Mediterranean diet modified with more plant-based foods may
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Decreased meat intake supplemented with a parallel increase in plant-based foods may amplify the beneficial cardiometabolic effects of the Mediterranean diet and reduce CV risk, according to a study published in Heart.

“The Mediterranean (MED) diet, based on higher consumption of plant-based foods, has been proved to be better than the previously widely recommended low-fat diet for reduction in cardiometabolic risk and prevention of cardiovascular diseases. Accordingly, the MED diet has gained popularity in clinical settings and is currently the backbone of clinical cardiology dietary guidelines,” researchers wrote. “It remains unclear whether a modified MED diet, higher in green plant nutritional sources with further restriction of meat, could offer cardiometabolic benefits beyond these found with the conventional MED diet.”

To further examine the effect of a green MED diet, researchers randomly assigned 294 participants (mean age, 51 years; 88% men) with abdominal obesity or dyslipidemia (BMI, 31.3 kg/m²; waist circumference, 109.7 cm) from a previous trial to either adhere to the healthy dietary guidance (HDG) diet, the MED diet or the green MED diet.

The researchers found both the MED diet group and the green MED diet group achieved similar weight loss compared with the HDG diet group (–5.4 kg vs. –6.2 kg vs. –1.5 kg, respectively), but the green MED diet group had the greatest reduction in waist circumference (green MED, –8.6 cm; MED, –6.8 cm; HDG, –4.3 cm; P for green MED vs. MED = .033; P for green MED vs. HDG < .001).

Further analysis showed within 6 months, patients on the green MED diet achieved the greatest decreases in LDL (green MED, –6.1 mg/dL; MED, –2.3 mg/dL, HDG, –0.2 mg/dL; P = .012), diastolic BP (green MED, –7.2 mm Hg; MED, –5.2 mm Hg; HDG, –3.4 mm Hg), homeostatic model assessment for insulin resistance (–0.77, –0.46 and –0.21, respectively) and LDL/HDL ratio (–0.38, –0.21 and –0.14, respectively).

Of the three groups, the green MED group also had the greatest reduction in high-sensitivity C-reactive protein (P for green MED vs. MED = .023; P for green MED vs. HDG = .044) and the greatest improvement in Framingham 10-year risk score (P for green MED vs. MED = .073; P for green MED vs. HDG < .001).

“This study’s results suggest that while calorie-restricted MED diets promote weight loss and benefit metabolic state, the green MED diet provides a significant improvement in cardiovascular risk,” researchers wrote. “Additional restriction of meat intake with a parallel increase in plant-based, protein-rich foods may further benefit the cardiometabolic state ... beyond the known beneficial effects of the traditional MED diet.”

Source: https://heart.bmj.com/content/early/2020/11/25/heartjnl-2020-317802
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