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The Mediterranean diet pyramid: simple graphic format of the most up-to-date international scientific evidence supporting the health benefits and culinary pleasures of the healthy, traditional Mediterranean eating and drinking pattern. All plant foods (fruits, vegetables, grains, nuts, legumes, seeds, olives and olive oil) are placed in a single group at the base of the pyramid, indicating that they should be the basis of most meals. The frequency of consuming fish and shellfish is at least two times per week, poultry should be consumed in low-to-moderate amounts; relatively low consumption of red meat and moderate consumption of wine, normally with meals is suitable. (With permission from Oldways Preservation Trust).
Source publication
The present paper reviews the main aspects of the health properties of Mediterranean food pattern and its components with particular regard to rheumatoid arthritis. The Mediterranean diet is based on a pattern of eating closely tied to the Mediterranean region and is characterized by an abundance of foods from plant sources, limited meat consumptio...
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Citations
... In that study, only recommendations were given, and the diets differed under all aspects. However, there is limited but univocal evidence to suggest that the Mediterranean diet is beneficial in the prevention and treatment of pathological conditions, including RA [5,18,50]. The protective effect of the Mediterranean diet on RA disease activity may be due to changes in the gut microbiota of the patients as shown in the study Prevention with Mediterranean Diet-(PREDIMED): [51]. ...
Introduction:
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease affecting the synovial joints and causing severe disability. Environmental and lifestyle factors, including diet, have been proposed to play a role in the onset and severity of RA. Dietary manipulation may help to manage the symptoms of RA by lowering inflammation and potentially decreasing pain.
Methods:
In 40 patients with long-standing RA with stable symptoms and treated with conventional (c-) and biological (b-) disease modifying anti-rheumatic drugs (DMARDs), the effect of a 3-month diet avoiding meat, gluten, and lactose (and all dairy products; privative diet) was evaluated in comparison with a control balanced diet including those foods. Both diets were designed to reduce weight since all patients were overweight or obese. Patients were randomly assigned to one of the diets, and RA was clinically assessed at Time 0 (T0), through the Visual Analogue Scale (VAS), for pain, and the Disease Activity Score of 28 joints (DAS 28) for RA activity. Patients were also administered the Short Form Health survey (SF-36) and the Health Assessment Questionnaire (HAQ). At T0, a blood sample was collected for laboratory tests and adipokines measurements, and anthropometric measurements were compared. These evaluations were repeated at the end of the 3 months' dietary regimens.
Results:
A significant decrease in VAS and the improvement of the overall state of physical and mental health, assessed through SF-36, was observed in patients assigned to the privative diet. Both dietary regimens resulted in the improvement of quality of life compared to baseline values; however, the change was significant only for the privative diet. With either diet, patients showed significant decreases in body weight and body mass index, with a reduction in waist and hips circumference and lower basal glucose and circulating leptin levels. A privative diet was also able to significantly reduce systolic (p = 0.003) and diastolic (p = 0.025) arterial pressure. The number of circulating leukocytes and neutrophils, and the level of hs-C-Reactive Protein also decreased after 3 months of the meat-, lactose-, and gluten-free diet.
Conclusions:
Our results suggest that a privative diet can result in a better control of inflammation in RA patients under stable optimized drug treatment.
... It is hypothesised that changes in environmental and lifestyle factors [4], one of which is diet, may contribute to the expression and severity of RA [5]. As such, dietary manipulation is commonly used to manage and minimise the symptoms of RA [6] through several mechanisms, such as lowering inflammation, increasing antioxidant levels, altering lipid profiles in favour of lipids 1 3 that provide anti-inflammatory benefits, as well as potentially modifying the intestinal flora [5][6][7]. ...
