biostudies-literatureUnknown16(12)Wallerer S<h4>Background</h4>Given the global rise in type 2 diabetes mellitus (T2D), the Mediterranean diet (MedDiet) has gained attention as a promising preventive dietary pattern.<h4>Objectives</h4>This study aims to update and extend our previous systematic review by synthesizing current evidence from randomized controlled trials (RCTs) and prospective cohort studies on the association between MedDiet adherence and incident T2D in adults, and to evaluate the certainty of evidence.<h4>Methods</h4>We conducted a systematic search in MEDLINE, Cochrane CENTRAL, and Scopus from 2014 to May 2025. Eligible studies were prospective cohorts reporting on the adherence to an a priori-defined MedDiet or, for RCTs, MedDiet intervention compared with any other diet and T2D incidence. Random-effects dose-respoAdvances in nutrition (Bethesda, Md.)100562https://www.ebi.ac.uk/biostudies/studies/S-EPMC12720176biostudies-literatureAdherence to Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose-Response Meta-analysis.PMC12720176Hoffmann GBantle GSchwingshackl LStadelmaier JWallerer SFloegel EKiesswetter EfalseAdherence to Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose-Response Meta-analysis.<h4>Background</h4>Given the global rise in type 2 diabetes mellitus (T2D), the Mediterranean diet (MedDiet) has gained attention as a promising preventive dietary pattern.<h4>Objectives</h4>This study aims to update and extend our previous systematic review by synthesizing current evidence from randomized controlled trials (RCTs) and prospective cohort studies on the association between MedDiet adherence and incident T2D in adults, and to evaluate the certainty of evidence.<h4>Methods</h4>We conducted a systematic search in MEDLINE, Cochrane CENTRAL, and Scopus from 2014 to May 2025. Eligible studies were prospective cohorts reporting on the adherence to an a priori-defined MedDiet or, for RCTs, MedDiet intervention compared with any other diet and T2D incidence. Random-effects dose-respo2025-01-01T00:00:00Z2025 Dec2026-06-06T04:40:04.1Z2026-05-25T03:12:07.4ZS-EPMC127201764124104510.1016/j.advnut.2025.100562