Nutritional Therapy in Diabetes: Mediterranean Diet

Diabetes mellitus is a chronic illness which has an outstanding impact on public health due to its increasing prevalence, poor prognosis, and due to the high impact on cardiovascular health. Such is its importance, that diabetes is actually considered an independent predictor of cardiovascular disease (which includes coronary heart disease and stroke). Moreover, the cardiovascular risk of individuals with diabetes is considered to be equivalent to the risk of nondiabetic individuals with pre-existing cardiovascular diesease. Therefore, persons with diabetes mellitus have an increased susceptibility to atherosclerosis and an increased prevalence of ahterogenic risk factors, notably hypertension, obesity, and anormal lipids. This compendium of the abnormalities can be found in people with metabolic syndrome (MetS) which is now regarded as a prelude to diabetes and such as diabetes, MetS is a substantial predictor of cardiovascular disease and all-cause mortality(Ford, et al. 2002). Morbidity and mortality from these chronic diseases in the general population have a multifactorial origin, resulting from the interaction between genetic background and environmental factors. Among the latter, diet is probably the most relevant factor in order to prevent acute complications and to reduce the risk of long-term complications. Thus, it has been demonstrated that medical nutrition therapy is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing, the rate of development of diabetes complications. The basis of what constitutes optimal nutrition has been the subject of decades of research spanning the whole range of study designs, from ecological studies to in vitro modulation of gene expression. Based on this approach, there is now sufficient evidence supporting the notion that the monounsaturated fatty acids (MUFA) as a nutrient, olive oil as a food, and the Mediterranean diet (MedDiet) as a food pattern are associated with a decreased risk of cardiovascular disease, MetS, and diabetes mellitus. In the last decade, research in nutritional epidemiology has moved from the single food approach to the dietary pattern, which better reflects the complexity of interactive effects of multiple nutrients on health status(Hu 2002; Trichopoulou, et al. 2003; Trichopoulou, et al. 1995). Thus, the MedDiet pattern is built on the basis of a consumption of fat primarily from