Effects of the Mediterranean diet on the cardiovascular risk factors
DOI:
https://doi.org/10.19230/jonnpr.2787Keywords:
Mediterranean diet, primary prevention, cardiovascular disease, blood pressure, diabetes, inflammationAbstract
Background: Eating habits have been modified, which together with a more sedentary lifestyle has contributed to a significant increase in cardiovascular risk factors and consequently in cardiovascular disease. It is believed that this epidemic could be reduced with a change to a healthier lifestyle and diet, such as the Mediterranean diet.
Objetive: To demonstrate the benefit of the Mediterranean diet as a valid dietary pattern for the primary prevention of cardiovascular disease
Methods: study of the articles found in bibliographic review of different databases through systematic technique
Results: In interventions with Mediterranean diet, a global beneficial effect on blood pressure has been observed with significant reductions in systolic, diastolic or both depending on the study. There is also a positive effect on glucose levels, HbA1c and incidence of type 2 diabetes mellitus with a significant level of significance. Regarding the lipid profile, the results are more variable, although generally it is considered that there is a reduction of total cholesterol, triglycerides, concentration and oxidation of LDL and ApoB and an increase of HDL. Inflammatory markers such as CRP, IL6, IL8, TNF alpha, ICAM, P-selectin, are also reduced in several of the studies analyzed. Likewise, the Mediterranean diet has proven to be an useful tool in the reversal of the metabolic syndrome.
Conclusions: After a few decades in which prevention and treatment of cardiovascular diseases focused on the use of low-fat diets, the Mediterranean diet is currently emerging as a healthier alternative since it has shown a greater reduction in blood pressure, glycaemia, lipid profile, markers of inflammation and endothelial damage.
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References
Arós F, Estruch R. Dieta mediterránea y prevención de la enfermedad cardiovascular. Rev Esp Cardiol. 1 de octubre de 2013;66(10):771-4.
Salvadó JS, Lorda PG, Ripollès JMS i. La alimentación y la nutrición a través de la historia. Editorial Glosa, S.L.; 2005. 491 p.
Rojas J, Bermúdez V, Leal E, Aparicio D, Peña G, Acosta L, et al. Origen étnico y enfermedad cardiovascular. Arch Venez Farmacol Ter. junio de 2008;27(1):40-57.
Incidencia de la dieta en la hominización [Internet]. Investigación y Ciencia. [citado 8 de diciembre de 2017]. Disponible en: http://www.investigacionyciencia.es/revistas/investigacion-y-ciencia/la-antrtida-sin-hielo-348/incidencia-de-la-dieta-en-la-hominizacin-3578
Flandrin JL, Montanari M. Historia de la alimentación. Trea; 2004. 1101 p.
Arroyo P. La alimentación en la evolución del hombre: su relación con el riesgo de enfermedades crónico degenerativas. Bol Méd Hosp Infant México. diciembre de 2008;65(6):431-40.
Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. diciembre de 2011;14(12A):2274-84.
Howard BV, Van Horn L, Hsia J, Manson JE, Stefanick ML, Wassertheil- Smoller S, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 8 de febrero de 2006;295(6):655-66.
Toledo E, Hu FB, Estruch R, Buil-Cosiales P, Corella D, Salas-Salvadó J, et al. Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial. BMC Med. 19 de septiembre de 2013;11:207.
Storniolo CE, Casillas R, Bulló M, Castañer O, Ros E, Sáez GT, et al. A Mediterranean diet supplemented with extra virgin olive oil or nuts improves endothelial markers involved in blood pressure control in hypertensive women. Eur J Nutr. febrero de 2017;56(1):89-97.
Doménech M, Roman P, Lapetra J, García de la Corte FJ, Sala-Vila A, de la Torre R, et al. Mediterranean diet reduces 24-hour ambulatory blood pressure, blood glucose, and lipids: one-year randomized, clinical trial. Hypertens Dallas Tex 1979. julio de 2014;64(1):69-76.
