Original Article

European Journal of Clinical Nutrition (2006) 60, 478–485. doi:10.1038/sj.ejcn.1602340; published online 23 November 2005

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

Guarantor: A Michalsen.

Contributors: AM, NL, SM, TB, GD designed the study. AM wrote the original manuscript. AM and NK coordinated the trial. SM and NK were responsible for quality control. NL and SM performed the statistical calculations and analyses. CP was the dietitian and mainly responsible for collection of data. LB and FK analysed all blood samples. All authors contributed to interpretation of data and critically revised the manuscript.

A Michalsen1, N Lehmann2, C Pithan1, N T M Knoblauch1, S Moebus2, F Kannenberg3, L Binder4, T Budde5 and G J Dobos1

  1. 1Department of Internal Medicine V, Kliniken Essen-Mitte, Chair of Complementary Medicine at the University Duisburg-Essen, Germany
  2. 2Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg, Essen, Germany
  3. 3The Institute of Arteriosclerosis Research at the University of Münster, Münster, Germany
  4. 4Department of Clinical Chemistry, University Clinic of Göttingen, Göttingen, Germany
  5. 5Department of Cardiology, Alfried Krupp Krankenhaus, Essen, Germany

Correspondence: Dr A Michalsen, Abteilung für Innere Medizin V, Kliniken Essen-Mitte, Am Deimelsberg 34a, 45276 Essen, Germany. E-mail: andreas.michalsen@uni-essen.de

Received 21 February 2005; Revised 2 September 2005; Accepted 14 September 2005; Published online 23 November 2005.

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Abstract

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 (59.4plusminus8.6 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.

Sponsorship:

 

Alfried Krupp Foundation, Essen, Germany.

Keywords:

coronary artery disease, Mediterranean diet, n-3 fatty acids, C-reactive protein, cardiovascular risk, inflammation

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