Key result
Mediterranean diet plus exercise improves cardiometabolic markers without consistent additive or synergistic benefits.
Why the study?
Although the Mediterranean diet and regular physical activity are established components of cardiovascular prevention, evidence regarding their combined cardiometabolic effects remains heterogeneous.
Does the combination of the Mediterranean diet and physical exercise improve cardiometabolic health in adults?
Does the combination of the Mediterranean diet and physical exercise improve cardiometabolic health in adults?
The Mediterranean diet and regular physical activity are complementary components of cardiometabolic prevention, though evidence for a synergistic effect remains inconclusive due to study heterogeneity.
Supports combined Mediterranean diet and exercise counseling; leaves open additive or synergistic effects for future trials.
Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. The Mediterranean diet (MD) and regular physical activity are established components of cardiovascular prevention, but evidence regarding their combined cardiometabolic effects remains heterogeneous. Objective: This narrative review critically summarizes current evidence on the joint role of the MD and physical exercise in cardiometabolic health. Methods: A structured literature search was conducted in PubMed, Web of Science, and Scopus using terms related to the MD, CVD, cardiometabolic health, physical activity, and exercise. Experimental and observational human studies published between 2016 and 2026 were considered, together with relevant systematic reviews and meta-analyses. Particular attention was given to 10 key human studies, including randomized intervention studies and observational cohorts. Owing to substantial heterogeneity in populations, interventions, comparators, follow-up periods, and outcomes, the evidence was synthesized narratively. Results: The key studies generally reported favorable changes in body weight and composition, blood pressure, glucose regulation, and lipid profiles. One observational study also found a lower likelihood of cardiovascular medication initiation among participants with sustained adherence to both lifestyle components. However, most outcomes were surrogate cardiometabolic markers, and the independent effects of diet and exercise were often difficult to isolate. Conclusions: The MD and regular physical activity appear to be complementary components of cardiometabolic prevention. However, current evidence does not establish a consistent additive or synergistic effect. Further long-term, well-controlled studies are needed to clarify their independent and combined contributions across different populations.
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Binti et al. (2026) conducted a review in Cardiometabolic health and cardiovascular disease. Mediterranean diet and physical exercise vs. Control diets, physical inactivity, or separate interventions was evaluated. The combination of the Mediterranean diet and regular physical activity yielded favorable changes in surrogate cardiometabolic markers, though current evidence does not establish a consistent additive or synergistic effect.
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