Mediterranean diet increases endothelial function in adults: A systematic review and meta-analysis of randomized controlled trials

Shannon, Oliver, Mendes, Inês, Köchl, Christina, Mazidi, Mohsen, Ashor, Ammar, Rubele, Sofia, Minihane, Anne-Marie ORCID:, Mathers, John and Siervo, Mario (2020) Mediterranean diet increases endothelial function in adults: A systematic review and meta-analysis of randomized controlled trials. Journal of Nutrition, 150 (5). 1151–1159. ISSN 0022-3166

[thumbnail of Accepted_Manuscript]
PDF (Accepted_Manuscript) - Accepted Version
Download (1MB) | Preview


BACKGROUND: The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. METHODS: Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. RESULTS: Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P <0.001; I2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)-the reference method for noninvasive, clinical measurement of endothelial function-by 1.66% (absolute change; 95% CI: 1.15, 2.17; P <0.001; I2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P >0.05). CONCLUSIONS: MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD. This study has the PROSPERO registration number: CRD42018106188.

Item Type: Article
Uncontrolled Keywords: mediterranean diet,cardiovascular disease,dietary patterns,endothelial function,flow-mediated dilation,healthy aging,medicine (miscellaneous),nutrition and dietetics,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2701
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 08 Jan 2020 04:22
Last Modified: 22 Oct 2022 05:39
DOI: 10.1093/jn/nxaa002

Actions (login required)

View Item View Item