Mediterranean Diet and Sports Injury Prevention: A Systematic Review

Background and/or Objectives: Approximately 8.6 million sports and recreation related injuries occur in the United States every year. Given the Mediterranean diet’s (MD’S) anti-inflammatory and bone-supportive properties, it presents a promising nutritional strategy to offer injury prevention strategies to mitigate injury risk and enhance recovery among athletes.

Objective: To evaluate the potential role of the MD in preventing sports-related injuries among athletic populations.

Design: A systematic review was conducted in accordance with PRISMA guidelines. 382 articles were selected and screened.14 studies met inclusion criteria: 4 narrative reviews, 4 cross-sectional studies, 2 randomized controlled trials, 2 cohort studies, 1 quasi-experimental study, and 1 case-control study. Studies included both recreational and professional athletes and were predominantly conducted in Spain (n=4) and Italy (n=3).

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Main Outcome Measures: Injury incidence, bone health indicators, oxidative stress markers, and inflammation-related biomarkers were the primary outcomes assessed.

Results: High MD-adherence was consistently associated with reduced injury risk, enhanced bone mineral density, and lower fracture incidence. Key components, Omega-3 fatty acids (O3) and extra virgin olive oil (EVOO), were found to reduce neuroinflammation and oxidative muscle damage. Some studies demonstrated that combining MD with physical activity improved vascular function and cardiovascular resilience, which are implicated in injury prevention.

Conclusions: This review highlights a significant gap in the current literature linking MD adherence to reduced injury rates in athletic populations. Nonetheless, emerging evidence supports MD’s protective role via anti-inflammatory, antioxidant, and musculoskeletal pathways, suggesting its potential as a holistic dietary intervention not only to enhance performance but also to reduce injury risk. Future research should incorporate objective injury surveillance tools and standardized MD adherence assessments across diverse athletic cohorts to establish causality and validate MD as a preventive strategy in sports medicine.