Article pour les cliniciens
Une revue systématique de la diète méditerranéenne pour la perte de poids à long terme.
PMID: 26721635
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Médecine interne (voir sous-spécialités ci-dessous)Relevance - 6/7
Intérêt médiatique - 6/7 -
Médecine familiale (MF)/Médecine générale (MG)Relevance - 6/7
Intérêt médiatique - 5/7 -
Médecine interne générale - Soins primairesRelevance - 6/7
Intérêt médiatique - 5/7 -
Special Interest - Obesity -- PhysicianRelevance - 6/7
Intérêt médiatique - 5/7 -
- EndocrinologieRelevance - 5/7
Intérêt médiatique - 5/7 -
Santé publiqueRelevance - 5/7
Intérêt médiatique - 5/7 -
- CardiologieRelevance - 5/7
Intérêt médiatique - 4/7
Résumé (en anglais)
BACKGROUND: Although the long-term health benefits of the Mediterranean diet are well established, its efficacy for weight loss at =12 months in overweight or obese individuals is unclear. We therefore conducted a systematic review of randomized controlled trials (RCTs) to determine the effect of the Mediterranean diet on weight loss and cardiovascular risk factor levels after =12 months.
METHODS: We systematically searched MEDLINE, EMBASE, and the Cochrane Library of Clinical Trials for RCTs published in English or French and with follow-up =12 months that examined the effect of the Mediterranean diet on weight loss and cardiovascular risk factor levels in overweight or obese individuals trying to lose weight.
RESULTS: Five RCTs (n = 998) met our inclusion criteria. Trials compared the Mediterranean diet to a low-fat diet (4 treatment arms), a low-carbohydrate diet (2 treatment arms), and the American Diabetes Association diet (1 treatment arm). The Mediterranean diet resulted in greater weight loss than the low-fat diet at =12 months (range of mean values: -4.1 to -10.1 kg vs 2.9 to -5.0 kg), but produced similar weight loss as other comparator diets (range of mean values: -4.1 to -10.1 kg vs -4.7 to -7.7 kg). Moreover, the Mediterranean diet was generally similar to comparator diets at improving other cardiovascular risk factor levels, including blood pressure and lipid levels.
CONCLUSION: Our findings suggest that the Mediterranean diet results in similar weight loss and cardiovascular risk factor level reduction as comparator diets in overweight or obese individuals trying to lose weight.
Commentaires cliniques (en anglais)
General Internal Medicine-Primary Care(US)
The health benefits of the Mediterranean Diet are well known, though many individuals also use weight loss as a reason why a diet is modified. This study provides evidence showing the limitation of Mediterranean diet if used for weight loss alone, but also reinforces the other health benefits of adhering to it. Ultimately, when counseling patients about obesity, weight loss is only one part of the puzzle.
General Internal Medicine-Primary Care(US)
As a Primary care physician, I can tell my patients that the Mediterranean diet can be used as part of weight loss diet and it is as effective as other diets but may have additional cardiovascular benefit based on PREDIMED data described in the discussion. Inability to pool the data is a significant draw back.
Public Health
I'm not sure how much this paper really adds to our knowledge. Most clinicians are aware of the large Spanish RCT that showed that a Mediterranean diet was associated with lower CAD rates. Since the Look Ahead long term f/u didn't show any benefit in terms of CAD, I'm not sure how important these findings are. If weight loss per se isn't associated with reduced CAD risk long term, then why should we care about the individual types of diets used. It seems to me that the Mediterranean diet has the best data for influencing the long term outcomes that many clinicians (and perhaps many patients) care about.
Public Health
This is a valuable review of how the Mediterranean diet is similar (amount of weight lost and kept off at 12 or more months) and perhaps different (glycemic control in type 2 diabetes) from other well-known diets.
Special Interest - Obesity -- Physician
No matter that weight loss depends on calories, not on food type. Food choices are an important part of the dietary advice as far as CV events are considered, and the study does not include events but merely CV risk factors.
Special Interest - Obesity -- Physician
As a general practitioner, it is relevant to learn that a systematic review had been designed to examine the long-term (12 months) effect of the Mediterranean diet on weight loss and cardiovascular risk factor levels among overweight and obese individuals trying to lose weight. The study found that the Mediterranean diet is more efficacious for 12-month weight loss compared with low-fat diets, but not compared with other comparator diets.
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