Effects of the Mediterranean diet on Cholesterol

Effects of the Mediterranean diet on Cholesterol

Introduction
The eating patterns of individuals who live in countries located around the Mediterranean Sea, such as Greece, Italy, and Spain, served as an inspiration for developing this eating plan. The plant-based foods that comprise most of the diet include whole grains, vegetables, legumes, fruits, nuts, seeds, herbs, and spices.1Most of the extra fat comes from olive oil—everything in moderation, including fish, seafood, dairy, and chicken. We save our red meat consumption for special occasions and limit sugar intake. The Mediterranean diet, for instance, does not include high information on processed carbohydrates or red meat. Instead, the Mediterranean diet emphasizes eating plenty of vegetables (and fresh fruit for dessert), whole-grain cereals, and low-fat dairy products.1 Vegetables are central to the Mediterranean diet, which also emphasizes consuming whole-grain grains and low-fat dairy products. As a result of its abundance of foods synergistically increasing HDL (“good”) cholesterol levels, the Mediterranean diet may be very beneficial for cardiovascular health. It has been shown that the Mediterranean diet benefits cholesterol levels, a vital sign of heart health. Therefore, the benefits of the Mediterranean diet on cholesterol reduction are discussed in this work.
Article 1
Study design
The online supplemental materials include the study’s methodology, participant selection and follow-up. Primary outcomes included changes in plasma lipids and faecal levels of short-chain fatty acids. Secondary outcomes included shifts in gut microbiota and intermediate markers of metabolic disease such as blood pressure and fasting blood glucose1. In brief, the health and lifestyle behaviours of the 334 people who satisfied the inclusion/exclusion criteria were evaluated. The research presents the Italian Mediterranean Index, which was derived by applying the 11-unit dietary score to the measurement of MD adherence.
Research purpose
The objective of this study was to examine the effect of an isocaloric Mediterranean diet (MD) intervention on metabolic gut microbiota, health,and systemic metabolome in individuals with lifestyle risk factors for metabolic disease.
Methods
In this study, the authors evaluated the effects of an 8-week isocaloric dietary intervention with those of a Mediterranean diet (MD) and a control diet on the gut microbiota, blood, and urine metabolomic profiles of 82 persons who were overweight or obese1. Without expecting anything in return, each participant submitted their written informed consent for the study.
Results
The MedD group’s increased MD adherence led to a significant change in both their fibre and animal protein consumption. Reductions in plasma and urinary carnitine concentrations demonstrated compliance. The plasma cholesterol levels and faecal bile acid levels were considerably lower in the MedD group than in the ConD group1. The use of shotgun metagenomics demonstrated that the gut microbiome of individuals whose systemic inflammation was reduced as a result of the intervention had altered according to their degrees of MD adherence. The MD therapy elevated the carbohydrate degradation genes1 of the fibre-degrading bacteria Faecalibacteriumprausnitzii and the butyrate-metabolizing microorganisms. After dietary modification, urinary urolithins, faecal bile acid degradation, and insulin sensitivity were all enhanced in the MedD group. These benefits were connected with alterations in the gut microbiota makeup.
Conclusion
The individuals’ blood cholesterol dropped, and they experienced several alterations to their microbiota and metabolome that are significant to future methods for enhancing metabolic health after switching to an MD while keeping their calorie consumption.
Limitations
This study only looks at the short-term effects of dietary induction; hence its findings may not be generalizable. Nonetheless, earlier research has shown that dietary induction phase modifications highly indicate long-term metabolic and cardiovascular impacts.
Article 2
Research design
An internet-based, computer-generated, random-numbering method was used to randomly assign participants to the intensive-lifestyle or the nonrestrictive MedDiet intervention group, with stratification by location, age, and gender. Registered dietitians counselled control group participants to adhere to a standard MedDiet without calorie limitations2. Those placed in the intensive-intervention group were given a calorie-restricted MedDiet and exercise guidelines to help them reach their weight reduction targets. Regarding physical exercise, participants were urged to engage in at least 44 minutes of moderate-intensity aerobic activity per day in addition to resistance, balance, or flexibility training.
Research purpose
This study aimed to evaluate the effects of a non-hypocaloric Mediterranean eating pattern with no exercise on those of a hypocaloric Mediterranean eating pattern with exercise to see whether the latter improved HDL function.
Methods
Three hundred ninety-one participants comprised the whole of the Prevención with DietaMediterránea-Plus research. Participants were recruited at the Hospital del Mar Medical Research Institute, where they provided plasma samples at baseline and six months later2. The objective of the PREDIMED-Plus study, a multicenter, parallel, randomized controlled trial, is to compare the incidence of cardiovascular disease between a MedDiet with spontaneous caloric intake and no physical activity and a MedDiet with energy restriction, physical activity, and behavioural support.
Results
Those who participated in the intensive lifestyle intervention lost more weight over 6 months than those on the control diet, but there was no difference in HDL cholesterol2. Weight reduction was the primary mediator of the relationship between the intense lifestyle and improved HDL functional characteristics, namely lower triglyceride and apoC-III levels compared to the control diet.
Conclusion
Reducing caloric intake and increasing exercise enhance HDL triglyceride metabolism in persons over 50 with metabolic syndrome.
