Mediterranean dietary pattern, inflammation and endothelial function: a systematic review and meta-analysis of intervention trials.
BACKGROUND
High adherence to a Mediterranean diet (MD) is associated with reduced all-cause and cardiovascular mortality risk. To our knowledge, there is no systematic review and meta-analysis of randomized controlled trials that has compared the effects of an MD on outcomes of endothelial function and inflammation.


RESULTS
Literature search was performed using the electronic databases MEDLINE, EMBASE, and the Cochrane Trial Register. Inclusion criteria were: randomized controlled trials, 19 + years of age, and minimum intervention period of 12 weeks. Study specific weighted mean differences (WMD) were pooled using a random effect model. Seventeen trials including 2300 subjects met the objectives. MD regimens resulted in a significantly more pronounced increase in flow mediated dilatation [WMD: 1.86%, 95% CI 0.23 to 3.48, p = 0.02; I(2) = 43%], and adiponectin [WMD: 1.69 μg/ml, 95% CI 0.27 to 3.11, p = 0.02; I(2) = 78%], while high-sensitive C reactive protein [WMD: -0.98 mg/l, 95% CI -1.48 to -0.49, p < 0.0001; I(2) = 91%], interleukin-6 [WMD: -0.42 pg/ml, 95% CI -0.73 to -0.11, p = 0.008; I(2) = 81%], and intracellular adhesion molecule-1 [WMD: -23.73 ng/ml, 95% CI -41.24 to -6.22 p = 0.008; I(2) = 34%] turned out to be significantly more decreased.


CONCLUSIONS
The results of the present meta-analysis provide evidence that an MD decreases inflammation and improves endothelial function.
University of Vienna, Faculty of Life Sciences, Department of Nutritional Sciences, Althanstrasse 14 UZA II, A-1090 Vienna, Austria. Electronic address: lukas.schwingshackl@univie.ac.at.
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Schwingshackl
University of Vienna, Faculty of Life Sciences, Department of Nutritional Sciences, Althanstrasse 14 UZA II, A-1090 Vienna, Austria.
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Hoffmann
D052242:Adiponectin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016208:Databases, Factual; D038441:Diet, Mediterranean; D019040:E-Selectin / Q000097:blood; D004727:Endothelium / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000517:prevention & control*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D052242:Adiponectin; D015415:Biomarkers; D019040:E-Selectin; C573420:ICAM1 protein, human; D015850:Interleukin-6; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein
Endothelial function; Inflammation; Mediterranean dietary pattern; Meta-analysis