Role of the Mediterranean diet in the reduction of cardiovascular risk factors
DOI:
https://doi.org/10.19230/jonnpr.5331Abstract
Introduction: Cardiovascular diseases (CVD) are a heterogeneous group of disorders whose underlying cause of development is usually atherosclerosis. It is estimated that dietary factors are responsible for the principal contribution, among all behavioral risk factors, to the risk of CVD mortality at the population level throughout Europe. Therefore, an appropriate dietary pattern individually adjusted to the clinical characteristics of each patient, such as the Mediterranean diet, could help to reduce cardiovascular comorbidities and even prevent and treat them when they already exist.
Objective: The principal aim of this review is to analyze the role of the Mediterranean diet in reducing cardiovascular risk factors and overall cardiovascular morbidity and mortality, focusing on its impact on arterial hypertension, obesity, dyslipidemia and diabetes mellitus type 2.
Results: Studies have been carried out comparing different diets for prevention and management, with the MedDiet being the one that has shown the most benefit. It can positively influence cardiovascular comorbidities such as arterial hypertension, obesity, dyslipidemia, and type 2 diabetes mellitus if there is a high level of adherence to it, which is the most complicated aspect since nowadays there are influences that promote the change from traditional diets to Westernized diets.
Conclusion: An adequate dietary pattern, such as the Mediterranean diet, is one of the most important measures to prevent the leading cause of death worldwide, such as cardiovascular diseases and their associated comorbidities.
Downloads
References
Francula-Zaninovic S, Nola IA. Management of Measurable Variable Cardiovascular Disease' Risk Factors. Curr Cardiol Rev. 2018;14(3):153-163. doi: 10.2174/1573403X14666180222102312.
Chiva-Blanch G, Badimon L, Estruch R. Latest Evidence of the Effects of the Mediterranean Diet in Prevention of Cardiovascular Disease. Curr Atheroscler Rep. octubre de 2014;16(10):446. doi: 10.1007/s11883-014-0446-9.
Sikalidis AK, Kelleher AH, Kristo AS. Mediterranean Diet. Encyclopedia. junio de 2021;1(2):371-87. doi: 10.1002/alz.12421.
Rees K, Takeda A, Martin N, Ellis L, Wijesekara D, Vepa A, et al. Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease. Base de datos Cochrane Syst Rev . 2019: 13;3(3):CD009825. doi: 10.1002/14651858.CD009825.pub3.
Bazzano LA, Green T, Harrison TN, Reynolds K. Dietary Approaches to Prevent Hypertension. Curr Hypertens Rep. 1 de diciembre de 2013;15(6):694-702. doi: 10.1007/s11906-013-0390-z.
Elliott WJ. Systemic hypertension. Curr Probl Cardiol . 2007;32(4):201–59. doi: 10.1016/j.cpcardiol.2007.01.002.
Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension global hypertension practice guidelines. J Hypertens. junio de 2020;38(6):982. doi: 10.1097/HJH.0000000000002453.
Shenasa M, Shenasa H. Hypertension, left ventricular hypertrophy, and sudden cardiac death. Int J Cardiol . 2017;237:60–3. doi: 10.1016/j.ijcard.2017.03.002.
Bischoff SC, Schweinlin A. Obesity therapy. Clin Nutr ESPEN. 2020; 38:9-18. doi: 10.1016/j.clnesp.2020.04.013.
Manuel Moreno G. Definición y clasificación de la obesidad. Rev Médica Clín Las Condes. 2012;23(2):124–8. http://dx.doi.org/10.1016/s0716-8640(12)70288-2
Pi-Sunyer FX. The Obesity Epidemic: Pathophysiology and Consequences of Obesity. Obes Res. 2002;10(S12):97S-104S. doi: 10.1038/oby.2002.202.
McTigue KM, Hess R, Ziouras J. Obesity in Older Adults: A Systematic Review of the Evidence for Diagnosis and Treatment. Obesity. 2006;14(9):1485-97. doi: 10.1038/oby.2006.171.
Lee BY, Bartsch SM, Mui Y, Haidari LA, Spiker ML, Gittelsohn J. A systems approach to obesity. Nutr Rev. 2017;75(suppl_1):94-106. doi: 10.1093/nutrit/nuw049.
Cheng D. Prevalence, predisposition and prevention of type II diabetes. Nutr Metab. 2005;2(1):29. doi: 10.1186/1743-7075-2-29.
Tamayo T, Rosenbauer J, Wild SH, Spijkerman AMW, Baan C, Forouhi NG, et al. Diabetes in Europe: An update. Diabetes Res Clin Pract. 2014;103(2):206-17. doi: 10.1016/j.diabres.2013.11.007.
Chawla R. Complicaciones de la diabetes. Santiago Auroch; 2013.
Georgoulis M, Kontogianni MD, Yiannakouris N. Mediterranean Diet and Diabetes: Prevention and Treatment. Nutrients. 2014;6(4):1406-23. doi: 10.3390/nu6041406.
