Session 4: CVD, diabetes and cancer Evidence for the use of the Mediterranean diet in patients with CHD

Diet is associated with the development of CHD. The incidence of CHD is lower in southern European countries than in northern European countries and it has been proposed that this difference may be a result of diet. The traditional Mediterranean diet emphasises a high intake of fruits, vegetables, bread, other forms of cereals, potatoes, beans, nuts and seeds. It includes olive oil as a major fat source and dairy products, fish and poultry are consumed in low to moderate amounts. Many observational studies have shown that the Mediterranean diet is associated with reduced risk of CHD, and this result has been confirmed by meta-analysis, while a single randomised controlled trial, the Lyon Diet Heart study, has shown a reduction in CHD risk in subjects following the Mediterranean diet in the secondary prevention setting. However, it is uncertain whether the benefits of the Mediterranean diet are transferable to other non-Mediterranean populations and whether the effects of the Mediterranean diet will still be feasible in light of the changes in pharmacological therapy seen in patients with CHD since the Lyon Diet Heart study was conducted. Further randomised controlled trials are required and if the risk-reducing effect is confirmed then the best methods to effectively deliver this public health message worldwide need to be considered.

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The Mediterranean Diet and Cognitive Function among Healthy Older Adults in a 6-Month Randomised Controlled Trial: The MedLey Study

Nutrients ◽

10.3390/nu8090579 ◽

2016 ◽

Vol 8 (9) ◽

pp. 579 ◽

Cited By ~ 37

Author(s):

Alissa Knight ◽

Janet Bryan ◽

Carlene Wilson ◽

Jonathan Hodgson ◽

Courtney Davis ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Randomised Controlled Trial ◽

Mediterranean Diet ◽

Controlled Trial ◽

Healthy Older Adults ◽

The Mediterranean ◽

Randomised Controlled

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The Mediterranean diet pattern with intermittent semi-fasting may facilitate weight loss: randomised controlled trial

Mediterranean Journal of Nutrition and Metabolism ◽

10.3233/mnm-180257 ◽

2019 ◽

Vol 12 (2) ◽

pp. 153-161 ◽

Cited By ~ 1

Author(s):

Ana Molina Jimenez ◽

Sara Lopez Oliva ◽

Elena Garicano Vilar ◽

Begoña de Cuevillas ◽

Maria del Carmen Morais Moreno ◽

...

Keyword(s):

Weight Loss ◽

Randomised Controlled Trial ◽

Mediterranean Diet ◽

Controlled Trial ◽

Diet Pattern ◽

The Mediterranean ◽

Randomised Controlled

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Can we modify the Mediterranean diet for non-Mediterranean populations? Results from two randomised controlled trials.

Proceedings of The Nutrition Society ◽

10.1017/s0029665120002347 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Alexandra Wade ◽

Courtney Davis ◽

Kathryn Dyer ◽

Jonathan Hodgson ◽

Richard Woodman ◽

...

Keyword(s):

Mediterranean Diet ◽

Processing Speed ◽

Randomised Controlled Trials ◽

Mean Difference ◽

Controlled Trials ◽

Mediterranean Populations ◽

Dairy Foods ◽

Cognitive Benefits ◽

The Mediterranean ◽

Randomised Controlled

AbstractThe Mediterranean diet is rich in bioactive nutrients and may be effective at preventing cardiovascular disease and dementia. However, long-term sustainability could be limited in non-Mediterranean populations with different nutrient requirements and food preferences. To address this issue, our research group conducted two randomised controlled trials to examine whether the Mediterranean diet can be adapted to increase sustainability for an Australian population, while still providing cardiovascular and cognitive benefits. In our first trial (n = 41), we examined a Mediterranean diet designed to meet the calcium requirements of older adults by including 3–4 daily serves of dairy foods (milk, cheese and yoghurt) (MedDairy). In our second trial (n = 33), we tested a Mediterranean diet supplemented with 2–3 weekly serves of fresh, lean pork (MedPork), designed to provide an alternate source of protein. Both trials employed a low-fat control diet (LF) and a 24-week parallel crossover design, consisting of two 8-week intervention periods and an 8-week washout separating interventions. We found that the MedDairy intervention significantly increased dairy food (mean difference = 1.0 ± 0.2 serves, P < 0.001) and calcium intake (mean difference = 25.9 ± 6.8 mg/MJ, P < 0.001) compared to LF. Further, MedDairy led to greater improvements in morning home systolic blood pressure (mean difference = -1.6 ± 0.6 mmHg, P = 0.01), triglycerides (mean difference = -0.05 ± 0.02 mmol/L, P < 0.01), HDL (mean difference = 0.04 ± 0.01 mmol/L, P = < 0.01), and total cholesterol to HDL ratio (mean difference = -0.4 ± 0.10 mmol/L, P = < 0.001). The MedDairy intervention also led to greater improvements in processing speed (P = 0.04), a measure of cognitive function, as well as self-reported mood (P = 0.01). No significant differences were observed between MedPork and LF for blood pressure or other markers of cardiometabolic health. However, the MedPork intervention led to greater improvements in processing speed (P = 0.01) and mood (P = 0.03). Our findings demonstrate that a Mediterranean diet with added dairy foods is capable of delivering adequate calcium to ageing populations while providing cardiovascular and cognitive benefits. Further, a Mediterranean diet supplemented with fresh, lean pork offers comparable cardiovascular benefits to a low-fat diet and greater improvements to cognitive function and mood. Our findings are of particular relevance to non-Mediterranean populations at risk of cardiovascular disease and dementia, and offer two options for modifying the Mediterranean diet depending on dietary priorities.

