The metabolic syndrome can be prevented by the Mediterranean diet, characterized by fiber, omega-3 polyunsaturated fatty acidsand polyphenols. However, the composition of the Mediterranean diet, which can be viewed as a natural multiple supplement, is poorly controlled, and its beneficial effects poorly predictable.

The metabolic syndrome is associated with intestinal dysbiosis and the gut microbiom and seems to be the main target and player in the interactions occurring between probiotics, prebiotics, omega 3polyunsaturated fatty acids, and polyphenols.

From the reviewed evidence, it is reasonable to manage growth and metabolism of gutmicroflora with specific prebiotics and polyphenols. Even though the healthy properties of functional foods and nutraceuticals still need to be fully elucidated, available data suggest that well-designed supplements, containing the better ratio of omega-3polyunsaturated fatty acids and antioxidants, specific probiotic strains, and selected polyphenols and prebiotics, could be useful in metabolic syndrome prevention and treatment.