The Mediterranean diet (MD) is considered the best dietary approach for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Recently, time-restricted feeding (TRF) has gained attention for its lifestyle compatibility and health benefits.

This study aimed to compare the effects of a hypocaloric MD with a 10-h TRF protocol to an unrestricted MD in MASLD patients with overweight/obesity and evaluate differences between early and late TRF.

This 12-week randomised controlled trial in MASLD patients with overweight/obesity consisted of three groups, all following a hypocaloric Mediterranean-type diet. The control group had no eating time restrictions. The early TRF (eTRF) and late TRF (lTRF) groups had a 10-h eating window, from 8 AM to 6 PM and from 12 PM to 10 PM, respectively. Various health parameters were measured. Compliance was tracked via food diaries, and an 8-week follow-up occurred post-intervention.

Fifty-nine MASLD individuals (27 males; 52.9 years; body mass index 32.1 kg/m2) completed the trial (control, n = 19; eTRF, n = 20; lTRF, n = 20). All groups showed significant 12-week reductions in body weight, anthropometry and blood pressure. Glycated haemoglobin A1c and insulin resistance, as measured by the Matsuda index, homeostatic model assessment for insulin resistance and fasting glucose-to-insulin ratio, improved in the eTRF group at 12 weeks.

This study corroborates the efficacy of MD in ameliorating cardiometabolic risk factors such as body weight and blood pressure in MASLD patients. The combination with an eTRF protocol may improve glycaemic control (NCT05866744).

The study is registered at clinicaltrials.gov (NCT05866744).

Cancer burden can be reduced by controlling modifiable risk factors, including diet. We provided an evidence-based assessment of cancer cases and deaths attributable to diet in Italy in 2020. We considered dietary factor-cancer type pairs for which the World Cancer Research Fund/American Institute for Cancer Research - Continuous Update Project reported either 'convincing' or 'probable' evidence of causal association. Relative risks were retrieved from recent meta-analyses and dietary intakes (around 2005) from a national food consumption survey. Sex-specific population attributable fractions (PAFs) were computed by comparing the distribution of dietary intakes in the Italian population against counterfactual scenarios based on dietary recommendations. Using data from national cancer and mortality registries in 2020, we estimated the number of attributable cancer cases and deaths, assuming ~15-year lag period. Unhealthy diet accounted for 6.3% (95% CI: 2.5%-9.9%) of all cancer cases in men and 4.5% (95% CI: 1.7%-7.4%) in women. PAFs of colorectal cancer were 10.5% and 7.0% for any intake of processed meat, 3.3% and 2.0% for high red meat, 4.8% and 4.3% for low dairy products, and 7.9% and 9.0% for low fiber intakes in men and women, respectively. PAFs for low intake of non-starchy vegetables and fruit ranged from 0.8% to 16.5% in men and 0.6%-17.8% in women for cancers of the aerodigestive tract. The estimated cancer burden associated with unfavorable dietary habits in Italy is considerable, but appears lower than for other high-income countries, reflecting the typically Mediterranean diet.

Knowledge gap theory posits that individuals with better education have better opportunities to obtain, understand and utilise available information. In a health-related context, this insight could lead to a more effective disease prevention. The aim of our study was to test the hypothesis that knowledge gap underlies differences in behaviour aimed at maintaining brain health.

We conducted an online survey investigating Slovenian public view on brain, brain research, and science-based recommendations for brain health. The survey was filled out by a total of 2,568 respondents, of whom 2,450 completed it in full. They were divided into two subgroups based on their self-reported brain-related education, i.e., the lay subgroup (n = 1,012) and a topically educated group (n = 1,438), i.e., the educated subgroup. Among the latter, 728 participants reported to have a Bachelor's degree or higher education. We analysed the views of this sample subgroup on brain, neuroscience, and science-based brain health recommendations, and compared them with age- and education-matched lay subgroup (n = 565) from the same survey.

Educated individuals showed greater awareness and adherence to science-based recommendations compared to the lay respondents, specifically in the perceived importance of following a healthy diet, exercising, ensuring time for rest, relaxation and maintenance of social contacts, acquiring new knowledge and skills and using supplements that are considered to improve mental abilities (all p < 0.005), but not in the perceived importance of getting enough sleep, avoiding drugs and alcohol or injuries and performing mentally-challenging activities or cognitive training (all p > 0.10). Educated individuals more frequently reported following a healthy diet, engaging in physical activity and socialising, acquiring new knowledge and skills, performing mental challenges and cognitive training, and using supplements (all p < 0.005), but not getting sufficient sleep, avoiding drugs, alcohol or injury, or ensuring time for rest and relaxation (all p > 0.08). A larger proportion of lay than educated participants (32 and 17%, respectively) identified lack of information as a reason for not engaging in healthy practices (p < 0.001). Educated participants outperformed lay individuals in identifying diseases amenable to lifestyle modification.

Understanding the differences in brain health perceptions between educated and lay individuals is crucial for developing effective public health strategies. Our results highlight a substantial knowledge gap in the Slovenian population and the need for targeted educational interventions that account for varying degrees of knowledge in different population segments which could lead to better adherence to healthy lifestyle practices.

Chrono-nutritional factors may play a significant role in glucose regulation and the risk of type 2 diabetes (T2D). We investigated the association between breakfast skipping (BS) and fasting plasma glucose (FPG) levels in a non-diabetic cohort of the ABCD project (nutrition, cardiovascular wellness and diabetes) representing the general population of Palermo, Italy Among the 623 participants included in the analysis, 118 individuals were identified as BS. In men, BS was associated with higher values of FPG (p < .05), glycated haemoglobin (p < .01), triglycerides (p < .05) and insulin (p < .005). Among women, no significant differences were observed between BS and non-skippers. Multivariate regression analysis confirmed that BS was an independent predictor of higher FPG levels in men (p < .01); waist circumference emerged as the primary predictor of FPG in women (p < .001). This study supports the importance of dietary habits in glycaemic control and T2D risk.