... The scientific and general interest in MD has grown dramatically in recent years as a healthy and recommended dietary pattern for the prevention and treatment of a range of health conditions including primary and secondary prevention of cardiovascular disease (CVD) [11,12], type 2 diabetes mellitus [13,14], dementia [15] and various types of cancer [16][17][18]. While there is evidence to recommend MD as a beneficial dietary regime for conditions associated with inflammation, e.g., the prevention of CVD [19], to date, there is limited evidence to suggest that the MD is beneficial in the prevention and treatment of other conditions, including RA [5,7]. Several reviews have aimed to evaluate the effectiveness of a range of different dietary interventions, including vegetarian or vegan, MD, elimination, fasting and elemental diets, for the treatment of RA, and management of its side effects, including fatigue [6,[20][21][22][23], however, the results remain largely inconclusive and there is lack of systematic reviews analysing the role of the MD in both the aetiology and the management of pain and stiffness in RA. ...
Rheumatoid arthritis is a progressive autoimmune disease characterised by severely swollen and painful joints. To compliment pharmacotherapy, people living with rheumatoid arthritis often turn to dietary interventions such as the Mediterranean diet. The aim of the present systematic review is to discuss the effects of the Mediterranean diet on the management and prevention of rheumatoid arthritis in human prospective studies. Four studies met the inclusion criteria, including two intervention studies reporting improvement in the pain visual analogue scale (p < 0.05) and a decrease in the health assessment questionnaire for rheumatoid arthritis score (p < 0.05) in the Mediterranean diet groups. Only one study reported a reduction in the 28 joint count disease activity score for rheumatoid arthritis for the Mediterranean diet group (p < 0.05). This review has identified beneficial effects of the Mediterranean diet in reducing pain and increasing physical function in people living with rheumatoid arthritis. However, there is currently insufficient evidence to support widespread recommendation of the Mediterranean diet for prevention of rheumatoid arthritis.
... Olive oil's beneficial effects has been attributed to its highly present antioxidant phenolic compounds, vitamin E and high concentration in monounsaturated fatty acids (Musumeci et al., 2013b). Recently, various phenolic compounds extracted from EVOO and olive leaves have attracted much attention due to their antioxidant and antiinflammatory properties (Oliviero et al., 2009). Moreover, in our previous study, we investigated a possible preventive treatment for OA, given by the combination of Mediterranean diet, based on consumption of EVOO, and mild physical activity. ...
... Phenolic compounds in EVOO have been shown to exert beneficial impact, as they may interact with the inflammatory cascade (Rosillo et al., 2014) and have an anti-inflammatory effect with reductions in joint edema and migration of inflammatory cells. This interaction is primarily related to their ability to scavenge free radicals (Oliviero et al., 2009;Rosignoli et al., 2013). On the other hand, other reports on the biological properties of olive oil constituents (Visioli and Bernardini, 2011;Rosignoli et al., 2013) suggest that the anti-inflammatory effects of phenolic olive oil extracts are likely dependent on the mixture of the different phenolic compounds considering the different synergic links that could exist between these compounds. ...
Osteoarthritis (OA) is a common joint disease with important socio-economic impact. Looking for a novel natural treatment represents an important challenge and a public health objective. A wide range of previous studies highlighted the antioxidant and anti-inflammatory properties especially of phenolic compounds present in olive oil. Therefore, the aim of this study was to investigate the anti-inflammatory activity of Tunisian Extra Virgin Olive Oil (EVOO) extracts in an in vitro OA model. To this aim we evaluated the polar and apolar olive oil fractions and olive leaf extract. The antioxidant capacity of these extracts was determined by using DPPH and FRAP assays. For the in vitro study, the human OA chondrocytes were exposed to lipopolysaccharide (LPS) to induce inflammatory response. The inducible isoform of nitric oxide syntheses (iNOS) and collagen type II expressions were evaluated by immunocytochemistry and western blot analysis. Principal outcome showed that the extracts had important anti-inflammatory potential by decreasing iNOS synthesis in OA chondrocytes. The anti-inflammatory effect was dependent on the extract composition and the used dose. An insignificant effect was seen on collagen type II expression. These results show that nutritional components contained in Tunisian EVOO influence the cellular metabolism, suggesting their potential therapeutic use in patients with inflammatory joint diseases.