Maiorino MI, Bellastella G, Petrizzo M, Gicchino M, Caputo M, Giugliano D, et al. Effect of a Mediterranean diet on endothelial progenitor cells and carotid intima-media thickness in type 2 diabetes: Follow-up of a randomized trial. Eur J Prev Cardiol. marzo de 2017;24(4):399-408.
Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez-González MA; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013 Apr 4;368(14):1279-90)
Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018: 21;378(25):e34.
Assaf-Balut C, García de la Torre N, Durán A, Fuentes M, Bordiú E, Del Valle L, et al. A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): A randomized controlled trial: The St. Carlos GDM prevention study. PloS One. 2017;12(10):e0185873.
Salas-Salvadó J, Bulló M, Estruch R, Ros E, Covas M-I, Ibarrola- Jurado N, et al. Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial. Ann Intern Med. 7 de enero de 2014;160(1):1-10.
Richard C, Couture P, Ooi EMM, Tremblay AJ, Desroches S, Charest A, et al. Effect of Mediterranean diet with and without weight loss on apolipoprotein B100 metabolism in men with metabolic syndrome. Arterioscler Thromb Vasc Biol. febrero de 2014;34(2):433-8.
Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of Mediterranean diet on metabolic syndrome and its components: a metaanalysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57:1299-313.
Grosso G, Mistretta A, Frigiola A, Gruttadauria S, Biondi A, Basile F, et al. Mediterranean diet and cardiovascular risk factors: a systematic review. Crit Rev Food Sci Nutr. 2014;54:593-610.
Richard C, Couture P, Desroches S, Lichtenstein AH, Lamarche B. Effect of weight loss, independent of change in diet composition, on apolipoprotein AI kinetic in men with metabolic syndrome. J Lipid Res. enero de 2013;54(1):232-7.
Richard C, Couture P, Desroches S, Nehmé B, Bourassa S, Droit A, et al. Effect of an isoenergetic traditional Mediterranean diet on the high- density lipoprotein proteome in men with the metabolic syndrome. J Nutr Nutr. 2014;7(1):48-60.
Hernáez Á, Castañer O, Goday A, Ros E, Pintó X, Estruch R, et al. The Mediterranean Diet decreases LDL atherogenicity in high cardiovascular risk individuals: a randomized controlled trial. Mol Nutr Food Res. septiembre de 2017;61(9).
Grover SA, Kaouache M, Joseph L, Barter P, Davignon J. Evaluating the incremental benefits of raising high-density lipoprotein cholesterol levels during lipid therapy after adjustment for the reductions in other blood lipid levels. Arch Intern Med. 2009;169:1775-80.
Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK, et al, Plasma HDL. cholesterol and risk of myocardial infarction: a mendelian randomisation study.Lancet. 2012;380:572-80.
Godos J, Zappalá G, Bernardini S, Giambini I, Bes-Rastrollo M, Martinez-Gonzalez M. Adherence to the Mediterranean diet is inversely associated with metabolic syndrome occurrence: a meta-analysis of observational studies. Int J Food Sci Nutr. 2017; 68: 138-148.
Casas R, Urpi-Sardà M, Sacanella E, Arranz S, Corella D, Castañer O, et al. Anti-Inflammatory Effects of the Mediterranean Diet in the Early and Late Stages of Atheroma Plaque Development. Mediators Inflamm. 1 de enero de 2017;2017:1-12.
Richard C, Couture P, Desroches S, Lamarche B. Effect of the Mediterranean diet with and without weight loss on markers of inflammation in men with metabolic syndrome. Obes Silver Spring Md. enero de 2013;21(1):51-7.
Sotos-Prieto M, Luben R, Khaw KT, Wareham NJ, Forouhi NG. The association between Mediterranean Diet Score and glucokinase regulatory protein gene variation on the markers of cardiometabolic risk: an analysis in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. Br J Nutr. 2014;112:1-10.
