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Crit Rev Food Sci Nutr. 2018;58(18):3070-3084. doi: 10.1080/10408398.2017.1351917. Epub 2017 Oct 17.

Central obesity and the Mediterranean diet: A systematic review of intervention trials.

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a Department of Rehabilitation, Nutrition and Sport , School of Allied Health, La Trobe University , Victoria , Australia.
b Department of Preventive Medicine and Public Health , University of Navarra , Spain.
c CIBERobn, Instituto de Salud Carlos III , Spain.
d IDISNA Navarra's Health Research Institute.
e Department of Physiology, Anatomy and Microbiology, School of Life Sciences , La Trobe University , Victoria , Australia.


Central obesity is associated with chronic low-grade inflammation, and is a risk factor for cardiometabolic syndrome. The Mediterranean diet pattern has a convincing evidence-base for improving cardiometabolic health. This review investigated the impact of Mediterranean diet interventions on central obesity, specifically. A systematic literature search was conducted in the MEDLINE, CINAHL, EMBASE and Cochrane library databases. Search terms included: 'Mediterranean Diet', 'Mediterranean dietary pattern', 'central obesity' and 'visceral fat'. The search was limited to English language and humans ≥18 years. Eighteen articles met the eligibility criteria and reported at least one outcome measure of central obesity with Mediterranean diet intervention. Central obesity measures included waist circumference (16 studies), waist-hip ratio (5 studies) and visceral fat (2 studies). Thirteen (72%) of the studies, totaling 7186 subjects (5168 subjects assigned to a Mediterranean Diet), reported a significant reduction in central obesity with a Mediterranean-type diet. However, seven out of these 13 interventions employed energy restriction, and only three showed a statistically significant favorable effect of the Mediterranean diet relative to a control group. This systematic review highlights the potential for a Mediterranean diet intervention to reduce central obesity and in turn reduce obesity-related chronic disease risk and associated public health burden.


Mediterranean diet; central obesity; visceral fat; waist circumference

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