Association of Mediterranean Diet and Olive Oil Intake with Type 2 Diabetes Risk

Gözde Okburan; Serap Kızıler

doi:10.23751/pn.2026.18610

Association of Mediterranean Diet and Olive Oil Intake with Type 2 Diabetes Risk

Authors

Gözde Okburan Eastern Mediterranean University
Serap Kızıler Eastern Meditarranean University

Keywords:

Diabetes, Mediterranean Diet, mediterranean diet score , Olive Oil

Abstract

The Mediterranean Diet (MD) is widely acknowledged for its protective role against chronic non-communicable diseases, including type 2 diabetes mellitus (T2DM). Extra-virgin olive oil (EVOO), the principal fat source of the MD, is considered a key contributor to its cardiometabolic benefits. This cross-sectional study evaluated the associations between adherence to the Mediterranean Diet (MD), olive oil consumption, and estimated risk of type 2 diabetes mellitus (T2DM) in a sample of 375 non-diabetic adults residing in Famagusta, Cyprus. Dietary intake data were collected using validated food-frequency questionnaires. Adherence to the MD was quantified using the Mediterranean Diet Assessment Scale (MEDAS), while the estimated risk of T2DM was determined using the Finnish Diabetes Risk Score (FINDRISC), a validated risk assessment instrument. Overall adherence to the MD was not significantly associated with estimated T2DM risk, as no correlation was observed between MEDAS scores and FINDRISC values. In contrast, higher olive oil consumption was significantly associated with lower T2DM risk scores, whereas greater sunflower oil intake was positively associated with increased T2DM risk. These findings suggest that the type of dietary fat consumed particularly olive oil may exert a more substantial influence on T2DM risk than adherence to the overall MD pattern alone. Prospective, large-scale studies are needed to confirm these associations and clarify the underlying biological mechanisms.

References

1. Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Scientific reports. 2020 Sep 8;10(1):1-1.

2. Federation, I. D. IDF Diabetes Atlas, 10th ed. Brussels:2021. (https://diabetesatlas.org/atlas/tenth-edition/)

3. Adua E, Kolog EA, Afrifa-Yamoah E, Amankwah B, Obirikorang C, Anto EO, et al. Predictive model and feature importance for early detection of type II diabetes mellitus. Translational Medicine Communications. 2021 Dec;6:1-5.

4. Schwingshackl L, Missbach B, König J, Hoffmann G. Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis. Public health nutrition. 2015 May;18(7):1292-9.

5. Altomare R, Cacciabaudo F, Damiano G, Palumbo VD, Gioviale MC, Bellavia M, et al. The Mediterranean diet: a history of health. Iranian journal of public health. 2013;42(5):449.

6. Zheng X, Zhang W, Wan X, Lv X, Lin P, Si S, et al. The effects of Mediterranean diet on cardiovascular risk factors, glycemic control and weight loss in patients with type 2 diabetes: a meta-analysis. BMC nutrition. 2024 Apr 19;10(1):59.

7. Guasch-Ferré M, Hruby A, Salas-Salvadó J, Martínez-González MA, Sun Q, Willett WC, et al. Olive oil consumption and risk of type 2 diabetes in US women. The American journal of clinical nutrition. 2015 Aug 1;102(2):479-86.

8. Dehghani, F., Morvaridzadeh, M., Pizarro, A. B., Rouzitalab, T., Khorshidi, M., Izadi, A., et al. (2021). Effect of extra virgin olive oil consumption on glycemic control: A systematic review and meta-analysis. Nutrition, Metabolism and Cardiovascular Diseases, 31(7), 1953-1961.

9. Schwingshackl L, Lampousi AM, Portillo MP, Romaguera D, Hoffmann G, Boeing H. Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials. Nutrition & diabetes. 2017 Apr;7(4):e262-.

10. Salas-Salvadó, J., Bulló, M., Babio, N., MARTinez-GONZalez, M. A., Ibarrola-Jurado, N., Basora, J., et al. (2011). Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes care, 34(1), 14-19.

11. Qian F, Korat AA, Malik V, Hu FB. Metabolic effects of monounsaturated fatty acid-enriched diets compared with carbohydrate or polyunsaturated fatty acid-enriched diets in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabetes care. 2016 Aug 1;39(8):1448-57.

12. Marrano N, Spagnuolo R, Biondi G, Cignarelli A, Perrini S, Vincenti L, et al. Effects of extra virgin olive oil polyphenols on beta-cell function and survival. Plants. 2021 Feb 3;10(2):286.

13. Loizzo MR, Lecce GD, Boselli E, Menichini F, Frega NG. Inhibitory activity of phenolic compounds from extra virgin olive oils on the enzymes involved in diabetes, obesity and hypertension. Journal of Food Biochemistry. 2011 Apr;35(2):381-99.

14. Hadrich F, Bouallagui Z, Junkyu H, Isoda H, Sayadi S. The α-glucosidase and α-amylase enzyme inhibitory of hydroxytyrosol and oleuropein. Journal of oleo science. 2015;64(8):835-43.

15. Wu L, Velander P, Liu D, Xu B. Olive component oleuropein promotes β-cell insulin secretion and protects β-cells from amylin amyloid-induced cytotoxicity. Biochemistry. 2017 Sep 26;56(38):5035-9.

