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SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 |
doi: 10.3389/fnut.2025.1523995
Determinants of Adherence to the Mediterranean Diet among Individuals with Type 2 Diabetes Mellitus Living in Mediterranean Countries: A Systematic Review
Provisionally accepted- 1 Maastricht University, Maastricht, Netherlands
- 2 Lebanese International University, Beirut, Beirut, Lebanon
Background: 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.Objective: 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 seventeen studies, with participant numbers ranging from 106 to 7447.Results: 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.
Keywords: Sociodemographic, type 2 diabetes, mediterranean diet, Health Promotion, Nutrition Therapy, self-efficacy
Received: 06 Nov 2024; Accepted: 17 Jan 2025.
Copyright: © 2025 Ayoub, Haidar, Blaak and De Vries. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Janot Ayoub, Maastricht University, Maastricht, Netherlands
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