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The Mediterranean Diet (MedDiet) has been promoted as a means of preventing and treating cardiodiabesity. The aim of this study was to answer a number of key clinical questions (CQs) about the role of the MedDiet in cardiodiabesity in order to provide a framework for the development of clinical practice guidelines. A systematic review was conducted to answer five CQs formulated using the Patient, Intervention, Comparison, and Outcome (PICO) criteria. Twenty articles published between September 2013 and July 2016 were included, adding to the 37 articles from the previous review. There is a high level of evidence showing that MedDiet adherence plays a role in the primary and secondary prevention of cardiovascular disease (CVD) and improves health in overweight and obese patients. There is moderate-to-high evidence that the MedDiet prevents increases in weight and waist circumference in non-obese individuals, and improves metabolic syndrome (MetS) and reduces its incidence. Finally, there is moderate evidence that the MedDiet plays primary and secondary roles in the prevention of type 2 diabetes mellitus (T2DM). The MedDiet is effective in preventing obesity and MetS in healthy and at-risk individuals, in reducing mortality risk in overweight or obese individuals, in decreasing the incidence of T2DM and CVD in healthy individuals, and in reducing symptom severity in individuals with T2DM or CVD.

BACKGROUND/OBJECTIVES: The primary objective of this study was to explore physicians' adherence to the dietary pattern known as the Mediterranean diet (MD). As a secondary objective we assessed physicians' awareness on the benefits of the MD and of the possibility of prescribing it. SUBJECTS/METHODS: Physicians' adherence to the MD was evaluated through the Spanish associations SEMERGEN and CAMFIC, who sent the validated PREDIMED screener to their affiliates. The results reflected a high, medium, low or very low level of adherence depending on total score. The sample was drawn between 2014 and 2016. The second questionnaire evaluated the physicians' knowledge of the MD and their opinion about recommending it. RESULTS: The PREDIMED test was answered by 422 Spanish physicians. In 8 out of 14 questions, more than 50% of the individuals scored only 1 point. However, 3 questions resulted in 1 point being scored by almost all physicians. Thus, on average, 55% of questions obtained 1-point scoring. The second questionnaire was answered by 212 physicians; 70% of them considered themselves to be aware of the benefits of the MD. More than 60% said they could invest 5 min of their time to recommend the MD. CONCLUSIONS: Primary care physicians do not show a high level of adherence to the MD and emphasize the need for creating tools to evaluate it in their patients. This research can be useful as both a database and a justification for the creation of a new protocol to help physicians increase their own and their patients' MD adherence.