Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome

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Although it is not clear that how mediterranean style diet reduce the inflammation state associated with metabolic syndrome, C reactive protein has been suggested to form lesion directly with endothelial dysfunction and leukocyte activation.

Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome

A Randomized Trial

Katherine Esposito, MD; Raffaele Marfella, MD, PhD; Miryam Ciotola, MD; Carmen Di Palo, MD; Francesco Giugliano, MD; Giovanni Giugliano, MD; Massimo D’Armiento, MD; Francesco D’Andrea, MD; Dario Giugliano, MD, PhD

ABSTRACT

Context The metabolic syndrome has been identified as a target for dietary therapies to reduce risk of cardiovascular disease; however, the role of diet in the etiology of the metabolic syndrome is poorly understood.

Objective To assess the effect of a Mediterranean-style diet on endothelial function and vascular inflammatory markers in patients with the metabolic syndrome.

Design, Setting, and Patients Randomized, single-blind trial conducted from June 2001 to January 2004 at a university hospital in Italy among 180 patients (99 men and 81 women) with the metabolic syndrome, as defined by the Adult Treatment Panel III.

Interventions Patients in the intervention group (n = 90) were instructed to follow a Mediterranean-style diet and received detailed advice about how to increase daily consumption of whole grains, fruits, vegetables, nuts, and olive oil; patients in the control group (n = 90) followed a prudent diet (carbohydrates, 50%-60%; proteins, 15%-20%; total fat,

Main Outcome Measures Nutrient intake; endothelial function score as a measure of blood pressure and platelet aggregation response to L-arginine; lipid and glucose parameters; insulin sensitivity; and circulating levels of high-sensitivity C-reactive protein (hs-CRP) and interleukins 6 (IL-6), 7 (IL-7), and 18 (IL-18).

Results After 2 years, patients following the Mediterranean-style diet consumed more foods rich in monounsaturated fat, polyunsaturated fat, and fiber and had a lower ratio of omega-6 to omega-3 fatty acids. Total fruit, vegetable, and nuts intake (274 g/d), whole grain intake (103 g/d), and olive oil consumption (8 g/d) were also significantly higher in the intervention group (P<.001 the level of physical activity increased in both groups by approximately without difference between .22 mean body weight decreased more patients intervention group kg than those control compared with consuming diet had significantly reduced serum concentrations hs-crp .01 il-6 .04 il-7 and il-18 as well insulin resistance endothelial function score improved change p but remained stable at years follow-up still features metabolic syndrome>

Conclusion A Mediterranean-style diet might be effective in reducing the prevalence of the metabolic syndrome and its associated cardiovascular risk.

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