The Effect of Mediterranean Diet on Metabolic Syndrome and its Components A Meta-Analysis of 50 Studies and 534,906 Individuals

Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece.
Journal of the American College of Cardiology (Impact Factor: 16.5). 03/2011; 57(11):1299-313. DOI: 10.1016/j.jacc.2010.09.073
Source: PubMed


The aim of this study was to meta-analyze epidemiological studies and clinical trials that have assessed the effect of a Mediterranean diet on metabolic syndrome (MS) as well as its components.
The Mediterranean diet has long been associated with low cardiovascular disease risk in adult population.
The authors conducted a systematic review and random effects meta-analysis of epidemiological studies and randomized controlled trials, including English-language publications in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials until April 30, 2010; 50 original research studies (35 clinical trials, 2 prospective and 13 cross-sectional), with 534,906 participants, were included in the analysis.
The combined effect of prospective studies and clinical trials showed that adherence to the Mediterranean diet was associated with reduced risk of MS (log hazard ratio: -0.69, 95% confidence interval [CI]: -1.24 to -1.16). Additionally, results from clinical studies (mean difference, 95% CI) revealed the protective role of the Mediterranean diet on components of MS, like waist circumference (-0.42 cm, 95% CI: -0.82 to -0.02), high-density lipoprotein cholesterol (1.17 mg/dl, 95% CI: 0.38 to 1.96), triglycerides (-6.14 mg/dl, 95% CI: -10.35 to -1.93), systolic (-2.35 mm Hg, 95% CI: -3.51 to -1.18) and diastolic blood pressure (-1.58 mm Hg, 95% CI: -2.02 to -1.13), and glucose (-3.89 mg/dl, 95% CI:-5.84 to -1.95), whereas results from epidemiological studies also confirmed those of clinical trials.
These results are of considerable public health importance, because this dietary pattern can be easily adopted by all population groups and various cultures and cost-effectively serve for primary and secondary prevention of the MS and its individual components.

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    • "Mediterranean diet, especially all-cause mortality , reducing the risk of cardiovascular disease and cancer which has been shown to be related to human health, is the best known and most researched dietary pattern [27]. "
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    ABSTRACT: Mediterranean diet (MD) is considered a model for healthy eating. However, prospective evidence in Turkey evaluating the relationship between MD and cardiovascular events is scarce. We surveyed the adherence of Alanya population to MD and its association with coronary heart diseases (CHD). The study population consisted of participants in Alanya, a region placed southern Turkey. Followed-up 900 participants (52 percent women) initially free of CHD during 5.1 years. The general dietary habits of study population were detected with a food frequency questionnaire. Data obtained from that questionnaire were tested with Mediterranean diet score in order to find out the relevance to Mediterranean diet. A MD score (scale 0-8) was computed reflecting high ratio of monounsaturated to saturated fat; high intake of legumes, cereals, vegetables, and fruits; low intakes of meat and it's products, milk and dairy products. Scoring < 5 was defined as Low-MD consuming, while 5+ as High-MD consuming. We observed 25 incident cases of CHD. Consumption of High-MD was 21% in men and 19% in women. The risk for myocardial infarction, coronary bypass, coronary angioplasty, and any cardiovascular disease in men increased by 1.3 (P = 0.02), 1.4 (P = 0.03), 1.5 (P = 0.01), and 1.3 (P = 0.02), respectively, for each MD score decrease. In women, the risk for myocardial infarction and angioplasty increased by 1.3 (P = 0.02) and 1.5 (P = 0.01), respectively, for each MD score decrease. The risk for coronary bypass, and any cardiovascular disease in women, crude odds ratios ranged from 1.1 to 1.3 but were not statistically significant. The current rate of MD in Alanya is fairly low. There is an inverse association between adherence to MD and the incidence of fatal and non-fatal CHD in initially healthy adults.
    International Journal of Clinical and Experimental Medicine 02/2015; 8(2):2860-6. · 1.28 Impact Factor
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    • "Moreover, the dietary habits of children may influence other habits such as the time spent engaged in sedentary or physically active pursuits. The Mediterranean diet (MD) is of special interest as it has been shown to have a positive impact on health-related quality of life (Costarelli, Koretsi, & Georgitsogianni, 2013), cardiovascular disease (Domínguez et al., 2013) and metabolic syndrome (Kastorini et al., 2011) and also shows some associations with obesity, albeit these findings are more equivocal (Buckland, Bach, & Serra-Majem, 2008). "
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    Appetite 05/2014; 80. DOI:10.1016/j.appet.2014.04.027 · 2.69 Impact Factor
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    • "Recent systematic reviews have estimated the reduction in risk of several common non-communicable, and age-related, diseases associated with increased F&V consumption (Additional file 1: Table S3). These benefits of specific food groups strengthen the evidence for the health-protecting effects of the MD and other healthy dietary patterns [3,4,51,52,75-78]. Such effects are likely to have a significant impact on the burden of chronic diseases, including associated disability and health care costs, among ageing populations. "
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    ABSTRACT: Retirement from work involves significant lifestyle changes and may represent an opportunity to promote healthier eating patterns in later life. However, the effectiveness of dietary interventions during this period has not been evaluated. We undertook a systematic review of dietary interventions among adults of retirement transition age (54 to 70 years). Twelve electronic databases were searched for randomized controlled trials evaluating the promotion of a healthy dietary pattern, or its constituent food groups, with three or more months of follow-up and reporting intake of specific food groups. Random-effects models were used to determine the pooled effect sizes. Subgroup analysis and meta-regression were used to assess sources of heterogeneity. Out of 9,048 publications identified, 67 publications reporting 24 studies fulfilled inclusion criteria. Twenty-two studies, characterized by predominantly overweight and obese participants, were included in the meta-analysis. Overall, interventions increased fruit and vegetable (F&V) intake by 87.8 g/day (P <0.00001), with similar results in the short-to-medium (that is, 4 to 12 months; 85.6 g/day) and long-term (that is, 12 to 58 months; 87.0 g/day) and for body mass index (BMI) category. Interventions produced slightly higher intakes of fruit (mean 53.7 g/day) than of vegetables (mean 41.6 g/day), and significant increases in fish (7 g/day, P = 0.03) and decreases in meat intake (9 g/day, P <0.00001). Increases in F&V intakes were positively associated with the number of participant intervention contacts. Dietary interventions delivered during the retirement transition are therefore effective, sustainable in the longer term and likely to be of public health significance.
    BMC Medicine 04/2014; 12(1):60. DOI:10.1186/1741-7015-12-60 · 7.25 Impact Factor
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