Potential Underlying Mechanisms

The antioxidant and anti-inflammatory properties of the individual components of the Mediterranean diet are responsible for its atheroprotective effects. The foods that comprise the basis of the Mediterranean diet, which is by definition plant based, undergo minimal processing, leading to the effective preservation of their nutrients, hence the overall diet exerts higher antioxidants levels. Moreover, given that the main fat source of the Mediterranean diet is olive oil, the amount of saturated and trans fat provided by this dietary pattern is very low (Kastorini et al. 2011). A meta-analysis of seven RCTs assessing the effect of the Mediterranean diet over low-fat diets on cardiovascular risk factors showed that after 2 years of follow-up the Mediterranean diet was more beneficial regarding changes on systolic and diastolic BP, total cholesterol, and hs-CRP (Nordmann et al. 2011). A second meta-analysis of both epidemiological studies and RCTs showed that adherence to the Mediterranean diet is optimal both for the metabolic syndrome overall and for its components related to CVD development (insulin resistance, HDL, TG, and blood pressure levels) (Kastorini et al. 2011; Santaniemi et al. 2013).

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