The relationship between adherence to the Mediterranean diet and abdominal obesity and related metabolic risk
Mediterranean diet and obesity with metabolic disorder
DOI:
https://doi.org/10.12873/444abuKeywords:
Mediterranean Diet, visceral obesity, metabolic disorder, insulin resistanceAbstract
Introduction: The Mediterranean diet is rich in bioactive compounds that have protective effects against metabolic disorders, and insulin resistance and reduce weight.
Objective: To explore the relationship between adherence to the Mediterranean diet and central obesity as well as related metabolic disorders.
Material and Methods: A cross-sectional study was conducted on 480 participants between the ages (18 - 65) years who were diagnosed with metabolic disorders. Data was collected using a structured questionnaire to determine socio-demographic data, anthropometric measurements, and biochemical laboratory results of metabolic parameters. The Mediterranean Diet Adherence Screener was used to measure the adherence of participants to the Mediterranean Diet. Pearson correlation and multiple linear regression were used to measure the strength and magnitude of association between parameters.
Results: The results show that higher adherence to Mediterranean Diet has significantly (P< 0.05) and inversely associated with triglyceride, cholesterol, LDL- cholesterol, cholesterol/ HDL ratio, triglyceride/ HDL ratio, HbA1c, fasting blood sugar, waist circumference, and waist-hip ratio by 39.64, 44.2, 1.284, 2.2, 4.062, 0.682, 3.36, 0.634, and 0.023 units, respectively, for each unit increase in the Mediterranean diet score. The results also show that the HDL- -cholesterol will increase by 7.56 for each unit increase in the Mediterranean diet score.
Conclusion: adherence to the Mediterranean diet should be considered a key aspect of public health nutritional strategies to control the increasing prevalence of obesity and metabolic disorders
References
Global BMI Mortality Collaboration, Di Angelantonio E, Bhupathiraju ShN, Wormser D, Gao P, Kaptoge S, Berrington de Gonzalez A, Cairns BJ, Huxley R, Jackson ChL, Joshy G, Lewington S, Manson JE, Murphy N, Patel AV, Samet JM, Woodward M, Zheng W, Zhou M, Bansal N, Barricarte A, Carter B, Cerhan JR, Smith GD, Fang X, Franco OH, Green J, Halsey J, Hildebrand JS, Jung KJ, Korda RJ, McLerran DF, Moore SC, O'Keeffe LM, Paige E, Ramond A, Reeves GK, Rolland B, Sacerdote C, Sattar N, Sofianopoulou E, Stevens J, Thun M, Ueshima H, Yang L, Yun YD, Willeit P, Banks E, Beral V, Chen Zh, Gapstur SM, Gunter MJ, Hartge P, Jee SH, Lam TH, Peto R, Potter JD, Willett WC, Thompson SG, Danesh J, Hu FB. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016 Aug 20;388(10046):776-86. doi: 10.1016/S0140-6736(16)30175-1.
Buckland G, Bach A, Serra-Majem L. Obesity and the Mediterranean diet: a systematic review of observational and intervention studies. Obes Rev. 2008 Nov;9(6):582-93. doi: 10.1111/j.1467-789X.2008.00503.x.
Godos J, Galvano F. Insights on Mediterranean Diet from the SUN Cohort: Cardiovascular and Cognitive Health. Nutrients. 2020 May 8;12(5):1332. doi: 10.3390/nu12051332.
Trichopoulou A, Martínez-González MA, Tong TY, et al. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med. 2014;12:112. doi: 10.1186/1741-7015-12-112.
Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018 Jun 21;378(25). doi: 10.1056/NEJMoa1800389
Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2014 Dec;17(12):2769-82. doi: 10.1017/S1368980013003169.
Abu Salma BM, Thekrallah F, Qatawneh A, Hasan H, Shawaqfeh S, Al Tarawneh M. Effect of intermittent fasting on improving body composition and anthropometric measurements of women with polycystic ovarian syndrome. Nutr Clín Diet Hosp. 2024;44(2):122-9. doi: 10.12873/442abu.
Dinu M, Pagliai G, Casini A, Sofi F. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomized trials. Eur J Clin Nutr. 2018 Jan;72(1):30-43. doi: 10.1038/ejcn.2017.58. PMID: 28488692.
Moreno Celis U, Garcia Gasca T, Anaya Loyola M, Rodriguez Garcia V. Obesity: A metabolic disorder. 2020.
Richardson LA, Izuora K, Basu A. Mediterranean diet and its association with cardiovascular disease risk factors: a scoping review. Int J Environ Res Public Health. 2022 Oct 6; 19(19):12762. doi: 10.3390/ijerph191912762. PMID: 36232062; PMCID: PMC9566634.
Kalkuz S, Demircan A. Effects of the Mediterranean diet adherence on body composition, blood parameters and quality of life in adults. Postgrad Med J. 2021 Dec; 97(1154):798-802. doi: 10.1136/postgradmedj-2020-138667.
Tosti V, Bertozzi B, Fontana L. Health benefits of the Mediterranean diet: metabolic and molecular mechanisms. J Gerontol A Biol Sci Med Sci. 2018 Mar 2;73(3):318-326. doi: 10.1093/gerona/glx227.
