Mediterranean dietary pattern, inflammation and endothelial function: a systematic review and meta-analysis of intervention trials

Nutr Metab Cardiovasc Dis. 2014 Sep;24(9):929-39. doi: 10.1016/j.numecd.2014.03.003. Epub 2014 Apr 2.

Abstract

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.

Methods and 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.

Conclusion: The results of the present meta-analysis provide evidence that an MD decreases inflammation and improves endothelial function.

Keywords: Endothelial function; Inflammation; Mediterranean dietary pattern; Meta-analysis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adiponectin / blood
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Databases, Factual
  • Diet, Mediterranean*
  • E-Selectin / blood
  • Endothelium / physiology*
  • Humans
  • Inflammation / blood
  • Inflammation / prevention & control*
  • Intercellular Adhesion Molecule-1 / blood
  • Interleukin-6 / blood
  • Randomized Controlled Trials as Topic
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome
  • Vascular Cell Adhesion Molecule-1 / blood

Substances

  • Adiponectin
  • Biomarkers
  • E-Selectin
  • ICAM1 protein, human
  • Interleukin-6
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein