Why Is the Association Between Mediterranean Diet and Physical Performance in Athletes Inconclusive? Implications for Future Studies

Abstract

Background/Objectives: Athletes increasingly turn to nutrition and supplements to enhance performance, yet the evidence surrounding the efficacy of the Mediterranean diet (MD) remains inconclusive. This scoping review aims to evaluate identify gaps in the existing literature and provide implications for future research on the MD's potential to improve athletic performance across various demographics, sport types, and performance measures. Methods: We conducted a systematic search of peer-reviewed studies published across four databases (PubMed, Scopus, Scielo, and Google Scholar) using the following terms and their combinations: "mediterranean diet", "performance", "athlete", "sport". The search placed no restrictions on the experimental design or the time period of the publication and focused on athletes regardless of competitive level. We examined targeted studies about the MD's effects on key performance metrics, such as endurance, strength, and speed, while also evaluating possible confounding factors like dietary intake, body composition, and training status. We further aimed to identify gaps in the literature by investigating the consistency of dosing protocols, supplementation duration, and methodologies used. Results: The preliminary findings suggest that while some studies report benefits of the MD for recovery and endurance, only 40% show statistically significant improvements in performance outcomes, often with methodological limitations. The studies also lacked homogeneity in participant demographics, dosage, and performance assessments, hindering comparability. Our review highlights the need for future research that incorporates standardized dosing, homogeneous athlete populations, and controlled dietary conditions. Conclusions: This review provides a framework to guide further research and offers insights into the potential role of the MD in sports nutrition.

Keywords: gaps; nutrition; sports.

Figure 1

PRISMA flowchart of the selection process.