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Impact of a mediterranean-type diet on carviovascular disease risk factors: a randomized clinical trial (Greenheartediet - rate)
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RESUMO: Introdução: As doenças cardiovasculares (CVD) são a principal causa de morte em todo o mundo, e também em Portugal, assumindo-se como um dos principais fatores responsáveis pela perda da qualidade de vida. Diversos estudos têm salientado o papel da alimentação como fulcral para a prevenção das CVD. Objetivo: Este estudo centrou-se na avaliação do impacto de uma dieta do tipo mediterrânea nos fatores de risco cardiovasculares (CRFs) em indivíduos com elevado risco para a doença. Metodologia: Trata-se de um ensaio clínico randomizado, decorrido na região do Algarve entre julho e dezembro de 2023. Foram recrutados 102 participantes (≥50 anos) sem histórico de enfarte agudo do miocárdio, mas com critérios de risco de CVD elevado segundo o algoritmo SCORE2/SCORE2 OP. Parâmetros antropométricos e de composição corporal [peso corporal, índice de massa corporal (BMI), perímetro da cintura (WC), perímetro do braço, prega cutânea bicipital e tricipital, massa gorda, massa muscular e gordura visceral], como também bioquímicos (colesterol total, lipoproteína de baixa densidade (LDL c), lipoproteína de elevada densidade (HDL-c), triglicerídeos (TG), hemoglobina glicada (HbA1c) e proteína c-reativa (CRP) foram avaliados no início da intervenção e no final, após 12 semanas de intervenção. Foi também avaliada a adesão à dieta mediterrânica (MD) segundo aplicação do PREDIMED. Os participantes foram, aleatoriamente, randomizados em três grupos: grupo sem intervenção (grupo 1a), grupo de exercício físico (grupo 1b) e grupo exercício físico e dieta (grupo 2). Resultados: Apenas 88 participantes deram por concluído o estudo. A amostra era maioritariamente constituída por mulheres (73,9%) e apresentavam uma idade média de 70,1 ± 7,9 anos. Para a variável peso corporal, BMI, prega cutânea tricipital, massa gorda e massa muscular, ambos os grupos apresentavam resultados estatisticamente significativos. O grupo 2 foi o único grupo com melhorias significativas no WC, prega cutânea bicipital, gordura visceral, área muscular do braço e triglicerídeos. No grupo 1b, verificou-se uma diminuição significativa no colesterol total e HDL-c. Entre grupos, apenas foram observadas diferenças significativas na variável LDL-C, HDL-c, HbA1c e prega cutânea tricipital. Relativamente à adesão à MD, ambos os grupos, no início, apresentavam moderada adesão, contudo, após a intervenção, apenas o grupo 2 apresentou alta adesão (p=0,024). Conclusão: O nosso estudo veio demonstrar que uma alimentação do tipo mediterrânica, sem restrição calórica, incrementada com alimentos de base vegetal, diariamente, promove a melhoria dos parâmetros cardiometabólicos, como o perímetro da cintura e a gordura visceral.
ABSTRACT: Introduction: Cardiovascular diseases (CVD) are the leading cause of death worldwide, including Portugal, serving as one of the primary factors contributing to the deterioration of quality of life. Numerous studies have underscored the pivotal role of diet in preventing CVD. Objective: This study aimed to assess the impact of a Mediterranean-type on cardiovascular risk factors (CRFs) in individuals at high risk for the disease. Methodology: This was a randomized clinical trial conducted in the Algarve region between July and December 2023. A total of 102 participants (≥50 years old) without a history of acute myocardial infarction but with high CVD risk criteria according to the SCORE2/SCORE2 OP algorithm were recruited. Anthropometric and body composition parameters [body weight, body mass index (BMI), waist circumference (WC), arm circumference, bicipital and tricipital skinfold thickness, fat mass, muscle mass, and visceral fat], as well as biochemical parameters (total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), hemoglobina glicada (HbA1c), and C-reactive protein (CRP), were evaluated at baseline and after 12 weeks of intervention. Adherence to the Mediterranean Diet (MD) was also assessed using the PREDIMED questionnaire. Participants were randomly assigned to three groups: no intervention group (group 1a), physical exercise group (group 1b), and physical exercise and diet group (group 2). Results: Only 88 participants completed the study. The sample was predominantly composed of women (73.9%) with a mean age of 70.1 ± 7.9 years. For the variables of body weight, BMI, tricipital skinfold thickness, fat mass, and muscle mass, both groups showed statistically significant results. Group 2 was the only group with significant improvements in WC, bicipital skinfold thickness, visceral fat, arm muscle area, and TG. In group 1b, a significant decrease in total cholesterol and HDL-c was observed. Between groups, significant differences were observed only in the LDL-C, HDL, HbA1c, and tricipital skinfold thickness variables. Regarding adherence to the MD, both groups initially showed moderate adherence; however, after the intervention, only group 2 showed high adherence (p=0.024). Conclusion: Our study has demonstrated that a Mediterranean-type diet, without caloric restriction, supplemented with plant-based foods daily, promotes improvement in cardiometabolic parameters such as WC and visceral fat.
ABSTRACT: Introduction: Cardiovascular diseases (CVD) are the leading cause of death worldwide, including Portugal, serving as one of the primary factors contributing to the deterioration of quality of life. Numerous studies have underscored the pivotal role of diet in preventing CVD. Objective: This study aimed to assess the impact of a Mediterranean-type on cardiovascular risk factors (CRFs) in individuals at high risk for the disease. Methodology: This was a randomized clinical trial conducted in the Algarve region between July and December 2023. A total of 102 participants (≥50 years old) without a history of acute myocardial infarction but with high CVD risk criteria according to the SCORE2/SCORE2 OP algorithm were recruited. Anthropometric and body composition parameters [body weight, body mass index (BMI), waist circumference (WC), arm circumference, bicipital and tricipital skinfold thickness, fat mass, muscle mass, and visceral fat], as well as biochemical parameters (total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), hemoglobina glicada (HbA1c), and C-reactive protein (CRP), were evaluated at baseline and after 12 weeks of intervention. Adherence to the Mediterranean Diet (MD) was also assessed using the PREDIMED questionnaire. Participants were randomly assigned to three groups: no intervention group (group 1a), physical exercise group (group 1b), and physical exercise and diet group (group 2). Results: Only 88 participants completed the study. The sample was predominantly composed of women (73.9%) with a mean age of 70.1 ± 7.9 years. For the variables of body weight, BMI, tricipital skinfold thickness, fat mass, and muscle mass, both groups showed statistically significant results. Group 2 was the only group with significant improvements in WC, bicipital skinfold thickness, visceral fat, arm muscle area, and TG. In group 1b, a significant decrease in total cholesterol and HDL-c was observed. Between groups, significant differences were observed only in the LDL-C, HDL, HbA1c, and tricipital skinfold thickness variables. Regarding adherence to the MD, both groups initially showed moderate adherence; however, after the intervention, only group 2 showed high adherence (p=0.024). Conclusion: Our study has demonstrated that a Mediterranean-type diet, without caloric restriction, supplemented with plant-based foods daily, promotes improvement in cardiometabolic parameters such as WC and visceral fat.
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Cardiovascular disease Risk factor Diet Mediterranean diet