Mediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Shannon, Oliver M; Mendes, In�s; K�chl, Christina; Mazidi, Mohsen; Ashor, Ammar W; Rubele, Sofia; Minihane, Anne-Marie; Mathers, John C; Siervo, Mario

Abstract

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

Citation

Shannon, O. M., Mendes, I., Köchl, C., Mazidi, M., Ashor, A. W., Rubele, S., …Siervo, M. (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. https://doi.org/10.1093/jn/nxaa002

• Journal Article Type: Article
• Acceptance Date: Jan 3, 2020
• Online Publication Date: Feb 6, 2020
• Publication Date: 2020-05
• Deposit Date: Jan 30, 2020
• Publicly Available Date: Feb 7, 2021
• Journal: The Journal of Nutrition
• Print ISSN: 0022-3166
• Electronic ISSN: 1541-6100
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 150
• Issue: 5
• Pages: 1151–1159
• DOI: https://doi.org/10.1093/jn/nxaa002
• Keywords: Nutrition and Dietetics; Medicine (miscellaneous)
• Public URL: https://nottingham-repository.worktribe.com/output/3828274
• Publisher URL: https://academic.oup.com/jn/advance-article/doi/10.1093/jn/nxaa002/5728755