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Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors.
Am J Med. 2011 Sep; 124(9):841-51.e2.AJ

Abstract

BACKGROUND

Evidence from individual trials comparing Mediterranean to low-fat diets to modify cardiovascular risk factors remains preliminary.

METHODS

We systematically searched MEDLINE, EMBASE, Biosis, Web of Science, and the Cochrane Central Register of Controlled Trials from their inception until January 2011, as well as contacted experts in the field, to identify randomized controlled trials comparing Mediterranean to low-fat diets in overweight/obese individuals, with a minimum follow-up of 6 months, reporting intention-to-treat data on cardiovascular risk factors. Two authors independently assessed trial eligibility and quality.

RESULTS

We identified 6 trials, including 2650 individuals (50% women) fulfilling our inclusion criteria. Mean age of enrolled patients ranged from 35 to 68 years, mean body mass index from 29 to 35 kg/m(2). After 2 years of follow-up, individuals assigned to a Mediterranean diet had more favorable changes in weighted mean differences of body weight (-2.2 kg; 95% confidence interval [CI], -3.9 to -0.6), body mass index (-0.6 kg/m(2); 95% CI, -1 to -0.1), systolic blood pressure (-1.7 mm Hg; 95% CI, -3.3 to -0.05), diastolic blood pressure (-1.5 mm Hg; 95% CI, -2.1 to -0.8), fasting plasma glucose (-3.8 mg/dL, 95% CI, -7 to -0.6), total cholesterol (-7.4 mg/dL; 95% CI, -10.3 to -4.4), and high-sensitivity C-reactive protein (-1.0 mg/L; 95% CI, -1.5 to -0.5). The observed heterogeneity across individual trials could, by and large, be eliminated by restricting analyses to trials with balanced co-interventions or trials with restriction of daily calorie intake in both diet groups.

CONCLUSION

Mediterranean diets appear to be more effective than low-fat diets in inducing clinically relevant long-term changes in cardiovascular risk factors and inflammatory markers.

Authors+Show Affiliations

Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Switzerland. nordmanna@uhbs.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21854893

Citation

Nordmann, Alain J., et al. "Meta-analysis Comparing Mediterranean to Low-fat Diets for Modification of Cardiovascular Risk Factors." The American Journal of Medicine, vol. 124, no. 9, 2011, pp. 841-51.e2.
Nordmann AJ, Suter-Zimmermann K, Bucher HC, et al. Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med. 2011;124(9):841-51.e2.
Nordmann, A. J., Suter-Zimmermann, K., Bucher, H. C., Shai, I., Tuttle, K. R., Estruch, R., & Briel, M. (2011). Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. The American Journal of Medicine, 124(9), 841-e2. https://doi.org/10.1016/j.amjmed.2011.04.024
Nordmann AJ, et al. Meta-analysis Comparing Mediterranean to Low-fat Diets for Modification of Cardiovascular Risk Factors. Am J Med. 2011;124(9):841-51.e2. PubMed PMID: 21854893.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. AU - Nordmann,Alain J, AU - Suter-Zimmermann,Katja, AU - Bucher,Heiner C, AU - Shai,Iris, AU - Tuttle,Katherine R, AU - Estruch,Ramon, AU - Briel,Matthias, PY - 2011/03/09/received PY - 2011/04/07/revised PY - 2011/04/08/accepted PY - 2011/8/23/entrez PY - 2011/8/23/pubmed PY - 2011/10/25/medline SP - 841 EP - 51.e2 JF - The American journal of medicine JO - Am J Med VL - 124 IS - 9 N2 - BACKGROUND: Evidence from individual trials comparing Mediterranean to low-fat diets to modify cardiovascular risk factors remains preliminary. METHODS: We systematically searched MEDLINE, EMBASE, Biosis, Web of Science, and the Cochrane Central Register of Controlled Trials from their inception until January 2011, as well as contacted experts in the field, to identify randomized controlled trials comparing Mediterranean to low-fat diets in overweight/obese individuals, with a minimum follow-up of 6 months, reporting intention-to-treat data on cardiovascular risk factors. Two authors independently assessed trial eligibility and quality. RESULTS: We identified 6 trials, including 2650 individuals (50% women) fulfilling our inclusion criteria. Mean age of enrolled patients ranged from 35 to 68 years, mean body mass index from 29 to 35 kg/m(2). After 2 years of follow-up, individuals assigned to a Mediterranean diet had more favorable changes in weighted mean differences of body weight (-2.2 kg; 95% confidence interval [CI], -3.9 to -0.6), body mass index (-0.6 kg/m(2); 95% CI, -1 to -0.1), systolic blood pressure (-1.7 mm Hg; 95% CI, -3.3 to -0.05), diastolic blood pressure (-1.5 mm Hg; 95% CI, -2.1 to -0.8), fasting plasma glucose (-3.8 mg/dL, 95% CI, -7 to -0.6), total cholesterol (-7.4 mg/dL; 95% CI, -10.3 to -4.4), and high-sensitivity C-reactive protein (-1.0 mg/L; 95% CI, -1.5 to -0.5). The observed heterogeneity across individual trials could, by and large, be eliminated by restricting analyses to trials with balanced co-interventions or trials with restriction of daily calorie intake in both diet groups. CONCLUSION: Mediterranean diets appear to be more effective than low-fat diets in inducing clinically relevant long-term changes in cardiovascular risk factors and inflammatory markers. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/21854893/Meta_analysis_comparing_Mediterranean_to_low_fat_diets_for_modification_of_cardiovascular_risk_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00410-4 DB - PRIME DP - Unbound Medicine ER -