Cardiovascular Disease Clinical Trial
Official title:
Effect of an Atlantic Diet on Anthropometric Indices and Serum Lipid Profile in a General Population: a Randomised Controlled Trial
BACKGROUND:
The Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and
Galicia, a region in northwest Spain. The SEAD has been associated with a lower risk of
non-fatal acute myocardial infarction. Possible mechanisms of this association may be related
with a lower concentration of markers of inflammation and with reduced triglycerides,
insulin, insulin resistance, and systolic blood pressure.
Aim: To evaluate the effect of an Atlantic Diet on i) lipid profile, ii) markers of
inflammation, and iii) anthropometric indices in a population-based study
METHODS:
This is a non-pharmacological clinical trial study which is performed on a family-oriented
basis. 250 families (~ 750 children and adults, older than 3 years) were selected to
participate in the study and randomized into Atlantic Diet (AD) (n=125 families) and control
(n=125 families) groups. The AD groups participate in a diet program 1 day a month for 3
months in 120-minute diet sessions and freely receive AD food, characterized by a high intake
of vegetables, cheese, olive oil, mussels and by wine consumption during meals. Control group
subjects do not participate in any regular diet activity during this period and did not
receive additional food. Exclusion criteria are alcoholism, lipid treatment, dementia, and
terminal disease.
Weight, BMI, waist circumference (WC), skin folds, nutrient intake from 3-day recalls, food
frequency questionnaire, physical activity, blood pressure, metabolic function (fasting blood
glucose, HBA1c, insulin resistance and lipid profile), and inflammation markers (c-reactive
protein, interleukin 6 and tumor necrosis factor-alpha) are measured at baseline, 3 and 6
months. Mixed effect models will be performed to assess the significance of changes in the
cardiometabolic parameters.
The primary end point is the change in lipid profile compared with baseline and the control
group arm at the end of Month 6. The secondary exploratory end points were change in
anthropometric indices and inflammation markers at Month 6.
The intervention period lasted 6 months. At the baseline visit all AD subjects received
information on the Atlantic diet and how to follow it; the nutritionists' messages were
adapted to the clinical condition of each subject, his/her preferences, needs, beliefs and
culture. Special care was taken with patients who were obese, had diabetes or who had high
blood cholesterol; conflicts with recommendations made by subjects' own doctors or
nutritionists were avoided. All questionnaires (see below) were filled out in the presence of
the nutritionists, except for 3-day food records which the subjects handed in completed. The
latter were reviewed in the presence of the subjects in order to correct any errors or add
missing information. At the 3 and 6 month visits, the nutritionists reminded the subjects
about the Atlantic diet and the helped them complete their questionnaires.
Foods were provided to the families of the AD group. Wine was provided only to non-tee-total
adults. Food packages were delivered every three weeks to the family home. The food included
in the package was calculated for the total number of family members, even if not all were
taking part in the study. At delivery, a form was filled in to verify that the previous lot
of food had been consumed, and to note any problems.
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