Mediterranean dietary pattern, inflammation and endothelial function: A systematic review and meta-analysis of intervention trials

Background: High adherence to a Mediterranean diet (MD) is associated with reduced all-cause and cardiovascular mortality risk. To our knowledge, there is no systematic review and meta-analysis of randomized controlled trials that has compared the effects of an MD on outcomes of endothelial function and inflammation. Methods and results: Literature search was performed using the electronic databases MEDLINE, EMBASE, and the Cochrane Trial Register. Inclusion criteria were: randomized controlled trials, 19 + years of age, and minimum intervention period of 12 weeks. Study specific weighted mean differences (WMD) were pooled using a random effect model. Seventeen trials including 2300 subjects met the objectives. MD regimens resulted in a significantly more pronounced increase in flow mediated dilatation [WMD: 1.86%, 95% CI 0.23 to 3.48, p = 0.02; I-2 = 43%], and adiponectin [WMD: 1.69 mu g/ml, 95% CI 0.27 to 3.11, p = 0.02; I-2 = 78%], while high-sensitive C reactive protein [WMD: -0.98 mg/l, 95% CI -1.48 to -0.49, p < 0.0001; I-2 = 91%], interleukin-6 [WMD: -0.42 pg/ml, 95% CI -0.73 to -0.11, p = 0.008; I-2 = 81%], and intracellular adhesion molecule-1 [WMD: -23.73 ng/ml, 95% CI -41.24 to -6.22 p = 0.008; I-2 = 34%] turned out to be significantly more decreased. Conclusion: The results of the present meta-analysis provide evidence that an MD decreases inflammation and improves endothelial function. (C) 2014 Elsevier B. V. All rights reserved.