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

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 24; no. 9; pp. 929 - 939
• Main Authors: Schwingshackl, L., Hoffmann, G.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2014
• Subjects: adhesion; adiponectin; Adiponectin - blood; Biomarkers - blood; C-Reactive Protein - metabolism; Cardiovascular; cardiovascular diseases; Databases, Factual; Diet, Mediterranean; E-Selectin - blood; eating habits; Endothelial function; Endothelium - physiology; Humans; Inflammation; Inflammation - blood; Inflammation - prevention & control; Intercellular Adhesion Molecule-1 - blood; interleukin-6; Interleukin-6 - blood; Mediterranean diet; Mediterranean dietary pattern; Meta-analysis; metabolism; mortality; randomized clinical trials; Randomized Controlled Trials as Topic; Reproducibility of Results; risk; Sensitivity and Specificity; systematic review; Treatment Outcome; Vascular Cell Adhesion Molecule-1 - blood; Mediterranean dietary pattern; Inflammation; Endothelial function; Meta-analysis
• ISSN: 0939-4753; 1590-3729; 1590-3729
• DOI: 10.1016/j.numecd.2014.03.003

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. 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; I2 = 43%], and adiponectin [WMD: 1.69 μg/ml, 95% CI 0.27 to 3.11, p = 0.02; I2 = 78%], while high-sensitive C reactive protein [WMD: −0.98 mg/l, 95% CI −1.48 to −0.49, p < 0.0001; I2 = 91%], interleukin-6 [WMD: −0.42 pg/ml, 95% CI −0.73 to −0.11, p = 0.008; I2 = 81%], and intracellular adhesion molecule-1 [WMD: −23.73 ng/ml, 95% CI −41.24 to −6.22 p = 0.008; I2 = 34%] turned out to be significantly more decreased. The results of the present meta-analysis provide evidence that an MD decreases inflammation and improves endothelial function.