Poulimeneas D, Anastasiou CA, Santos I, Hill JO, Panagiotakos DB, Yannakoulia M. Exploring the relationship between the Mediterranean diet and weight loss maintenance: the MedWeight study. Br J Nutr. 2020 Oct 28;124(8):874-880. doi: 10.1017/S0007114520001798.
Norton, K. (2018). Standards for Anthropometry Assessment. 10.4324/9781315385662-4.
Ross R, Neeland IJ, Yamashita S, Shai I, Seidell J, Magni P, Santos RD, Arsenault B, Cuevas A, Hu FB, Griffin BA, Zambon A, Barter P, Fruchart JC, Eckel RH, Matsuzawa Y, Després JP. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol. 2020 Mar;16(3):177-189. doi: 10.1038/s41574-019-0310-7.
Salma BMA, Takruri HR, Kazaleh FAA, Thekrallah FM, Elmoumani FI, et al. Docosahexaenoic acid and eicosapentaenoic acid supplementation improves plasma lipid profile in late pregnancy. J Clin Nutr Metab. 2018;2(2).
Davis C, Bryan J, Hodgson J, Murphy K. Definition of the Mediterranean diet: a literature review. Nutrients. 2015 Nov 5;7(11):9139-53. doi: 10.3390/nu7115459.
Marventano S, Izquierdo Pulido M, Sánchez-González C, Godos J, Speciani A, Galvano F, Grosso G. Legume consumption and cardiovascular disease risk: a systematic review and meta-analysis. Public Health Nutr. 2017 Feb;20(2):245-254. doi: 10.1017/S1368980016002299.
Guasch-Ferré M, Satija A, Blondin SA, Janiszewski M, Emlen E, O'Connor LE, Campbell WW, Hu FB, Willett WC, Stampfer MJ. Meta-analysis of randomized controlled trials of red meat consumption in comparison with various comparison diets on cardiovascular risk factors. Circulation. 2019 Apr 9;139(15):1828-1845. doi: 10.1161/CIRCULATIONAHA.118.035225.
Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr. 2010 Nov;92(5):1189-96. doi: 10.3945/ajcn.2010.29673.
Schwingshackl L, Morze J, Hoffmann G. Mediterranean diet and health status: active ingredients and pharmacological mechanisms. Br J Pharmacol. 2020 Mar;177(6):1241-1257. doi: 10.1111/bph.14778.
Tricò D, Moriconi D, Berta R, Baldi S, Quinones-Galvan A, Guiducci L, Taddei S, Mari A, Nannipieri M. Effects of Low-Carbohydrate versus Mediterranean Diets on Weight Loss, Glucose Metabolism, Insulin Kinetics and β-Cell Function in Morbidly Obese Individuals. Nutrients. 2021 Apr 18;13(4):1345. doi: 10.3390/nu13041345. PMID: 33919503; PMCID: PMC8074206.
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, Colagiuri S, Guariguata L, Motala AA, Ogurtsova K, Shaw JE, Bright D, Williams R; IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov;157:107843. doi: 10.1016/j.diabres.2019.107843.
Bendall CL, Mayr HL, Opie RS, Bes-Rastrollo M, Itsiopoulos C, Thomas CJ. Central obesity and the Mediterranean diet: a systematic review of intervention trials. Crit Rev Food Sci Nutr. 2018;58(18):3070-3084. doi: 10.1080/10408398.2017.1351917.
Estruch R, Martínez-González MA, Corella D, Salas-Salvadó J, Fitó M, Chiva-Blanch G, Fiol M, Gómez-Gracia E, Arós F, Lapetra J, Serra-Majem L, Pintó X, Buil-Cosiales P, Sorlí JV, Muñoz MA, Basora-Gallisá J, Lamuela-Raventós RM, Serra-Mir M, Ros E; PREDIMED Study Investigators. Effect of a high-fat Mediterranean diet on bodyweight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomized controlled trial. Lancet Diabetes Endocrinol. 2019 May;7(5). doi: 10.1016/S2213-8587(19)30074-9.
Mancini JG, Filion KB, Atallah R, Eisenberg MJ. Systematic review of the Mediterranean diet for long-term weight loss. Am J Med. 2016 Apr;129(4):407-415.e4. doi: 10.1016/j.amjmed.2015.11.028.
Schwingshackl L, Schwedhelm C, Galbete C, Hoffmann G. Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis. Nutrients. 2017 Sep 26;9(10):1063. doi: 10.3390/nu9101063.
Barrea L, Muscogiuri G, Frias-Toral E, Laudisio D, Pugliese G, Castellucci B, Garcia-Velasquez E, Savastano S, Colao A. Nutrition and immune system: from the Mediterranean diet to dietary supplementation through the microbiota. Crit Rev Food Sci Nutr. 2021;61(18):3066-3090. doi: 10.1080/10408398.2020.1792826.
