Edward P. Havranek, MD
In overweight patients with increased cardiovascular (CV) risk, is a Mediterranean diet (MD) better than a low-fat diet (LFD) for reducing CV risk factors?
Included studies compared MDs with LFDs in overweight or obese patients with established coronary artery disease or ≥ 1 additional CV risk factor and reported intention-to-treat data on changes in body weight, blood pressure (BP), and lipid values. Outcomes included body weight, body mass index (BMI), waist circumference, and systolic and diastolic BP.
MEDLINE, EMBASE/Excerpta Medica, Biosis, and Web of Science (all to Jan 2011); Cochrane Central Register of Controlled Trials; reference lists; clinical trial registries; and recently published editorials and reviews were searched for randomized controlled trials (RCTs) in any language with ≥ 6 months of follow-up. Experts were contacted. 6 RCTs (n = 2650, mean age 35 to 68 y, 50% women, mean BMI 29 to 35 kg/m2) met the selection criteria and were included in meta-analyses. 4 RCTs were primary prevention trials, 1 was a secondary prevention trial, and 1 was both.
Persistence on diet ranged from 85% to 95% for MDs and 78% to 93% for LFDs. Meta-analysis showed that, compared with an LFD, an MD increased weight loss and changes in BMI and systolic and diastolic BP but not waist circumference (Table). There was significant statistical heterogeneity (I2 = 60% to 97%; P ≤ 0.03) across study results for all outcomes.
In overweight patients with increased cardiovascular risk, a Mediterranean diet is better than a low-fat diet for reducing body weight, body mass index, and blood pressure.
*Abbreviations defined in Glossary. A negative difference favors a Mediterranean diet.
†Not statistically significant.
Edward P. Havranek. Review: A Mediterranean diet reduces cardiovascular risk factors in overweight patients compared with a low-fat diet. Ann Intern Med. 2011;155:JC6–3. doi: 10.7326/0003-4819-155-12-201112200-02003
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Published: Ann Intern Med. 2011;155(12):JC6-3.
Cardiology, Coronary Risk Factors, Obesity, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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