... In particular, an interesting discussion has arisen among the scientific community about the origin of the positive effects of the so-called Mediterranean diet on the individual well-being, since its first announcement in the Seven Country Study in 1970 [1]. During this period, a number of papers has been published attempting to establish a rational link between the habit of a Mediterranean diet and the reduction of some degenerative diseases, such as cardiovascular and metabolic diseases, Alzheimer's, cancer and inflammatory disorders, as well as a life span expectation [2][3][4][5][6][7][8][9][10][11][12]. The traditional Mediterranean diet is based on the intake of vegetables, fish, fruits, grains and extra-virgin olive oil (EVOO) as main lipid supplies. ...
This review is a brief but comprehensive overview on the multi-target profile of oleocanthal, an extra-virgin olive oil (EVOO) phenol corresponding to the (-)-decarboxymethylligstroside aglycone, speculating about its potential in the prevention and/or treatment of various diseases, such as neurodegeneration, inflammation and cancer.
... Specific components of the MDP have received increasing attention because of a variety of health-promoting properties in chronic inflammatory and degenerative diseases [41]. Both nutritive (fat) and non-nutritive (nonfat) components of the MDP have been shown to exert important anti-inflammatory activities both in vitro and in vivo by modulating the arachidonic acid cascade, the expression of some proinflammatory genes, and the activity of immune cells [1]. ...
Arthritis encompasses a heterogeneous group of diseases characterised by inflammation that leads not only to joint damage, bone erosion, severe pain and disability, but also affects other organs of the body, resulting in increased morbidity and mortality. Although the mechanisms underlying the pathogenesis of joint diseases are for the most part unknown, a number of nutrient and non-nutrient components of food have been shown to affect the inflammatory process and, in particular, to influence clinical disease progression. The Mediterranean diet model has already been linked to a number of beneficial health effects: both fat and non-fat components of the Mediterranean dietary pattern have been shown to exert important anti-inflammatory activities by affecting the arachidonic acid cascade, the expression of some proinflammatory genes, and the activity of immune cells. N-3 polyunsaturated fatty acids, in particular, have been shown to affect lymphocyte and monocyte functions, crucially involved in adaptive and innate immunity. Although some aspects concerning the mechanisms of action through which the Mediterranean diet pattern exerts its beneficial effects remain to be elucidated, arthritis patients may potentially benefit from it in view of their increased cardiovascular risk and the treatment they require which may have side effects.
Ten years ago the Mediterranean diet was inscribed into the United Nations Educational, Scientific and Cultural Organization (UNESCO) Representative List of Intangible Cultural Heritage of Humanity. This official recognition of the Mediterranean diet as intangible cultural heritage, and awareness of its significance, has provided us with a measure with which to monitor our path in the field. Indeed, the last ten years has seen several undertakings with varying implications in the years to come. Emphasis on safeguarding the intangible heritage of the Mediterranean diet and activities to avoid possible erosions which may affect it at a national, regional and local level have taken centre stage. Preserving our heritage also recognized the importance of further research and we ask what needs to be focused on over the next ten years. Gradually, several myths and misconceptions associated with the traditional Mediterranean diet have emerged and should be clearly addressed and dispelled, particularly those that label as "Mediterranean" an eating pattern that is not in line with the traditional diet. Going beyond physical health benefits, the Mediterranean diet naturally infuses any reference to 'Sustainability' by pure definition as ideally, sustainable diets are protective and respectful of biodiversity, culturally acceptable, accessible, economically affordable, nutritionally adequate, and safe and healthy. As our ‘Regional’ Mediterranean diet becomes the base for a global reference diet with all the acknowledged benefits, we agree that ‘humanity as a whole’ will benefit from its preservation and scientific-based evidence. A true ‘intangible cultural heritage of humanity’.