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS), characterized by neurodegeneration, axonal damage, demyelination, and inflammation. Recently, gut dysbiosis has been linked to MS and other autoimmune conditions. Namely, gut microbiota has a vital role in regulating immune function by influencing immune cell development, cytokine production, and intestinal barrier integrity. While balanced microbiota fosters immune tolerance, dysbiosis disrupts immune regulation, damages intestinal permeability, and heightens the risk of autoimmune diseases. The critical factor in shaping the gut microbiota and modulating immune response is diet. Research shows that high-fat diets rich in saturated fats are associated with disease progression. Conversely, diets rich in fruits, yogurt, and legumes may lower the risk of MS onset and progression. Specific dietary interventions, such as the Mediterranean diet (MD) and ketogenic diet, have shown potential to reduce inflammation, support neuroprotection, and promote CNS repair. Probiotics, by restoring microbial balance, may also help mitigate immune dysfunction noted in MS. Personalized dietary strategies targeting the gut microbiota hold promise for managing MS by modulating immune responses and slowing disease progression. Optimizing nutrient intake and adopting anti-inflammatory diets could improve disease control and quality of life. Understanding gut-immune interactions is essential for developing tailored nutritional therapies for MS patients.

The relationship between diet and sleep quality is intricate, with growing evidence suggesting that dietary patterns and meal timing (chrononutrition) can significantly influence sleep outcomes. This scoping review aims to compare the impact of Mediterranean diet and chrononutrition methods on sleep variables, including sleep quality, duration, and efficiency. While the Mediterranean diet is renowned for its health benefits in chronic diseases, chrononutrition focuses on how the timing of food intake affects health and circadian biology.

Literature search following PRISMA guidelines using PubMed and Google Scholar focused on Mediterranean diet and chrononutrition effects on sleep quality. Studies assessed sleep quality using subjective methods like Pittsburgh Sleep Quality Index, analyzing data on study type, sample size, age group, diet, duration, sleep parameters, and outcomes.

Thirty three studies met inclusion criteria, 24 focusing on Mediterranean diet and 9 on chrononutrition. Among the 24 Mediterranean diet studies, most of which were observational studies, 17 reported a positive association between adherence to Mediterranean diet and improved self-reported sleep quality, while the remaining studies found no significant association. In contrast, evidence supporting the positive effects of chrononutrition on sleep quality was limited, with only two out of nine studies having found improvement in sleep quality.

Mediterranean diet demonstrates a more consistent and positive influence on sleep quality compared to chrononutrition. However, a limitation of review is that the reviewed Mediterranean diet studies were mainly cross-sectional or observational, while the reviewed chrononutrition studies were mainly interventional trials. Larger interventional clinical trials are needed to determine optimal dietary strategies and meal timing for promoting healthy sleep.

This systematic review aimed to summarise the current knowledge regarding the effects of the Mediterranean diet (MD) on the secondary prevention of cardiovascular diseases (CVDs). A systematic search was done on Web of Sciences, PubMed, Scopus, and Google Scholar databases until January 2025. The majority of the included studies (15 of 16 RCTs) supported the role of MD following in the secondary prevention of CVDs. According to the RCT results, the patients in the MD group had lower cardiovascular deaths, non-fatal myocardial infarction, and other events. They also had healthier lipid profiles and blood fatty acids, higher flow-mediated dilation and endothelial progenitor cell levels, and lower endothelial progenitor cells compared to a low-fat diet. However, both MD and control (low-fat diet) groups promoted similar decreases in blood pressure and body mass index. The findings of this review suggested that adherence to the MD could be beneficial in the secondary prevention of CVD.

In adults with established cardiovascular disease (CVD) risk factors, as compared with minimal intervention, what is the most effective dietary program intervention, with or without pharmacological management, physical activity, and behavioral support cointerventions, for reducing risk of early mortality and major cardiovascular events based on the best available systematic review and network meta-analyses of randomized clinical trials (RCTs)?

Based on 40 RCTs evaluating 7 dietary programs, moderate certainty evidence suggests that Mediterranean dietary programs (for example, high in vegetables, fruits, extra virgin olive oil, nuts, legumes, and fish), accompanied by varying cointerventions including pharmacological management (for example, statins), physical activity and behavioral support (for example, nutrition education, smoking cessation, and stress management), were superior to minimal interventions for reducing risk of all cause [1.7% absolute risk reduction (ARR)], cardiovascular mortality (1.3% ARR), stroke (0.7% ARR), and myocardial infarction (1.7% ARR) in patients with established CVD risk factors (for example, obesity, hypertension, dyslipidemia, or a previous cardiovascular event) over a 5-y period. Results from randomized trials with food provisions (for example, extra virgin olive oil, mixed nuts, primarily walnuts) among those living in Mediterranean regions had the largest treatment effects. Similarly, moderate certainty evidence demonstrated that low-fat dietary programs (for example, 20-30% total fat, <10% saturated fat, and high in fish, vegetables, and fruits together with varying cointerventions) were superior to minimal intervention for reducing all-cause mortality (0.9% ARR) and myocardial infarction (0.7% ARR) based on trials conducted in Mediterranean, North American, and Northern European regions. Network metaregression did not detect statistically significant differences in estimates when controlling for the presence of pharmacological management, physical activity, and behavioral support.

Background: A high-quality diet is linked to cardiometabolic risk reduction. Culinary medicine interventions are effective in improving nutrition and health outcomes. While personalized nutrition is usually related to improving patient outcomes through knowledge about gene-nutrient interactions, tailoring interventions based on participant motivation and biopsychosocial environment may improve outcomes. The stage of change framework categorized participants based on current behaviors and intentions for future behaviors. Our goal was to assess participant perceptions regarding accomplishments, challenges, and needs up to one year following a culinary medicine program according to their stage of change at entry. Methods: Participant perceptions were collected at (1) the intervention end (open-ended questionnaire), (2) six months (semi-structured interview), and (3) twelve months (open-ended questionnaire). Analysis was performed inductively following a thematic analysis approach. Results: Twenty-four participants completed 70 perspectives (58/12 from participants who entered at a contemplation/action stage of change). Perceptions were related to (1) acquire culinary and nutritional knowledge: improve knowledge about healthy nutrition, use new recipes, and ask for hands-on cooking classes; (2) improve culinary and self-regulatory skills: improve confidence in the kitchen, expand cooking skills, organizing and planning, and creativity and pleasure; (3) adopt home cooking and healthy nutrition: adopt home-cooking habits, spreading home cooking to other family members, improve nutrition habits throughout the day, and decrease consumption of ultra-processed food; and (4) address the sustainability of health changes: achievements in maintaining long-term health changes, challenges in maintaining long-term health changes, and facilitators for a long-term change. Conclusions: These results provide one-year-long information about participant facilitators, barriers, and needs for making home-cooking changes categorized to the participant stage of change at program entry. This information can help reform effective personalized culinary medicine programs.

