Meta-Analysis Comparing Mediterranean to Low-Fat Diets for Modification of Cardiovascular Risk Factors - 18/08/11
, Katja Suter-Zimmermann, PhD a, Heiner C. Bucher, MD, MPH a, Iris Shai, RD, PhD b, Katherine R. Tuttle, MD c, Ramon Estruch, MD, PhD d, Matthias Briel, MD, MSc a, e
Requests for reprints should be addressed to Alain J. Nordmann, MD, MSc, Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Hebelstrasse 10, Basel CH-4031, SwitzerlandAbstract |
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/m2. 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/m2; 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.
Le texte complet de cet article est disponible en PDF.Keywords : Low-fat diet, Mediterranean diet, Meta-analysis
Plan
| Funding: A. Nordmann, M. Briel, K. Suter-Zimmermann, and H. Bucher, as collaborators of the Basel Institute for Clinical Epidemiology and Biostatistics, are supported by an unrestricted grant from santésuisse and the Gottfried and Julia Bangerter-Rhyner Foundation. The Heart Institute of Spokane Diet Intervention and Evaluation Trial was supported by a grant from the Washington State Attorney General Vitamins Settlement Fund. The Daily-Dose Consensus Interferon and Ribavirin: Efficacy of Combined Therapy (DIRECT) trial was supported by the Nuclear Research Center Negev, the Dr. Robert C. and Veronica Atkins Research Foundation, and the Daniel S. Abraham International Center for Health and Nutrition, Ben Gurion University, Israel. The Predimed study was supported by unrestricted grants from the Spanish Ministry of Health and the Generalitat Valenciana. This meta-analysis was supported by an unrestricted grant from the Forlen Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. |
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| Conflict of Interest: None of the authors have a relationship with industry or financial associations that might pose a conflict of interest in connection with the submitted article. |
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| Authorship: A. Nordmann and M. Briel had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors had access to the data and fulfill criteria for authorship. |
Vol 124 - N° 9
P. 841 - septembre 2011 Retour au numéro
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