Mediators Inflamm. 2014;2014:750860.

Early Effects of a Hypocaloric, Mediterranean Diet on Laboratory Parameters in Obese Individuals.

Greco M1, Chiefari E1, Montalcini T2, Accattato F1, Costanzo FS3, Pujia A2, Foti D1, Brunetti A1, Gulletta E1.

  • 1Department of Health Sciences, Magna Græcia University of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy.
  • 2Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy.
  • 3Department of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy.



Calorie restriction is a common strategy for weight loss in obese individuals. However, little is known about the impact of moderate hypocaloric diets on obesity-related laboratory parameters in a short-term period. Aim of this study was to evaluate the variation of laboratory biomarkers in obese individuals following a Mediterranean, hypocaloric (1400-1600 Kcal/die) diet. 23 obese, pharmacologically untreated patients were enrolled and subjected to the determination of anthropometric variables and blood collection at baseline, 1 and 4 months after diet initiation. After 4 months of calorie restriction, we observed a significant decrease in body weight and BMI (both P < 0.0001), insulin (P = 0.037), HOMA-IR (P = 0.026), leptin (P = 0.008), and LDH (P = 0.023) and an increase in EGF (P = 0.013). All these parameters, except LDH, varied significantly already at 1 month after diet initiation. Also, lower levels of insulin (P = 0.025), leptin (P = 0.023), and EGF (P = 0.035) were associated with a greater (>5%) weight loss. Collectively, our data support a precocious improvement of insulin and leptin sensitivity after a modest calorie restriction and weight reduction. Moreover, EGF and LDH may represent novel markers of obesity, which deserve further investigations.

PMID: 24729662



Obesity is a chronic disorder that has become a worldwide epidemic, affecting approximately one third of the global population, with a threatening increase in children and adolescents in developed countries (1). It represents an important issue in public health, since it predisposes to several widespread pathologies, including cardiovascular diseases, type 2 diabetes mellitus, metabolic syndrome and several types of cancer. As a consequence, interest in the study of obesity has progressively increased.

From a biological point of view, the adipose tissue, which is characteristically expanded in the obese, has been considered for many years a quite inert lipid storage organ, whereas more recently it has been demonstrated to produce and release different bioactive molecules, defined adipokines, which play a role in inflammation, insulin resistance, hemostasis, and atherogenesis (Fig.1). Different factors predispose to obesity, including an excessive calorie intake, sedentary life, and genetic susceptibility. Calorie restriction generally represents the main intervention to obtain weight loss. By comparing different hypocaloric diets, the Mediterranean diet has proved to confer the highest improvement in insulin sensitivity (2). However, most studies have been designed to demonstrate a benefit of diets on biochemical parameters after at least 6 months from food restriction, and for a weight loss of at least 10% of the initial weight.

Figure 1


In our study, we wondered whether a moderately hypocaloric Mediterrean diet could be efficacious to determine changes in laboratory parameters in a short-time period. Therefore, we evaluated several indexes after 1 and 4 months from the prescription of a personalized hypocaloric Mediterranean diet (1400–1600 kcal/die), balanced in nutrient distribution (55% carbohydrates, 20% proteins, 25% mono- and polyunsaturated fats) and with a proper intake of micronutrients (Fig.2).
In our study, besides the anthropometric features [weight, body mass index (BMI), fat and lean mass, and their ratio], parameters of insulin resistance [glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR)], coagulative parameters, biochemical markers [lipid and hepatic profiles, and lactate dehydrogenase (LDH)], proinflammatory indexes [high sensitivity C reactive protein (hPCR), interleukins and adipokines (leptin, adiponectin, resistin, and visfatin)] and growth factors [vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF)] have been evaluated in 23 obese patients.

Our data show that even a modest (<5%) weight loss subsequent to a Mediterranean diet is associated with an early improvement of insulin sensitivity, with statistically significant reduction of insulin levels and HOMA-IR index (3). Among the proinflammatory cytokines and adipokines analysed, serum leptin showed a significant precocious reduction, compatible with an increase in leptin sensitivity (4). Interestingly, EGF and LDH also emerged as putative, novel obesity biomarkers, worthy of additional investigations.

In conclusion, the fact that even a modest weight loss following calorie restriction can result in a precocious improvement of insulin and leptin sensitivity potentially suggests that even a slightly restrictive diet might prevent or ameliorate insulin resistance-related disorders, and contribute to gain health benefits.



  1. Tsai AG, Williamson DF, Glick HA (2011) Direct medical cost of overweight and obesity in the USA: a quantitative systematic review. Obesity Reviews 12:50–61. doi: 10.1111/j.1467-789X.2009.00708.x.
  2. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, Golan R, Fraser D, Bolotin A, Vardi H, Tangi-Rozental O, Zuk-Ramot R, Sarusi B, Brickner D, Schwartz Z, Sheiner E, Marko R, Katorza E, Thiery J, Fiedler GM, Blüher M, Stumvoll M, Stampfer MJ; Dietary Intervention Randomized Controlled Trial (DIRECT) Group. (2008) Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. The New England Journal of Medicine, 359: 229–241. doi: 10.1056/NEJMoa0708681.
  3. Larson-Meyer DE, Heilbronn LK, Redman LM, Newcomer BR, Frisard MI, Anton S, Smith SR, Alfonso A, Ravussin E (2006) Effect of calorie restriction with or without exercise on insulin sensitivity, beta-cell function, fat cell size, and ectopic lipid in overweight subjects. Diabetes Care, 29:1337-1344.
  4. Jéquier E (2002) Leptin signaling, adiposity, and energy balance. Annals of the New York Academy of Sciences, 967:379–388.


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