Effect of a high-fat Mediterranean diet on bodyweight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomised controlled trial (original) (raw)
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Obesity and the Mediterranean diet: a systematic review of observational and intervention studies
Obesity Reviews, 2008
World Health Organization projections estimate that worldwide approximately one-third of adults are overweight and one-tenth are obese. There is accumulating research into the Mediterranean diet and whether it could prevent or treat obesity. Therefore, the purpose of this paper was to systematically review and analyse the epidemiological evidence on the Mediterranean diet and overweight/obesity. We identified 21 epidemiological studies that explored the relationship between the Mediterranean diet and weight. These included seven cross-sectional, three cohort and 11 intervention studies. Of these, 13 studies reported that Mediterranean diet adherence was significantly related to less overweight/obesity or more weight loss. Eight studies found no evidence of this association. Exploring the relationship between the Mediterranean diet and overweight/obesity is complex, and there are important methodological differences and limitations in the studies that make it difficult to compare results. Although the results are inconsistent, the evidence points towards a possible role of the Mediterranean diet in preventing overweight/ obesity, and physiological mechanisms can explain this protective effect. Despite this, more research is needed to substantiate this association. Epidemiological studies should use a consistent universal definition of the Mediterranean diet, and address common methodological limitations to strengthen the quality of research in this area.
Nutrients, 2018
A moderately high-fat Mediterranean diet does not promote weight gain. This study aimed to investigate the association between dietary intake of specific types of fat and obesity and body weight. A prospective cohort study was performed using data of 6942 participants in the PREDIMED trial, with yearly repeated validated food-frequency questionnaires, and anthropometric outcomes (median follow-up: 4.8 years). The effects of replacing dietary fat subtypes for one another, proteins or carbohydrates were estimated using generalized estimating equations substitution models. Replacement of 5% energy from saturated fatty acids (SFA) with monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids (PUFA) resulted in weight changes of −0.38 kg (95% Confidece Iinterval (CI): −0.69, −0.07), and −0.51 kg (95% CI: −0.81, −0.20), respectively. Replacing proteins with MUFA or PUFA decreased the odds of becoming obese. Estimates for the daily substitution of one portion of red meat with whit...
PLoS ONE, 2012
Objective: Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes.
American Journal of Clinical Nutrition, 2010
Background: There is an association between a greater adherence to a Mediterranean diet and a reduced risk of developing chronic diseases. However, it is not clear whether this dietary pattern may be protective also against the development of obesity. Objective: We assessed the association between the adherence to the Mediterranean dietary pattern (MDP), prospective weight change, and the incidence of overweight or obesity. Design: We conducted a prospective cohort study [the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol Consumption, Cessation of Smoking, Eating Out of Home, and Obesity (EPIC-PANACEA) project] in 373,803 individuals (103,455 men and 270,348 women; age range: 25-70 y) from 10 European countries. Anthropometric measurements were obtained at recruitment and after a median follow-up time of 5 y. The relative Mediterranean Diet Score (rMED; score range: 0-18) was used to assess adherence to the MDP according to the consumption of 9 dietary components that are characteristic of the Mediterranean diet. The association between the rMED and 5-y weight change was modeled through multiadjusted mixed-effects linear regression. Results: Individuals with a high adherence to the MDP according to the rMED (11-18 points) showed a 5-y weight change of 20.16 kg (95% CI: 20.24, 20.07 kg) and were 10% (95% CI: 4%, 18%) less likely to develop overweight or obesity than were individuals with a low adherence to the MDP (0-6 points). The low meat content of the Mediterranean diet seemed to account for most of its positive effect against weight gain. Conclusion: This study shows that promoting the MDP as a model of healthy eating may help to prevent weight gain and the development of obesity.
Adherence to a Mediterranean Diet Is Associated with Reduced 3Year Incidence of Obesity1
2000
Few studies have prospectively examined dietary patterns and adult weight change, and results to date are inconsistent. This study examines whether a Mediterranean diet (MD) pattern is associated with reduced 3-y incidence of obesity using data from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The sample included 17,238 women and 10,589 men not obese
2014
Abdominal obesity is a strong predictor of metabolic disorders. Prospective data on the association between the Mediterranean diet and surrogate markers of abdominal adiposity are scarce. The present study evaluated the relationship between adherence to the Mediterranean diet and (1) changes in waist circumference (WC) and 10-year incidence of abdominal obesity. We conducted a prospective, populationbased study in 3058 male and female Spaniards aged 25 -74 years, followed from 2000 to 2009. Dietary intake and leisure-time physical activity levels were recorded using validated questionnaires. Weight, height and WC were measured. Adherence to the Mediterranean diet, determined using the previously validated REGICOR-Mediterranean diet score (R-MDS), based on the distribution of population food intake and on the dietary recommendations (MDS-rec), was negatively associated with WC gain (P¼0·007 and 0·024, respectively) in fully adjusted models. In the multivariate logistic analysis, the odds of abdominal obesity incidence decreased across the tertiles of the R-MDS, but the association was not significant. In conclusion, adherence to the Mediterranean diet was associated with lower abdominal fat gain, but not with 10-year incidence of abdominal obesity.
