Elsevier

Atherosclerosis

Volume 170, Issue 1, September 2003, Pages 115-124
Atherosclerosis

Effect of a nutritional intervention promoting the Mediterranean food pattern on plasma lipids, lipoproteins and body weight in healthy French-Canadian women

https://doi.org/10.1016/S0021-9150(03)00243-0Get rights and content

Abstract

The present study examined the effect of a nutritional intervention promoting the Mediterranean food pattern in uncontrolled ‘real life’ conditions among a group of 77 French-Canadian women. The principal objective was to document changes in the plasma lipid-lipoprotein profile and in body weight that occurred in response to the intervention. The 12-week nutritional intervention included two group sessions, three individual sessions and four 24-h recalls (phone interview) with a registered dietitian. A score based on the 11 components of the Mediterranean pyramid, ranging from 0 to 44 points, was established to evaluate the adhesion to the Mediterranean food pattern. The Mediterranean score increased from 21.1±3.6 at baseline to 28.6±4.4 after 6 weeks of intervention (P<0.0001) with no further increase at week 12. Small but significant decreases in total cholesterol and apolipoprotein B (apoB) as well as in body mass index (BMI) were observed after 6 weeks of intervention. No significant change in plasma concentrations of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were observed in response to the nutritional intervention. In conclusion, a nutritional intervention program promoting the Mediterranean food pattern was effective in modifying food habits of healthy women from the Québec City metropolitan area and resulted in small but significant effects on specific cardiovascular risk factors.

Introduction

The increasing interest for the Mediterranean diet arises primarily from results of the Seven Countries Study, which demonstrated that the 15 year mortality rate from coronary heart disease (CHD) in Southern Europe, where a Mediterranean diet was consumed, was two to threefold lower than in Northern Europe or United States [1]. While several variants of the Mediterranean diet have been identified, specific features at the basis of this unique dietary pattern are a high consumption of fruits, vegetables, legumes and grains; food with high monounsaturated to saturated fatty acid (SFA) ratio; moderate consumption of dairy products and ethanol (mainly wine); and low consumption of meat and meat products [2], [3], [4]. Recently, results from a dietary intervention performed in men with CHD showed that a Mediterranean diet prevented the recurrence of cardiovascular events more than the usual prudent Western diet [5], [6], [7].

Several studies have examined the role of single nutrients or foods in determining the risk of cardiovascular disease [8], [9], [10], [11], [12], [13]. Complex diets consumed by free-living individuals do not consist of single nutrients or foods but rather of a combination of foods containing multiple nutrients and non-nutrients. Some studies have shown that the dietary pattern as a whole was more important than specific dietary components with respect to survival among older people [14], [15].

The extent to which Canadians may be able to modify their food habits towards the Mediterranean food pattern and whether such changes would be sufficient to generate significant effects on the metabolic profile is unknown. Most of the studies that have examined the effect of a Mediterranean diet or a diet high in monounsaturated fatty acids (MUFA) on cardiovascular risk have been conducted under relatively well controlled conditions in which food or menus were provided to participants [8], [16], [17], [18]. Nutritional interventions undertaken in free-living uncontrolled conditions imply that participants receive knowledge, advice and support to modify their food habits in a real-life context, i.e. they continue to buy their foods and cook their meals. Such an intervention favors the modification of food habits but other factors such as cultural, socio-economic, familial and personal factors will undoubtedly modulate the response to this type of intervention. In this study, our objective was to examine whether a nutritional intervention promoting the Mediterranean food pattern in uncontrolled conditions would result in significant modifications of food habits in French-Canadian women. We also wanted to verify the effects of the intervention on plasma lipid-lipoprotein profile and body weight. For that purpose, we studied a group of 77 healthy women from the Québec City metropolitan area, aged between 30 and 65 years.

Section snippets

Subjects

Women from the Québec City metropolitan area were recruited through the Laval University newspaper during the summer of 2001. Women included in the study were aged between 30 and 65 years. To be eligible, women had to be free from metabolic disorders requiring treatment, to have stable body weight for at least 3 months prior to the start of the study and to be in charge of food purchases and meal preparation most of the time. Only women with a diet concordant with usual Canadian food pattern

Results

At baseline, subjects had a mean BMI of 25.8±3.9 kg/m2 and a mean waist circumference of 83.4±10.8 cm. Plasma lipid-lipoprotein profile was in the normal range. Mean values at baseline were 3.02±0.75 mmol/l for LDL-C concentrations, 1.63±0.41 mmol/l for HDL-C concentrations and 3.34±0.83 for total cholesterol to HDL-C ratio. The mean age was 46.8±7.9 years.

As shown in Table 1, the Mediterranean Score increased significantly from 21.1±3.6 at baseline to 28.6±4.4 after 6 weeks of intervention (P

Discussion

Our study was conducted in a group of free-living healthy women. Results showed that in response to a nutritional intervention promoting the Mediterranean dietary pattern, marginal but significant improvements in the metabolic profile were observed. Our results also indicated that beneficial changes in the metabolic profile were more pronounced among the subgroup of women who had a more deteriorated metabolic profile at baseline. We also showed that the nutritional intervention resulted in

Acknowledgements

J.G. is a recipient of a studentship from the Fonds pour la Formation de Chercheurs et d'Aide à la recherche-Fonds de la recherche en santé du Québec, S.L. is a research scholar from the Fonds de la recherche en santé du Québec and B.L is the recipient of a Canada Research Chair in Nutrition, Functional Foods and Cardiovascular Health from the Canada Research Chair Program. The authors express their gratitude to the subjects and their familly for their motivation and implication throughout the

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