Limitations
The findings were only seen in persons over 60 who had metabolic syndrome and obesity; thus they cannot be applied to other groups. Second, using a healthy, standard MedDiet as a control group and a more extensive intervention consisting of real-life modifications to nutrition and physical activity customized to the participants’ clinical circumstances, we anticipated finding only minor differences between intervention groups. Third, whereas those in the intensive-lifestyle-intervention group had a significant increase in their levels of physical activity, there was less of a gap between the groups concerning their calorie consumption. Still, the study’s overarching goal is an aggressive reduction in energy use2. So far, we have just thought about the first six months of the intervention. In conclusion, after six months of research, 16 of the 407 people recruited at our centre were no longer contactable. This might introduce some bias into our calculations.
Article 3
Study design
In May 2017, the DIRECT-PLUS study followed participants for 18 months as they ate a monitored lunch in a controlled environment. Most health assessments and behavioural modification workshops for improving one’s lifestyle were conducted at the office’s medical section. Age >29 and the presence of dyslipidaemiaor abdominal obesity were other inclusion criteria3. The institutional review board and medical ethics committee at Soroka University Medical Centre approved the study’s methodology. No monetary or non-removable presents were given to the participants, and all gave their written approval.
Research purpose
The purpose of this research was to evaluate the aftereffects of a Mediterranean diet that had a greater emphasis on plant-based foods and less emphasis on meat on the risk of cardiometabolic disease.
Methods
People with abdominal obesity/dyslipidaemia were allocated to one of three diet groups for the parallel, randomized clinical research DIRECT-PLUS: the healthy dietary guideline (HDG) group, the Mediterranean diet group, or the green Mediterranean diet group. The average daily consumption of walnuts in the Mediterranean diet was 28 grams, with a comparable calorie restriction3. The green Mediterranean diet is also characterized by green tea and a plant-based protein shake prepared from Wolffia globosa. The cardiometabolic status was examined during the six months of diet-induced weight reduction.
Results
Of the total number of people that offered to help with the research, 378, only 294 were considered eligible participants. Table 1 shows the research participants’ baseline demographic and clinical characteristics across the various treatment groups. Out of the total sample size of 35 women, 14 were considered postmenopausal3. One lady in the HDG group admitted to using frequent hormone replacement therapy. Serum levels of oestradiol and progesterone in women were comparable before any treatment was given. A total of 98.3 percent of participants were still active after six months. A comparable weight reduction was seen in both the Mediterranean and the low-carbohydrate groups. In contrast to the Mediterranean group, those in the green Mediterranean lost more weight around the middle. LDL-C/HDL-C ratios reduced more in the green Mediterranean group than in the Mediterranean and HDG.
Conclusions
The green MED diet may increase the favourable cardiometabolic benefits of the traditional Mediterranean diet by adding green tea, walnuts,and Mankai and reducing the amount of meat and poultry consumed.
Limitations
Because of the predominance of males in the workplace where we performed our research, male participants constituted the vast majority of the study population. Consequently, concluding the impact of the investigated treatments in this demographic may be severely constrained by the possibility that extending the findings to women is of little relevance. However, the randomization method was stratified by gender to ensure that each intervention group had an equal percentage of female participants. Results were consistent when only males were included in the sensitivity analysis3. The physical activity intervention was tracked in this study, but only via participant reports; no hard data were collected. Even though adherence to the diet was monitored using a validated food-frequency-questionnaire14 and food changes questionnaire, the research could not determine what in the green MED diet contributed to the positive results. Therefore, the reduction in meat and poultry consumption was not the result of an objective evaluation based on biochemical tests of bodily fluids but rather self-report3. It is also crucial to remember that the researchers did not attempt to identify a perfect match for calorie restriction but chose a range based on predicted gender.
Conclusion
Researchers from all around the globe have researched the Mediterranean diet extensively. It is a way of eating that has been shown to improve heart health by increasing HDL cholesterol and decreasing triglycerides. It does this by supplying many essential nutrients to the body. People can do much for their health by eating more of these foods. Using the three primary sources, the study has offered clear evidence of how the Med Diet may help reduce Cholesterol. One example is combining the Mediterranean diet’s cholesterol-lowering benefits with exercise and weight loss.

References
1. Meslier V, Laiola M, Roager HM, et al. Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake. Gut. 2020;69(7):1258-1268. doi:10.1136/gutjnl-2019-320438.
2. Sanllorente A, Soria-Florido MT, Castañer O, et al. A lifestyle intervention with an energy-restricted Mediterranean diet and physical activity enhances HDL function: a substudy of the PREDIMED-Plus randomized controlled trial. Am J Clin Nutr. 2021;114(5):1666-1674. doi:10.1093/ajcn/nqab246.
3. Tsaban G, Yaskolka Meir A, Rinott E, et al. The effect of green Mediterranean diet on cardiometabolic risk; a randomized controlled trial [published online ahead of print, 2020 Nov 23]. Heart. 2020;heartjnl-2020-317802. doi:10.1136/heartjnl-2020-317802.1.