Plasma irisin depletion under energy restriction is associated with improvements in lipid profile in metabolic syndrome patients.

OBJECTIVE: A recently discovered myokine, irisin, may have an important role in energy metabolism. This study aimed to evaluate the relationship between this hormone and the lipid profile of patients with metabolic syndrome (MetS) following a hypocaloric diet. DESIGN: Ninety-three Caucasian adults (52 men/41 women) diagnosed with MetS followed an 8-week-long energy-restricted programme (-30% of the energy requirements). Anthropometric measurements, biochemical markers and plasma irisin levels were analysed before and after the nutritional intervention. RESULTS: Global plasma irisin levels were significantly reduced at the end of the study (-72.0 ± 100.9 ng/ml, P < 0.001) accompanying the weight loss (-6.9%). The depletion of irisin significantly correlated with changes in some atherogenic-related variables: total cholesterol (B = 0.106, P = 0.018), total cholesterol/high-density lipoprotein cholesterol ratio (B = 0.002, P = 0.036), low-density lipoprotein cholesterol (B = 0.085, P = 0.037) and apolipoprotein B (B = 0.052, P = 0.002), independently of changes in body weight. CONCLUSIONS: An association between the reduction in plasma irisin levels and the depletion of important lipid metabolism biomarkers was observed in patients with MetS undergoing an energy-restricted programme.

A new dietary strategy for long-term treatment of the metabolic syndrome is compared with the American Heart Association (AHA) guidelines: the MEtabolic Syndrome REduction in NAvarra (RESMENA) project.

The long-term effects of dietary strategies designed to combat the metabolic syndrome (MetS) remain unknown. The present study evaluated the effectiveness of a new dietary strategy based on macronutrient distribution, antioxidant capacity and meal frequency (MEtabolic Syndrome REduction in NAvarra (RESMENA) diet) for the treatment of the MetS when compared with the American Heart Association guidelines, used as Control. Subjects with the MetS (fifty-two men and forty-one women, age 49 (se 1) years, BMI 36·11 (se 0·5) kg/m²) were randomly assigned to one of two dietary groups. After a 2-month nutritional-learning intervention period, during which a nutritional assessment was made for the participants every 15 d, a 4-month self-control period began. No significant differences were found between the groups concerning anthropometry, but only the RESMENA group exhibited a significant decrease in body weight ( - 1·7%; P= 0·018), BMI ( - 1·7%; P= 0·019), waist circumference ( - 1·8%; P= 0·021), waist:hip ratio ( - 1·4%; P= 0·035) and android fat mass ( - 6·9%; P= 0·008). The RESMENA group exhibited a significant decrease in alanine aminotransferase and aspartate aminotransferase (AST) concentrations ( - 26·8%; P= 0·008 and - 14·0%; P= 0·018, respectively), while the Control group exhibited a significant increase in glucose (7·9%; P= 0·011), AST (11·3%; P= 0·045) and uric acid (9·0%; P< 0·001) concentrations. LDL-cholesterol (LDL-C) concentrations were increased (Control group: 34·4%; P< 0·001 and RESMENA group: 33·8%; P< 0·001), but interestingly so were the LDL-C:apoB ratio (Control group: 28·7%; P< 0·001, RESMENA group: 17·1%; P= 0·009) and HDL-cholesterol concentrations (Control group: 21·1%; P< 0·001, RESMENA group: 8·7; P= 0·001). Fibre was the dietary component that most contributed to the improvement of anthropometry, while body-weight loss explained changes in some biochemical markers. In conclusion, the RESMENA diet is a good long-term dietary treatment for the MetS.

A decline in inflammation is associated with less depressive symptoms after a dietary intervention in metabolic syndrome patients: a longitudinal study.

