2025-06-30
Metabolism in danger: could your plate make the difference?
Cardiology and Vascular Medicine
#MetabolicSyndrome #MediterraneanDiet #Obesity
#Type2Diabetes #Hypertension
Metabolic syndrome (MetS) is a multifactorial disorder affecting up to 40% of Western populations. It is defined by the coexistence of several abnormalities: abdominal obesity, high blood pressure, insulin resistance, and dyslipidemia. This combination greatly increases the risk of type 2 diabetes, cardiovascular events, and premature death.
Despite current lifestyle recommendations and pharmacological treatments, the results often fall short. Long-term adherence is difficult, side effects are common, and the approach remains symptomatic. Given these limitations, nutrition — especially the Mediterranean Diet (MD) — is receiving growing attention as a standalone therapeutic strategy.
This study was designed to compare the effectiveness of the Mediterranean Diet with other dietary or therapeutic approaches for managing MetS, through a systematic review and meta-analysis of available randomized controlled trials (RCTs).
Twelve randomized clinical trials, totaling 2,013 patients, were analyzed. Interventions included enriched MD (olive oil, nuts), low-fat diets, or combined programs with physical activity or behavioral support.
The results reveal significant clinical benefits of the Mediterranean diet on several metabolic parameters. Body mass index (BMI) decreased on average by −0.83 kg/m² (p < 0.00001), while waist circumference decreased by −1.81 cm (p < 0.00001). Triglycerides showed a marked drop of −22.38 mg/dL (p < 0.00001) and fasting blood glucose decreased by −4.28 mg/dL (p = 0.005). A reduction in insulin levels of −2.21 µU/mL (p = 0.01) was also observed, as well as an improvement in insulin resistance measured by HOMA-IR, with a decrease of −0.72 (p < 0.00001).
Other markers — total cholesterol, HDL, LDL, blood pressure — also showed improvements, although less consistently due to heterogeneity in the protocols. No major adverse effects were reported.
Meta-regressions show that intervention duration and weekly frequency of the diet influence effectiveness, particularly on fat mass, HDL, and blood glucose.
Metabolic syndrome remains a complex, multifactorial, and constantly evolving condition, making its long-term stabilization particularly difficult. The current therapeutic challenge lies in the implementation of approaches that are effective, sustainable, and easily accessible. It is in this context that this review was conducted, to evaluate whether the Mediterranean diet presents superiority compared to other existing strategies to improve clinical parameters of metabolic syndrome.
The results obtained confirm that the Mediterranean diet has notable positive effects on several key markers, including body weight, waist circumference, triglycerides, blood glucose, and insulin sensitivity. Its integration into care practices could thus significantly strengthen the prevention of cardiovascular and metabolic diseases. Further work will involve the design of more standardized studies, precisely defining the nutritional components of the Mediterranean diet (particularly in terms of lipids and macronutrients), its application frequency, and ways to integrate it with other interventions such as physical activity. Identifying patient profiles most likely to respond favorably would also be crucial. Ultimately, the Mediterranean diet could establish itself as a central pillar of the nutritional strategy against metabolic syndrome.
Metabolic syndrome (MetS) is a multifactorial disorder affecting up to 40% of Western populations. It is defined by the coexistence of several abnormalities: abdominal obesity, high blood pressure, insulin resistance, and dyslipidemia. This combination greatly increases the risk of type 2 diabetes, cardiovascular events, and premature death.
Despite current lifestyle recommendations and pharmacological treatments, the results often fall short. Long-term adherence is difficult, side effects are common, and the approach remains symptomatic. Given these limitations, nutrition — especially the Mediterranean Diet (MD) — is receiving growing attention as a standalone therapeutic strategy.
This study was designed to compare the effectiveness of the Mediterranean Diet with other dietary or therapeutic approaches for managing MetS, through a systematic review and meta-analysis of available randomized controlled trials (RCTs).
Can the mediterranean diet treat metabolic syndrome?
Twelve randomized clinical trials, totaling 2,013 patients, were analyzed. Interventions included enriched MD (olive oil, nuts), low-fat diets, or combined programs with physical activity or behavioral support.
The results reveal significant clinical benefits of the Mediterranean diet on several metabolic parameters. Body mass index (BMI) decreased on average by −0.83 kg/m² (p < 0.00001), while waist circumference decreased by −1.81 cm (p < 0.00001). Triglycerides showed a marked drop of −22.38 mg/dL (p < 0.00001) and fasting blood glucose decreased by −4.28 mg/dL (p = 0.005). A reduction in insulin levels of −2.21 µU/mL (p = 0.01) was also observed, as well as an improvement in insulin resistance measured by HOMA-IR, with a decrease of −0.72 (p < 0.00001).
Other markers — total cholesterol, HDL, LDL, blood pressure — also showed improvements, although less consistently due to heterogeneity in the protocols. No major adverse effects were reported.
Meta-regressions show that intervention duration and weekly frequency of the diet influence effectiveness, particularly on fat mass, HDL, and blood glucose.
Read next: Towards a mediterranean diet for all!
A menu against Syndrome X?
Metabolic syndrome remains a complex, multifactorial, and constantly evolving condition, making its long-term stabilization particularly difficult. The current therapeutic challenge lies in the implementation of approaches that are effective, sustainable, and easily accessible. It is in this context that this review was conducted, to evaluate whether the Mediterranean diet presents superiority compared to other existing strategies to improve clinical parameters of metabolic syndrome.
The results obtained confirm that the Mediterranean diet has notable positive effects on several key markers, including body weight, waist circumference, triglycerides, blood glucose, and insulin sensitivity. Its integration into care practices could thus significantly strengthen the prevention of cardiovascular and metabolic diseases. Further work will involve the design of more standardized studies, precisely defining the nutritional components of the Mediterranean diet (particularly in terms of lipids and macronutrients), its application frequency, and ways to integrate it with other interventions such as physical activity. Identifying patient profiles most likely to respond favorably would also be crucial. Ultimately, the Mediterranean diet could establish itself as a central pillar of the nutritional strategy against metabolic syndrome.
Read next: Mobile Application and Management of Metabolic Syndrome
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