Review published in Advances in Nutrition finds high adherence to the Mediterranean diet associated with higher levels of physical fitness

The Centers for Disease Control and Prevention (CDC) reports that “regular physical activity is one of the most important things you can do for your health.”  Being physically fit can “improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities.”  Fortunately, most adults at any age have the ability to improve their physical fitness.  In fact, higher physical fitness has been associated with improved health and reduced mortality in all phases of the lifespan, from youth to old age.

In addition to physical fitness, good nutrition is also essential to maintaining good overall health.  In particular, studies have shown that the Mediterranean diet has been associated with favorable health outcomes over the entire life span.  Moreover, some evidence suggests that the Mediterranean diet could have a positive impact on physical fitness.  Antioxidant-rich ingredients such as olive oil, fruits, vegetables, whole grains and fish, which are hallmarks of the Mediterranean diet, lead to high-quality nutrient intake, which in turn promotes greater physical fitness.

Published in Advances in Nutrition, the international review journal of the American Society for Nutrition, High Adherence to the Mediterranean Diet is Associated with Higher Physical Fitness in Adults: A Systematic Review and Meta-Analysis examines the link between the Mediterranean diet and general physical fitness as well as specific components of fitness such as cardiorespiratory, motor, and musculoskeletal fitness.  The authors believe that their study represents the first systematic review and meta-analysis to provide a comprehensive picture of the associations between high and low adherence to the Mediterranean diet and physical fitness in adulthood. 

To conduct their research, the authors searched the scientific literature for relevant studies as far back as 1972 and up to January 2022.  Their search led them to 30 studies that met their criteria: 19 cross-sectional studies, 10 prospective cohort studies, and 1 randomized controlled study.  Altogether these studies comprised 36,807 individuals, with a mean age range from 21 to 86 years.

According to the findings, “high Mediterranean diet adherence was associated with higher levels of cardiorespiratory fitness, musculoskeletal fitness, and overall physical fitness in the entire adult population.”  The authors further noted that “sex, age, BMI, health status, current smoking status, and total energy intake did not influence the strength of these associations.”  Interestingly though, the authors did not find any significant association between Mediterranean diet adherence and motor skills fitness such as agility and speed.

The authors did acknowledge some limitations of their review and meta-analysis.  For example, many of the studies they reviewed were conducted among specific populations (e.g., healthy, obese, younger, older), making it difficult to determine whether findings could be generalized to all populations.  Studies had different methods of measuring Mediterranean diet adherence, making it difficult to determine the degree to which low or high adherence influences physical fitness.  Finally, the authors believe additional research is needed to better understand the biological and environmental mechanisms underlying the associations between the Mediterranean diet and its various components with improved physical fitness.

Despite acknowledging certain limitations to their study, in conclusion, the authors believe “promoting optimal adherence to the Mediterranean diet during adulthood, which was positively associated with a powerful health indicator such as physical fitness, should be a cornerstone of public health initiatives to prevent different diseases.”