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

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

doi:10.1001/jama.292.12.1440

Cited by 1,876 publications

(672 citation statements)

References 30 publications

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“…The reduced risk of fractures associated with high HDL-cholesterol level is consistent with the protection observed for MUFA, because a high MUFA intake, typical of the Mediterranean food pattern, has been repeatedly shown to increase HDL levels (Mensink and Katan, 1992;Mensink et al, 2003;Esposito et al, 2004).…”

Section: Discussionsupporting

confidence: 67%

“…The major fat present in olive oil is the monounsaturated 18-carbon oleic acid. A wide array of studies have shown that olive oil exerts important anti-inflammatory effects (Visioli and Galli 2002;Esposito et al, 2004;Beauchamp et al, 2005;Serrano-Martínez et al, 2005) and antioxidant effects (Ramírez-Tortosa et al, 1999;Visioli and Galli, 2002;Pitsavos et al, 2005), which may explain why it has been reported to be negatively associated with the risk of CHD in epidemiologic studies (FernandezJarne et al, 2002;Barzi et al, 2003). These anti-inflammatory and antioxidant effects have been partly explained because of the high content of polyphenols present in virgin olive oil (Carrasco-Pancorbo et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

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Dietary fat intake and the risk of osteoporotic fractures in the elderly

et al. 2007

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Objective: To explore the association between fat intake, serum lipids and the risk of osteoporotic fractures in the elderly. Design: A hospital-based case-control study. Setting: The study was conducted at a tertiary centre and referral hospital for the province of Jaén (Spain). Subjects: Cases (n ¼ 167) were patients aged 65 years or more with a low-energy fracture selected from the population attended at the hospital. Controls (patients without antecedents of any fracture) were 1:1 matched to cases by sex and age (n ¼ 167). Methods: Diet was assessed by a semiquantitative food frequency questionnaire. Serum total cholesterol and high-density lipoprotein (HDL) cholesterol were also measured. Results: Participants in the two upper quartiles of polyunsaturated fat (PUFA) intake showed an increased risk of fracture, with statistically significant differences with respect to the first quartile in the adjusted model (odds ratio (OR) ¼ 3.59; 95% confidence interval (CI) ¼ 1.06-12.1 and OR ¼ 5.88; 95% CI ¼ 1.38-25.02); P ¼ 0.01 for the trend test). A higher ratio of monounsaturated fat (MUFA) to PUFA was associated with a reduced risk of fracture (OR ¼ 0.20; 95% CI ¼ 0.07-0.60 for the fourth quartile; P ¼ 0.002 for the trend test). The intake of omega-6 fatty acids was associated with an elevated risk of fracture (OR ¼ 3.41; 95% CI ¼ 1.05-11.15 for the fourth quartile; P ¼ 0.01 for the trend test). HDL-cholesterol levels were inversely associated with the risk of fracture (test for trend P ¼ 0.03 across quartiles). Conclusions: PUFA intake was associated with an increased risk of osteoporotic fractures in the elderly, whereas a high ratio of MUFA:PUFA was associated with decreased risk.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Dietary fat intake and the risk of osteoporotic fractures in the elderly

et al. 2007

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“…A recent study has assessed the effect of a Mediterranean-style diet on endothelial function and vascular inflammatory markers in patients with the metabolic syndrome (Esposito et al 2004). After 2 years patients following the Mediterranean-style diet were found to have significantly reduced serum concentrations of highsensitivity C-reactive protein (P=0 .…”

Section: Mediterranean Diet and Diseasementioning

confidence: 99%

Micronutrients: dietary intake v. supplement use

Woodside¹,

McCall²,

McGartland³

et al. 2005

Proc. Nutr. Soc.

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Whilst clinical deficiency of micronutrients is uncommon in the developed world, a suboptimal intake of certain micronutrients has been linked with an increased risk of chronic diseases such as CVD and cancer. Attention has therefore focused on increasing micronutrient status in order to theoretically reduce chronic disease risk. Increasing micronutrient status can involve a number of approaches: increasing dietary intake of micronutrient-rich foods; food fortification; use of supplements. Observational cohort studies have demonstrated an association between high intakes of micronutrients such as vitamin E, vitamin C, folic acid and β-carotene, and lower risk of CHD, stroke and cancer at various sites. However, randomised intervention trials of micronutrient supplements have, to date, largely failed to show an improvement in clinical end points. The discordance between data from cohort studies and the results so far available from clinical trials remains to be explained. One reason may be that the complex mixture of micronutrients found, for example, in a diet high in fruit and vegetables may be more effective than large doses of a small number of micronutrients, and therefore that intervention studies that use single micronutrient supplements are unlikely to produce a lowering of disease risk. Studies concentrating on whole foods (e.g. fruit and vegetables) or diet pattern (e.g. Mediterranean diet pattern) may be more effective in demonstrating an effect on clinical end points. The present review will consider the clinical trial evidence for a beneficial effect of micronutrient supplements on health, and review the alternative approaches to the study of dietary intake of micronutrients.

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“…In randomized trials, lifestyle interventions reduced the prevalence of the metabolic syndrome by 40-80% in the intervention groups (6)(7)(8)(9)(10)(11)(12). However, the respective influence of nutrient intake and exercise on the metabolic syndrome prevalence is difficult to disentangle since more fit individuals might also eat a healthier diet.…”

Section: Introductionmentioning

confidence: 99%

Diet or exercise: what is more effective in preventing or reducing metabolic alterations?

Ciccone

Guidi

et al. 2008

European Journal of Endocrinology

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Objective/design: The influence of diet and exercise on metabolic syndrome is controversial since fit individuals might also eat healthier foods. We evaluated the association of diet/exercise variation with reductions in metabolic variables and C-reactive protein (CRP) values in the experimental and control arms of a 1-year randomized lifestyle intervention trial performed in patients with multiple metabolic abnormalities. Methods: A prospective study of 169 cases and 166 controls after a lifestyle intervention was performed. Results: In the intervention group, 15/169 (8.9%), 63/169 (37.3%), and 70/169 (41.4%) reached only dietary, only exercise, and dietary/exercise targets respectively. Reductions in weight, body mass index (BMI), and waist were significant only in patients who increased exercise. Most controls did not reach any target (131/166, 78.9%), while only few patients reached only dietary (13/166, 7.8%), only exercise (5/166, 3.0%), and dietary/exercise targets (17/166, 10.2%). Weight, BMI, and waist reduction was more pronounced in those reaching the exercise target. In the whole cohort, increased exercise was inversely associated with weight, BMI, waist, and CRP, increased saturated fat was directly associated with weight, BMI, waist, and diastolic pressure variations, while increased fiber intake was inversely associated with glucose values in a multiple regression model. After adjusting for waist changes, the associations between exercise and CRP (ßZK0.023; 95% CI K0.028 K0.017; P!0.001) and the associations between fiber and glucose (ßZK0.022; K0.031 K0.013; P!0.001) remained significant. Conclusions: Independent of weight reduction, exercise level and fiber intake are inversely associated with CRP and fasting glucose values respectively. Change in lifestyle may lower inflammation and prevent metabolic deterioration.European Journal of Endocrinology 159 685-691

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

Cited by 1,876 publications

References 30 publications

Dietary fat intake and the risk of osteoporotic fractures in the elderly

Dietary fat intake and the risk of osteoporotic fractures in the elderly

Micronutrients: dietary intake v. supplement use

Diet or exercise: what is more effective in preventing or reducing metabolic alterations?

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