16. Pehlivanoğlu EF, Balcıoğlu H, Ünlüoğlu İ. Akdeniz diyeti bağlılık ölçeği’nin türkçe’ye uyarlanması geçerlilik ve güvenilirliği. Osmangazi Tıp Dergisi. 2020;42(2):160-4.

17. Rakicioğlu N, Tek N, Ayaz A, Pekcan A. Yemek ve besin fotoğraf kataloğu ölçü ve miktarlar. Ankara:Ata Ofset Matbaacılık, 2012.

18. Jan A, Weir CB. BMI classification percentile and cut off points. StatPearls: Treasure Island, FL, USA. 2021:1-4.

19. Pekcan, G. Diyet el kitabı 12. ed. Ankara: Hatiboğlu Yayın Evi:2020

20. Piqueras, P., Ballester, A., Durá-Gil, J. V., Martinez-Hervas, S., Redón, J., & Real, J. T. (2021). Anthropometric indicators as a tool for diagnosis of obesity and other health risk factors: a literature review. Frontiers in Psychology, 12, 631179.

21. Yildiz T, Zuhur S, Zuhur SS. Diabetes Risk Assessment and Awareness in a University Academics and Employees. Medical Bulletin of Sisli Etfal Hospital. 2021 Oct 1;55(4).

22. Loosen SH, Krieg S, Krieg A, Luedde T, Kostev K, Roderburg C. Adult Body Height Is Associated with the Risk of Type 2 but Not Type 1 Diabetes Mellitus: A Retrospective Cohort Study of 783,029 Individuals in Germany. Journal of Clinical Medicine. 2023 Mar 12;12(6):2199.

23. Wittenbecher C, Kuxhaus O, Boeing H, Stefan N, Schulze MB. Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors. Diabetologia. 2019 Dec;62:2211-21.

24. Abiemo EE, Alonso A, Nettleton JA, Steffen LM, Bertoni AG, Jain A, et al. Relationships of the Mediterranean dietary pattern with insulin resistance and diabetes incidence in the Multi-Ethnic Study of Atherosclerosis (MESA). British journal of nutrition. 2013 Apr;109(8):1490-7.

25. Sarsangi P, Salehi-Abargouei A, Ebrahimpour-Koujan S, Esmaillzadeh A. Association between adherence to the Mediterranean diet and risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies. Advances in Nutrition. 2022 Sep 1;13(5):1787-98.

26. Milenkovic, T., Bozhinovska, N., Macut, D., Bjekic-Macut, J., Rahelic, D., Velija Asimi, Z., & Burekovic, A. (2021). Mediterranean Diet and Type 2 Diabetes Mellitus: A Perpetual Inspiration for the Scientific World. A Review. Nutrients, 13(4), 1307.

27. Dağ A. Lefkoşa’da yaşayan yetişkin bireylerin beslenme alışkanlıkları ve beslenme durumlarının saptanması. Beslenme ve Diyet Dergisi. 2019 Aug 29;47(2):50-60.

28. Zazpe I, Santiago S, Toledo E, Bes-Rastrollo M, de la Fuente-Arrillaga C, Martínez-González MÁ. Diet quality indices in the SUN cohort: observed changes and predictors of changes in scores over a 10-year period. Journal of the Academy of Nutrition and Dietetics. 2021 Oct 1;121(10):1948-60.

29. Martínez-González MA, Sayón-Orea C, Bullón-Vela V, Bes-Rastrollo M, Rodríguez-Artalejo F, Yusta-Boyo MJ, et al. Effect of olive oil consumption on cardiovascular disease, cancer, type 2 diabetes, and all-cause mortality: A systematic review and meta-analysis. Clinical Nutrition. 2022 Dec 1;41(12):2659-82.

30. Pimpin L, Wu JH, Haskelberg H, Del Gobbo L, Mozaffarian D. Is butter back? A systematic review and meta-analysis of butter consumption and risk of cardiovascular disease, diabetes, and total mortality. PLoS one. 2016 Jun 29;11(6):e0158118.

31. Pădureţ S. The effect of fat content and fatty acids composition on color and textural properties of butter. Molecules. 2021 Jul 28;26(15):4565.

32. Guo J, Givens DI, Astrup A, Bakker SJ, Goossens GH, Kratz M, et al. The impact of dairy products in the development of type 2 diabetes: where does the evidence stand in 2019?. Advances in Nutrition. 2019 Nov 1;10(6):1066-75.

33. Liu S, van der Schouw YT, Soedamah-Muthu SS, Spijkerman AM, Sluijs I. Intake of dietary saturated fatty acids and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort: associations by types, sources of fatty acids and substitution by macronutrients. European journal of nutrition. 2019 Apr 1;58:1125-36.

34. Ikwuobe OJ, Rana K, Brown J, Pararasa C, Shabir K, Bellary S, Bailey C, Griffiths H. Odd-chain fatty acids predict insulin sensitivity in people with T2DM and protect HepG2 cells from palmitate-induced insulin resistance via PPARα. Free Radical Biology and Medicine. 2016 Nov 1;100:S174.

35. Weir NL, Nomura SO, Steffen BT, Guan W, Karger AB, Klein R, et al. Associations between omega-6 polyunsaturated fatty acids, hyperinsulinemia and incident diabetes by race/ethnicity: The Multi-Ethnic Study of Atherosclerosis. Clinical Nutrition. 2020 Oct 1;39(10):3031-41.