Wu Y, Ding Y, Tanaka Y, Zhang W. Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention. Int J Med Sci. 6 de septiembre de 2014;11(11):1185-200. doi: 10.7150/ijms.10001.
Ceriello A, Esposito K, La Sala L, Pujadas G, De Nigris V, Testa R, et al. The protective effect of the Mediterranean diet on endothelial resistance to GLP-1 in type 2 diabetes: a preliminary report. Cardiovasc Diabetol . 2014;13(1). doi: 10.1186/s12933-014-0140-9.
Guijarro C, Cosín-Sales J. Colesterol LDL y aterosclerosis: evidencias. Clínica E Investig En Arterioscler. 2021;33:25-32. doi: 10.1016/j.arteri.2020.12.004.
Bhatnagar D, Soran H, Durrington PN. Hypercholesterolaemia and its management. BMJ. 21 de agosto de 2008;337:a993. doi: 10.1136/bmj.a993.
Weitgasser R, Ratzinger M, Hemetsberger M, Siostrzonek P. LDL-Cholesterin und kardiovaskuläre Ereignisse: je niedriger desto besser? Wien Med Wochenschr. 2018;168(5):108-20. doi: 10.1007/s10354-016-0518-2.
Stancu C, Sima A. Statins: mechanism of action and effects. J Cell Mol Med. 2001;5(4):378-87. doi: 10.1111/j.1582-4934.2001.tb00172.x.
Wahrburg U, Kratz M, Cullen P. Mediterranean diet, olive oil and health. Eur J Lipid Sci Technol.2002;104(9-10):698-705. https://doi.org/10.1002/1438-9312(200210)104:9/10<698::AID-EJLT698>3.0.CO;2-A
Mattioli AV, Palmiero P, Manfrini O, Puddu PE, Nodari S, Dei Cas A, et al. Mediterranean diet impact on cardiovascular diseases: a narrative review. J Cardiovasc Med. 2017;18(12):925-35. doi: 10.2459/JCM.0000000000000573.
Sociedad Española De Nutrición Comunitaria [Internet]. Nutricioncomunitaria.org.. Disponible en: https://www.nutricioncomunitaria.org/es/noticia/guias-alimentarias-senc-2016
Minelli P, Montinari MR. The Mediterranean Diet And Cardioprotection: Historical Overview And Current Research. J Multidiscip Healthc. 2019 27;12:805-815. doi: 10.2147/JMDH.S219875.
Daniele ND, Noce A, Vidiri MF, Moriconi E, Marrone G, Annicchiarico-Petruzzelli M, et al. Impact of Mediterranean diet on metabolic syndrome, cancer and longevity. Oncotarget. 2016;8(5):8947-79. doi: 10.18632/oncotarget.13553.
Abellán Alemán J, Zafrilla Rentero MP, Montoro-García S, Mulero J, Pérez Garrido A, Leal M, et al. Adherence to the “Mediterranean Diet” in Spain and Its Relationship with Cardiovascular Risk (DIMERICA Study). Nutrients. noviembre de 2016;8(11):680. doi: 10.3390/nu8110680.
AlAufi NS, Chan YM, Waly MI, Chin YS, Mohd Yusof BN, Ahmad N. Application of Mediterranean Diet in Cardiovascular Diseases and Type 2 Diabetes Mellitus: Motivations and Challenges. Nutrients. enero de 2022;14(13):2777. https://doi.org/10.3390/nu14132777
Karam G, Agarwal A, Sadeghirad B, Jalink M, Hitchcock CL, Ge L, et al. Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis. BMJ. 2023;380:e072003. doi: 10.1136/bmj-2022-072003.
Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018;378(25):e34. doi: 10.1056/NEJMoa1800389.
Magriplis E, Panagiotakos D, Kyrou I, Tsioufis C, Mitsopoulou AV, Karageorgou D, et al. Presence of Hypertension Is Reduced by Mediterranean Diet Adherence in All Individuals with a More Pronounced Effect in the Obese: The Hellenic National Nutrition and Health Survey (HNNHS). Nutrients. 2020;12(3):853. doi: 10.3390/nu12030853.
Davis CR, Hodgson JM, Woodman R, Bryan J, Wilson C, Murphy KJ. A Mediterranean diet lowers blood pressure and improves endothelial function: results from the MedLey randomized intervention trial. Am J Clin Nutr. 2017;105(6):1305-1313. doi: 10.3945/ajcn.116.146803.
Gao M, Wang F, Shen Y, Zhu X, Zhang X, Sun X. Trajectories of Mediterranean Diet Adherence and Risk of Hypertension in China: Results from the CHNS Study, 1997–2011. Nutrients. 2018;10(12):2014. doi: 10.1038/tp.2016.186.
Bakaloudi DR, Chrysoula L, Kotzakioulafi E, Theodoridis X, Chourdakis M. Impact of the Level of Adherence to Mediterranean Diet on the Parameters of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2021;13(5):1514. doi: 10.3390/nu13051514.
