Dataset Information

Mediterranean Diet and its Effect on Endothelial Function: A Meta-analysis and Systematic Review.

ABSTRACT:

Background

Endothelial dysfunction serves as an early marker for the risk of cardiovascular disease (CVD); therefore, it is a site of therapeutic interventions to reduce the risk of CVD.

Aims

To examine the effect of the Mediterranean diet (MedDiet), as an intervention, on structural and functional parameters of endothelial function, and how it may reduce the risk of CVD and associated mortality.

Methods

Medline database was searched for randomized controlled trials. Random-effects meta-analysis was conducted on 21 independent datasets. Meta-regression and subgroup analysis were performed to assess whether the effect of MedDiet was modified by health status (healthy subjects or with increased CVD risk), type of MedDiet intervention (alone or combined), type of parameter (functional or structural), study design (cross-over or parallel), BMI, age, and study duration. Our study used sample size, mean, and standard deviation of endothelial function measurements for both MedDiet intervention and control in the analyses.

Results

Inverse relationship between endothelial function and intake of MedDiet was observed (SMD: 0.34; 95% CI: 0.16, 0.52; P = 0.0001). Overall, MedDiet increased FMD by 1.39% (95% CI: 0.47, 2.19; P < 0.001). There was a significant improvement in endothelial function in both healthy patients and in those with an increased risk of CVD. No significant variation was observed in the effects of MedDiet on endothelial function, due to study design or type of intervention.

Conclusions

These findings support that MedDiet can reduce the risk of CVD by improving endothelial function.

SUBMITTER: Fatima K

PROVIDER: S-EPMC9892125 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Mediterranean Diet and its Effect on Endothelial Function: A Meta-analysis and Systematic Review.

Fatima Kaneez K Rashid Ahmed Mustafa AM Memon Usama Abdul Ahad UAA Fatima Syeda Sidra SS Javaid Syed Sarmad SS Shahid Omema O Zehri Fazila F Obaid Muhammad Adil MA Ahmad Mahlika M Almas Talal T Minhas Abdul Mannan Khan AMK

Irish journal of medical science 20220222 1

<h4>Background</h4>Endothelial dysfunction serves as an early marker for the risk of cardiovascular disease (CVD); therefore, it is a site of therapeutic interventions to reduce the risk of CVD.<h4>Aims</h4>To examine the effect of the Mediterranean diet (MedDiet), as an intervention, on structural and functional parameters of endothelial function, and how it may reduce the risk of CVD and associated mortality.<h4>Methods</h4>Medline database was searched for randomized controlled trials. Random ...[more]

PMID: 35192097

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Project description:The Mediterranean diet (MD) may provide metabolic benefits but no systematic review to date has examined its effect on a multitude of outcomes related to metabolic health. This systematic review with meta-analysis (International Prospective Register of Systematic Reviews, PROSPERO; number CRD42019141459) aimed to examine the MD's effect on metabolic syndrome (MetSyn) incidence, components and risk factors (primary outcomes), and incidence and/or mortality from MetSyn-related comorbidities and receipt of pharmacologic treatment for MetSyn components and comorbidities (secondary outcomes). We searched Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science for controlled trials published until June 2019, comparing the MD with no treatment, usual care, or different diets in adults. Studies not published in English and not promoting the whole MD were excluded. Two authors independently extracted data and assessed risk of bias using the Cochrane Collaboration's and Risk of Bias in non-randomised studies (ROBINS-I) tools. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effects meta-analyses, subgroup analyses and meta-regressions were performed, and heterogeneity was quantified using the I2 statistic. We identified 2654 reports and included 84 articles reporting 57 trials (n = 36,983). In random effects meta-analyses, the MD resulted in greater beneficial changes in 18 of 28 MetSyn components and risk factors (body weight, body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR) index, total-, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, alanine transaminase, hepatic fat mass, C-reactive protein, interleukin-6, tumour necrosis factor-a, and flow-mediated dilatation) and lower risk of cardiovascular disease incidence (risk ratio (RR) = 0.61, 95% confidence intervals (CI) 0.42-0.80; I2 = 0%), and stroke (RR = 0.67, 95% CI 0.35-0.98; I2 = 0%). Only six studies reported effects on pharmacotherapy use, and pooled analysis indicated no differences between diet groups. Lack of consistency in comparator groups and other study characteristics across studies resulted in high heterogeneity for some outcomes, which could not be considerably explained by meta-regressions. However, a consistent direction of beneficial effect of the MD was observed for the vast majority of outcomes examined. Findings support MD's beneficial effect on all components and most risk factors of the MetSyn, in addition to cardiovascular disease and stroke incidence. More studies are needed to establish effects on other clinical outcomes and use of pharmacotherapy for MetSyn components and comorbidities. Despite the high levels of heterogeneity for some outcomes, this meta-analysis enabled the comparison of findings across studies and the examination of consistency of effects. The consistent direction of effect, suggesting the MD's benefits on metabolic health, supports the need to promote this dietary pattern to adult populations.

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Dataset Information

Mediterranean Diet and its Effect on Endothelial Function: A Meta-analysis and Systematic Review.

Background

Aims

Methods

Results

Conclusions

Publications

Mediterranean Diet and its Effect on Endothelial Function: A Meta-analysis and Systematic Review.

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