Meta-analysis comparing mediterranean to low-fat diets for modification of cardiovascular risk factors

Alain J. Nordmann, Katja Suter-Zimmermann, Heiner C. Bucher, Iris Shai, Katherine R. Tuttle, Ramon Estruch, Matthias Briel

    Research output: Contribution to journalArticlepeer-review

    214 Scopus citations

    Abstract

    Background: Evidence from individual trials comparing Mediterranean to low-fat diets to modify cardiovascular risk factors remains preliminary. Methods: We systematically searched MEDLINE, EMBASE, Biosis, Web of Science, and the Cochrane Central Register of Controlled Trials from their inception until January 2011, as well as contacted experts in the field, to identify randomized controlled trials comparing Mediterranean to low-fat diets in overweight/obese individuals, with a minimum follow-up of 6 months, reporting intention-to-treat data on cardiovascular risk factors. Two authors independently assessed trial eligibility and quality. Results: We identified 6 trials, including 2650 individuals (50% women) fulfilling our inclusion criteria. Mean age of enrolled patients ranged from 35 to 68 years, mean body mass index from 29 to 35 kg/m2. After 2 years of follow-up, individuals assigned to a Mediterranean diet had more favorable changes in weighted mean differences of body weight (-2.2 kg; 95% confidence interval [CI], -3.9 to -0.6), body mass index (-0.6 kg/m2; 95% CI, -1 to -0.1), systolic blood pressure (-1.7 mm Hg; 95% CI, -3.3 to -0.05), diastolic blood pressure (-1.5 mm Hg; 95% CI, -2.1 to -0.8), fasting plasma glucose (-3.8 mg/dL, 95% CI, -7 to -0.6), total cholesterol (-7.4 mg/dL; 95% CI, -10.3 to -4.4), and high-sensitivity C-reactive protein (-1.0 mg/L; 95% CI, -1.5 to -0.5). The observed heterogeneity across individual trials could, by and large, be eliminated by restricting analyses to trials with balanced co-interventions or trials with restriction of daily calorie intake in both diet groups. Conclusion: Mediterranean diets appear to be more effective than low-fat diets in inducing clinically relevant long-term changes in cardiovascular risk factors and inflammatory markers.

    Original languageEnglish
    Pages (from-to)841-851.e2
    JournalAmerican Journal of Medicine
    Volume124
    Issue number9
    DOIs
    StatePublished - 1 Jan 2011

    Keywords

    • Low-fat diet
    • Mediterranean diet
    • Meta-analysis

    ASJC Scopus subject areas

    • Medicine (all)

    Fingerprint

    Dive into the research topics of 'Meta-analysis comparing mediterranean to low-fat diets for modification of cardiovascular risk factors'. Together they form a unique fingerprint.

    Cite this