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New Discoveries about the World's Healthiest Foods: A Mediterranean-style Diet Helps Reverse Metabolic Syndrome, Lowering Risk of Cardiovascular Disease & Type 2 Diabetes

A second study also published in the September 2004 issue of JAMA demonstrated that a Mediterranean-style diet significantly reduces factors contributing to metabolic syndrome (a metabolic imbalance that increases risk for cardiovascular disease and type 2 diabetes) in persons with this disorder.

Recent estimates indicate that 24% of American adults have metabolic syndrome, which consists of several factors including abdominal obesity, atherogenic dyslipidemia (high levels of LDL cholesterol likely to form atherosclerotic plaques), elevated blood pressure, and glucose intolerance.

This study, conducted at a university hospital in Italy from June 2001 to January 2004, was a randomized trial involving 180 patients (99 men and 81 women) with metabolic syndrome. Half the patients were instructed to follow a Mediterranean-style diet and given detailed advice about how to increase their daily consumption of whole grains, fruits, vegetables, nuts and olive oil. The other 90 patients followed a prudent diet (50-60% carbohydrates, 15-20% protein, and less than 30% total fat).

After two years, patients following the Mediterranean diet had significant decreases in body weight, blood pressure, blood sugar levels, insulin resistance, total cholesterol, and triglycerides, and a significant increase in levels of protective HDL cholesterol, all of which were much greater than those seen in the group following the prudent diet.

Endothelial function also improved significantly in the Mediterranean diet group but remained unchanged in the prudent dieters. (The endothelium, the lining of the blood vessels, plays a critical role in cardiovascular health.) Followers of the Mediterranean diet also experienced a significant reduction in several inflammatory markers that indicate increased risk for blood vessel dysfunction (hs CRP, IL-6, IL-7, IL-18).

Only 40 patients consuming the Mediterranean diet—less than half the group—still showed features of metabolic syndrome, compared with 78 patients following the prudent diet.

The authors of the study concluded, "… a Mediterranean-style diet rich in whole grains, fruits, vegetables, legumes, walnuts, and olive oil might be effective in reducing both the prevalence of the metabolic syndrome and its associated cardiovascular risk."


Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D'Armiento M, D'Andrea F, Giugliano D. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA. 2004 Sep 22;292(12):1440-6.

PMID: 15383514

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