The Mediterranean diet (MedDiet) is a healthy dietary pattern associated with reduced risk of chronic diseases. However, adherence is declining, particularly among younger populations. Therefore, it is crucial to identify the main aspects that affect its adherence, particularly food preferences and sensory function, which have received insufficient attention. Our aims were to investigate the impact of socio-demographic and lifestyle factors on adherence to the MedDiet among young individuals; to assess the association of taste preferences and food liking with MedDiet adherence; and to evaluate the associations between taste perception modalities, taste and food preferences, and adherence.

A cross-sectional study on young adults (aged 20.5 ± 4.7 years) in a Mediterranean country (n = 879) was carried out. Demographic characteristics, clinical characteristics, anthropometric characteristics, lifestyle characteristics, MedDiet adherence, taste preferences, and food preferences were assessed. Taste perception for bitter, salty, sweet, sour, and umami was determined by rating different concentrations of prototypical tastants. We computed a total taste perception score and three scores to combine food preferences.

We identified several socio-demographic and lifestyle factors associated with adherence to the MedDiet, as well as food preferences, taste preferences, and taste perception determinants. Food preferences were significantly associated with total adherence to the MedDiet. Higher preference for olive oil, oranges, broccoli, fish, and legumes was associated with higher MedDiet adherence (p < 0.05 for all). Conversely, higher preference for sweet foods, red meat, and butter was associated with lower adherence (p < 0.05 for all). The combined positive score for food preference was strongly associated with higher MedDiet adherence (p = 1.4 × 10-23) in the multivariate adjusted model. The combined negative food preference score was inversely associated (p = 1.9 × 10-8). Likewise, taste preferences were significantly associated with adherence to the MedDiet (strong inverse association for sweet taste preference and direct association for bitter taste preference; both p < 0.001). Moreover, bitter taste perception was inversely associated with adherence to the MedDiet and with bitter foods (p < 0.05). In conclusion, future precision nutrition studies should measure food liking and taste preferences, which are crucial determinants of MedDiet adherence, especially in young people.

With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals' health-related quality of life, a multidimensional concept that comprises an individual's physical, mental, and social wellbeing. While a balanced, nutrient-dense diet, such as Mediterranean diet, is widely recognized for its role in chronic disease prevention, particularly in reducing the risk of cardiovascular diseases and certain cancers, its potential benefits extend beyond these well-known effects, showing promise in improving physical and mental wellbeing, and promoting health-related quality of life.

A systematic search of the scientific literature in electronic databases (Pubmed/Medline) was performed to identify potentially eligible studies reporting on the relation between adherence to the Mediterranean diet and health-related quality of life, published up to December 2024.

A total of 28 studies were included in this systematic review, comprising 13 studies conducted among the general population and 15 studies involving various types of patients. Overall, most studies showed a significant association between adherence to the Mediterranean diet and HRQoL, with the most significant results retrieved for physical domains of quality of life, suggesting that diet seems to play a relevant role in both the general population and people affected by chronic conditions with an inflammatory basis.

Adherence to the Mediterranean diet provides significant benefits in preventing and managing various chronic diseases commonly associated with aging populations. Furthermore, it enhances the overall health and quality of life of aging individuals, ultimately supporting more effective and less invasive treatment approaches for chronic diseases.

Patients with type 2 diabetes mellitus (T2DM) are often encouraged to adopt a healthy diet, such as the Mediterranean Diet (MD) yet limited evidence exists about adherence. An increased shift toward a "Western" dietary pattern was observed.

This systematic review aims to gain insight into the various factors that may enhance or reduce adherence to the MD in patients with T2DM residing in Mediterranean countries.

We retrieved published studies from 2000 to 2023 from PubMed, Cochrane, Embase, CINAHL, Web of Science, Medline, and PsycINFO databases. The criteria for inclusion included individuals residing in Mediterranean countries aged 18+ with T2DM who underwent assessment using a validated MD scoring tool. We included 17 studies, with participant numbers ranging from 106 to 7,447.

Compliance with the MD was moderate, with the most significant determinants of adherence being age, physical activity, body mass index (BMI), marital status, and educational level. However, limited information is available on psychological and economic determinants.

Various factors, especially sociodemographic ones, influence adherence to the MD among patients with T2DM. Future research should explore economic and psychological factors that may significantly impact adherence.

Prospero: CRD42023396094.

Pain, poor quality of life (QOL) and gastrointestinal (GI) symptoms are commonly experienced by individuals with endometriosis. Although diet and nutrition supplements are frequently used to manage endometriosis-related symptoms, there is limited understanding of the breadth and quality of research in this field. Our aim was to undertake a scoping review of diet and nutrition supplement intervention studies in people with endometriosis, diagnosed by ultrasound or surgery.

MEDLINE Complete, Embase, CINAHL and PsycINFO databases were searched for articles published in English from database inception to November 2024. Quality was assessed by two reviewers independently using the Joanna Briggs Institute appraisal tools. In total, 5130 publications were screened and 13 were included.

Among these, five evaluated the effect of diet intervention, one evaluated the effect of a combined diet-supplement intervention and seven evaluated the effect of a nutrition supplement in endometriosis. Overall, there were seven randomised controlled trials (RCTs) (n = 1 diet intervention, n = 6 nutrition supplement), two nonrandomised controlled studies (n = 1 diet intervention, n = 1 combined diet-supplement) and four uncontrolled studies (n = 3 diet intervention, n = 1 nutrition supplement). On the basis of evidence from the RCTs, the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet improved QOL and GI symptoms, whereas garlic supplements and combination trace element supplements may be beneficial for improving reduced pain symptoms related to endometriosis. The quality of most included studies was poor. Adherence to the interventions was only measured in five studies and only one diet study measured baseline diet.

High-quality RCTs of diet and nutrition supplement interventions are needed to progress the understanding of whether they should be integrated into the clinical management of endometriosis.

This study aimed to review meta-analyses of randomised controlled trials that evaluated the effectiveness of the Mediterranean Diet for the primary and secondary prevention of cardiovascular disease.

