# Drug-Food Interactions with a Focus on Mediterranean Diet
## 3 Mediterranean Food Products and Potential DFIs
### Med-D Food Products
\begin{table}
\begin{tabular}{l l l l l} \hline
**Fruit** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline Apples & PK & OAT transporter inhibition & Moderate & Good \\ Apricots & - & - & - & - \\ Avocados & PD & Anticogulants—Vitamin K & Moderate & Theoretical \\ Bananas & PD & Hyperkaliemia, high K\({}^{*}\) & Moderate & Theoretical \\ Cherries & - & - & - & - \\ Clementines & PK & CYP mediated drug metabolism & Moderate & Moderate \\ Grapefruit & PK & P-gp transport \& CYP mediated & \\ Grapefruit & PK & drug metabolism & Serious-avoid & High \\ Grapes & PK & UGT mediated drug metabolism & Moderate & Good \\ Lime & PK & - & - \\ Melons & PD & Synerg antidiabetic medications & Low & Theoretical \\ Oranges & PK & OAT transporter inhibition & Moderate & Good \\ Peaches & PD & Hyperkaliemia, high K\({}^{*}\) & Moderate & Theoretical \\ Pears & - & - & - \\ Pomegranates & PK & CYP mediated drug metabolism & None & High \\ Pomelo & PK & P-gp transport \& CYP mediated & Use with caution & Good \\ Strawberries & PK/PD & Metabolism \& anticoagulation & Low & Theoretical \\ Tangerines & PK & CYP mediated drug metabolism & Moderate & Moderate \\ \hline \end{tabular}
\begin{tabular}{l l l l} \hline
**Food** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline Barley & PK & Modulation GI absorption & Moderate & Low \\ Buckwheat & - & - & - & - \\ Bulgur & - & - & - & - \\ Farro-flax seed & PD & Anticogulants, n-3 FAs & Moderate & Low \\ Millet & - & - & - & - \\ Oats \& fibers & PK & Modulation GI absorption & Moderate & Good \\ Polenta & - & - & - & - \\ Rice & - & - & - & - \\ Wheat Berries & PK & Modulation GI absorption & Moderate & Low \\ Breads & - & - & - & - \\ Couscous & - & - & - & - \\ Almonds & - & - & - & - \\ Cashews & PD & Synergism antidiabetic & Minor & Low \\ Chickpeas & & medications & & \\ Fava beans & PD & Synergism with anti-Parkinson & Moderate & Low \\ Green peas & - & drugs (high L-dopa content) & - & - \\ Hazelnuts & & - & - & - \\ Kidney beans & PK & Modulation GI absorption & Minor & Low \\ Lentils & PD & Hyperkaliemia, high K\({}^{+}\) & Minor & Low \\ Peanuts & PD & Tyramine pressure effect & \\  & & (MAOIs) & Use with caution & Low \\ Pistachios & - & - & - \\ Sesame seeds (tachini) & PK & CYP mediated metabolism & None & Moderate \\ Split peas & PK & Modulation GI absorption & Minor & Theoretical \\ Walnuts & PK & Modulation GI absorption & Moderate & Theoretical \\ \hline \end{tabular}
\begin{tabular}{l l l l} \hline
**Food** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline Barley & PK & Modulation GI absorption & Moderate & Low \\ Buckwheat & - & - & - & - \\ Bulgur & - & - & - & - \\ Farro-flax seed & PD & Anticogulants, n-3 FAs & Moderate & Low \\ Millet & - & - & - \\ Oats \& fibers & PK & Modulation GI absorption & Moderate & Good \\ Polenta & - & - & - & - \\ Rice & - & - & - & - \\ Wheat Berries & PK & Modulation GI absorption & Moderate & Low \\ Breads & - & - & - & - \\ Couscous & - & - & - & - \\ Almonds & - & - & - \\ Cashews & PD & Synergism antidiabetic & Minor & Low \\ Chickpeas & & medications & & \\ Fava beans & PD & Synergism with anti-Parkinson & Moderate & Low \\ drugs (high L-dopa content) & & - & - \\ Green peas & - & - & - & - \\ Hazelnuts & & - & - & - \\ Kidney beans & PK & Modulation GI absorption & Minor & Low \\ Lentils & PD & Hyperkaliemia, high K\({}^{+}\) & Minor & Low \\ Peanuts & PD & Tyramine pressure effect & \\  & & (MAOIs) & Use with caution & Low \\ Pistachios & - & - & - \\ Sesame seeds (tachini) & PK & CYP mediated metabolism & None & Moderate \\ Split peas & PK & Modulation GI absorption & Minor & Theoretical \\ Walnuts & PK & Modulation GI absorption & Moderate & Theoretical \\ \hline \end{tabular}
\begin{tabular}{l l l l} \hline
