Mediterranean diet vs. inflammatory disease

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Hi All,

The below is a pdf-available free to all paper that appears to detail the

changes

occurring in the patients of an inflammatory disease, rheumatoid arthritis, when

they adapt to a Mediterranean diet. Note that the caloric intake decreased,

although the decrease was not significant.

Details excerpted below may help any without ability to view pdfs. The paper

appears to not yet be in Medline.

Nutr Metab (Lond). 2005 Sep 20;2(1):26 [Epub ahead of print]

Fat intake and composition of fatty acids in serum phospholipids in a

randomized,

controlled, Mediterranean dietary intervention study on patients with rheumatoid

arthritis.

Hagfors, Ingela Nilsson, Lars Skoldstam, Gunnar Johansson

Nutrition & Metabolism 2005, 2:26 (10 October 2005)

http://www.nutritionandmetabolism.com/content/pdf/1743-7075-2-26.pdf

Abstract (provisional)

Background

We have previously reported that rheumatoid arthritis patients, who adopted a

modified Cretan Mediterranean diet, obtained a reduction in disease activity and

an

improvement in physical function and vitality. This shift in diet is likely to

result in an altered intake of fatty acids. Therefore, the objective of the

present

study was to examine the dietary intake of fatty acids, as well as the fatty

acid

profile in serum phospholipids, during the dietary intervention study presented

earlier.

Results

From baseline to the end of the study, changes in the reported consumption of

various food groups were observed in the Mediterranean diet group. The change in

diet resulted in a number of differences between the Mediterranean diet group

and

the control diet group regarding the fatty acid intake. For instance, a lower

ratio

of n-6 to n-3 fatty acids was observed in the Mediterranean diet group, both

assessed by diet history interviews (dietary intake) and measured in serum

phospholipids. Moreover, the patients in the Mediterranean diet group that

showed a

moderate or better clinical improvement during the study (diet responders), had

a

higher reported intake of n-3 fatty acids and a lower ratio of n-6 to n-3 fatty

acids compared to the patients with minor or no improvement. Also the fatty acid

profile in serum phospholipids differed in part between the diet responders and

the

diet non-responders.

Conclusions

The changes in the fatty acid profile, indicated both by dietary assessments and

through fatty acids in s-phospholipids may, at least in part, explain the

beneficial

effects of the Cretan Mediterranean diet that we have presented earlier.

.... At baseline the two groups were equal except for the disease duration and

the

body mass index (BMI). The MD group had a significantly higher BMI and a longer

disease duration compared to the CD group (p=0.024 and 0.047, respectively).

.... patients were randomized to either a modified Cretan Mediterranean diet

group or

a control diet group, by means of block randomization stratified for sex. At

baseline the two groups were equal except for the disease duration and the body

mass

index (BMI). The MD group had a significantly higher BMI and a longer disease

duration compared to the CD group (p=0.024 and 0.047, respectively).

The experimental diet used in the present study was based on the Cretan

Mediterranean diet previously tested by de Lorgeril et al, in a secondary

prevention

study of coronary heart disease [19]. However, some modifications of the diet

were

done in order to suit Swedish food habits. We instructed our MD group to eat a

large

amount of vegetables, fruit, pulses, cereals, fish (particularly fish with a

high

content of omega-3 fatty acids) and nuts and seeds with a high content of & #945;

-LNA. The intake of meat (such as pork, beef, lamb or mutton) and processed meat

(including cured meat, sausage, pâté or the like) were to be replaced by

poultry,

fish or vegetarian dishes. Both olive oil and canola oil were used in salad

dressings

and for food preparation. The MD group was also informed to use two types of

margarine based on canola oil: a liquid margarine (80% fat) for food preparation

and

half-fat margarine (40% fat) to use on bread. In addition, the MD group was

advised

to replace high fat dairy products with low fat products. In the present study,

no

recommendations were given regarding alcohol consumption. To compensate for the

antioxidants in wine, we advised the MD group to drink green or black tea.

