The traditional Mediterranean diet (MedDiet) is now widely recommended in the prevention of CVD. However, it is not known whether the MedDiet has the same beneficial cardiovascular effects in women and in men. The objective of the present study was to investigate sex-related differences with regard to changes in cardiometabolic variables in response to a 4-week isoenergetic MedDiet. Participants were thirty-eight men and thirty-two premenopausal women aged between 25 and 50 years who had slightly elevated LDL-cholesterol (LDL-C) concentrations (3·4-4·9 mmol/l) or total cholesterol:HDL-cholesterol ratio $ 5·0. A 4-week run-in period preceded the MedDiet in order to control the inter-and intra-individual variability. Cardiometabolic variables were measured before and after the MedDiet. Total cholesterol, LDL-C, apoB and apoA-1 plasma concentrations as well as diastolic blood pressure decreased (P,0·05) in both men and women (respectively, 10, 10, 10, 6 and 5 % for men and 6, 7, 9, 4 and 4 % for women). ApoA-2 concentrations and insulin concentrations 2 h after the oral administration of 75 g of glucose demonstrated sex £ time interactions (respectively, P¼0·05 and P¼ 0·03) and only men experienced a decrease for these variables (respectively, 8 and 25 %). In conclusion, consuming a MedDiet led to significant changes in plasma lipid profile in both men and women, while only men had significant improvements in insulin homeostasis. These results support the importance of investigating sex-related differences in response to diet in order to perhaps further individualise dietary guidelines in the prevention of CVD and type 2 diabetes.

It is expected that a dietary intervention based on the traditional Mediterranean food pattern should be associated with a reduction in fast-food consumption but this has never been tested before. We assessed the impact of a 12-week dietary intervention, promoting the adoption of a Mediterranean food pattern, on fast-food consumption among seventy-one healthy women aged between 30 and 65 years. The dietary intervention consisted of two group sessions and seven individual sessions with a dietitian. To determine the Mediterranean dietary score (MedScore) and fast-food consumption, an FFQ was administered. During the 12-week intervention, the MedScore significantly increased (from 21·1 (SD 3·6) units at baseline to 28·6 (SD 4·4) units at week 12, P, 0·0001), while the fast-food consumption significantly decreased (from 51·7 (SD 46·4) g/d at baseline to 20·5 (SD 18·2) g/d at week 12, P, 0·0001). Moreover, women who had a higher consumption of fast food at baseline decreased their fast-food consumption to the most (r 2 0·50, P, 0·0001). When four subgroups were formed on the basis of median values of Medscore and fast-food consumption changes, it was found that only the subgroup of women which increased the most their MedScore and decreased the most their fast-food consumption experienced a significant decrease in BMI (P,0·01). In conclusion, a dietary intervention promoting the Mediterranean food pattern led to a decrease in fast-food consumption among healthy women even if it was not a specific target of the intervention. Dietary strategies for increasing intake of healthy foods may be a useful approach for decreasing intake of less healthy foods. Mediterranean food pattern: Fast-food consumption: BMI: Lipid profileIn the past 30 years, a dramatic increase in fast-food consumption has occurred. Several studies, supported by a recent review of the literature, suggest that the increase in fast-food consumption may be one of the important contributors of remarkable increases in overweight and obesity rates in the past decades (1,2) . In fact, fast food is characterised by a high energy density (3) , a high palatability (4) and a poor content in dietary fibres (3) , and all these factors have been associated to promote an increase in energy intake (4 -6) . Moreover, some evidence showed that fast-food consumption is also related to some cardiovascular risk factors (7,8) . To counter the increased rates of obesity and related diseases, many organisations recently recommended low energy density food patterns such as the Mediterranean diet (9)

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ObjectiveTo investigate differences between men and women with regard to changes in metabolic parameters associated with cardiovascular risks in response to a 4‐week eucaloric controlled nutritional intervention based on the traditional Mediterranean diet.MethodsParticipants were men and premenopausal women who had a slightly elevated plasma LDL‐cholesterol concentration (between 3.4 and 4.9 mM) and at least one factor of the metabolic syndrome. During the intervention, all foods and drinks concordant with the traditional Mediterranean diet were provided to participants. Metabolic parameters were measured before and after the controlled intervention. These preliminary analyses included data from 23 men and 16 women.ResultsCompared with baseline, plasma concentrations of total cholesterol, LDL‐cholesterol and apolipoprotein‐B significantly decreased in both men and women (respectively 9%, 10% and 9% for men and 9%, 9% and 12% for women; P<0.05). Significant decreases in area under the insulin curve and a significant improvement in insulin sensitivity were observed only in men (P<0.05).ConclusionAccording to our preliminary results, consuming a traditional Mediterranean diet leads to significant changes in plasma lipid‐lipoprotein profile in both men and women. Significant improvements in plasma glucose–insulin homeostasis were observed, but in men only.Supported by CIHR and HSFC

ObjectiveTo investigate the impact of a 4‐week eucaloric controlled nutritional intervention based on the traditional Mediterranean diet (MedDiet) on the metabolic syndrome (MetS) in men and women.MethodsParticipants were 37 men and 32 premenopausal women who had a slightly elevated plasma LDL‐cholesterol concentration (between 3.4 and 4.9 mM) and at least one factor of the MetS. During the intervention, all foods and drinks concordant with the MedDiet were provided to participants. The MetS was assessed before and after the controlled intervention as defined by the National Cholesterol Education Program Adult Treatment Panel III criteria.ResultsAt baseline, 43.2% of men and 37.5% of women had the MetS. The prevalence of the MetS was reduced by 13.5% in men and was increased by 3.1% in women (men vs women, P=0.14). The reversion of the MetS was 3.5 times greater in men than in women, however this odds ratio was not significant (95% confidence interval, 0.67–18.24). No significant change was observed in the number of criteria of the MetS in women (P=1.00) whereas a trend was noted in men (P=0.08).ConclusionA 4‐week controlled nutritional intervention based on the MedDiet does not lead to significant changes in the MetS in women, although men tend to have beneficial effects in response to this intervention.Supported by CIHR and HSFQ