Five databases (Medline, Embase, Cochrane, CINAHL and ProQuest) were searched from inception to November 2022. Inclusion criteria were: (i) systematic review of randomised controlled studies with metanalysis; (ii) adults ≥18 years from the general population with (secondary prevention) and without (primary prevention) established cardiovascular disease; (iii) Mediterranean Diet compared with another dietary intervention or usual care. Review selection and quality assessment using AMSTAR-2 were completed in duplicate. GRADE was extracted from each review, and results were synthesised narratively.

Eighteen meta-analyses of 238 randomised controlled trials were included, with an 8% overlap of primary studies. Compared to usual care, the Mediterranean Diet was associated with reduced cardiovascular disease mortality (n = 4 reviews, GRADE low certainty; risk ratio range: 0.35 [95% confidence interval: 0.15-0.82] to 0.90 [95% confidence interval: 0.72-1.11]). Non-fatal myocardial infarctions were reduced (n = 4 reviews, risk ratio range: 0.47 [95% confidence interval: 0.28-0.79] to 0.60 [95% confidence interval: 0.44-0.82]) when compared with another active intervention. The methodological quality of most reviews (n = 16/18; 84%) was low or critically low and strength of evidence was generally weak.

This review showed that the Mediterranean Diet can reduce fatal cardiovascular disease outcome risk by 10%-67% and non-fatal cardiovascular disease outcome risk by 21%-70%. This preventive effect was more significant in studies that included populations with established cardiovascular disease. Better quality reviews are needed.

this paper aims to present the evidence for the role of diet in the prevention and treatment of depression, review the potential underlying mechanisms and provide practice recommendations for mental health clinicians.

A literature review was conducted through searches of PubMed with the search terms 'depression', 'diet', 'prevention', 'treatment' and 'mechanisms' and combinations thereof. Additional articles were identified through hand searching.

Greater adherence to several healthy dietary patterns, traditional diets such as the Mediterranean diet and other diets such as the DASH diet are associated with or can treat symptoms of depression. Several limitations of the research were noted, many of which relate to inherent challenges of studying diet. Mechanisms by which dietary intervention can influence mood include the gut microbiome, modulation of inflammatory processes, reduction in oxidative stress and modulation of hypothalamic-pituitary-adrenal axis function. Recommendations for mental health clinicians to enable translation of the evidence into practice are provided.

Diet can play an important role in preventing and treating depression. Mental health clinicians are well placed to provide dietary counselling and to use clinical judgement in choosing the specific approach that reflects the needs of the patient but are encouraged to refer to a specialist dietitian where necessary.

Cardiometabolic diseases are a major global health concern, with diet playing a crucial role in their prevention and management. Recent advancements in the identification of metabolic signatures related to dietary patterns offer a more objective assessment of individualized dietary exposure and provide deeper insights into diet-disease associations.

Recent studies have shown that distinct metabolic signatures are associated with the adherence to various dietary patterns. These signatures show even stronger associations with cardiometabolic disease incidence, independent of traditional risk factors and self-reported adherence to such dietary patterns. Emerging dietary approaches, such as sustainable diets, health outcome-focused diets, and population data-driven dietary patterns, also hold promise for improving cardiometabolic health. Additionally, metabolic signatures could offer insights into diet-disease associations in underrepresented populations, addressing genetic and lifestyle differences.

Application of metabolomics provides a more precise understanding of how dietary patterns influence cardiometabolic health. Although the number of studies remains limited, and current evidence is inconsistent, the approach has significant potential for improving clinical and public health strategies. Future research should prioritize prospective studies and address population- and outcome-specific dietary needs to enable targeted interventions that optimize cardiometabolic health.

Despite the well-known benefits of the Mediterranean diet (MD), low adherence is observed globally, highlighting the need to investigate the underlying causes of this trend. Large-scale, periodically repeated surveys, such as the European Health Interview Survey (EHIS), could be useful for the investigation of the factors that influence adherence to healthy dietary patterns. National EHIS-3 in Greece was designed to collect data on the consumption of all food groups, making it possible to determine adherence to MD.

This study aimed to investigate the socioeconomic factors that influence MD adherence by conducting a secondary data analysis from 7706 participants aged 15-85 years who participated in the 2019 national EHIS. MD adherence was evaluated by MedDietScore. Bivariate comparisons between the score tertiles and socioeconomic groups were performed. Logistic regression analyses were used to estimate the association between MedDietScore tertiles and demographic and socioeconomic factors, using high adherence as the reference category. Finally, cluster analysis was applied to identify the most significant factors in relation to the classification of the participants in MD adherence groups.

Educational level, followed by income status, emerged as the most significant factor associated with adherence to MD. Individuals who have attained only primary education had a 3.80 times higher likelihood of presenting low MD adherence instead of high MD adherence compared to persons with tertiary education. Individuals in the lower income group had 2.53 times higher odds of being in the low MD adherence instead of high MD adherence than individuals in the higher income group. These relationships remained statistically significant after adjusting for confounding factors. The group that most frequently adhered to high MD (53.4%) comprised individuals who had tertiary education, higher income, and were couples without children. Conversely, those with primary or secondary education who are single parents or live in one-person households and fall into the lower and medium income groups are most likely to have low MD adherence (44.8%).

Public policies to promote MD adherence should consider socioeconomic factors. Integrating questions to evaluate adherence to dietary patterns into EHIS would allow for future intercountry and longitudinal comparisons.

Children's diets in school-age are inherently unhealthy, with few meeting dietary recommendations. Yet, little is known about similarities and differences on dietary patterns across countries and their association with obesity. We aimed to derive dietary patterns in childhood and explore their association with adiposity-related outcomes in childhood and adolescence.

This study included data from six European countries (Spain, France, UK, Greece, Lithuania and Norway) during childhood (n = 1597) and adolescence (n = 803). Using a food frequency questionnaire, we derived data-driven dietary patterns through exploratory factor analyses and calculated the Mediterranean KIDMED index. We assessed body mass index z-score (zBMI), fat mass proportion and waist-to-height ratio at both visits. Associations were estimated using generalized linear regressions, adjusted for key-confounders.

"Meat", "Dairy", "Western", "Healthy" and "Sweets and fats" dietary patterns were derived. Norwegian children showed better diet quality, with higher consumption of fruits and vegetables, and highest "Healthy pattern" adherence, and Lithuanian children, the worst, with higher sweets consumption, and highest "Western pattern" adherence. Children with lower intake of healthy foods (vegetables, fruits, fish) tended to have higher adiposity, e.g., children with average or low "Healthy pattern" adherence (vs. high) had higher fat mass proportion in childhood (average: β (95% CI) 1.44 (0.48; 2.39), low: 1.10 (0.09; 2.12)). Low adherence to a "Healthy pattern" (vs. high) was associated with increased adolescent zBMI, and child and adolescent waist-to-height ratio. Low "Dairy pattern" adherence (vs. high), was associated with lower zBMI and fat mass in childhood, but not in adolescence. No significant associations were seen with the KIDMED index.

Many European children have poor diets and a low adherence to a healthy diet pattern may be of concern for adiposity-related outcomes. Assessment of children's dietary patterns can help tailor dietary advice and provide support for families aiming to prevent future excess weight gain.

Nutrition, the gut microbiota and immunity are all important factors in the maintenance of health. However, there is a growing realization of the complex interplay between these elements coalescing in a nutrition-gut microbiota-immunity axis. This regulatory axis is critical for health with disruption being implicated in a broad range of diseases, including autoimmune disorders, allergies and mental health disorders. This new perspective continues to underpin a growing number of innovative therapeutic strategies targeting different elements of this axis to treat relevant diseases. This review describes the inter-relationships between nutrition, the gut microbiota and immunity. It then details several human diseases where disruption of the nutrition-gut microbiota-immunity axis has been identified and presents examples of how the various elements may be targeted therapeutically as alternate treatment strategies for these diseases.

A healthy diet is a key determinant of successful aging. However, the psychological, social, and physiological changes associated with ageing often disrupt dietary behaviours. Hungary has one of the highest rates of chronic age-related diseases in the European Union, exacerbated by unhealthy dietary patterns and rapid population aging. This study evaluates attitudes and barriers to healthy eating among older adults in a socioeconomically disadvantaged region of Hungary, identifying determinants of these attitudes across different age groups. A cross-sectional survey sampled 678 adults aged 18 and older from Northeast Hungary, assessing their beliefs on healthy eating through an attitude score (range: 9-45). Multivariate regression analyses were conducted to explore relationships between mental health, self-perceived health, and attitudes toward healthy eating. The mean attitude score was 31.47 (± 5.14), with older adults (≥ 65 years) showing significantly greater uncertainty about dietary choices. The cost of healthy food was the most frequently reported barrier, regardless of age. Regression results revealed that older adults with higher well-being (B = 0.03, p = 0.026), life satisfaction (B = 0.40, p = 0.005), and self-perceived health (fair: B = 2.20, p = 0.003; good/very good: B = 1.96, p = 0.031) were more likely to have positive attitudes toward healthy eating. These results emphasize the importance of addressing both mental and physical health in educational interventions to promote healthier diets. Tailored approaches addressing affordability and accessibility of healthy foods are critical to advancing Hungary's National Healthy Aging Program and mitigating dietary risk factors among vulnerable populations.

Cardiovascular-kidney-metabolic (CKM) syndrome is a systemic clinical condition characterized by pathological and physiological interactions among metabolic abnormalities, chronic kidney disease, and cardiovascular diseases, leading to multi-organ dysfunction and a higher incidence of cardiovascular endpoints. Traditional approaches to managing CKM syndrome risk are inadequate in these patients, necessitating strategies targeting specific CKM syndrome risk factors. Increasing evidence suggests that addressing uremic toxins and/or pathways induced by uremic toxins may reduce CKM syndrome risk and treat the disease. This review explores the interactions among heart, kidney, and metabolic pathways in the context of uremic toxins and underscores the significant role of uremic toxins as potential therapeutic targets in the pathophysiology of these diseases. Strategies aimed at regulating these uremic toxins offer potential avenues for reversing and managing CKM syndrome, providing new insights for its clinical diagnosis and treatment.

The loss of skeletal muscle mass and strength, known as sarcopenia, is prevalent in older adults and linked to an increased risk of disability, frailty, and early mortality. Muscle health is crucial for the functionality and independence of older adults. As the aging population continuously grows, finding cost-effective strategies for preventing and treating sarcopenia is an important public health priority. While nutrition is recognized as a key factor in the development of sarcopenia, its role in preventing and treating the condition is still under investigation. In recent decades, nutritional research has shifted from a focus on individual nutrients or healthy foods to examining the combination of nutrients and foods in dietary patterns, along with their potential synergistic and antagonistic effects. A balanced diet and regular participation in physical activity are essential for maintaining musculoskeletal health. One of the healthy eating patterns with the greatest evidence of multiple health benefits is the Mediterranean diet, which has also been linked to positive effects on muscle function in observational studies. However, there is a lack of intervention studies. This review explores the updated evidence from longitudinal prospective studies on associations between adherence to the Mediterranean diet and sarcopenia in order to promote preventive and intervention strategies for healthy muscle aging.

The COVID-19 pandemic has led to significant lifestyle changes, including alterations in dietary habits and increases in sedentary behavior. The Mediterranean diet (MD) has been associated with various health benefits, which are especially important given the health challenges posed by the pandemic. During the pandemic, an overall shift towards consuming more highly processed foods has been observed.

This systematic review investigated adherence to MD during the COVID-19 pandemic, focusing on gender differences and factors influencing adherence to MD in the general public. The literature search focused on papers published between January 1, 2019, and July 8, 2024, across various databases such as Web of Science (WOS), Scopus, PubMed MEDLINE, and PsycINFO.

Following the PRISMA guidelines, this search identified 14,347 references, of which 5,734 were duplicates. After a thorough multi-level screening process, 29 studies, encompassing 55,242 participants, met the inclusion criteria. While seven studies reported that men adhered to a MD more than women during the COVID-19 pandemic, 12 studies also indicated that women had higher adherence to a MD compared to men. Nine studies, however, found no significant gender differences in MD adherence. Additionally, older age, higher education levels, higher socioeconomic status, and increased physical activity were linked to greater adherence to a MD in the pandemic context.

Gender-specific differences in dietary behavior are influenced by factors such as socioeconomic status, gender roles, and pandemic phases as well as biases in sample composition and methodological weaknesses. Significant gaps in the evidence, particularly concerning sexual and gender minorities, are highlighted.

