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Intensive dietary intervention promoting the Mediterranean diet in people with high cardiometabolic risk: a non-randomized study

Acta Diabetologica volume 55, pages 219–226 (2018)Cite this article

Abstract

Aims

Mediterranean diet (MD) is acknowledged to exert a number of beneficial health effects. We assessed the efficacy and the durability of a 3-month intensive dietary intervention aimed at implementing the MD on body weight and cardiometabolic risk factors in subjects at high risk.

Methods

One hundred and sixteen subjects participated in the study (71 assigned to the intensive intervention and 45 to the conventional intervention). The intensive intervention consisted of 12 weekly group educational meetings and a free-of-charge supply of meals prepared according to the MD model. The conventional intervention consisted of an individual education session along with monthly reinforcements of nutritional messages by the general practitioner. All participants were followed up for 9 months.

Results

The two groups had similar pre-intervention characteristics. After the intervention, mean body weight decreased significantly in both groups (p < 0.001). However, the intervention group lost more weight (6.8 ± 4.0 vs. 0.7 ± 1.3, p < 0.0001) and showed a greater reduction in plasma glucose, triglycerides, blood pressure and an increase in HDL cholesterol than the control group (p < 0.01–p < 0.002). In the subgroup of participants with type 2 diabetes, there was a significant reduction in HbA1c level following the intensive (p < 0.0001) but not the conventional intervention. At follow-up, weight loss still persisted in the intervention group (p < 0.0001), while it was lost in the control group. Both interventions significantly reduced blood pressure in the long term (p < 0.001). A significant reduction in daily total energy intake was observed in both groups with a greater reduction in saturated fat and a higher increase in fibre intake in the intervention than in the control group (p < 0.009 and p < 0.001, respectively).

Conclusions

A 3-month intensive dietary intervention inspired to the traditional MD produced greater and more durable weight loss and improvement in cardiometabolic risk profile than the conventional intervention.

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Acknowledgements

The study was financially supported by Farmagourmet and Banca di Credito Cooperativo di Fisciano, Salerno, Italy.

Author information

Affiliations

  1. Azienda Sanitaria Salerno, Salerno, Italy

    M. Grimaldi, M. Rispoli, M. Guglielmi, A. Limardi & P. Calatola

  2. Department of Clinical Medicine and Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy

    O. Ciano, M. Manzo, M. Lucibello, S. Pardo, B. Capaldo & G. Riccardi

Authors
  1. M. Grimaldi
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  2. O. Ciano
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  3. M. Manzo
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  4. M. Rispoli
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  5. M. Guglielmi
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  6. A. Limardi
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  7. P. Calatola
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  8. M. Lucibello
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  9. S. Pardo
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  10. B. Capaldo
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  11. G. Riccardi
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Corresponding author

Correspondence to B. Capaldo.

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Conflict of interest

Mario Grimaldi, Ornella Ciano, Manuela Manzo, Matteo Rispoli, Michele Guglielmi, Alessandro Limardi, Pasquale Calatola, Marianna Lucibello, Serena Pardo, Brunella Capaldo and Gabriele Riccardi state that there is no conflict of interest.

Ethical standard statement

The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent disclosure

Informed consent was obtained from all participants.

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Managed by Massimo Federici.

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Grimaldi, M., Ciano, O., Manzo, M. et al. Intensive dietary intervention promoting the Mediterranean diet in people with high cardiometabolic risk: a non-randomized study. Acta Diabetol 55, 219–226 (2018). https://doi.org/10.1007/s00592-017-1078-7

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  • DOI: https://doi.org/10.1007/s00592-017-1078-7

Keywords

  • Mediterranean diet
  • Lifestyle intervention
  • Cardiometabolic risk
  • Weight loss