Over the past decades, the prevalence of the metabolic syndrome (MetS), a health condition identified by a cluster of risk factors linked to the development of cardiovascular disease, type 2 diabetes mellitus and some types of cancer, has dramatically increased in the world. The rising of MetS incidence and progression appear related to Westernization of dietary habits in the world, with a corresponding increase in the consumption of meat or meat products, snacks, baked desserts and sugar-sweetened beverages not only in the Western countries, but also in the Mediterranean region and among the Eastern populations. Otherwise epidemiological evidence suggests that a high dietary intake of fruits, vegetables, fish and whole grains can improve all the risk factors related to MetS. Particularly adherence to the Mediterranean diet seems to have positive effects on the prevalence and progression of the MetS. In this article we reviewed cohort studies, cross-sectional studies and clinical trials, showing new evidence supporting the beneficial role of adherence to the Mediterranean dietary pattern on the MetS progression. Analysis of the literature suggests that Mediterranean diet should be considered as a healthy and sustainable lifestyle playing a key role in primary and secondary prevention of MetS and its components.
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