Dinu M, Pagliai G, Lotti S, Giangrandi I, Colombini B, Sofi F. Adherence to Mediterranean Diet Measured through Medi-Lite Score and Obesity: A Retrospective Study.Nutrients. 2021;13(6):2007. doi: 10.3390/nu13062007.
Lotfi K, Saneei P, Hajhashemy Z, Esmaillzadeh A. Adherence to the Mediterranean Diet, Five-Year Weight Change, and Risk of Overweight and Obesity: A Systematic Review and Dose–Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr. 2022;13(1):152-66. doi: 10.1093/advances/nmab092.
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. 2015;25(6):569-74. doi: 10.1001/jamainternmed.2015.4838.
Eguaras S, Toledo E, Hernández-Hernández A, Cervantes S, Martínez-González MA. Better Adherence to the Mediterranean Diet Could Mitigate the Adverse Consequences of Obesity on Cardiovascular Disease: The SUN Prospective Cohort. Nutrients 2015;7(11):9154-62. doi: 10.3390/nu7115457.
Shatwan IM, Alhinai EA, Alawadhi B, Surendran S, Aljefree NM, Almoraie NM. High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries. Nutrients. 2021;13(3):995. doi: 10.3390/nu13030995.
Funtikova AN, Benítez-Arciniega AA, Gomez SF, Fitó M, Elosua R, Schröder H. Mediterranean diet impact on changes in abdominal fat and 10-year incidence of abdominal obesity in a Spanish population. Br J Nutr. 2014;111(8):1481-7. doi: 10.1017/S0007114513003966.
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: Effect of the MedDiet with and Without WL. Obesity (Silver Spring). 2013;21(1):51–7. doi: 10.1002/oby.20239.
Formisano E, Pasta A, Cremonini AL, Di Lorenzo I, Sukkar SG, Pisciotta L. Effects of a Mediterranean Diet, Dairy, and Meat Products on Different Phenotypes of Dyslipidemia: A Preliminary Retrospective Analysis. Nutrients. 2021;13(4):1161. https://doi.org/10.3390/nu13041161
Son DH, Kwon YJ, Lee HS, Kim HM, Lee JW. Effects of a Calorie-Restricted Mediterranean-Style Diet on Plasma Lipids in Hypercholesterolemic South Korean Patients. Nutrients. 2021;13(10):3393. doi: 10.3390/nu13103393.
Violi F, Loffredo L, Pignatelli P, Angelico F, Bartimoccia S, Nocella C, et al. Extra virgin olive oil use is associated with improved post-prandial blood glucose and LDL cholesterol in healthy subjects. Nutr Diabetes. 2015;5(7):e172. doi: 10.1038/nutd.2015.23.
Martín-Peláez S, Fito M, Castaner O. Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review. Nutrients. 2020;12(8):2236. doi: 10.3390/nu12082236.
Schröder H. Protective mechanisms of the Mediterranean diet in obesity and type 2 diabetes. J Nutr Biochem. 2007;18(3):149-60. doi: 10.1016/j.jnutbio.2006.05.006.
Milenkovic T, Bozhinovska N, Macut D, Bjekic-Macut J, Rahelic D, Velija Asimi Z, et al. Mediterranean Diet and Type 2 Diabetes Mellitus: A Perpetual Inspiration for the Scientific World. A Review. Nutrients. 2021;13(4):1307. doi: 10.3390/nu13041307.
Schwingshackl L, Missbach B, König J, Hoffmann G. Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis. Public Health Nutr. 2015;18(7):1292-9. doi: 10.1017/S1368980014001542.
Esposito K, Maiorino MI, Bellastella G, Panagiotakos DB, Giugliano D. Mediterranean diet for type 2 diabetes: cardiometabolic benefits. Endocrine. 2017;56(1):27-32. doi: 10.1007/s12020-016-1018-2.
Cea-Soriano L, Pulido J, Franch-Nadal J, Santos JM, Mata-Cases M, Díez-Espino J, et al. Mediterranean diet and diabetes risk in a cohort study of individuals with prediabetes: propensity score analyses. Diabet Med. 2022;39(6):e14768. doi: 10.1111/dme.14768.
Salas-Salvadó J, Bulló M, Babio N, Martínez-González MÁ, Ibarrola-Jurado N, Basora J, et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet. Diabetes Care . 2011;34(1):14–9. doi: 10.2337/dc10-1288.
Downloads
Published
Issue
Section
License
All accepted originals remain the property of JONNPR. In the event of publication, the authors exclusively transfer their rights of reproduction, distribution, translation and public communication (by any sound, audiovisual or electronic medium or format) of their work. To do so, the authors shall sign a letter transferring these rights when sending the paper via the online manuscript management system.
The articles published in the journal are freely used under the terms of the Creative Commons BY NC SA license, therefore.
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
