Abstract
The Mediterranean diet is upheld in the 2015-2020 Dietary Guidelines as an example of an eating pattern that promotes good health, a healthy body weight, and disease prevention throughout the lifespan. The Mediterranean eating pattern is based on a variety of unprocessed plant foods including fruits, vegetables, whole grains, legumes, nuts, and seeds that are high in polyphenols. The majority of polyphenols arrive in the colon where bacteria degrade them into smaller phenolics that can be translocated via the portal vein to the liver. In the liver, the phenolics undergo additional biotransformation prior to release into the circulation and transport to specific tissues where bioactive effects take place before removal in the urine. Recent epidemiologic studies using improved assessment techniques support that high versus low dietary polyphenol intake predicts reduced risk for neurodegenerative diseases, diabetes, cardiovascular disease, hypertension, obesity, and early death from all causes. Emerging science reveals that many of these health-related benefits can be traced to the biotransformed, gut-derived phenolics. In conclusion, the high consumption of unprocessed plant foods by inhabitants of countries bordering the Mediterranean Sea has been linked to multiple health and disease prevention benefits that are in large part due to a varied intake of polyphenols.