|DOI / URL||link|
|Title (Primary)||The effect of green Mediterranean diet on cardiometabolic risk; a randomised controlled trial|
|Author||Tsaban, G.; Meir, A.Y.; Rinott, E.; Zelicha, H.; Kaplan, A.; Shalev, A.; Katz, A.; Rudich, A.; Tirosh, A.; Shelef, I.; Youngster, I.; Lebovitz, S.; Israeli, N.; Shabat, M.; Brikner, D.; Pupkin, E.; Stumvoll, M.; Thiery, J.; Ceglarek, U.; Heiker, J.T.; Körner, A.; Landgraf, K.; von Bergen, M.; Blüher, M.; Stampfer, M.J.; Shai, I.|
|Topic||T9 Healthy Planet|
|Keywords||obesity; metabolic syndrome; cardiac risk factors and prevention|
Background A Mediterranean diet is favourable for cardiometabolic risk.
Objective To examine the residual effect of a green Mediterranean diet, further enriched with green plant-based foods and lower meat intake, on cardiometabolic risk.
Methods For the DIRECT-PLUS parallel, randomised clinical trial we assigned individuals with abdominal obesity/dyslipidaemia 1:1:1 into three diet groups: healthy dietary guidance (HDG), Mediterranean and green Mediterranean diet, all combined with physical activity. The Mediterranean diets were equally energy restricted and included 28 g/day walnuts. The green Mediterranean diet further included green tea (3–4 cups/day) and a Wolffia globosa (Mankai strain; 100 g/day frozen cubes) plant-based protein shake, which partially substituted animal protein. We examined the effect of the 6-month dietary induction weight loss phase on cardiometabolic state.
Results Participants (n=294; age 51 years; body mass index 31.3 kg/m2; waist circumference 109.7 cm; 88% men; 10 year Framingham risk score 4.7%) had a 6-month retention rate of 98.3%. Both Mediterranean diets achieved similar weight loss ((green Mediterranean −6.2 kg; Mediterranean −5.4 kg) vs the HDG group −1.5 kg; p<0.001), but the green Mediterranean group had a greater reduction in waist circumference (−8.6 cm) than the Mediterranean (−6.8 cm; p=0.033) and HDG (−4.3 cm; p<0.001) groups. Stratification by gender showed that these differences were significant only among men. Within 6 months the green Mediterranean group achieved greater decrease in low-density lipoprotein cholesterol (LDL-C; green Mediterranean −6.1 mg/dL (−3.7%), −2.3 (-0.8%), HDG −0.2 mg/dL (+1.8%); p=0.012 between extreme groups), diastolic blood pressure (green Mediterranean −7.2 mm Hg, Mediterranean −5.2 mm Hg, HDG −3.4 mm Hg; p=0.005 between extreme groups), and homeostatic model assessment for insulin resistance (green Mediterranean −0.77, Mediterranean −0.46, HDG −0.27; p=0.020 between extreme groups). The LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio decline was greater in the green Mediterranean group (−0.38) than in the Mediterranean (−0.21; p=0.021) and HDG (−0.14; p<0.001) groups. High-sensitivity C-reactive protein reduction was greater in the green Mediterranean group (−0.52 mg/L) than in the Mediterranean (−0.24 mg/L; p=0.023) and HDG (−0.15 mg/L; p=0.044) groups. The green Mediterranean group achieved a better improvement (−3.7% absolute risk reduction) in the 10-year Framingham Risk Score (Mediterranean−2.3%; p=0.073, HDG−1.4%; p<0.001).
Conclusions The green MED diet, supplemented with walnuts, green tea and Mankai and lower in meat/poultry, may amplify the beneficial cardiometabolic effects of Mediterranean diet.
|Persistent UFZ Identifier||https://www.ufz.de/index.php?en=20939&ufzPublicationIdentifier=24868|
|Tsaban, G., Meir, A.Y., Rinott, E., Zelicha, H., Kaplan, A., Shalev, A., Katz, A., Rudich, A., Tirosh, A., Shelef, I., Youngster, I., Lebovitz, S., Israeli, N., Shabat, M., Brikner, D., Pupkin, E., Stumvoll, M., Thiery, J., Ceglarek, U., Heiker, J.T., Körner, A., Landgraf, K., von Bergen, M., Blüher, M., Stampfer, M.J., Shai, I. (2021):
The effect of green Mediterranean diet on cardiometabolic risk; a randomised controlled trial
Heart 107 (13), 1054 - 1061