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Salads are a main component of the Mediterranean diet. Helen Rushbrook/Stocksy
  • Researchers are working to understand how people can decrease their risk for type 2 diabetes, including how specific diets can help.
  • By analyzing specific biomarkers, researchers report that following a Mediterranean diet is associated with a lower risk of developing type 2 diabetes.
  • People interested in starting a Mediterranean diet can seek guidance from their doctors or other specialists to ensure safe actions that meet unique dietary needs.

A​ study published today in the journal PLOS Medicine looks at adherence to the Mediterranean diet and the incidence of type 2 diabetes.

Researchers studied how specific biomarkers in the blood can be used to measure how well people are sticking to a Mediterranean diet.

Based on their measurements, the researchers reported that following a Mediterranean diet could help to decrease someone’s risk for type 2 diabetes.

They also said using the biomarkers as a measurement tool may also help people stay on their diet plans.

Type 2 diabetes is common in the United States as well as around the world.

It can contribute to certain complications and poor health outcomes such as nerve damage, kidney problems, and heart conditions.

However, certain risk factors can increase someone’s chances of developing the condition, including obesity and a sedentary lifestyle.

Researchers are still working to fully understand the risk factors for type 2 diabetes and how people can best decrease their risk by making lifestyle changes.

One area of interest is how adherence to specific diets may benefit people who are at risk for diabetes and people who have diabetes.

The Mediterranean diet is one option that may offer certain benefits. This diet focuses on plant-based sources of nutrients and limits the consumption of processed foods.

Angela Ginn-Meadow, RD, RN, a registered dietitian and diabetes educator who was not involved in the study, offered further insight to Medical News Today.

“The Mediterranean diet consists of plant-based foods such as vegetables, beans, nuts and seeds, fruit, and whole grains. Other food sources include fish and seafood… The dairy sources include yogurt and cheese. And red meat and concentrated sugars, or honey are rarely consumed. Following this eating pattern has shown benefits in reducing the risk of diabetes, lowering fasting blood glucose, reducing A1c, lowering triglyceride levels and lowering cardiovascular events.”

Angela Ginn-Meadow, registered dietitian

Previous research has indicated that the Mediterranean diet may lower a person’s risk for type 2 diabetes.

However, one of the difficulties of this research is that it often relies on self-reporting from participants about dietary habits and food choices.

Researchers in the new study wanted to figure out a more objective way to examine adherence to a Mediterranean diet.

Researchers created a scoring system based on several components in a person’s bloodwork.

Nita Gandhi Forouhi, PhD, a study author and a professor at the University of Cambridge in England, explained to MNT:

“Our goal was to develop a blood-based nutritional biomarker score that could objectively indicate the consumption of the Mediterranean diet and to test its association with the risk of developing type 2 diabetes.”

Nita Gandhi Forouhi, University of Cambridge

T​he researchers used data from a specific trial to create their biomarker score.

In this trial, participants followed either components of a Mediterranean diet or their regular diet.

Based on the levels of certain elements in participants’ blood, carotenoids and fatty acids, researchers said they could distinguish with some accuracy who was on the Mediterranean diet and who was continuing their regular diet.

Next, researchers examined how biomarker scores lined up with type 2 diabetes.

“We applied the biomarker score in a study that included 9,453 people who developed type 2 diabetes and a reference group of 12,749 people who remained free of type 2 diabetes during the follow-up period of the EPIC-InterAct study in eight countries of Europe. We found that the higher the biomarker score level, the lower the risk of new-onset type 2 diabetes. This was the case even after we accounted for a range of other factors that may have influenced the results, such as people’s age, gender, levels of physical activity, smoking habit, or body mass index, and waist circumference.”

Nita Gandhi Forouhi, University of Cambridge

Based on their analysis, researchers reported that higher adherence to the Mediterranean diet was associated with approximately an 11% decreased risk of developing type 2 diabetes.

Overall, they said, the results indicate that adherence to the Mediterranean diet may help to reduce individual risk for type 2 diabetes.

Ginn-Meadow commented on how this data may be helpful when it comes to diabetes prevention.

“This study has provided additional evidence of the benefit of the Mediterranean eating pattern across the population. Researchers can evaluate circulating carotenoids and fatty acids biomarkers for dietary adherence. As the rates of diabetes soar, we must think beyond a single food item and use healthy eating patterns as a tool for prevention and management of diabetes.”

Angela Ginn-Meadow, registered dietitian

While offering unique insight into how the Mediterranean diet may influence type 2 diabetes risk, the study did have certain limitations.

First, there was a certain risk of errors in measuring the nutritional biomarkers. Researchers also noted the possibility of residual confounding and how it is not clear how specifically the biomarker score lines up with the Mediterranean diet.

Other factors included limitations from how researchers collected data and conducted their research, including limitations based on participants who dropped out of the study and how researchers created the biomarker score.

The study also focused on participants from European countries, possibly indicating the need for greater diversity in the future.

Gandhi Forouhi said further research is needed to understand how well the biomarkers they examined align with adherence to the Mediterranean diet. She explained future avenues of research:

“An issue that is unresolved and needs to be addressed is how specific biomarker scores can be to particular diets. It is currently unknown to what extent our biomarker score is a distinct indicator of adherence to the Mediterranean diet or is more broadly indicative of a healthy diet, and whether factors beyond dietary intakes such as absorption and nutrient metabolism meaningfully affect its levels. These gaps in understanding can be tackled with future research that is designed to answer these specific questions.”

Nita Gandhi Forouhi, University of Cambridge

While further research does need to be considered, experts say some people, particularly those at risk for type 2 diabetes, may want to try a Mediterranean diet.

To do so safely, they recommend people seek dietary recommendations from their doctors or specialists trained to help them make wise food choices to meet their unique needs.

Bill Bradley, a registered dietitian with Mediterranean Living who was not involved in the study, offered a few tips for starting a Mediterranean diet to Medical News Today:

“To follow the Mediterranean Diet, focus on consuming fresh, whole foods such as vegetables, fruits, beans, nuts, seeds, whole grains, and fresh herbs and spices. Incorporate high-quality sources of protein, such as grass-fed meat, poultry, eggs, and dairy, and fish and seafood from the sea or ocean. Use fresh extra virgin olive oil as your primary fat source, and consume wine and moonshine in moderation. Bitter greens are also an essential part of the Mediterranean diet and can be incorporated into salads or cooked dishes. By following these guidelines and minimizing processed foods, you can reap the benefits of this heart-healthy, anti-inflammatory diet.”

Bill Bradley, registered dietitian