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

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.