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Ann Ig. 2011 Jan-Feb;23(1):13-25.

Randomized, controlled nutrition education trial promotes a Mediterranean diet and improves anthropometric, dietary, and metabolic parameters in adults.

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Servizio di Igiene degli Alimenti e della Nutrizione, Asl Foggia.


Several studies have shown that uptake of a Mediterranean diet could prevent many chronic diseases, such as cancer. However, the effectiveness of Mediterranean diet promotion interventions has not been well researched. The aim of this study was to evaluate the effectiveness of a nutrition education intervention for promoting the Mediterranean diet, by assessing changes in anthropometric, physical activity, dietetic and metabolic parameters in healthy adult subjects, before and after the intervention. Eighty participants, both sexes, aged 51-59 years, were randomly assigned in a 1:1 ratio to the intervention or the control group. The intervention group participated in the Med-Food Anticancer Program (MFAP), designed to promote a Mediterranean diet. This was organized into 15 weeks of intensive training and 10 weeks of consolidation. Participants of the two groups were assessed at baseline (T0) and after 25 weeks (T1) for anthropometric, physical activity, dietetic, and metabolic parameters. The hypothesis was that subjects participating in MFAP would show an improvement in these parameters. The primary endpoint was an improvement of the Mediterranean Adequacy Index (MAI), calculated by dividing the percentage of total energy from typical Mediterranean food groups by the percentage of total energy from non-typical Mediterranean food groups. At T1, the intervention group showed a significant decrease in body weight (-8.3%, P = 0.045), body mass index (-12.4%, P = 0.05), cheese (53.0%, P < 0.0001) and meat (-49.3%, P = 0.005) intake, fasting glycaemia (-9.2%, P = 0.012), and fasting insulin (-32.6%, P = 0.014), C-Reactive Protein (-34.0%, P = 0.005). They showed a significant increase in MAI (+213, P < 0.0001), physical activity (expressed in steps per day, +200.4%, P < 0.0001), fruit (+38.8, P < 0.0001), vegetables (29.3%, P < 0.0001), and dietary fiber (+38.6%, P = 0.04) intake. In contrast, the control group presented non-significant variations in measured parameters, for exception of cheese intake (+18.2%, P < 0.0001). The MFAP was found to promote uptake of the Mediterranean diet, and improve anthropometric, physical activity, dietary, and metabolic parameters in healthy subjects.

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