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421727.

Chronic kidney disease (CKD) is prevalent among elderly patients with type 2 diabetes mellitus (T2DM). The association between dietary patterns and CKD in elderly T2DM patients remains understudied. This study aimed to investigate the relationship between dietary patterns and CKD in elderly Chinese patients with T2DM.

This community-based cross-sectional study included 5,713 elderly T2DM patients (aged ≥ 65 years) from Xiangcheng District, Suzhou, China. Dietary intake was assessed using a validated food frequency questionnaire, and dietary patterns were identified using factor analysis. Each participant was assigned a score for each identified dietary pattern, with higher scores indicating a greater alignment of their diet with the respective pattern. Quartiles of these pattern scores were utilized as the primary exposures in the analysis. CKD was defined as albuminuria, reduced estimated glomerular filtration rate (eGFR), or both. Logistic regression models assessed CKD prevalence across quartiles of dietary pattern scores, expressed as adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

CKD prevalence was 45.7%. Four dietary patterns were identified: "traditional southern", "high-protein", "balanced" and "imbalanced". A balanced dietary pattern, featured with high intake of fruits, dairy products, eggs, snacks, crab and shellfish, and fish and shrimp, was associated with lower CKD prevalence. The adjusted ORs for CKD across ascending quartiles were 0.99 (95% CI: 0.85-1.16), 0.89 (95% CI: 0.76-1.04), and 0.73 (95% CI: 0.62-0.86). The imbalanced dietary pattern, characterized by high intake of green leafy vegetables, refined grains, and red meat but low dietary diversity, was associated with increased CKD prevalence, with ORs of 1.01 (95% CI: 0.86-1.18), 1.15 (95% CI: 0.98-1.35), and 1.25 (95% CI: 1.07-1.46) across quartiles. No significant associations were observed for "traditional southern" or "high-protein" dietary patterns.

Dietary patterns were associated with CKD prevalence in elderly Chinese T2DM patients. A "balanced dietary pattern", consistent with local dietary customs, was associated with a lower risk of CKD. Further longitudinal and intervention studies are needed to confirm these associations.

To evaluate the effect of egg consumption on health outcomes.

A systematic search in PubMed, Scopus, Lilacs, and Web of Science was developed using terms ("egg consumption" or "egg intake") and ("health" or "chronic diseases" or "diabetes" or "cancer" or "cholesterol" or "dyslipidemia"), and meta-analyses of observational or interventional studies published since January 2020 were included. The studies' quality was evaluated through AMSTAR-2 and NutriGrade, and the strength of evidence according to sample size, heterogeneity, and quality of articles. Fourteen meta-analyses were included (10 observational, 4 interventional studies). The wide range of outcomes, with substantial variability and high heterogeneity, indicated a lack of robust evidence. The overall quality of studies was critically low. The level of evidence was very weak for all the significant associations: risk of heart failure (RR 1.15; 95%CI: 1.02-1.30), cancer mortality (RR 1.13; 95%CI 1.06-1.20), higher levels of LDL cholesterol (WMD 7.39; 95%CI 5.82-8.95), total cholesterol (WMD 9.12; 95%CI 7.35-10.89), and apolipoprotein B-100 (WMD 0.06; 95%CI 0.03-0.08). Conversely, egg intake has been weakly associated with improvements in HDL cholesterol (WMD 1.37; 95%CI 0.49-2.25), apolipoprotein A1 (WMD 0.03; 95%CI 0.01-0.05), and growth parameters in children (WMD 0.47; 95%CI 0.13-0.80). No evidence of association was found among all cardiovascular outcomes and all-cause mortality risk between high vs. low egg consumption.

Due to the critically low strength of studies, insufficient evidence is available to discourage egg consumption, suggesting eggs can be part of a healthy diet.

Multiple professional societies recommend the Mediterranean and/or Dietary Approaches to Stop Hypertension dietary patterns in their cardiovascular disease prevention guidelines because these diets can improve cardiometabolic health and reduce the risk of cardiovascular events. Furthermore, low sodium intake can be particularly beneficial for patients with hypertension. Carbohydrate restriction, with an emphasis on including high-quality carbohydrates and limiting refined starches and foods and beverages with added sugars, can promote weight loss and cardiometabolic benefits in the short term, compared with higher carbohydrate intake. Evidence is lacking for sustained, long-term effects of low carbohydrate and very low carbohydrate intake on cardiometabolic risk and cardiovascular outcomes. Time-restricted eating, in the context of an overall healthy dietary pattern, can promote cardiometabolic health by aligning food intake with the circadian rhythm, although its effect on hard clinical outcomes remains to be proven. Although there is no one dietary pattern that is appropriate for all patients, engaging in shared decision-making with patients, utilizing behaviour-change principles and engaging members of the health-care team, such as registered dietitian nutritionists, can lead to substantial improvement in the lifestyle and overall health trajectory of a patient. Emphasizing the similarities, rather than differences, of recommended dietary patterns, which include an emphasis on vegetables, fruits, legumes, nuts, whole grains and minimally processed protein foods, such as fatty fish or plant-based proteins, can simplify the process for both patients and clinicians alike.

Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6-17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children's eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents' younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents' education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents' cultural background.

Background/Objectives: Athletes seek healthy diets for their health and performance. The Mediterranean Diet (MedDiet) has been widely studied for its health benefits. We conducted a scoping review of the scientific literature for studies reporting on the relationship between MedDiet adherence and performance and health outcomes in athletes. Methods: Five bibliographic databases were searched from inception to December 2023. We included studies with any competing, recreational, professional, elite, or occupational athlete (of any age) who played a physical sport as part of a team or as an individual, in which the MedDiet was used as an intervention, or adherence was measured. A total of 7993 unique records were identified, screened, and assessed for eligibility. Results: A total of 32 studies were included: 23 observational studies, 6 randomised controlled trials, and 3 quasi-experimental studies. Almost all studies (n = 31) were conducted in Mediterranean countries. Anthropometrics (n = 19) and body composition (n = 12) were the two most measured outcomes. There was a wide range of athlete ages and calibres and great variability in the outcomes reported; however, there were limited reports for each outcome. Only one RCT reported on specific sport-related performance outcomes. Three RCTs provided individualised dietary recommendations for macronutrients based on sports nutrition guidelines, but only two of them assessed macronutrient intake. Conclusions: This is the first scoping review of MedDiet adherence on outcomes related to sport. We found a limited evidence base across different sports and athletes, with few studies conducted outside of Mediterranean countries. Importantly, more intervention studies are needed to provide high-level causal evidence on the impact of the MedDiet pattern on performance and health outcomes in athletes.

