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Nutrition in acute and chronic diseases

Mediterranean diet and the hallmarks of ageing

Abstract

Ageing is a multifactorial process associated with reduced function and increased risk of morbidity and mortality. Recently, nine cellular and molecular hallmarks of ageing have been identified, which characterise the ageing process, and collectively, may be key determinants of the ageing trajectory. These include genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion and altered intercellular communication. Healthier dietary patterns reduce the risk of age-related diseases and increase longevity and may influence positively one or more of these hallmarks. The Mediterranean dietary pattern (MedDiet) is a plant-based eating pattern that was typical of countries such as Greece, Spain, and Italy pre-globalisation of the food system and which is associated with better health during ageing. Here we review the potential effects of a MedDiet on each of the nine hallmarks of ageing, and provide evidence that the MedDiet as a whole, or individual elements of this dietary pattern, may influence each hallmark positively—effects which may contribute to the beneficial effects of this dietary pattern on age-related disease risk and longevity. We also highlight potential avenues for future research.

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Fig. 1: Mechanisms through which the Mediterranean diet may impact the hallmarks of ageing.

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Funding

This research was supported by the Alzheimer’s Research UK Prevention and Risk Reduction Fund (ARUK-PRRF2017-006) and the UK Nutrition Research Partnership (UK NRP), an initiative supported by the Medical Research Council (MRC), Biotechnology and Biological Sciences Research Council (BBSRC) and the National Institute for Health Research (NIHR) (MR/T001852/1).

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This study was conceived by MS, and designed by OMS, MS and JCM. OMS, AWA, FS, GS, CMR, JL, JM, AG, NR, LL, ES, BCMS, AMM, MS and JCM drafted and critically revised the paper, with OMS taking a lead role. NR created the schematic. All authors approved the final version of the paper prior to submission.

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Correspondence to Mario Siervo.

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Shannon, O.M., Ashor, A.W., Scialo, F. et al. Mediterranean diet and the hallmarks of ageing. Eur J Clin Nutr 75, 1176–1192 (2021). https://doi.org/10.1038/s41430-020-00841-x

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