tuttle, K. R., Estruch, R., & Briel, M. (2011). Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. American Journal of Medicine, 124(9), 841-851. https://doi.org/10.1016/j.amjmed.2011.04.024

Papamichael, M. M., Itsiopoulos, C., Susanto, N. H., & Erbas, B. (2017). Does adherence to the Mediterranean dietary pattern reduce asthma symptoms in children? A systematic review of observational studies. Public health Nutrition, 20(15), 2722-2734. https://doi.org/10.1017/S1368980017001823

Papamichael, M. M., Katsardis, C., Lambert, K., Tsoukalas, D., Koutsilieris, M., Erbas, B., & Itsiopoulos, C. (2019). Efficacy of a Mediterranean diet supplemented with fatty fish in ameliorating inflammation in paediatric asthma: a randomised controlled trial. Journal of human nutrition and dietetics. 32(2), 185-197. https://doi.org/10.1111/jhn.12609

Polidori, M. C., Nelles, G., & Pientka, l. (2010). Prevention of dementia: Focus on lifestyle. International Journal of Alzheimers's Disease, 2010, 393579. https://doi.org/10.4061/2010/393579

Roberts, R. C., Farmer, C. B., & Walker, C. K. (2018). The human brain microbiome; there are bacteria in our brains! Neuroscience Meeting, San Diego, California, U.S.A., Society for Neuroscience, Program No. 594.08. Retrieved from https://www.sfn.org/-/media/SfN/Documents/NEW-SfN/Meetings/Neuroscience-2018/Sessions-and-Events/Program/Book-5_Tuesday.pdf?la=en&hash=C990B451CBAA8D44617A37A35C23CCC3DFB65C85

Ryan, M. C., Itsiopoulos, C., Thodis, T., Ward, G., Trost, N., Hofferberth, S., ... Wilson, A. M. (2013). The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. Journal of Hepatology, 59(1), 138-143. https://doi.org/10.1016/j.jhep.2013.02.012

Sampson, L. (1985). Food frequency questionnaires as a research instrument. Clinical Nutrition 4(3), 171-178.

Sarris, J., Logan, A. C., Akbaraly, T. N., Amminger, G. P., Balanzá-Martínez, V., Freeman, M. P., ... Jacka, F. N. (2015). Nutritional medicine as mainstream in psychiatry. The Lancet psychiatry, 2(3), 271-274. https://doi.org/10.1016/S2215-0366(14)00051-0

Scarmeas, N., Stern, Y., Tang, M. X., Mayeux, R., & Luchsinger, J. A. (2006). Mediterranean diet and risk for Alzheimer’s disease. Annals of Neurology, 59(6), 912-921. https://doi.org/10.1002/ana.20854

Schreiber, S., Vogel, J., Schwimmer, H. D., Marks, S. M., Schreiber, F., & Jagust, W. (2016). Impact of lifestyle dimensions on brain pathology and cognition. Neurobiology of aging, 40, 164-172. https://doi.org/10.1016/j.neurobiolaging.2016.01.012

Serra-Majem, L., Roman, B., & Estruch, R. (2006). Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutrition Reviews, 64(Suppl. 1), S27-S47. https://doi.org/10.1111/j.1753-4887.2006.tb00232.x

Sexton, P., Black, P., Metcalf, P., Wall, C. R., Ley, S., Wu, L., ... Kolbe, J. (2013). Influence of Mediterranean diet on asthma symptoms, lung function, and systemic inflammation: a randomized controlled trial. Journal of asthma, 50(1), 75-81. https://doi.org/10.3109/02770903.2012.740120

Sofi, F., Cesari, F., Abbate, R., Gensini, G. F., & Casini, A. (2008). Adherence to Mediterranean diet and health status: meta-analysis. BMJ, 337, a1344. https://doi.org/10.1136/bmj.a1344

Sofi, F., Abbate, R., Gensini, G. F., & Casini, A. (2010). Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. American journal of clinical nutrition, 92(5), 1189-1196. https://doi.org/10.3945/ajcn.2010.29673

Sofi, F., Macchi, C., Abbate, R., Gensini, G. F., & Casini, A. (2014). Mediterranean diet and health status: An updated meta-analysis and a proposal for a literature-based adherence score. Public health nutrition, 17(12), 2769-2782. https://doi.org/10.1017/S1368980013003169

