Managing Cardiometabolic Risk
Managing Cardiometabolic Risk in Abdominally Obese Patients
Nutrition
- 1Key Points (1 page)
- 2Managing abdominally obese patients at increased cardiometabolic risk: the nutritional perspective (1 page)
- 3Targeting excess body weight (1 page)
- 4CVD and its nutritional components (2 pages)
- 5Reducing blood pressure (1 page)
- 6Moderate alcohol consumption (1 page)
- 7The Mediterranean diet (1 page)
- 8Other dietary measures to lower CVD risk and cholesterol levels (2 pages)
- 9References (1 page)
The Mediterranean diet
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Table 2: 
Table 2: A Mediterranean diet can reduce the recurrence of myocardial infarction and cardiac death by 70%. Such a diet gets <35% of its energy from fat (from rapeseed oil), <10% of its energy from saturated fat, 0.6% of its energy from omega-3 fatty acids (34). The Lyon Diet Heart Study tested a Mediterranean-type diet characterized by a low intake of total and saturated fats and a high intake of omega-3 fatty acids, fruits, vegetables, wholegrain cereals, and vegetable protein—in short, a diet high in antioxidants, vitamins, and minerals (34). After 46 months of follow-up, the group on the Mediterranean diet had a 72% reduction in cardiac death and non-fatal myocardial infarction compared to the group on the traditional diet. The risk of recurrent heart disease also dropped 56% (34). The Mediterranean diet has also been shown to benefit total cholesterol, apolipoprotein B concentration, and LDL particle size (35-37). Table 2 provides some nutritional tips on how to achieve cardiometabolic health.
The traditional Mediterranean diet has received a great deal of attention because of initial results from the Seven Countries Study, which demonstrated that this diet was associated with a decreased CHD mortality rate, mainly due to its low saturated fat content (31). This diet is characterized by abundant intake of fresh fruits and vegetables, whole grain products, monounsaturated fat from olive oil, and low-fat dairy products (mainly cheese and yogurt). The traditional Mediterranean diet has the following features: 1) a high monounsaturated-to-saturated fat ratio, 2) moderate alcohol consumption, and 3) limited consumption of meat and meat products. Some studies have taken a different view of daily meat consumption, suggesting the diet stresses greater consumption of fish and poultry and a restricted-to-moderate consumption of eggs (zero to 4 eggs per week) (32, 33). In terms of macronutrients, 25 to 30% of total energy intake comes from fat, with limited consumption of saturated fat (<7% to 8% of total energy intake). Monounsaturated fats as well as foods rich in antioxidants (e.g., cranberries, blueberries, and blackberries), fibre, and selenium (e.g., Brazil nuts, seafood, and poultry) also figure prominently (33).
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