Royal College of Surgeons in Ireland
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Mediterranean diet and its effect on endothelial function: a meta-analysis and systematic review

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journal contribution
posted on 2022-03-02, 16:45 authored by Kaneez Fatima, Ahmed Mustafa Rashid, Usama Abdul Ahad Memon, Syeda Sidra Fatima, Syed Sarmad Javaid, Omema Shahid, Fazila Zehri, Muhammad Adil Obaid, Mahlika Ahmad, Talal Almas, Abdul Mannan Khan Minhas
Background: Endothelial dysfunction serves as an early marker for the risk of cardiovascular disease (CVD); therefore, it is a site of therapeutic interventions to reduce the risk of CVD.
Aims: To examine the effect of the Mediterranean diet (MedDiet), as an intervention, on structural and functional parameters of endothelial function, and how it may reduce the risk of CVD and associated mortality.
Methods: Medline database was searched for randomized controlled trials. Random-effects meta-analysis was conducted on 21 independent datasets. Meta-regression and subgroup analysis were performed to assess whether the effect of MedDiet was modified by health status (healthy subjects or with increased CVD risk), type of MedDiet intervention (alone or combined), type of parameter (functional or structural), study design (cross-over or parallel), BMI, age, and study duration. Our study used sample size, mean, and standard deviation of endothelial function measurements for both MedDiet intervention and control in the analyses.
Results: Inverse relationship between endothelial function and intake of MedDiet was observed (SMD: 0.34; 95% CI: 0.16, 0.52; P = 0.0001). Overall, MedDiet increased FMD by 1.39% (95% CI: 0.47, 2.19; P < 0.001). There was a significant improvement in endothelial function in both healthy patients and in those with an increased risk of CVD. No significant variation was observed in the effects of MedDiet on endothelial function, due to study design or type of intervention.
Conclusions: These findings support that MedDiet can reduce the risk of CVD by improving endothelial function.


Open Access funding provided by the IReL Consortium



The original article is available at

Published Citation

Fatima K, et al,. Mediterranean diet and its effect on endothelial function: a meta-analysis and systematic review. Ir J Med Sci. 2022

Publication Date

22 February 2022

PubMed ID



  • Undergraduate Research


Springer Nature


  • Published Version (Version of Record)