Mediterranean diet could lower BP, atherogenic lipids for children and adolescents
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Key takeaways:
- The Mediterranean diet was linked to modest reductions in systolic BP and atherogenic lipids in children and adolescents.
- The diet did not appear to affect diastolic BP, glucose or insulin resistance.
Switching to a Mediterranean diet during childhood and adolescence was associated with modest reductions in BP and an improved profile, which may extend to better heart health during adulthood, researchers reported.
A meta-analysis of nine randomized controlled trials evaluating a Mediterranean diet intervention for children and adolescents in Iran, Mexico, Spain and Turkey was published in JAMA Network Open.
“In 2020, metabolic syndrome was observed in approximately 3% of children and 5% of adolescents, with slight differences in prevalence among various countries and regions, which underscores the urgent need for multisectoral interventions to improve cardiometabolic health in this population. In this sense, lifestyle factors, particularly diet, seem to exert a significant role on cardiometabolic health,” José Francisco López-Gil, PhD, of the One Health Research Group at Universidad de Las Américas in Quito, Ecuador, and colleagues wrote. “The Mediterranean diet has gained recognition for its health benefits among various healthy dietary patterns. This eating pattern is characterized by the use of olive oil as the primary dietary fat and abundant consumption of seasonal fruits, vegetables, legumes, whole grains and nuts, with low intake of red and processed meats, ultraprocessed food, sweets, confections and pastries. ... Therefore, our objective was to review and analyze the randomized clinical trials that have assessed Medierranean diet interventions among children and adolescents.”
For their systematic review and meta-analysis, López-Gil and colleagues analyzed nine randomized controlled trials that evaluated the effects of the Mediterranean diet on cardiometabolic markers such as BP, triglycerides, cholesterol, glucose and insulin in children and adolescents.
The average study duration was 17 weeks and involved 577 participants (mean age, 11 years; 60% girls). The trials included children and adolescents of varying body weights at baseline. Three trials included a prescribed Mediterranean diet alone, whereas the others varied between diet plus physical activity or nutritional education regarding the Mediterranean diet. All intervention arms were compared with usual care, low-fat diet with or without physical activity or no action at all.
Cardiometabolic effects of Mediterranean diet
Compared with the control groups, the various Mediterranean diet-based interventions were significantly associated with reductions in:
- systolic BP (mean difference, 4.75 mm Hg; 95% CI, 8.97 to 0.52);
- triglycerides (mean difference, 16.42 mg/dL; 95% CI, 27.57 to 5.27);
- total cholesterol (mean difference, 9.06 mg/dL; 95% CI, 15.65 to 2.48); and
- LDL (mean difference, 10.48 mg/dL; 95% CI, 17.77 to 3.19).
In addition, the various Mediterranean diet-based interventions were associated with elevations in HDL compared with controls (mean difference, 2.24 mg/dL; 95% CI, 0.34-4.14), but no significant differences were observed for diastolic BP, glucose and homeostatic model assessment for insulin resistance.
Modest effect may confer future benefit
“The findings from this systematic review and meta-analysis indicate that Mediterranean diet-based interventions ... were associated with reductions in systolic BP, triglycerides, total cholesterol and LDL-C and increases in HDL-C. However, caution should be exercised when interpreting the results due to the limited number of randomized controlled trials,” the researchers wrote. “The use of different types of interventions, such as prescribed diet, nutrition education, or a combination of diet and physical activity or exercise, may have contributed to the inconsistency among the results obtained. Additionally, the variation in geographic locations (Mediterranean and non-Mediterranean countries) or whether interventions were targeted solely at young individuals or involved parents and families may have also influenced our findings.”
The researchers stated that Mediterranean diet’s effects on systolic BP and lipids were modest, but even small improvements in these biomarkers for CVD could improve heart and vascular health in adulthood.
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