**3. The potential of diet in preventing cardiovascular disease and diabetes**

The 2016 American Diabetes Association (ADA) Lifestyle Guidelines support the idea of a healthy diet to improve overall health, in light of achieving body weight, individualized glycemic, blood pressure, and lipid goals [75]. The 2016 European Guidelines on CVD prevention in clinical practice acknowledge that the Mediterranean diet is the most studied specific dietary pattern, which comprises many of the foods and nutrients that have been recommended previously, such as high intake of fruits, vegetables, whole grain products, fish, and unsaturated fatty acids [76]. The PREDIMED study (Prevention with Mediterranean Diet) demonstrated that Mediterranean diet reached a statistically significant reduction in the rate of the composite cardiovascular primary end-point of myocardial infarction (MI), stroke, or cardiovascular death [77]. The Mediterranean diet protects the heart, improves lipid profile, reduces blood pressure, and improves glucose tolerance [78]. Current evidence indicates that the Mediterranean diet is effective in improving glycemic control and reducing cardiovascular risk factors in people with T2DM and should therefore be considered in the overall strategy for the management of people with diabetes [79]. In the most extensive study assessing the effects of the Mediterranean diet on patients with newly diagnosed T2DM, the follow-up results over 8.1 years show that compared to a traditional low-fat diet, the rate of regression in the intima-media thickness of the carotid artery was higher by 49%, and the rate of progression lower by 25% in the Mediterranean diet group [80, 81].