The American Journal of Medicine, 2011
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/m 2 . After 2 years of follow-up, individuals assigned to a Mediterranean diet had more favorable changes in weighted mean differences of body weight (Ϫ2.2 kg; 95% confidence interval [CI], Ϫ3.9 to Ϫ0.6), body mass index (Ϫ0.6 kg/m 2 ; 95% CI, Ϫ1 to Ϫ0.1), systolic blood pressure (Ϫ1.7 mm Hg; 95% CI, Ϫ3.3 to Ϫ0.05), diastolic blood pressure (Ϫ1.5 mm Hg; 95% CI, Ϫ2.1 to Ϫ0.8), fasting plasma glucose (Ϫ3.8 mg/dL, 95% CI, Ϫ7 to Ϫ0.6), total cholesterol (Ϫ7.4 mg/dL; 95% CI, Ϫ10.3 to Ϫ4.4), and high-sensitivity C-reactive protein (Ϫ1.0 mg/L; 95% CI, Ϫ1.5 to Ϫ0.5). 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.
Nutrition, 2006
Objective: We evaluated the prevalence of obesity in relation to adherence to a Mediterranean diet. Methods: We conducted a cross-sectional survey that randomly enrolled 1514 men (18 to 87 y old) and 1528 women (18 to 89 y old) with no history of cardiovascular disease. Anthropometric indices were measured and frequency of various foods consumed during a usual week was recorded. Adherence to a Mediterranean diet was assessed by a diet score that incorporated the inherent characteristics of this diet. Results: Prevalences of overweight and obesity were 53% and 20% in men and 31% and 15% in women. An inverse relation was observed between diet score, waist-to-hip ratio (r ϭ Ϫ0.31, P Ͻ 0.001), and body mass index (r ϭ Ϫ0.4, P Ͻ 0.001) after adjusting for sex and age. Greater adherence to the Mediterranean diet (i.e., highest tertile) was associated with a 51% lower odds of being obese (odds ratio 0.49, 95% confidence interval 0.42 to 0.56) and a 59% lower odds of having central obesity (odds ratio 0.41, 95% confidence 0.35 to 0.47) compared with a non-Mediterranean diet (i.e., lowest tertile) after controlling for age, sex, physical activity status, metabolism, and other variables. Conclusion: We observed an inverse relation between adherence to a Mediterranean dietary pattern and prevalence of obesity in a free-eating, population-based sample of men and women, irrespective of various potential confounders.
Acta Diabetologica, 2017
Aims Mediterranean diet (MD) is acknowledged to exert a number of beneficial health effects. We assessed the efficacy and the durability of a 3-month intensive dietary intervention aimed at implementing the MD on body weight and cardiometabolic risk factors in subjects at high risk. Methods One hundred and sixteen subjects participated in the study (71 assigned to the intensive intervention and 45 to the conventional intervention). The intensive intervention consisted of 12 weekly group educational meetings and a freeof-charge supply of meals prepared according to the MD model. The conventional intervention consisted of an individual education session along with monthly reinforcements of nutritional messages by the general practitioner. All participants were followed up for 9 months. Results The two groups had similar pre-intervention characteristics. After the intervention, mean body weight decreased significantly in both groups (p < 0.001). However, the intervention group lost more weight (6.8 ± 4.0 vs. 0.7 ± 1.3, p < 0.0001) and showed a greater reduction in plasma glucose, triglycerides, blood pressure and an increase in HDL cholesterol than the control group (p < 0.01-p < 0.002). In the subgroup of participants with type 2 diabetes, there was a significant reduction in HbA1c level following the intensive (p < 0.0001) but not the conventional intervention. At follow-up, weight loss still persisted in the intervention group (p < 0.0001), while it was lost in the control group. Both interventions significantly reduced blood pressure in the long term (p < 0.001). A significant reduction in daily total energy intake was observed in both groups with a greater reduction in saturated fat and a higher increase in fibre intake in the intervention than in the control group (p < 0.009 and p < 0.001, respectively). Conclusions A 3-month intensive dietary intervention inspired to the traditional MD produced greater and more durable weight loss and improvement in cardiometabolic risk profile than the conventional intervention.