Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial.
BACKGROUND
The Mediterranean diet has been shown to have beneficial effects on cardiovascular risk factors.


OBJECTIVE
To compare the short-term effects of 2 Mediterranean diets versus those of a low-fat diet on intermediate markers of cardiovascular risk.


METHODS
Substudy of a multicenter, randomized, primary prevention trial of cardiovascular disease (Prevención con Dieta Mediterránea [PREDIMED] Study).


METHODS
Primary care centers affiliated with 10 teaching hospitals.


METHODS
772 asymptomatic persons 55 to 80 years of age at high cardiovascular risk who were recruited from October 2003 to March 2004.


METHODS
Participants were assigned to a low-fat diet (n = 257) or to 1 of 2 Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 liter per week (n = 257), or free nuts, 30 g/d (n = 258). The authors evaluated outcome changes at 3 months.


METHODS
Body weight, blood pressure, lipid profile, glucose levels, and inflammatory molecules.


RESULTS
The completion rate was 99.6%. Compared with the low-fat diet, the 2 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% 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
This short-term study did not focus on clinical outcomes. Nutritional education about low-fat diet was less intense than education about Mediterranean diets.


CONCLUSIONS
Compared with a low-fat diet, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors.
Estruch
Ramon
R
Institut d'Investigacions Biomèdiques August Pi Sunyer, Municipal Institut for Medical Research, University of Barcelona, and Catalan Institute of Health, Barcelona, Spain. restruch@clinic.ub.es
Martínez-González
Miguel Angel
MA
Corella
Dolores
D
Salas-Salvadó
Jordi
J
Ruiz-Gutiérrez
Valentina
V
Covas
María Isabel
MI
Fiol
Miguel
M
Gómez-Gracia
Enrique
E
López-Sabater
Mari Carmen
MC
Vinyoles
Ernest
E
Arós
Fernando
F
Conde
Manuel
M
Lahoz
Carlos
C
Lapetra
José
J
Sáez
Guillermo
G
Ros
Emilio
E
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000378:metabolism; D018752:Diet, Fat-Restricted; D038441:Diet, Mediterranean; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009754:Nuts / Q000737:chemistry; D000069463:Olive Oil; D010938:Plant Oils / Q000008:administration & dosage / Q000737:chemistry; D011446:Prospective Studies; D012307:Risk Factors
D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D004042:Dietary Fats, Unsaturated; D000069463:Olive Oil; D010938:Plant Oils; D002097:C-Reactive Protein; D002784:Cholesterol