Efficacy of Mediterranean diet for the prevention of neurological diseases: A systematic review and meta-analysis featured in the Italian National Guidelines "La Dieta Mediterranea"
PRISMA 2020 systematic review and meta-analysis (45 studies, >730,000 participants; search through Feb 2024) links higher Mediterranean diet adherence to lower odds/risk of several neurological and mental health endpoints—including Alzheimer disease, mild cognitive impairment, depression, and Parkinson disease—with authors grading moderate NUTRIGRADE certainty for several pooled estimates while finding no significant association for dementia prevalence or MCI-to-dementia progression.
Design
- Guidelines context: Italian “La Dieta Mediterranea” national guideline evidence synthesis
- Corpus: 45 studies, >730 000 participants (search through 28 Feb 2024)
- Appraisal: Newcastle–Ottawa + NUTRIGRADE certainty
- Model: random-effects pooling (RR / HR / OR as reported per endpoint)
Abstract-reported pooled associations (examples)
- Alzheimer disease: OR 0.92 (moderate certainty)
- Mild cognitive impairment: RR 0.93
- Depression: RR 0.96
- Parkinson disease: RR 0.90
- Nulls: no significant association reported for overall dementia prevalence or progression from MCI to dementia in abstract summary
Evidence hygiene
Predominantly observational adherence scores—confounding by socioeconomic patterning and co-interventions remains a core threat despite adjustment narratives.
Publication
Zuliani G, Gianfredi V, Veronese N, et al. Nutrition. 2026 Feb;142:112990. doi: 10.1016/j.nut.2025.112990. Epub 2025 Oct 11. PMID 41259881.
Outcomes
- Pooled models: higher Mediterranean diet adherence associated with Alzheimer disease OR 0.92 (moderate NUTRIGRADE certainty per abstract).
- Same synthesis reports RR 0.93 (mild cognitive impairment), RR 0.96 (depression), RR 0.90 (Parkinson disease) versus lower adherence; no significant association for dementia prevalence or MCI-to-dementia progression in abstract summary.