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.

Association between adherence to the Mediterranean diet and risk of sarcopenia: a systematic review and dose-response meta-analysis of observational studies

期刊论文
出版模式：

开放获取
发表日期：

2026年7月25日

查看全文

Chenping Xi,
Jiaqi Wang,
Xiaolin Liu,
Caijuan Si,
Xiaohua Ke,
Huiting Zhou

摘要

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%; P_{heterogeneity}=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, P_{dose−response}<0.001, P_nonlinearity=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.