Mediterranean diet and insulin sensitivity, lipid profile and blood pressure levels, in overweight and obese people; The Attica study

Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Lipids in Health and Disease (Impact Factor: 2.31). 09/2007; 6(1):22. DOI: 10.1186/1476-511X-6-22
Source: PubMed

ABSTRACT We aimed to investigate if overweight and obese adults "close" to Mediterranean diet present better insulin, lipids profile and better pressure levels, compared to individuals close to a more Westernized diet.
The ATTICA study is a population-based cohort that has randomly enrolled 3042 adult men and women, stratified by age - gender, from the greater area of Athens, during 2001-2002. Of them, in this work were have studied 1762 participants with excess body weight, meaning overweight (BMI: 25-29.9 kg/m2) and obese (BMI>30 kg/m2). 1064 were men and 698 women (20-89 years old). Adherence to Mediterranean diet was assessed through a diet-score that was based on a validated food-frequency questionnaire. Blood pressure was measured and also fasting glucose, insulin and blood lipids. Insulin sensitivity was also assessed by the homeostasis model assessment (HOMA) approach (glucose x insulin/22.5).
Individuals with excess bodyweight in the highest tertile of diet score, were more insulin sensitive than those in the lowest tertile (11.4% lower HOMA, p = 0.06), had 13% lower levels of total cholesterol (p = 0.001) and 3 mmHg decrease of systolic blood pressure levels (p < 0.001), when adjusted for age, sex and BMI. Multivariate analysis after taking into account several confounders demonstrated that insulin sensitivity, total cholesterol and systolic blood pressure were independently but only modestly correlated with Mediterranean diet in people with excess bodyweight.
Adherence to Mediterranean diet is modestly associated with a better insulin sensitivity, lower levels of total cholesterol and lower levels of systolic blood pressure in overweight and obese subjects. This may suggest that compared to general population, the beneficial effect of this diet in cardiovascular system of excess body weight people is limited.

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Available from: Antonis Zampelas, Sep 03, 2015
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    • "This inverse association between Mediterranean dietary pattern and the prevalence of type 2 DM was observed in various multiethnic studies. Several epidemiological studies explained lower odds of having DM[34] and inverse relation between glucose level,[35–37] insulin,[31–39] and HOMA-IR (as one of the basic features of metabolic syndrome and type 2 DM)[31333640–42] following adherence to the Mediterranean dietary pattern even after controlling different confounding agents.[43–48] Higher adherence to the Mediterranean dietary pattern score in normoglycemic persons decreased fasting glucose, insulin, and IR. "
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    • "Many studies [16,30] showed that the presence of one or more cardiovascular risk factors such as hypertension, hypercholesterolemia and diabetes, is linked to a lower adherence to the simplified MeDi [29,31]. Unfortunately, information about these cardiovascular risk factors was not available in this study. "
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    • "Martinez-Gonzalez & Bes- Ballostro, 2011 Weight gain Fraser et al., 2002 Martinez-Gonzalez & Bes- Ballostro, 2011 Waist circumference Romaguera et al., 2002 Martinez-Gonzalez & Bes- Ballostro, 2011 TC Estruch et al.,2006 Vicent-Baudry et al., 2005 Ambring et al., 2004 LDL-C Vicent-Baudry et al., 2005 Ambring et al., 2004 Ros et al., 2004 Andreoli et al., 2008 Decrease Increase No significant HDL-C Pitsavos et al., 2007 Estruch et al, 2006 Andreoli et al.,2008 Papadaki & Scott, 2008 Esposito et al., 2004; Esposito et al., 2003; Esposito et al., 2009; Athryros et al., 2011 Ambring et al., 2004 Michalsen et al., 2006 Goulet et al., 2003 TG Estruch et al.,2006 Vicent-Baudry et al., 2005 Ambring et al., 2004 Ros et al., 2004 Chrysohoou et al., 2004; Tzima et al., 2007; Barzi et al., 2003 Shai et al., 2008 Esposito et al., 2004 Esposito et al., 2009 Elhayany et al., 2011 Sabate et al., 2010 Michalsen et al., 2006 de Lorgeril et al., 1994 Castro et al., 2000 Goulet et al., 2003 Glucose Estruch et al., 2006 Vicent-Baudry et al., 2005 Andreoli et al.,2008 Panagiotakos et al., 2007 Tzima et al., 2007 Salas-Salvado et al., 2011 Ambring et al., 2004 SBP Estruch et al., 2006 Tzima et al., 2007 Psaltopoulou et al., 2004 Panagiotakos et al., 2006 Giussepe et al., 2008 Nunez-Cordoba et al., 2009 Andreoli et al., 2008 BP Estruch et al., 2006 Andreoli et al., 2008 Alvarez-Leon et al., 2006 Psaltopoulou et al., 2004 Pitsavos et al., 2007 Masala et al., 2008 CRP Estruch et al., 2006 Esposito et al., 2004 Blum et al., 2006 Fung et al., 2005 Chrysohoou et al., 2004 Panagiotakos et al., 2006 Pitsavos et al., 2007 Michalsen et al., 2006 Salas-Salvado et al., 2008 IL-6 Estruch et al., 2006 Esposito et al., 2004 Salas-Salvado et al., 2008 BMI: Body mass index; TC: Total Cholesterol; LDL-C: Low density lipoprotein cholesterol HDL: High density lipoprotein cholesterol; TG: Triglycerides; SBP: Systolic blood pressure; BP: Blood pressure; CRP: Protein C reactive; IL-6: Interleukin 6 Table 1. Studies that analyze Mediterranean diet and variation (decrease, increase, no significant) in intermediate cardiovascular disease phenotypes. "
    Recent Advances in Cardiovascular Risk Factors, 03/2012; , ISBN: 978-953-51-0321-9
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