Mitjavila MT, Fandos M, Salas-Salvadó J, Covas M-I, Borrego S, Estruch R, et al. The Mediterranean diet improves the systemic lipid and DNA oxidative damage in metabolic syndrome individuals. A randomized, controlled, trial. Clin Nutr Edinb Scotl. abril de 2013;32(2):172-8.
Mayneris-Perxachs J, Sala-Vila A, Chisaguano M, Castellote AI, Estruch R, Covas MI, et al. Effects of 1-Year Intervention with a Mediterranean Diet on Plasma Fatty Acid Composition and Metabolic Syndrome in a Population at High Cardiovascular Risk. PLoS ONE [Internet]. 20 de marzo de 2014 [citado 8 de diciembre de 2017];9(3). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3961210/
Sofi F, Dinu M, Pagliai G, Cesari F, Marcucci R, Casini A. Mediterranean versus vegetarian diet for cardiovascular disease prevention (the CARDIVEG study): study protocol for a randomized controlled trial. Trials. 4 de mayo de 2016;17(1):233.
Martínez-González MA, Sánchez-Villegas A. The emerging role of Mediterranean diets in cardiovascular epidemiology: monounsaturated fats, olive oil, red wine or the whole pattern? Eur J Epidemiol. 2004;19(1):9-13.
Eguaras S, Toledo E, Buil-Cosiales P, Salas-Salvadó J, Corella D, Gutierrez-Bedmar M, et al. Does the Mediterranean diet counteract the adverse effects of abdominal adiposity? Nutr Metab Cardiovasc Dis NMCD. junio de 2015;25(6):569-74.
Díaz-López A, Babio N, Martínez-González MA, Corella D, Amor AJ, Fitó M, et al. Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial. Diabetes Care. noviembre de 2015;38(11):2134-41.
Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. octubre de 2004;80(4):1029-35.
Samieri C, Grodstein F, Rosner BA, Kang JH, Cook NR, Manson JE, et al. Mediterranean diet and cognitive function in older age: results from the Women’s Health Study. Epidemiol Camb Mass. julio de 2013;24(4):490-9.
Martínez-Lapiscina EH, Clavero P, Toledo E, Estruch R, Salas-Salvadó J, San Julián B, et al. Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial. J Neurol Neurosurg Psychiatry. diciembre de 2013;84(12):1318-25.
Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, de la Torre R, Martínez-González MÁ, et al. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial. JAMA Intern Med. julio de 2015;175(7):1094-103.
Toledo E, Salas-Salvadó J, Donat-Vargas C, Buil-Cosiales P, Estruch R, Ros E, et al. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial. JAMA Intern Med. noviembre de 2015;175(11):1752-60.
Castelló A, Pollán M, Buijsse B, Ruiz A, Casas AM, Baena-Cañada JM, et al. Spanish Mediterranean diet and other dietary patterns and breast cancer risk: case-control EpiGEICAM study. Br J Cancer. 23 de septiembre de 2014;111(7):1454-62.
Buckland G, Travier N, Cottet V, González CA, Luján-Barroso L, Agudo A, et al. Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study. Int J Cancer. 15 de junio de 2013;132(12):2918-27.
Castelló A, Boldo E, Amiano P, Castaño-Vinyals G, Aragonés N, Gómez-Acebo I, et al. Mediterranean Dietary Pattern Is Associated to Low Risk of Aggressive Prostate Cancer: MCC-Spain Study. J Urol. 23 de agosto de 2017;
Clark HD, Wells GA, Huet C, McAlister FA, Salmi LR, Fergusson D, et al. Assessing the quality of randomized trials: Reliability of the Jadad scale. Contr Clin Trials. 1999;20(5):448-52.
Herbison P, Hay-Smith J, Gillespie WJ. Adjustment of meta-analyses on the basis of quality scores should be abandoned. J Clin Epidemiol. 2006;59(12):1249-56
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