Romatoid artrit eklemlerde ilerleyici yıkıma neden olan, kronik seyirli inflamatuvar otoimmün bir hastalıktır. Yaşam kalitesini ciddi şekilde etkileyen bu hastalık, en sık 40-50’li yaşlarda başlamakta ve kadınlarda erkeklere göre daha sık görülmektedir. Romatoid artritli hastalarda inflamasyonu azaltmak, antioksidan kapasiteyi artırmak ve lipit profilini iyileştirmek amacıyla beslenme tedavisine yönelik farklı yaklaşımlar incelenmektedir. Romatoid artrit hastalarının tıbbi beslenme tedavisinde ele alınan diyet modelleri arasında Akdeniz diyeti, anti-inflamatuvar diyet ve glutensiz diyet bulunmaktadır. Akdeniz diyetinin inflamatuvar belirteçlerde, hastalık aktivitesinde ve kardiyovasküler risk faktörlerinde azalmaya neden olabileceği belirtilmiştir. Genel olarak Akdeniz diyetine benzer özellikler taşıyan anti-inflamatuvar diyetin romatoid artrit üzerine olumlu etkileri olabileceği öne sürülmüş olmakla birlikte, hastalık aktivitesini azaltmaya yönelik yeterli kanıt bulunmamaktadır. Çölyak hastalarının tıbbi beslenme tedavisinde kullanılan glutensiz diyetin, romatoid artrit hastalarında da kullanılabileceği düşünülmektedir. Bu derlemede; romatoid artritte beslenme tedavisine yönelik farklı yaklaşımların hastalık aktivitesi üzerine etkisinin belirlenmesi amaçlanmıştır.
This chapter reviews the main aspects of the health properties of the Mediterranean diet in arthritis. Arthritis encompasses a wide spectrum of conditions affecting the bones, muscles, and joints. Although with different expressions, they share common inflammatory pathways, severe pain, and disability. An increased mortality is associated with arthritis when damage to extra-articular organs of the body is involved.
The Mediterranean food pattern has shown a number of beneficial and healthy effects in arthritis, in particular, with regard to inflammation and clinical disease progression. Most of these effects are related to the consumption of extra-virgin olive oil that, with its high content of monounsaturated fatty acids and nonfat bioactive components such as phenolic compounds, has demonstrated important antiinflammatory effects both in vitro and in vivo. Furthermore, growing evidences indicate an important role for Mediterranean diet components in affecting gut microbiota composition and its relation to chronic inflammatory and autoimmune processes. Although large-scale trials are warranted to enhance our knowledge on the possible benefits of dietary interventions in arthritis, the antiinflammatory Mediterranean diet pattern should be considered a valuable support to pharmacological treatment in arthritis.
Arthritis is an umbrella term for about a hundred rheumatic diseases and conditions affecting the musculoskeletal system. Arthritis causes not only inflammation and damage to joints, with subsequent bone erosion, severe pain, and disability, but can also cause damage to other organs of the body, leading to increased mortality.Although the mechanisms underlying the pathogenesis of joint diseases are for the most part unknown, a number of nutrient and non-nutrient dietary components have been shown to affect the inflammatory process and, in particular, to influence clinical disease progression. This chapter will focus on the benefit of the Mediterranean diet (MD) on arthritis patients. The antinflammatory MD pattern should be considered a valuable support to pharmacological treatment in arthritis. New, large-scale trials are warranted to confirm precedent findings and to enhance our knowledge of the possible benefits of dietary interventions in arthritis.
Diet-derived natural ligands of the peroxisome proliferator-activated receptor (PPAR) family of nuclear receptors have been widely reported to activate PPAR signaling, modifying gene and protein expressions in a variety of cells and tissues. Examples of such dietary factors include unsaturated fatty acids, spices, soy protein, and polyphenols. Recent data suggest that these nutrients may affect inflammation and immunity in arthritic diseases. This review describes these nutrients and their potential modulating effects on the pathophysiology of inflammatory and degenerative arthritis through PPAR signaling.
