India, May 27 -- A culturally adapted Mediterranean-style eating pattern may provide South Asians with a more realistic and sustainable way to follow a heart-friendly diet, as scientists examine whether Indian foods, spices, and traditional meal habits can reduce dietary inflammation in people with or at risk of coronary artery disease (1).
South Asians, including Indians, face a greater risk of developing coronary artery disease at an earlier age, highlighting the need for dietary approaches that are practical within Indian food culture.
A team of investigators has outlined an ongoing randomized controlled trial evaluating an Indian Adapted Mediterranean Diet (IAMD), which modifies the traditional Mediterranean diet to align with Indian culinary preferences, locally available foods, and eating patterns.
The study protocol has been published in the journal BMC Cardiovascular Disorders.
Indianized Mediterranean Eating Pattern
The Mediterranean diet is widely recognized for its anti-inflammatory and heart-protective properties. It emphasizes olive oil, whole grains, fruits, vegetables, fish, seafood, legumes, moderate dairy intake, and reduced salt and sugar consumption.
Despite its benefits, many foods central to the Mediterranean diet are rooted in Mediterranean culinary traditions and may not easily fit into Indian dietary practices. Because of this, the diet's practicality and acceptance among Indian populations may be limited.
To address these challenges, the investigators developed the Indian Adapted Mediterranean Diet, specifically designed around Indian tastes and culturally familiar ingredients.
The primary goal is to determine whether the diet can reduce dietary inflammation and improve cardiometabolic health in Indians who either have cardiovascular disease or are at elevated risk for it.
The report describes a single-center, open-label randomized controlled trial involving 140 adults with stable coronary artery disease or moderate to high cardiovascular disease risk, defined by an INTERHEART score of 10 or higher.
Participants were randomly assigned in a one-to-one ratio to either the IAMD intervention or standard dietary guidance for six months.
The average participant age is 51.9 years, 79 percent are men, and 81 percent already have coronary artery disease.
While participants and dietitians are aware of treatment allocation, outcome assessors will remain blinded.
Cardiovascular Risk and Dietary Inflammation Monitoring
Throughout the six-month intervention,
Investigators will evaluate changes in the Dietary Inflammation Index and energy-adjusted Dietary Inflammation Index among participants with or at risk of cardiovascular disease. These measurements help estimate whether a person's diet is likely to promote or reduce inflammation.
Additional evaluations will include markers of inflammation, cardiometabolic health, and obesity-related body measurements.
The analysis includes inflammatory biomarkers such as C-reactive protein and interleukins including interleukin-4, interleukin-6, and interleukin-10.
Cardiometabolic measurements include fasting blood sugar, glycated hemoglobin, fasting insulin, cholesterol levels, uric acid, and serum fatty acid composition.
Body mass index and other anthropometric measurements will also be recorded.
The investigators will also examine exploratory biomarkers including adiponectin, leptin, ghrelin, resistin, and glucagon-like peptide-1
Traditional Indian Foods in Meal Plans
The IAMD intervention provides individualized seven-day rotating meal plans tailored according to calorie needs, body mass index, ideal body weight, existing health conditions, and personal dietary preferences.
The plan incorporates validated North Indian recipes and prioritizes healthy fats such as mustard oil and groundnut oil, along with whole grains, legumes, nuts, seasonal fruits, vegetables, turmeric, and ginger.
At the same time, it reduces refined carbohydrates, red meat, and processed foods. Participants in the control group receive personalized standard dietary counseling based on routine clinical recommendations.
The trial aims to determine whether the Indian Adapted Mediterranean Diet can lower dietary inflammation and improve cardiometabolic health in Indians living with or at risk for cardiovascular disease.
The findings are expected to provide early evidence supporting a culturally relevant heart-healthy dietary strategy for South Asians. They may also contribute to the development of nutritional guidelines and public health policies focused on cardiovascular disease prevention in low- and middle-income countries.
However, the investigators acknowledged several limitations within the trial design, including its open-label nature, dependence on self-reported dietary intake, single-center setting, limited ability to evaluate clinical outcomes, and uncertainty regarding long-term adherence to the diet after the intervention period.