The Mediterranean diet (MD) plays an important role in delaying vascular aging. The main objective of this study was to analyze the association between adherence to the MD and vascular aging estimated with brachial-ankle pulse wave velocity (ba-PWV) in a Spanish population sample and the differences by sex.

Cross-sectional descriptive study. A total of 3437 subjects from the EVA, MARK and EVIDENT studies participated. The ba-PWV was assessed with the Vasera VS-1500® device. Vascular aging was classified as healthy vascular aging (HVA), normal vascular aging (NVA) and early vascular aging (EVA) and adherence to the MD was assessed with the Mediterranean Diet Adherence Screener questionnaire.

The mean age was 60.15 ± 9.55 (60.09 ± 9.71 in women; 60.20 ± 9.43 in men). Overall, MD adherence was observed in 48.0% of subjects (40% in women; 54% in men). The mean value of ba-PWV was 14.38 ± 2.71 (women 14.24 ± 2.89; men 14.49 ± 2.56). In multinomial logistic regression a positive association was found overall between HVA and NVA (OR = 1.751, 95% CI: 1.411-2.174, p < 0.001) and between HVA and EVA (OR = 1.501, 95% CI:1.295-1.740, p < 0.001); in women between HVA and NVA (OR = 2. 055, 95% CI:1.456-2.901, p < 0.001) and between HVA and EVA (OR = 1.413, 95% CI:1.124-1.776; p = 0.003); and in men between HVA and NVA (OR = 1.551, 95% CI: 1.175-2.047, p = 0.002) and between HVA and EVA (OR = 1.549, 95% CI: 1.275-1.882; p < 0.001).

The results of this work indicate that greater adherence to the MD is associated with healthier vascular aging.

Numerous primary and secondary studies have consistently demonstrated that probiotics, including lactobacillus and Bifidobacterium, possess a potential anti-obesity effect. However, it is worth noting that some studies have yielded contrasting results. Considering this, our study aims to present a comprehensive overview of published systematic reviews and meta-analyses, focusing on the efficacy and safety of probiotics in managing obesity. To achieve this objective, we conducted an umbrella review following the PRISMA protocol and Cochrane guidelines. We searched databases such as Embase, PubMed, Cochrane Library, and Google Scholar for relevant systematic reviews and meta-analyses published in English, without imposing any date restrictions. Our inclusion criteria encompassed studies evaluating the anti-obesity impact of probiotics, with a specific focus on changes in body mass index (BMI), fat mass percentage (FMP), body weight (BW), and body fat mass (BFM). These studies were meticulously reviewed by two independent reviewers. Our analysis included five systematic reviews and 18 meta-analyses that met the predefined inclusion and exclusion criteria. The meta-analyses revealed statistically significant reductions in the following parameters: BMI, a decrease of 0.30 kg/m2 (p < 0.00001, 95% CI - 0.36 to - 0.25); BFM, a reduction of 0.86 kg (p < 0.00001, 95% CI - 1.02 to - 0.71); BW, a decrease of 0.59 kg (p < 0.00001, 95% CI - 0.74 to - 0.44); and FMP, a substantial decline of 78% (p < 0.00001, 95% CI - 1.02 to - 0.54). In summary, our umbrella review suggests that existing evidence supports the potential benefits of probiotics in managing obesity and overweight. However, it is essential to acknowledge that the credibility of this evidence is somewhat limited due to the inclusion of studies with poor-quality designs and relatively small participant numbers. To establish the true efficacy of probiotics in obesity management, we recommend conducting robust studies involving larger participant cohorts.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide, affecting 30% of the population in Western countries. MASLD is considered the hepatic manifestation of the metabolic syndrome, pathophysiologically underpinned by insulin resistance and frequently co-exists with hypertension, central obesity and dyslipidaemia. Currently, safe and effective pharmacotherapies for MASLD are limited, making weight loss with lifestyle changes the mainstay therapy. A Mediterranean diet (MedDiet) has emerged as an effective dietary pattern for preventing and managing MASLD, but most studies have been conducted in Mediterranean countries, necessitating further investigation into its benefits in Western populations. Additionally, the effect of holistic multimodal lifestyle interventions, including physical activity combined with the MedDiet, is not well established. Finally, MASLD's widespread prevalence and rapid growth require improved accessibility to interventions. Digital health delivery platforms, designed for remote access, could be a promising approach to providing timely support to individuals with MASLD. This narrative review summarises the current evidence related to the effects of the MedDiet in Western, multicultural populations with MASLD. This includes a detailed description of the composition, prescription and adherence to dietary interventions in terms of how they have been designed and applied. The evidence related to the role of physical activity or exercise interventions prescribed in combination with the MedDiet for MASLD will also be reviewed. Finally, recommendations for the design and delivery of dietary and physical activity or exercise interventions to inform the design of future randomised controlled trials to facilitate the optimal management of MASLD are outlined.

The Advanced Lung Cancer Inflammation Index (ALI) represents both the inflammatory and nutritional status of the host, but its link with mortality in asthma patients is uncertain. The purpose of this study was to look at the relationship between ALI levels and all-cause and respiratory disease mortality in asthmatic patients. We conducted our research using cohort data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The National Death Index was used to calculate mortality until December 31, 2019. The study employed multivariate logistic regression to look into the relationship between ALI levels and asthma prevalence. Weighted Kaplan-Meier and multivariate-adjusted Cox analyses were utilized for investigating the relationship between ALI levels and all-cause and respiratory disease mortality in individuals with asthma. A restricted cubic spline (RCS) analysis was used to assess their nonlinear relationship. Subgroup and sensitivity analyses were also performed to evaluate the robustness of the results that were obtained. We enrolled 40,497 people in our study, and 5,469 of them had asthma, representing a 14% prevalence. A median follow-up of 11.19 (9.38, 14.29) years revealed 109 fatalities from respiratory diseases and 724 deaths from all causes. After correcting for several covariates, there was no longer any link (P-trend = 0.2) between ALI levels and the prevalence of asthma. When compared to the lowest quartile, the highest quartile of ALI levels was substantially linked to a lower risk of mortality from respiratory diseases and all causes (all P-trend < 0.001). In the RCS regression model, the relationship between ALI level and both all-cause and respiratory disease mortality in asthmatic participants was nonlinear, with P for nonlinearity of 0.006 and 0.015, respectively. We also discovered that the probability of mortality from respiratory disease decreased progressively to a nadir at an ALI level of 109.13 and then increased as the ALI level increased. Multiple subgroup and sensitivity analyses revealed that ALI was consistently related to lower all-cause and respiratory disease mortality in asthma patients. Our findings suggest that ALI is associated with a reduced risk of all-cause and respiratory disease mortality in asthma patients.

