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Vegetarian Diet vs. Mediterranean Diet to Reduce Cardiovascular Risk
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SOURCES : Sofi F, Dinu M, Pagliai G, et al. Low-calorie vegetarian versus Mediterranean diets for reducing body weight and improving cardiovascular risk profile. CARDIVEG study (Cardiovascular Prevention With Vegetarian Diet). Circulation 2018;137:1103-1113.
Anderson CAM. Dietary patterns to reduce weight and optimize cardiovascular health: Persuasive evidence for promoting multiple, healthful approaches. Circulation 2018;137:1114-1116.
Previous studies of diet and cardiovascular (CV) risk factors have suffered from population bias, lack of randomization, and retrospective analyses. Investigators from Florence, Italy, performed a randomized, open, cross-over study of the lacto-ovo vegetarian diet (VD) to the Mediterranean diet (MD) during two three-month intervals. The authors recruited subjects between the ages of 18-75 years (mean, 51 years; 78% female). Prospective recruits demonstrated a CV risk estimate of < 5% at 10 years, were overweight (body mass index [BMI] > 25 kg/m²), and presented with one or more of the following risk factors: total cholesterol > 190 mg/dL, LDL cholesterol > 115 mg/dL, or glucose > 110 mg/dL, but < 126 mg/dL. The subjects were told not to change their lifestyle or exercise habits. No weight loss goal was given, and both diets were low calorie.
The primary outcome was the difference in BMI and fat mass (bioelectrical impedance technique) changes between the two diets. Secondary endpoints were changes in blood CV risk parameters, such as lipid levels, glucose levels, oxidative stress profiles, and inflammation markers. Of the 118 patients randomized, 107 completed at least one phase of the study and were included in the analysis, and 100 completed the entire study.
Both diets reduced body weight and composition equally. Significant differences in some biochemical parameters were observed ( P < 0.01 for all). Vitamin B12 levels fell in the VD group and increased in the MD group. Uric acid fell in the VD group and rose in...