Association between adherence to the Mediterranean diet and risk of sarcopenia: a systematic review and dose-response meta-analysis of observational studies.
5 affiliations
- 1Department of Rehabilitation Medicine, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou, Zhejiang, 310013, The People's Republic of China.
- 2Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, The People's Republic of China.
- 3Department of Nutrition, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou, Zhejiang, 310013, The People's Republic of China.
- 4Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, The People's Republic of China. [email protected].
- 5Department of Rehabilitation Medicine, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou, Zhejiang, 310013, The People's Republic of China. [email protected].
Abstract
Background
Epidemiological studies have investigated the potential association between adherence to the Mediterranean diet and risk of sarcopenia, with inconsistent results.Objective
The current systematic review and meta-analysis was conducted to synthesize available evidence regarding the association between adherence to the Mediterranean diet and risk of sarcopenia.Methods
This review followed PRISMA guidelines and was registered in PROSPERO (CRD420251145903). A comprehensive literature search was conducted in four electronic databases, including ISI Web of Science, PubMed, Embase, China National Knowledge Infrastructure (CNKI) from database inception to July 2025. Random-effects model was applied to calculate the pooled odd ratios (ORs) and 95% confidence intervals (CIs) for the highest versus lowest categories of Mediterranean diet score in relation to sarcopenia risk. The Cochran's Q test and I-squared (I²) statistic were used to detect the sources of heterogeneity among the included studies.Results
Seven observational studies (3 cohort and 4 cross-sectional studies) with 9,709 participants were included. The results showed that high adherence to the Mediterranean diet was significantly associated with a reduced risk of sarcopenia (OR = 0.81; 95%CI:0.71-0.92, P = 0.002), with substantial heterogeneity (I² = 70.2%; Pheterogeneity=0.002). Dose-response analysis showed an inverse linear association between adherence to the Mediterranean diet and risk of sarcopenia (OR = 0.873; 95% CI:0.846-0.901, Pdose-response<0.001, Pnonlinearity=0.369). Subgroup analyses revealed an inverse association between adherence to the Mediterranean diet and risk of sarcopenia in the subgroups of sample size < 1000 (OR = 0.34, 95%CI: 0.20-0.58, P < 0.001), questionnaire/food record (OR = 0.83; 95%CI:0.77-0.89, P < 0.001), and posteriori method defining Mediterranean diet(OR = 0.35; 95%CI: 0.19-0.62, P < 0.001), with less evidence of heterogeneity.Conclusions
Our study suggested that high adherence to the Mediterranean diet was associated with a 19% reduced risk of sarcopenia. Further large prospective studies and randomized controlled trials are needed to affirm these findings.Trial registration
PROSPERO CRD420251145903.
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BibTeX
@article{xi2026association,
title = {{Association between adherence to the Mediterranean diet and risk of sarcopenia: a systematic review and dose-response meta-analysis of observational studies.}},
author = {Chenping Xi and Jiaqi Wang and Xiaolin Liu and Caijuan Si and Xiaohua Ke and Huiting Zhou},
journal = {BMC nutrition},
year = {2026},
month = jul,
doi = {10.1186/s40795-026-01434-w},
url = {https://europepmc.org/article/MED/42902420},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association between adherence to the Mediterranean diet and risk of sarcopenia: a systematic review and dose-response meta-analysis of observational studies.
AU - Chenping Xi
AU - Jiaqi Wang
AU - Xiaolin Liu
AU - Caijuan Si
AU - Xiaohua Ke
AU - Huiting Zhou
PY - 2026
DA - 2026/07/01
JO - BMC nutrition
DO - 10.1186/s40795-026-01434-w
UR - https://europepmc.org/article/MED/42902420
AB - Background Epidemiological studies have investigated the potential association between adherence to the Mediterranean diet and risk of sarcopenia, with inconsistent results.Objective The current systematic review and meta-analysis was conducted to synthesize available evidence regarding the association between adherence to the Mediterranean diet and risk of sarcopenia.Methods This review followed PRISMA guidelines and was registered in PROSPERO (CRD420251145903). A comprehensive literature search was conducted in four electronic databases, including ISI Web of Science, PubMed, Embase, China National Knowledge Infrastructure (CNKI) from database inception to July 2025. Random-effects model was applied to calculate the pooled odd ratios (ORs) and 95% confidence intervals (CIs) for the highest versus lowest categories of Mediterranean diet score in relation to sarcopenia risk. The Cochran's Q test and I-squared (I²) statistic were used to detect the sources of heterogeneity among the included studies.Results Seven observational studies (3 cohort and 4 cross-sectional studies) with 9,709 participants were included. The results showed that high adherence to the Mediterranean diet was significantly associated with a reduced risk of sarcopenia (OR = 0.81; 95%CI:0.71-0.92, P = 0.002), with substantial heterogeneity (I² = 70.2%; Pheterogeneity=0.002). Dose-response analysis showed an inverse linear association between adherence to the Mediterranean diet and risk of sarcopenia (OR = 0.873; 95% CI:0.846-0.901, Pdose-response<0.001, Pnonlinearity=0.369). Subgroup analyses revealed an inverse association between adherence to the Mediterranean diet and risk of sarcopenia in the subgroups of sample size < 1000 (OR = 0.34, 95%CI: 0.20-0.58, P < 0.001), questionnaire/food record (OR = 0.83; 95%CI:0.77-0.89, P < 0.001), and posteriori method defining Mediterranean diet(OR = 0.35; 95%CI: 0.19-0.62, P < 0.001), with less evidence of heterogeneity.Conclusions Our study suggested that high adherence to the Mediterranean diet was associated with a 19% reduced risk of sarcopenia. Further large prospective studies and randomized controlled trials are needed to affirm these findings.Trial registration PROSPERO CRD420251145903.
SN - 2055-0928
ER -