Randomized, controlled nutrition education trial promotes a Mediterranean diet and improves anthropometric, dietary, and metabolic parameters in adults

Servizio di Igiene degli Alimenti e della Nutrizione, Asl Foggia.
Annali di igiene: medicina preventiva e di comunità 01/2011; 23(1):13-25.
Source: PubMed


Several studies have shown that uptake of a Mediterranean diet could prevent many chronic diseases, such as cancer. However, the effectiveness of Mediterranean diet promotion interventions has not been well researched. The aim of this study was to evaluate the effectiveness of a nutrition education intervention for promoting the Mediterranean diet, by assessing changes in anthropometric, physical activity, dietetic and metabolic parameters in healthy adult subjects, before and after the intervention. Eighty participants, both sexes, aged 51-59 years, were randomly assigned in a 1:1 ratio to the intervention or the control group. The intervention group participated in the Med-Food Anticancer Program (MFAP), designed to promote a Mediterranean diet. This was organized into 15 weeks of intensive training and 10 weeks of consolidation. Participants of the two groups were assessed at baseline (T0) and after 25 weeks (T1) for anthropometric, physical activity, dietetic, and metabolic parameters. The hypothesis was that subjects participating in MFAP would show an improvement in these parameters. The primary endpoint was an improvement of the Mediterranean Adequacy Index (MAI), calculated by dividing the percentage of total energy from typical Mediterranean food groups by the percentage of total energy from non-typical Mediterranean food groups. At T1, the intervention group showed a significant decrease in body weight (-8.3%, P = 0.045), body mass index (-12.4%, P = 0.05), cheese (53.0%, P < 0.0001) and meat (-49.3%, P = 0.005) intake, fasting glycaemia (-9.2%, P = 0.012), and fasting insulin (-32.6%, P = 0.014), C-Reactive Protein (-34.0%, P = 0.005). They showed a significant increase in MAI (+213, P < 0.0001), physical activity (expressed in steps per day, +200.4%, P < 0.0001), fruit (+38.8, P < 0.0001), vegetables (29.3%, P < 0.0001), and dietary fiber (+38.6%, P = 0.04) intake. In contrast, the control group presented non-significant variations in measured parameters, for exception of cheese intake (+18.2%, P < 0.0001). The MFAP was found to promote uptake of the Mediterranean diet, and improve anthropometric, physical activity, dietary, and metabolic parameters in healthy subjects.

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    • "None of the studies satisfied all of the criteria of the quality assessment tool. However, included studies provided an adequate description of methods and randomization procedures, and the average retention rate for the 22 RCTs was 90 ± 10% for all studies, with 5 studies reporting retention rates <80% [29,31-34]. No studies were excluded from analysis based on quality assessment. "
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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.
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    • "It also reduces incidence of cardiovascular events in patients at risk (Estruch et al., 2013), improves anthropometric and metabolic parameters in subjects aged 51–59 years (Panunzio et al., 2011), influences cardiovascular risk factors (Estruch et al., 2006). Besides the impact of diet on survival (de Lorgeril et al., 1994), anthropometric and metabolic parameters (Panunzio et al., 2011), cardiovascular risk factors (Estruch et al., 2006) and cognitive function (Alles et al., 2012), a dietary pattern approach might also have impact on the ageing process and inflammatory parameters (Franceschi, 2007). However, apart from one study showing that components of the Mediterranean-type food pattern influence serum inflammatory markers (Salas-Salvado et al., 2008) there appear to be no randomized controlled trials on the effects of an entire diet on the ageing process in an elderly population. "
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    • "The current interest in this type of food comes from the conjunction of a increasingly scientific evidence of the advantages of its consumption in different health aspects and its high palatability, which validates it for long use purposes, contrarily to other healthy alternatives with low palatability, which are difficult to maintain on a long outlook basis(Panunzio et al., 2011). Supporting the cited scientific evidences on cardiovascular risk, and validated by well designed works(Fuentes et al., 2001; Jansen et al., 2000; Kris-Etherton et al., 1993; Mata et al., 1992), the FDA authorized a health claim on olive oil on coronary heart disease (CFSAN/Office of Nutritional Products, 2004). "

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