Higher Adherence to a Mediterranean Diet Is Associated with Improved Insulin Sensitivity and Selected Markers of Inflammation in Individuals Who Are Overweight and Obese without Diabetes

Nutrients. 2022 Oct 21;14(20):4437. doi: 10.3390/nu14204437.

Abstract

Insulin resistance (IR) and chronic low-grade inflammation are risk factors for chronic diseases including type 2 diabetes (T2D) and cardiovascular disease. This study aimed to investigate two dietary indices: Mediterranean Diet Score (MDS) and Dietary Inflammatory Index (DII®), and their associations with direct measures of glucose metabolism and adiposity, and biochemical measures including lipids, cytokines and adipokines in overweight/obese adults. This cross-sectional study included 65 participants (males = 63%; age 31.3 ± 8.5 years). Dietary intake via 3-day food diaries was used to measure adherence to MDS (0-45 points); higher scores indicating adherence. Energy-adjusted DII (E-DII) scores were calculated with higher scores indicating a pro-inflammatory diet. IR was assessed using hyperinsulinemic euglycemic clamps, insulin secretion by intravenous glucose tolerance test, adiposity by dual-energy X-ray absorptiometry, and circulating cytokine and adipokine concentrations by multiplex assays. Higher MDS was associated with greater insulin sensitivity (β = 0.179; 95%CI: 0.39, 0.318) after adjusting for age, sex and % body fat, and lower NF-κB, higher adiponectin and adipsin in unadjusted and adjusted models. Higher E-DII score was associated with increased total cholesterol (β = 0.364; 95%CI: 0.066, 0.390) and LDL-cholesterol (β = 0.305; 95%CI: 0.019, 0.287) but not with adiposity, glucose metabolism, cytokines or adipokines. Greater MDS appears to be associated with decreased IR and inflammatory markers in overweight/obese adults.

Keywords: diabetes; dietary inflammatory index; inflammation; insulin sensitivity; mediterranean diet; metabolic disease.

MeSH terms

  • Adipokines / metabolism
  • Adiponectin
  • Adult
  • Biomarkers
  • Cholesterol
  • Complement Factor D
  • Cross-Sectional Studies
  • Cytokines
  • Diabetes Mellitus, Type 2*
  • Diet
  • Diet, Mediterranean*
  • Glucose
  • Humans
  • Inflammation
  • Insulin Resistance*
  • Lipids
  • Male
  • NF-kappa B
  • Obesity / complications
  • Obesity / metabolism
  • Overweight / complications
  • Young Adult

Substances

  • Adipokines
  • Adiponectin
  • Biomarkers
  • Cholesterol
  • Complement Factor D
  • Cytokines
  • Glucose
  • Lipids
  • NF-kappa B