# R6 | anthropic/claude-opus-5 | run 2

## Prompt

Summarize the main documented health effects of the Mediterranean diet in 4-5 points, with a citation for each claim.

## Response

The strongest evidence supports cardiovascular protection, with additional documented benefits for type 2 diabetes, cancer risk, all-cause mortality, and cognitive/mental health.

## Cardiovascular Disease Prevention

This is the best-documented effect. In the PREDIMED randomized trial, 7,447 high-risk participants were assigned to a Mediterranean diet with extra-virgin olive oil, one with nuts, or a low-fat control diet; after 4.8 years, hazard ratios for major cardiovascular events were 0.70 for both Mediterranean groups versus control — a reduction of roughly 28-30% in the composite endpoint of myocardial infarction, stroke, or cardiovascular death. The reduction was especially pronounced for stroke [PREDIMED review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856841/) [Advances in Nutrition](https://advances.nutrition.org/article/S2161-8313(22)01211-X/fulltext).

## Type 2 Diabetes and Metabolic Syndrome

Higher adherence consistently improves glycemic markers. Findings on type 2 diabetes and cardiovascular risk factors have been replicated in experimental settings, confirming benefits against blood glucose impairment, poor insulin sensitivity, and type 2 diabetes risk [SUN Cohort insights](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284864/). PREDIMED also assessed diabetes incidence and metabolic syndrome status as secondary endpoints, with adherence linked to decreased risk of both.

## Cancer Incidence and Mortality

Observational studies indicate that high adherence is associated with reduced overall cancer mortality and lower incidence of several cancer types, particularly colorectal, aerodigestive tract, breast, stomach, pancreas, prostate, liver, and head and neck cancers [Cancer risk review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4778149/).

## All-Cause Mortality and Longevity

In the SUN cohort of 22,786 Spanish graduates, high Mediterranean diet adherence was associated with reduced incidence of all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes, weight gain, metabolic syndrome, depression, and cognitive decline — with an inverse dose-response relationship for many of these associations [SUN Cohort](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946224/).

## Mental Health and Cognition

Evidence here is growing but weaker than for cardiometabolic outcomes. PREDIMED data indicate the diet may improve overall quality of life, with physical activity adding cognitive benefits, and a dedicated trial (PREDI-DEP) was launched to test whether the diet supplemented with olive oil or nuts prevents relapse of unipolar depression [Literature review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536728/).

**Mechanistic note:** Benefits are thought to operate through improved glucose and lipid metabolism, enhanced endothelial function, and reduced oxidative stress and low-grade inflammation [Platelet RCT](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915168/).

One caveat: evidence for outcomes beyond cardiovascular disease is often rated low or very low due to small interventional studies or unclear associations [Systematic review](https://www.sciencedirect.com/science/article/abs/pii/S0378512220302231).

Would you like detail on how adherence is actually scored, or on the practical food-group targets used in these trials?
