# Drug-Food Interactions with a Focus on Mediterranean Diet
## 3 Mediterranean Food Products and Potential DFIs  
### Med-D Food Products  
Med-D allows the intake of all types of foods following a general food guidance pyramid (Figure 4) [2; 3]. In its base (level 1) are vegetables, fruits, nuts, and cereals that should be consumed in greater amounts and at daily frequency. Above them (level-2), sea food proteins and omega-3-fatty acids (n-3 FAs) are suggested to be consumed biweekly. Animal food products (level3) such as dairy, cheese, and eggs can be consumed in moderate portions during the week. Red meat (level 4) should be consumed in less proportions during the week along with saturated fat products and sweets. Regarding alcohol, a moderate consumption of wine and other fermented beverages is recommended (one to two glasses with meals). The pyramid is complete considering daily activities and physical exercise. Tables 1-3 summarize available data regarding potential DFIs for food products of level1 in the Med-D pyramid. \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Food** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline \hline \multirow{3}{*}{Artichoke} & PK & CYP mediated drug & Moderate & Moderate \\  & PK & metabolism & Moderate & Moderate \\ \cline{1-1} \cline{3-5} \cline{3-5} \cline{3-5} \cline{3-5} \cline{3-5 \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Food** & **Type of DFIs** & **Suggested Mechanism** & **Clinical Significance** & **Level of Evidence** \\ \hline Garlic & PK & & Moderate & Good \\ Green beans & - & - & - & - \\ Kale & PD & Anticagulants—Vitamin K & Moderate & Theoretical \\ Leeks & PD & Anticoagulants—Vitamin K & Minor & Theoretical \\ Mushrooms & - & - & - & - \\ Onions & PD & Anticoagulants—Vitamin K & Minor & Theoretical \\ Potatoes & - & - & - & - \\ Radish & PK & stimulate GI motility \& & \\  & & transit time & Minor & Moderate \\ Scallions & PD & Anticoagulants—Vitamin K & Minor & Theoretical \\ Shallots & PD & Anticoagulants—Vitamin K & Minor & Theoretical \\ Spinach & PD & Anticoagulants—Vitamin K & Moderate & Theoretical \\ Squash & PD & stimulant laxative may alter & Minor & Theoretical \\ Sweet potatoes & - & - & - & - \\ Swiss chard & PD & Anticoagulants—Vitamin K & Minor & Theoretical \\ Tomatoes & PK & CYP mediated drug & Minor & Moderate \\ metabolism & & & \\ Turnips & PD & Synergism antidiabetic & Minor & Moderate \\ Yams & PD & Synergism with estrogens & Moderate & Good \\ Zucchini & - & - & - & - \\ Anise & PK & CYP mediated metabolism & Moderate & Good \\ Basil & PD & Anticoagulants, n-3 FAs & Moderate & Low \\ Bayleaf & PD & Synergism with antidiabetic & Minor & Low \\  & & & \\ Cinnamon & PD & Synergism antidiabetic \& & Minor & Low \\  & & hepatotoxicity & & \\ Cloves & PD & potentiate the effects of & Moderate & Moderate \\  & & drugs that affect hemostasis & Moderate & Moderate \\ Cumin & PD & Synergism antidiabetic & Moderate & Moderate \\  & & medications & & \\ Fennel & - & - & - & - \\ Lavender & PD & Synergism with sedatives & Moderate & Low \\ Marjoram & PD & Potentate effects of drugs for & Moderate & Low \\  & & hemostasis & - & - \\ Mint & - & - & - \\ Oregono & PD & Potentate effects of drugs for & Moderate & Low \\ Parsley & - & - & - & - \\ Pepper & PK & CYP mediated drug & Minor & Moderate \\  & & metabolism & - & - \\ Sage & PD & Synergism with sedatives & Moderate & Low \\ Savory & PD & Anticoagulants, n-3 FAs & Moderate & Low \\ Sumac & PD & Induce nephrotoxicity of & Minor & Low \\  & drugs & Minor & Low \\ Tarragon & PD & Anticoagulants, n-3 FAs & Moderate & Low \\ Thyme & PD & Anticoagulants, n-3 FAs & Moderate & Low \\ \hline \hline \end{tabular}
\end{table} 
Table 1: _Cont._