タグ: Mediterranean-style diet

Mediterranean-style diet and risk of ischemic stroke, myocardial infarction, and vascular death: the Northern Manhattan Study

This article has described about the relation between the Mediterranean-style diet score (MeDi score) and risk of ischemic stroke, myocardial infarction, and vascular death on blacks and Hispanics in the United States. Although there is no relation between Mediterranean-style diet and stroke because population was too small, this is the first study that is multiethnic, population based, prospective cohort study in the United States.

Mediterranean-style diet and risk of ischemic stroke, myocardial infarction, and vascular death: the Northern Manhattan Study

Hannah Gardener, Clinton B Wright, Yian Gu, Ryan T Demmer, Bernadette Boden-Albala, Mitchell SV Elkind, Ralph L Sacco, and Nikolaos Scarmeas

Am J Clin Nutr 2011; 94: 1458-64.

Abstract

Background:

A dietary pattern common in regions near the Mediterranean appears to reduce risk of all-cause mortality and ischemic heart disease. Data on blacks and Hispanics in the United States are lacking, and to our knowledge only one study has examined a Mediterranean-style diet (MeDi) in relation to stroke.

Objective:

In this study, we examined an MeDi in relation to vascular events.

Design:

The Northern Manhattan Study is a population-based cohort to determine stroke incidence and risk factors (mean ± SD age of participants: 69 ± 10 y; 64% women; 55% Hispanic, 21% white, and 24% black). Diet was assessed at baseline by using a food-frequency questionnaire in 2568 participants. A higher score on a 0–9 scale represented increased adherence to an MeDi. The relation between the MeDi score and risk of ischemic stroke, myocardial infarction (MI), and vascular death was assessed with Cox models, with control for sociodemographic and vascular risk factors.

Results:

The MeDi-score distribution was as follows: 0–2 (14%), 3 (17%), 4 (22%), 5 (22%), and 6–9 (25%). Over a mean follow-up of 9 y, 518 vascular events accrued (171 ischemic strokes, 133 MIs, and 314 vascular deaths). The MeDi score was inversely associated with risk of the composite outcome of ischemic stroke, MI, or vascular death (P-trend = 0.04) and with vascular death specifically (P-trend = 0.02). Moderate and high MeDi scores were marginally associated with decreased risk of MI. There was no association with ischemic stroke.

Conclusions:

Higher consumption of an MeDi was associated with decreased risk of vascular events. Results support the role of a diet rich in fruit, vegetables, whole grains, fish, and olive oil in the promotion of ideal cardiovascular health.

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

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, <30%).

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 60%, without difference between groups (P = .22). Mean (SD) body weight decreased more in patients in the intervention group (−4.0 [1.1] kg) than in those in the control group (−1.2 [0.6] kg) (P<.001). Compared with patients consuming the control diet, patients consuming the intervention diet had significantly reduced serum concentrations of hs-CRP (P = .01), IL-6 (P = .04), IL-7 (P = 0.4), and IL-18 (P = 0.3), as well as decreased insulin resistance (P<.001). Endothelial function score improved in the intervention group (mean [SD] change, +1.9 [0.6]; P<.001) but remained stable in the control group (+0.2 [0.2]; P = .33). At 2 years of follow-up, 40 patients in the intervention group still had features of the metabolic syndrome, compared with 78 patients in the control group (P<.001).

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

Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors

I have read an article which describes about effect of Mediterranean diet on cardiovascular risk factors. In Mediterranean countries, epidemiological evidence has been shown to low rate of cardiovascular death. It is derived from original diet pattern that people eat olive oil, nuts, vegetables, beans, fishes and red wine and don’t eat red meat, daily products and sweets so much. In this article, authors said that Mediterranean diets supplemented with olive oil or nuts have beneficial effects on such cardiovascular risks as plasma glucose, blood pressure, body weight, lipid profile and inflammatory marker factors compared with a low-fat diet. Although the authors had shown the epidemiological evidence, the discussion lacks the reason why only olive oil has beneficial effect on CRP but nuts doesn’t have.

Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors

Ramon Estruch, MD, PhD; Miguel A´ngel Marti´nez-Gonza´lez, MD, PhD; Dolores Corella, PhD; Jordi Salas-Salvado´, MD, PhD; Valentina Ruiz-Gutie´rrez, PhD; Mari´a Isabel Covas, PhD; Miguel Fiol, MD, PhD; Enrique Go´mez-Gracia, MD, PhD; Mari Carmen Lo´pez-Sabater, PhD; Ernest Vinyoles, MD, PhD; Fernando Aro´s, MD, PhD; Manuel Conde, MD, PhD; Carlos Lahoz, MD, PhD; Jose´ Lapetra, MD, PhD; Guillermo Sa´ez, MD, PhD; and Emilio Ros, MD, PhD, for the PREDIMED Study Investigators

Background: The Mediterranean diet has been shown to have beneficial effects on cardiovascular risk factors.

Objective: To compare the short-term effects of 2 Mediterranean diets versus those of a low-fat diet on intermediate markers of cardiovascular risk.

Design: Substudy of a multicenter, randomized, primary prevention trial of cardiovascular disease (Prevencio´n con Dieta Mediterra´nea [PREDIMED] Study).

Setting: Primary care centers affiliated with 10 teaching hospitals.

Participants: 772 asymptomatic persons 55 to 80 years of age at high cardiovascular risk who were recruited from October 2003 to March 2004.

Interventions: Participants were assigned to a low-fat diet (n = 257) or to 1 of 2 Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 liter per week (n = 257), or free nuts, 30 g/d (n = 258). The authors evaluated outcome changes at 3 months.

Measurements: Body weight, blood pressure, lipid profile, glucose levels, and inflammatory molecules.

Results: The completion rate was 99.6%. Compared with the low-fat diet, the 2 Mediterranean diets produced beneficial changes in most outcomes. Compared with the low-fat diet, the mean changes in the Mediterranean diet with olive oil group and the Mediterranean diet with nuts group were – 0.39 mmol/L (95% CI, – 0.70 to – 0.07 mmol/L) and – 0.30 mmol/L (CI, – 0.58 to – 0.01 mmol/L), respectively, for plasma glucose levels; – 5.9 mm Hg (CI, – 8.7 to – 3.1 mm Hg) and – 7.1 mm Hg (CI, – 10.0 to – 4.1 mm Hg), respectively, for systolic blood pressure; and – 0.38 (CI, – 0.55 to – 0.22) and – 0.26 (CI, – 0.42 to – 0.10), respectively, for the cholesterol–high-density lipoprotein cholesterol ratio. The Mediterranean diet with olive oil reduced C-reactive protein levels by 0.54 mg/L (CI, 1.04 to 0.03 mg/L) compared with the low-fat diet.

Limitations: This short-term study did not focus on clinical outcomes. Nutritional education about low-fat diet was less intense than education about Mediterranean diets.

Conclusion: Compared with a low-fat diet, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors.

Ann Intern Med. 2006; 145: 1-11.