Sustained improvements in the cardiometabolic profile of patients with obstructive sleep apnea after a weight-loss Mediterranean diet/lifestyle intervention: 12-month follow-up (6 months post-intervention) of the “MIMOSA” randomized clinical trial

Mar 23, 2023Nutrition, metabolism, and cardiovascular diseases : NMCD

Long-term heart and metabolism benefits of a Mediterranean weight-loss diet in sleep apnea patients: 12-month follow-up of the MIMOSA trial

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Abstract

Intervention groups experienced significant improvements in cardiometabolic markers compared to standard care.

Lower insulin, triglycerides, and high-sensitivity C-reactive protein were observed in the Mediterranean diet and lifestyle intervention groups compared to standard care.
The Mediterranean diet group had lower diastolic blood pressure, while the lifestyle group showed reduced glucose and systolic blood pressure.
The relative risk of metabolic syndrome was 0.60 for the Mediterranean diet group and 0.33 for the lifestyle group compared to standard care.
The lifestyle group's risk of metabolic syndrome remained significantly lower than both other groups after adjusting for body weight change.

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BACKGROUND AND AIMS: Obstructive sleep apnea (OSA) and the metabolic syndrome (MS) frequently coexist and lead to increased cardiometabolic morbidity. We aimed to explore the long-term cardiometabolic benefits of a weight-loss Mediterranean diet/lifestyle intervention in OSA.

METHODS AND RESULTS: As many as 180 adults with overweight/obesity and polysomnography-diagnosed moderate-to-severe OSA were randomized to a standard care (SCG, n = 62), a Mediterranean diet (MDG, n = 59) or a Mediterranean lifestyle group (MLG, n = 59). All groups were prescribed with continuous positive airway pressure (CPAP), while intervention arms (MDG/MLG) additionally participated in a 6-month weight-loss intervention based on the Mediterranean diet/lifestyle. Cardiometabolic parameters were evaluated at baseline and 12 months (6 months post-intervention). Data were analyzed using the intention-to-treat method, and 12-month between-group differences were explored while adjusting for age, sex, baseline status and CPAP use. Compared to the SCG, intervention arms exhibited lower insulin, triglycerides and high-sensitivity C-reactive protein, and higher high-density lipoprotein cholesterol; the MDG also exhibited lower diastolic blood pressure, while the MLG exhibited lower glucose and systolic blood pressure (all P < 0.050). The relative risk (95% confidence interval) of MS was 0.60 (0.36, 0.99) in the MDG versus the SCG, 0.33 (0.20, 0.55) in the MLG versus the SCG and 0.55 (0.32, 0.93) in the MLG versus the MDG. The risk of MS remained lower in the MLG versus the other study groups (both P < 0.050) after additional adjustment for body weight change.

CONCLUSION: Cardiometabolic benefits of a 6-month healthy dietary/lifestyle intervention are sustainable 6 months post-intervention in OSA.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT02515357, August 4, 2015.

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Sustained improvements in the cardiometabolic profile of patients with obstructive sleep apnea after a weight-loss Mediterranean diet/lifestyle intervention: 12-month follow-up (6 months post-intervention) of the “MIMOSA” randomized clinical trial

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