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Open AccessArticle

Cardiometabolic Benefits of a Weight-Loss Mediterranean Diet/Lifestyle Intervention in Patients with Obstructive Sleep Apnea: The “MIMOSA” Randomized Clinical Trial

1
Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, 70 Eleftheriou Venizelou str., 17671 Athens, Greece
2
Center of Sleep Disorders, 1st Department of Critical Care and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital, 45-47 Ipsilantou str., 10676 Athens, Greece
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(6), 1570; https://doi.org/10.3390/nu12061570
Received: 24 April 2020 / Revised: 21 May 2020 / Accepted: 26 May 2020 / Published: 28 May 2020
(This article belongs to the Special Issue Mediterranean Diet and Health—New Insights into an Old Story)
Although continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnea (OSA), its cardiometabolic benefits are questionable. Our aim was to explore whether the combination of a weight-loss Mediterranean diet/lifestyle intervention with OSA standard care leads to greater cardiometabolic improvements compared with standard care alone. We randomly assigned 187 adult, overweight, polysomnography-diagnosed moderate-to-severe OSA patients to a standard care group (SCG, n = 65), a Mediterranean diet group (MDG, n = 62) or a Mediterranean lifestyle group (MLG, n = 60). All three groups were prescribed with CPAP. Additionally, the SCG only received brief written healthy lifestyle advice, while intervention arms were subjected to a six-month weight-loss behavioral intervention based on the Mediterranean diet. The MLG also received guidance for improving physical activity and sleep habits. Glucose metabolism indices, blood lipids, liver enzymes and blood pressure improved only in intervention arms, and were significantly lower compared to the SCG post-intervention (all p < 0.05). The age-, sex-, baseline- and CPAP use-adjusted relative risk (95% confidence interval) of metabolic syndrome was 0.58 (0.34–0.99) for the MDG and 0.30 (0.17–0.52) for the MLG compared to the SCG. The MLG additionally presented a lower relative risk of metabolic syndrome compared to the MDG (0.52 (0.30–0.89)). After further adjustment for body-weight change, a lower relative risk of metabolic syndrome was still evident for the MLG compared to the SCG. In conclusion, although standard care alone does not improve OSA patients’ cardiometabolic profile, its combination with a weight-loss Mediterranean diet/lifestyle intervention leads to significant cardiometabolic benefits. View Full-Text
Keywords: obstructive sleep apnea; metabolic syndrome; cardiometabolic profile; weight loss; dietary/lifestyle intervention; Mediterranean diet; Mediterranean lifestyle obstructive sleep apnea; metabolic syndrome; cardiometabolic profile; weight loss; dietary/lifestyle intervention; Mediterranean diet; Mediterranean lifestyle
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Georgoulis, M.; Yiannakouris, N.; Kechribari, I.; Lamprou, K.; Perraki, E.; Vagiakis, E.; Kontogianni, M.D. Cardiometabolic Benefits of a Weight-Loss Mediterranean Diet/Lifestyle Intervention in Patients with Obstructive Sleep Apnea: The “MIMOSA” Randomized Clinical Trial. Nutrients 2020, 12, 1570.

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