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Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors: A Randomized Trial
Study Questions:
Does a Mediterranean diet improve risk factors for cardiovascular disease?
Methods:
Data from a substudy of the PREDIMED (Prevención con Dieta Mediterránea) trial were used for this analysis. PREDIMED is a multicenter, randomized, primary prevention trial of cardiovascular disease, which enrolled asymptomatic patients (ages 55-80 years from primary care centers in 10 teaching hospitals in Spain). All participants were high risk for cardiovascular disease. Participants were assigned to a low-fat diet (n = 257) or to one of two Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 L/wk (n = 257), or free nuts, 30 g/d (n = 258). Primary outcomes of interest for the substudy included body weight, blood pressure, lipid profile, glucose levels, and inflammatory molecules, all of which were evaluated at 3 months.
Results:
A total of 772 adults were enrolled; the completion rate was 99.6%. Compared with the low-fat diet, the two Mediterranean diets produced beneficial changes in most outcomes. Compared with the low-fat diet, the mean changes in the Mediterranean diet with olive oil group and the Mediterranean diet with nuts group were -0.39 mmol/L (95% confidence interval [CI], -0.70 to - 0.07 mmol/L) and -0.30 mmol/L (CI, -0.58 to -0.01 mmol/L), respectively, for plasma glucose levels; -5.9 mm Hg (CI, -8.7 to -3.1 mm Hg) and -7.1 mm Hg (CI, -10.0 to -4.1 mm Hg), respectively, for systolic blood pressure; and -0.38 (CI, -0.55 to -0.22) and -0.26 (CI, -0.42 to -0.10), respectively, for the cholesterol–high-density lipoprotein cholesterol ratio. The Mediterranean diet with olive oil reduced C-reactive protein levels by 0.54 mg/L (CI, 1.04 to 0.03 mg/L) compared with the low-fat diet.
Conclusions:
The investigators concluded that compared with a low-fat diet, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors.
Perspective:
Although this paper is limited to intermediate outcomes, these findings complement PREDIMED’s results, which demonstrate reductions in cardiovascular events.
Keywords: Body Weight, Blood Pressure, Risk Factors, Primary Prevention, Glucose, Complement System Proteins, Cholesterol, C-Reactive Protein, Dietary Supplements, Plant Oils, Spain, Cardiovascular Diseases, Diet, Fat-Restricted, Primary Health Care
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