**Fruit** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline Apples & PK & OAT transporter inhibition & Moderate & Good \\ Apricots & - & - & - \\ Avocados & PD & Anticogulants—Vitamin K & Moderate & Theoretical \\ Bananas & PD & Hyperkaliemia, high K\({}^{*}\) & Moderate & Theoretical \\ Cherries & - & - & - \\ Clementines & PK & CYP mediated drug metabolism & Moderate & Moderate \\ Grapefruit & PK & P-gp transport \& CYP mediated & \\ Grapefruit & PK & drug metabolism & \\ Grapes & PK & UGT mediated drug metabolism & Moderate & Good \\ Lime & PK & - & - \\ Melons & PD & Synergism antidiabetic medications & Low & Theoretical \\ Oranges & PK & OAT transporter inhibition & Moderate & Good \\ Peaches & PD & Hyperkaliemia, high K\({}^{*}\) & Moderate & Theoretical \\ Pears & - & - & - \\ Pomegranates & PK & CYP mediated drug metabolism & None & High \\ Pomelo & PK & P-gp transport \& CYP mediated & Use with caution & Good \\ Strawberries & PK/PD & Metabolism \& anticoagulation & Low & Theoretical \\ Tangerines & PK & CYP mediated drug metabolism & Moderate & Moderate \\ \hline \end{tabular}
\begin{tabular}{l l l l l} \hline
**Food** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline Barley & PK & Modulation GI absorption & Moderate & Low \\ Buckwheat & - & - & - & - \\ Bulgur & - & - & - & - \\ Farro-flax seed & PD & Anticogulants, n-3 FAs & Moderate & Low \\ Millet & - & - & - \\ Oats \& fibers & PK & Modulation GI absorption & Moderate & Good \\ Polenta & - & - & - & - \\ Rice & - & - & - & - \\ Wheat Berries & PK & Modulation GI absorption & Moderate & Low \\ Breads & - & - & - & - \\ Couscous & - & - & - & - \\ Almonds & - & - & - & - \\ Cashews & PD & Synergism antidiabetic & Minor & Low \\ Chickpeas & & medications & & \\ Fava beans & PD & Synergism with anti-Parkinson & Moderate & Low \\ Green peas & - & drugs (high L-dopa content) & - & - \\ Hazelnuts & & - & - & - \\ Kidney beans & PK & Modulation GI absorption & Minor & Low \\ Lentils & PD & Hyperkaliemia, high K\({}^{+}\) & Minor & Low \\ Peanuts & PD & Tyramine pressure effect & \\  & PD & (MAOIs) & Use with caution & Low \\ Pistachios & - & - & - & - \\ Sesame seeds (tachini) & PK & CYP mediated metabolism & None & Moderate \\ Split peas & PK & Modulation GI absorption & Minor & Theoretical \\ Walnuts & PK & Modulation GI absorption & Moderate & Theoretical \\ \hline \end{tabular}
\begin{tabular}{l l l l} \hline
**Fruit** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline Apples & PK & OAT transporter inhibition & Moderate & Good \\ Avocados & PD & Anticogulants—Vitamin K & Moderate & Theoretical \\ Bananas & PD & Hyperkaliemia, high K\({}^{*}\) & Moderate & Theoretical \\ Cherries & - & - & - & - \\ Clementines & PK & CYP mediated drug metabolism & Moderate & Moderate \\ Grapefruit & PK & P-gp transport \& CYP mediated & \\ Grapes & PK & UGT mediated drug metabolism & Moderate & Good \\ Lime & PK & & - & - \\ Melons & PD & Synergism antidiabetic medications & Low & Theoretical \\ Oranges & PK & OAT transporter inhibition & Moderate & Good \\ Peaches & PD & Hyperkaliemia, high K\({}^{*}\) & Moderate & Theoretical \\ Pears & - & - & - & - \\ Pomegranates & PK & CYP mediated drug metabolism & None & High \\ Pomelo & PK & P-gp transport \& CYP mediated & Use with caution & Good \\ Strawberries & PK/PD & Metabolism \& anticoogulation & Low & Theoretical \\ Tangerines & PK & CYP mediated drug metabolism & Moderate & Moderate \\ \hline \end{tabular}
\end{table}