Sotos-Prieto, M., Moreno-Franco, B., Ordovás, J. M., León, M., Casasnovas, J. A., & Peñalvo, J. L. (2015). Design and development of an instrument to measure overall lifestyle habits for epidemiological research: the Mediterranean lifestyle (MEDLIFE) index. Public health butition, 18(6), 959-967. https://doi.org/10.1017/S1368980014001360

Staubo, S. C., Aakre, J. A., Vemuri, P., Syrjanen, J. A., Mielke, M. M., Geda, Y. E., ... Roberts, R. O. (2017). Mediterranean diet, micronutrients and macronutrients, and MRI measures of cortical thickness. Alzheimer's & dementia, 13(2), 168-177. https://doi.org/10.1016/j.jalz.2016.06.2359

Strasser, B., Siebert, U., & Schobersberger, W. (2010). Resistance training in the treatment of the metabolic syndrome: A systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Sports medicine, 40(5), 397-415. https://doi.org/10.2165/11531380-000000000-00000

Thompson, F. E., & Byers, T. (1994). Dietary assessment resource manual. Journal of nutrition, 124(S11), 2245S-2317S.

Trichopoulou, A., Bamia, C., & Trichopoulos, D. (2009). Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ, 338: b2337. https://doi.org/10.1136/bmj.b2337

Trichopoulou, A., Martínez-González, M. A., Tong, T. Y., Forouhi, N. G., Khandelwal, S., Prabhakaran, D., ... de Lorgeril, M. (2014). Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC medicine, 12: 112. https://doi.org/10.1186/1741-7015-12-112

United Nations Educational, Scientific and Cultural Organization (2010). Inscription of Mediterranean diet on the Representative List of the Intangible Heritage of Humanity. Intergovernmental committee for the safeguarding of the intangible cultural heritage. Paris: UNESCO, Nomination file No. 00884.

van de Wouw, M., Boehme, M., Lyte, J.M., Wiley, N., Strain, C., O'Sullivan, O., ... Cryan, J. F. (2018). Short-chain fatty acids: microbial metabolites that alleviate stress-induced brain-gut axis alterations. Journal of physiology, 596(20), 4923-4944. https://doi.org/10.1113/JP276431

Yannakoulia, M., Kontogianni, M., & Scarmeas, N. (2015). Cognitive health and Mediterranean Diet: Just diet or lifestyle pattern? Ageing research reviews, 20, 74-78. https://doi.org/10.1016/j.arr.2014.10.003

Ye, X., Scott, T., Gao, X., Maras, J. E., Bakun, P. J., & Tucker, K. L. (2013). Mediterranean diet, healthy eating index 2005, and cognitive function in middle-aged and older Puerto Rican adults. Journal of the academy of nutrition and dietetics, 113(2), 276-281. https://doi.org/10.1016/j.jand.2012.10.014

Zamora-Ros, R., Serafini, M., Estruch, R., Lamuela-Raventós, R. M., Martínez-González, M. A., Salas-Salvadó, J., ... Andres-Lacueva, C. (2013). Mediterranean diet and non enzymatic antioxidant capacity in the PREDIMED study: Evidence for a mechanism of antioxidant tuning. Nutrition, metabolism, and cardiovascular diseases, 23(12), 1167-1174. https://doi.org/10.1016/j.numecd.2012.12.008

Zell, M., & Grundmann, O. (2012). An orthomolecular approach to the prevention and treatment of psychiatric disorders. Advances in mind-body medicine, 26(2), 14-28.

Zhao, C., Noble, J. M., Marder, K., Hartman, J. S., Gu, Y., & Scarmaes, N. (2018). Dietary patterns, physical activity, sleep, and risk for dementia and cognitive decline. Current nutrition reports, 7(4), 335-345. https://doi.org/10.1007/s13668-018-0247-9

Published
2019-05-22
How to Cite
Meulenberg, C. J. W. (2019). Health benefits induced by adherence to the Mediterranean lifestyle components diet and physical activity. Annales Kinesiologiae, 10(1), 15-30. https://doi.org/10.35469/ak.2019.175