The objective of this study is to evaluate the correlation between dietary patterns, levels of physical activity (PA), and the occurrence of periodontal disease. Many lifestyles have been connected to periodontal disease, but little is known about diet and PA intake. This study included 185 people-62 healthy, 61 gingivitis, and 62 periodontitis. PA, Mediterranean diet score (MDS), and carbohydrate consumption frequency were gathered together with demographics. Clinical and radiographic evaluations calculated decayed, missing, and filled teeth (DMFT) index scores. PA, MDS, carbohydrate consumption, and periodontitis were evaluated. Periodontitis patients had higher DMFT scores, poorer periodontal features, and less daily tooth brushing. More PA overall, more PA in free time, and less sedentary behavior reduced periodontitis rates. Sedentary behavior increased periodontal disease risk in adjusted univariate regression models (OR = 0.235; p = 0.021). Of the study participants, 35 (18.9%) had high MDS. No correlation was established between Mediterranean diet (MD) and periodontitis. Periodontitis and MD, DMFT, and carbohydrate consumption do not seem to be substantially correlated. According to our research, a higher risk of periodontal disease was linked to more sedentary activity. To clarify the extent of the relationship between PA and periodontal disease, more prospective longitudinal research and approaches are required.Clinical Relevance: The periodontal status of individuals can be influenced by their lifestyle.

The aim of this study was to identify the blood lipidomic profile associated with a healthy eating pattern in a middle-aged US population sample and to determine its relationship with metabolic disorders and cardiovascular risk (CVR).

Self-reported information about diet and blood samples were obtained from 2114 adult participants in the Midlife in the United States study (MIDUS). Food intake data were used to design a Healthy Diet Index (MIDUS-HEI) and to evaluate the predictive value by examining its association with health variables. The associated lipid signature (HEI-LS) was constructed using Lasso regression, from lipidomic data (LC/MS). Associations between HEI-LS, cardiometabolic biomarkers, and estimated CVR were assessed using multiple linear regression.

MIDUS-HEI score was a robust indicator of dietary quality and inversely associated with body mass index (p < 0.001) and metabolic syndrome (p = 0.012). A lipidomic signature comprising 57 distinct lipid species was highly correlated with the MIDUS-HEI score (r = 0.39, p < 10⁻16). It was characterized by lower levels of saturated fatty acid and adrenic acid (n-6) and higher levels of docosahexaenoic acid (n-3). Healthier HEI-LS scores were strongly associated with better cardiometabolic indicators and lower estimated CVR (OR 0.89 CI 95% 0.87-0.91).

The MIDUS-HEI effectively assessed dietary quality, confirming the link between poor diet quality and metabolic disorders in American population. Lipidomic profiling offered an objective assessment of dietary patterns and provided insights into the relationship between diet quality, metabolic responses, and CVR. This approach supports precision nutrition strategies for at-risk populations.

Inflammation and endothelial dysfunction are important risk factors for chronic diseases, including cardiovascular diseases and related mortality.

This systematic review and meta-analysis aimed to assess the effects of 2 popular dietary patterns-a Mediterranean (MED) diet supplemented with olive oil and a low-fat diet (LFD)-on factors related to inflammation and endothelial function in adults.

The following online databases were searched for related studies published until August 7, 2024: PubMed/Medline, Scopus, Clarivate Analytics Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar. Two independent researchers selected the studies based on the eligibility criteria.

The effect sizes were expressed as Hedges' g with 95% CIs. A total of 16 eligible trials with 20 effect sizes were included in the analyses. This meta-analysis revealed that the MED diet supplemented with olive oil significantly improved all of the indicators of the study compared with the LFD, except in the case of E-selectin, in which a low and nonsignificant decrease was reported.

Available evidence suggests that a MED diet supplemented with olive oil compared with the LFD significantly improves inflammation and serum endothelial function in adults.

PROSPERO registration no. CRD42023485718.

Chronic viral inflammation is associated with oxidative stress and changes in gut microbiota. The Mediterranean diet (MD), with recognized anti-inflammatory and antioxidant properties, modulates gut microorganisms, specifically on the interaction between extra virgin olive oil, a key component of the MD with well-documented antioxidant effects. This study investigated the influence of adherence to MD and antioxidant-rich foods (extra virgin olive oil) on biochemical, inflammatory, and microbiota profiles in patients with chronic inflammation defined as a prolonged inflammatory response due to immune dysregulation following the acute phase of the viral infection. Participants were classified into low (n = 54) and high (n = 134) MD adherence groups (cut-off of 7 points based on previous studies utilizing the same threshold in the assessment of MD adherence). Gut microbiota was sequenced using the 16S technique, and the adherence to MD was assessed using a validated questionnaire for a Spanish population. High adherence to the MD was linked to significant improvements in inflammatory and oxidative stress markers, including reductions in LDL-cholesterol, glucose, and lactate dehydrogenase (LDH) levels, an indicative of redox balance, as well as a significant higher consumption of antioxidant foods. Moreover, gut microbiota analysis revealed distinct compositional shifts and a lower abundance of the Oscillibacter genus in the high adherence group. Notably, a significant interaction was observed between MD adherence and extra virgin olive oil consumption, with Oscillibacter abundance influencing LDH levels, suggesting that the MD antioxidant properties may modulate inflammation through gut microbiota-mediated mechanisms. These findings provide new evidence that adherence to the Mediterranean diet can reduce inflammatory markers in patients with long-COVID-19, a population that has not been extensively studied, while also highlighting the potential role of the bacterial genus Oscillibacter in modulating this effect.