To promote good compliance with the Mediterranean diet some food items were

supplied

free to the MD group, namely: frozen vegetables, tea, olive oil, canola oil and

the

liquid and half-fat margarine based on canola oil. Olive oil and canola oil,

were

supplied by Karlshamns AB, vegetables by Nestlé Sweden AB and margarine and tea

by

Van den Bergh Foods AB.

The CD subjects were instructed to adhere to their ordinary diet.

.... Table 2. Comparison of average daily intake (excluding supplements) of

energy,

fat and specific fatty acids between the Mediterranean Diet (MD) group and the

Control Diet (CD) group. The dietary intake is based on the diet history

interviews

performed between study weeks seven and twelve.

==================

MD group CD group----P-value*

(n=17) (n=17)----

==================

Energy (MJ) 8.8 ± 1.6 9.8 ± 3.2 p=0.242

Fat (g) 60.4 ± 21.9 89.3 ± 33.1 p=0.005

Total saturated fatty acids (g) 18.3 ± 8.2 40.5 ± 18.3 p<0.001

Total monounsaturated fatty acids (g) 25.3 ± 10.5 31.9 ± 11.1 p=0.088

Total polyunsaturated fatty acids (g) 11.8 ± 3.9 10.6 ± 3.5 p=0.381

Total n-6 fatty acids (g) † 7.9 ±2.5 8.2 ± 2.7 p=0.743

Total n-3 fatty acids (g) ‡ 3.1 ± 1.3 2.0 ± 0.9 p=0.008

Ratio n-6:n-3 2.7 ± 0.6 4.4 ± 0.9 p<0.001

Fat (E% ¶) 25.0 ±5.3 33.7 ± 5.6 p<0.001

Total saturated fatty acids (E%) 7.5 ± 2.4 15.0 ± 3.7 p<0.001

Total monounsaturated fatty acids (E%) 10.5 ± 2.8 12.2 ± 2.2 p=0.067

Total polyunsaturated fatty acids (E%) 5.0 ± 1.1 4.1 ± 1.1 p=0.028 ††

Fatty acids (g):

4:0-10:0 0.77(0.32-1.59) 3.51(1.72-4.79) p<0.001

12:0 0.44(0.28-0.93) 1.67(0.93-2.56) p<0.001

14:0 1.81(1.07-2.90) 4.68(2.79-6.19) p<0.001

16:0 9.46(7.29-13.29) 18.54(14.98-26.00) p<0.001

18:0 2.80(1.99-4.34) 6.85(5.94-9.97) p<0.001

20:0 0.14(0.10-0.19) 0.19(0.16-0.38) p=0.016

16:1 n 7 0.95(0.70-1.22) 1.25(1.05-1.84) p=0.014

18:1n-9 20.50(14.98-28.05) 27.55(21.52-35.67) p=0.049

18:2n-6 7.42(5.80-9.46) 7.90(5.78-9.77) p=0.892

18:3n-3 1.79(1.23-2.36) 1.42(1.09-2.09) p=0.454

20:4n-6 0.08(0.05-0.10) 0.08(0.04-0.13) p=0.708

20:5n-3 0.35(0.23-0.59) 0.11(0.06-0.18) p<0.001

22:5, n-3 and n-6 0.07(0.05-0.11) 0.02(0.01-0.05) p=0.001

22:6n-3 0.73(0.44-1.03) 0.21(0.12-0.30) p<0.001

==================

Data are presented as mean ± SD for normally distributed variables and as

medians

(25th-75th percentiles) for variables with skew distributions. *The P-values

refer

to the difference between diet- and control group. Differences between groups

were

analyzed by the Students t-test for independent samples for normally distributed

variables and by the Mann-Whitney U test for variables with skew distributions;

†sum of 18:2n-6 and 20:4n-6; ‡sum of 18:3n-3, 20:5n-3 and 22:6n-3; ¶E% =

percent

of total energy. ††Difference between groups regarding E% polyunsaturated fatty

acids was not significant (p=0.101) when under- and over-reporters

were excluded.

Al Pater, PhD; email: old542000@...

__________________________________

- PC Magazine Editors' Choice 2005

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