Mayr HL, Itsiopoulos C, Tierney AC, Kucianski T, Radcliffe J, Garg M, et al. Ad libitum Mediterranean diet reduces subcutaneous but not visceral fat in patients with coronary heart disease: a randomised controlled pilot study. Clin Nutr ESPEN. 2019;32:61-69. doi: 10.1016/j.clnesp.2019.05.001
Finicelli M, Di Salle A, Galderisi U, Peluso G. The Mediterranean diet: an update of the clinical trials. Nutrients. 2022 Jul 19;14(14):2956. doi: 10.3390/nu14142956.
Schiavo L, Scalera G, Sergio R, De Sena G, Pilone V, Barbarisi A. Clinical impact of Mediterranean-enriched-protein diet on liver size, visceral fat, fat mass, and fat-free mass in patients undergoing sleeve gastrectomy. Surg Obes Relat Dis. 2015 Sep-Oct;11(5):1164-70. doi: 10.1016/j.soard.2015.04.003.
Schröder H, Mendez MA, Ribas-Barba L, Covas MI, Serra-Majem L. Mediterranean diet and waist circumference in a representative national sample of young Spaniards. Int J Pediatr Obes. 2010 Dec;5(6):516-9. doi: 10.3109/17477161003777417.
Romaguera D, Norat T, Mouw T, May AM, Bamia C, Slimani N, Travier N, Besson H, Luan J, Wareham N, Rinaldi S, Couto E, Clavel-Chapelon F, Boutron-Ruault MC, Cottet V, Palli D, Agnoli C, Panico S, Tumino R, Vineis P, Agudo A, Rodriguez L, Sanchez MJ, Amiano P, Barricarte A, Huerta JM, Key TJ, Spencer EA, Bueno-de-Mesquita HB, Büchner FL, Orfanos P, Naska A, Trichopoulou A, Rohrmann S, Kaaks R, Bergmann M, Boeing H, Johansson I, Hellstrom V, Manjer J, Wirfält E, Uhre Jacobsen M, Overvad K, Tjonneland A, Halkjaer J, Lund E, Braaten T, Engeset D, Odysseos A, Riboli E, Peeters PH. Adherence to the Mediterranean diet is associated with lower abdominal adiposity in European men and women. J Nutr. 2009 Sep;139(9):1728-37. doi: 10.3945/jn.109.108902.
Delgado AM, Vaz Almeida MD, Parisi S. Chemistry of the Mediterranean diet. Cham, Switzerland: Springer; 2017.
Finicelli M, Squillaro T, Galderisi U, Peluso G. Polyphenols, the healthy brand of olive oil: insights and perspectives. Nutrients. 2021 Oct 27;13(11):3831. doi: 10.3390/nu13113831.
Muscogiuri G, Verde L, Sulu C, Katsiki N, Hassapidou M, Frias-Toral E, Cucalón G, Pazderska A, Yumuk VD, Colao A, Barrea L. Mediterranean diet and obesity-related disorders: what is the evidence? Curr Obes Rep. 2022 Dec;11(4):287-304. doi: 10.1007/s13679-022-00481-1.
Guasch-Ferré M, Willett WC. The Mediterranean diet and health: a comprehensive overview. J Intern Med. 2021 Sep;290(3):549-566. doi: 10.1111/joim.13333.
Alexander DD, Miller PE, Van Elswyk ME, Kuratko CN, Bylsma LC. A meta-analysis of randomized controlled trials and prospective cohort studies of eicosapentaenoic and docosahexaenoic long-chain omega-3 fatty acids and coronary heart disease risk. Mayo Clin Proc. 2017 Jan;92(1):15-29. doi: 10.1016/j.mayocp.2016.10.018.
Doundoulakis I, Farmakis IT, Theodoridis X, Konstantelos A, Christoglou M, Kotzakioulafi E, Chrysoula L, Siargkas A, Karligkiotis A, Kyprianou G, Mastromanoli E, Soulaidopoulos S, Zafeiropoulos S, Antza C, Tsiachris D, Chourdakis M. Effects of dietary interventions on cardiovascular outcomes: a network meta-analysis. Nutr Rev. 2024 May 10;82(6):715-725. doi: 10.1093/nutrit/nuad080.
Salas-Salvadó J, Guasch-Ferré M, Lee CH, Estruch R, Clish CB, Ros E. Protective effects of the Mediterranean diet on type 2 diabetes and metabolic syndrome. J Nutr. 2015 Apr 1;146(4):920S-927S. doi: 10.3945/jn.115.218487.
Samimi M, Jamilian M, Asemi Z, Esmaillzadeh A. Effects of omega-3 fatty acid supplementation on insulin metabolism and lipid profiles in gestational diabetes: randomized, double-blind, placebo-controlled trial. Clin Nutr. 2015 Jun;34(3):388-93. doi: 10.1016/j.clnu.2014.06.005.
Mohammadi E, Rafraf M, Farzadi L, Asghari-Jafarabadi M, Sabour S. Effects of omega-3 fatty acids supplementation on serum adiponectin levels and some metabolic risk factors in women with polycystic ovary syndrome. Asia Pac J Clin Nutr. 2012;21(4):511-8.
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