Abstract
Background: Obesity is slowly being redefined as a chronic inflammatory disorder that through multiple mechanisms contributes to the development of cardiometabolic disease and a reduction in quality of life. The Mediterranean diet has long been one of the diets most strongly linked with good health, however, evidence from long, term randomized trials demonstrating its integrated effects on chronic inflammation, obesity, and overall health is still scarce.
Objective: This trial sought to investigate the effects of prolonged compliance with the Mediterranean diet on chronic inflammation, measurements related to obesity, and general health outcomes in overweight and class I obese adults.
Methods: A total of 160 adults aged 20 to 65 years with a BMI of 25 to 35 kg/m2 were randomly assigned to either a Mediterranean diet (MedDiet) intervention group or a control group following their habitual diet (standard dietary advice) for 12 months. The intervention was based on personalized nutrition counseling, structured meal plans, and the provision of key MedDiet foods. Adherence was measured with the 14, item MedDiet Adherence Screener (MEDAS). Changes in inflammatory markers (high, sensitivity C, reactive protein, interleukin, 6, and tumor necrosis factor alpha) and obesity, related measures were the primary endpoints. The secondary endpoints were cardiometabolic risk factors and health, related quality of life. The data were analyzed using the intention, to, treat and per, protocol methods.
Results: Mediterranean diet adherence was importantly raised in the intervention group relative to controls (p < 0. 001). At 12 months, the intervention group exhibited significantly greater reduction in body weight, body mass index, waist circumference, and fat mass (all p < 0. 01). Decreased levels of hs C reactive protein, interleukin 6, and tumor necrosis factor were most pronounced in the Mediterranean diet group, and the effects remained significant even after one adjusts for weight change.Besides these, the improvements of blood pressure, lipid profile, insulin resistance, and quality of life scores were also much greater in the intervention group than in controls.
Conclusion: Maintaining a Mediterranean diet for 12 months made a significant difference in systemic inflammation, obesity related outcomes, cardiometabolic health, and quality of life in adults with overweight and obesity. These results emphasize the role of diet quality in controlling obesity related inflammation and the Mediterranean diet as a convenient and effective long term dietary approach for chronic disease prevention and health promotion