Mediterranean diet has no effect on markers of inflammation and metabolic risk factors in patients with coronary artery disease

Objective: Mediterranean diet is associated with decreased levels of inflammatory markers and metabolic risk factors in epidemiologic studies and recent trials on patients with metabolic syndrome. Given the recent improvements in medical treatments, it is unclear if such beneficial effects are also present in patients with coronary artery disease ( CAD). We therefore investigated the effect of Mediterranean diet on markers of inflammation and metabolic risk factors in patients with treated CAD. Design: Randomized, controlled trial. Subjects: A total of 101 patients (59.4 +/- 8.6 years, 23% female) with established and treated CAD (80% statins). Interventions: Participants were assigned to a Mediterranean diet group (MG; n = 48) with a 1-year program of 100 h of education, or to a written advice-only group (AG; n = 53). Before and after intervention, we measured serum high-sensitivity C-reactive protein (hs-CRP), fibrinogen, fasting insulin, homocysteine, serum lipids and plasma fatty acids. Results: The Mediterranean diet program increased the intakes of fish, fruits/vegetables and moderately of canola/olive oil and increased plasma concentrations of long-chain n-3 polyunsaturated fatty acids in the MG. Median hs-CRP and mean fibrinogen, homocysteine, fasting insulin, triglycerides and serum cholesterols remained unchanged in both groups. Conclusions: Adoption of a Mediterranean diet by patients with medically treated CAD has no effect on markers of inflammation and metabolic risk factors.