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Including pork in the Mediterranean diet for an Australian population: Protocol for a randomised controlled trial assessing cardiovascular risk and cognitive function

Nutrition Journal ◽

10.1186/s12937-017-0306-x ◽

2017 ◽

Vol 16 (1) ◽

Cited By ~ 7

Author(s):

Alexandra T. Wade ◽

Courtney R. Davis ◽

Kathryn A. Dyer ◽

Jonathan M. Hodgson ◽

Richard J. Woodman ◽

...

Keyword(s):

Cardiovascular Risk ◽

Cognitive Function ◽

Randomised Controlled Trial ◽

Mediterranean Diet ◽

Controlled Trial ◽

Australian Population ◽

Population Protocol ◽

The Mediterranean ◽

Randomised Controlled

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Faculty Opinions recommendation of Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718277731.793490993 ◽

2014 ◽

Author(s):

Andrew Tonkin

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Mediterranean Diet ◽

Cardiovascular Complications ◽

Final Report ◽

Lyon Diet Heart Study ◽

Heart Study ◽

Traditional Risk Factors

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Faculty Opinions recommendation of Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.736286716.793566848 ◽

2019 ◽

Author(s):

Linda Vignozzi

Keyword(s):

Systematic Review ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Meta Analysis ◽

Trial Data ◽

Safety And Efficacy ◽

Randomised Controlled

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The Beneficial Health Effects of Vegetables and Wild Edible Greens: The Case of the Mediterranean Diet and Its Sustainability

Applied Sciences ◽

10.3390/app10249144 ◽

2020 ◽

Vol 10 (24) ◽

pp. 9144

Author(s):

Elena Chatzopoulou ◽

Márcio Carocho ◽

Francesco Di Gioia ◽

Spyridon A. Petropoulos

Keyword(s):

Health Effects ◽

Mediterranean Diet ◽

Healthy Lifestyle ◽

Scientific Interest ◽

Mediterranean Populations ◽

Cultural Aspects ◽

Positive Effects ◽

Healthy Diets ◽

The World ◽

The Mediterranean

The Mediterranean diet (MD) concept as currently known describes the dietary patterns that were followed in specific regions of the area in the 1950s and 1960s. The broad recognition of its positive effects on the longevity of Mediterranean populations also led to the adoption of this diet in other regions of the world, and scientific interest focused on revealing its health effects. MD is not only linked with eating specific nutritional food products but also with social, religious, environmental, and cultural aspects, thus representing a healthy lifestyle in general. However, modern lifestyles adhere to less healthy diets, alienating people from their heritage. Therefore, considering the increasing evidence of the beneficial health effects of adherence to the MD and the ongoing transitions in consumers’ behavior, the present review focuses on updating the scientific knowledge regarding this diet and its relevance to agrobiodiversity. In addition, it also considers a sustainable approach for new marketing opportunities and consumer trends of the MD.

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Mediterranean Diet Implementation to Protect against Advanced Lung Cancer Index (ALI) Rise: Study Design and Preliminary Results of a Randomised Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073700 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3700

Author(s):

Aristea Gioxari ◽

Dimitrios Tzanos ◽

Christina Kostara ◽

Panos Papandreou ◽

Giannis Mountzios ◽

...

Keyword(s):

Lung Cancer ◽

Randomised Controlled Trial ◽

Nutritional Status ◽

Mediterranean Diet ◽

Controlled Trial ◽

Small Cell ◽

Advanced Lung Cancer ◽

Study Endpoint ◽

Preliminary Results ◽

Randomised Controlled

The Mediterranean diet (MD) has been inversely associated with lung cancer (LC) risk. Hereby we show the preliminary results of our prospective randomised controlled trial in inflammatory and nutritional status of LC patients after 3-month implementation of MD. In total, 30 patients with small-cell or non-small-cell LC (stages III–IV) were enrolled. They were randomly assigned either to Control group, receiving general nutritional guidelines, or the MD group, in which a personalised MD plan was provided. Medical and dietary history, anthropometrics, blood biomarkers, and circulating antioxidant vitamins were assessed. The main outcome was a significantly higher advanced lung cancer inflammation index (ALI) in patients of the control arm than those following MD (p = 0.003). In the MD group, platelets were significantly reduced at the study endpoint (p = 0.044). BMI and body fat mass remained unchanged in both arms, but serum glucose was significantly higher in control compared to MD group (p = 0.017). In conclusion, we showed for the first time that implementing a personalised MD for 3 months is promising to regulate prognostic biomarkers in advanced LC. The final results of our on-going trial will shed a light on the inflammatory, antioxidant and nutritional status of LC patients following MD.

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