Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Oct;60(7):3799-3810.
doi: 10.1007/s00394-021-02552-w. Epub 2021 Apr 10.

A weight-loss Mediterranean diet/lifestyle intervention ameliorates inflammation and oxidative stress in patients with obstructive sleep apnea: results of the "MIMOSA" randomized clinical trial

Michael Georgoulis  1 , Nikos Yiannakouris  1 , Roxane Tenta  1 , Elizabeth Fragopoulou  1 , Ioanna Kechribari  1 , Kallirroi Lamprou  2 , Eleni Perraki  2 , Emmanοuil Vagiakis  2 , Meropi D Kontogianni  3
Affiliations
Randomized Controlled Trial

A weight-loss Mediterranean diet/lifestyle intervention ameliorates inflammation and oxidative stress in patients with obstructive sleep apnea: results of the "MIMOSA" randomized clinical trial

Michael Georgoulis et al. Eur J Nutr. 2021 Oct.

Abstract

Purpose: Inflammation and oxidative stress are implicated in obstructive sleep apnea (OSA) pathophysiology. We aimed at exploring whether the combination of a weight-loss Mediterranean diet/lifestyle intervention with OSA standard care, i.e., continuous positive airway pressure (CPAP) prescription, can lead to greater improvements in inflammation and oxidative stress, compared to standard care alone.

Methods: This was a randomized controlled clinical trial in 187 adult, overweight patients with moderate-to-severe OSA. Participants were randomized to a standard care (SCG, n = 65), a Mediterranean diet (MDG, n = 62) or a Mediterranean lifestyle group (MLG, n = 60). All groups received OSA standard care. Intervention arms participated in a 6-month behavioral weight-loss intervention based on the Mediterranean diet, while the MLG also received counselling on physical activity and sleep habits.

Results: Seven patients were excluded and 53/180 were lost to follow-up. In intention to treat analysis (n = 180), the SCG did not exhibit changes in any of the markers assessed. Post-intervention age-, sex-, baseline- and CPAP use-adjusted plasma high sensitivity C-reactive protein levels (mg/L) were lower in the MDG and the MLG compared to the SCG (mean difference - 1.33, P = 0.039 and - 1.68, P = 0.007, respectively). The MLG also exhibited lower urinary 8-iso prostaglandin F2a levels (ng/mg creatinine) compared to the SCG and the MDG (mean difference - 1.10, P < 0.0001 and - 0.80, P = 0.001, respectively). Adiponectin and oxidized guanine levels were not altered in any of the study groups. Results were similar in per protocol analysis (n = 127).

Conclusion: A weight-loss Mediterranean diet/lifestyle intervention on top of CPAP has anti-inflammatory and antioxidant benefits in OSA.

Registration: The trial was prospectively registered at ClinicalTrials.gov (NCT02515357) on August 4, 2015.

Keywords: Inflammation; Mediterranean diet; Mediterranean lifestyle; Obstructive sleep apnea; Oxidative stress; Weight loss.

PubMed Disclaimer

References

    1. Greenstone M, Hack M (2014) Obstructive sleep apnoea. BMJ 348:g3745. https://doi.org/10.1136/bmj.g3745 - DOI - PubMed
    1. Carneiro G, Zanella MT (2018) Obesity metabolic and hormonal disorders associated with obstructive sleep apnea and their impact on the risk of cardiovascular events. Metabolism 84:76–84. https://doi.org/10.1016/j.metabol.2018.03.008 - DOI - PubMed
    1. Unnikrishnan D, Jun J, Polotsky V (2015) Inflammation in sleep apnea: an update. Rev Endocr Metab Disord 16(1):25–34. https://doi.org/10.1007/s11154-014-9304-x - DOI - PubMed - PMC
    1. Lavie L (2015) Oxidative stress in obstructive sleep apnea and intermittent hypoxia—revisited—the bad ugly and good: implications to the heart and brain. Sleep Med Rev 20:27–45. https://doi.org/10.1016/j.smrv.2014.07.003 - DOI - PubMed
    1. Farr OM, Mantzoros CS (2017) Sleep apnea in relation to metabolism: an urgent need to study underlying mechanisms and to develop novel treatments for this unmet clinical need. Metabolism 69:207–210. https://doi.org/10.1016/j.metabol.2017.01.028 - DOI - PubMed - PMC

Publication types

Associated data

LinkOut - more resources