BACKGROUND: Metabolic syndrome (MetS) and depression have become two prevalent diseases worldwide, whose interaction needs further investigation. Dietary treatment for weight loss in patients with MetS may improve depressive manifestations, however, the precise interactive pathways remain uncertain. Therefore, the aim of this study was to examine the effects of a hypocaloric diet designed to reduce MetS features on self-perceived depression and the possible underlying factors. METHODS: Sixty subjects (Age: 50 ± 1 y; BMI: 36.1 ± 0.6 kg/m(2)) with MetS were selected from the RESMENA study (control and intervention) after they completed the 6-months hypocaloric treatment and rated for depressive symptoms using the Beck Depression Inventory (BDI). Anthropometric and biochemical measurements including leptin, C-reactive protein (CRP) and insulin levels were evaluated. RESULTS: Depressive symptoms decreased during the weight loss intervention, with no differences between both dietary groups (control group -4.2 ± 0.8 vs RESMENA group -3.2 ± 0.6, P = 0.490). The number of criteria of the MetS was higher among subjects with more somatic-related depressive symptoms at baseline (B = 1.032, P-trend = 0.017). After six months of dietary treatment, body weight decreased in all subjects (-8.7%; confidence interval (95% CI) = 7.0-9.7) and also self-perceived depression (-37.9%; 95% CI = 2.7-4.9), as well as circulating leptin (-20.1%; 95% CI = 1.8-6.8), CRP (-42.8%; 95% CI = 0.6-3.0) and insulin (-37.7%; 95% CI = 4.1-7.2) concentrations. The decrease in BDI was significantly associated with declines in body fat mass (B = 0.34, 95% CI = 0.11-0.56) and also with the decrease in leptin (B = 0.16, 95% CI = 0.04-0.28) and CRP (B = 0.24, 95% CI = 0.01-0.46) concentrations. CONCLUSIONS: The decrease in depressive manifestations after a weight loss intervention was related with adiposity, CRP and leptin in subjects with MetS. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01087086.

Beneficial effects of the RESMENA dietary pattern on oxidative stress in patients suffering from metabolic syndrome with hyperglycemia are associated to dietary TAC and fruit consumption.

Hyperglycemia and oxidative stress are conditions directly related to the metabolic syndrome (MetS), whose prevalence is increasing worldwide. This study aimed to evaluate the effectiveness of a new weight-loss dietary pattern on improving the oxidative stress status on patients suffering MetS with hyperglycemia. Seventy-nine volunteers were randomly assigned to two low-calorie diets (-30% Energy): the control diet based on the American Health Association criteria and the RESMENA diet based on a different macronutrient distribution (30% proteins, 30% lipids, 40% carbohydrates), which was characterized by an increase of the meal frequency (seven-times/day), low glycemic load, high antioxidant capacity (TAC) and high n-3 fatty acids content. Dietary records, anthropometrical measurements, biochemical parameters and oxidative stress biomarkers were analyzed before and after the six-month-long study. The RESMENA (Metabolic Syndrome Reduction in Navarra) diet specifically reduced the android fat mass and demonstrated more effectiveness on improving general oxidative stress through a greater decrease of oxidized LDL (oxLDL) values and protection against arylesterase depletion. Interestingly, oxLDL values were associated with dietary TAC and fruit consumption and with changes on body mass index (BMI), waist circumference, fat mass and triacilglyceride (TG) levels. In conclusion, the antioxidant properties of the RESMENA diet provide further benefits to those attributable to weight loss on patients suffering Mets with hyperglycemia.

SERPINE1, PAI-1 protein coding gene, methylation levels and epigenetic relationships with adiposity changes in obese subjects with metabolic syndrome features under dietary restriction.

Plasminogen activator inhibitor 1 (PAI-1) has been associated with metabolic disorders, through different mechanisms, which could involve changes in DNA methylation. This work aimed to assess the potential relationships of the cytosine methylation levels within SERPINE1 gene transcriptional regulatory region, which codes for PAI-1, in peripheral white blood cells with anthropometrical, metabolic and inflammatory features. Forty-six obese subjects with metabolic syndrome features followed Control or Metabolic Syndrome Reduction in Navarra (RESMENA) energy-restricted (-30%E) diets for 8 weeks. SERPINE1 transcriptional regulatory region methylation at baseline was analyzed by a microarray technical. Both dietary strategies reduced anthropometric and biochemical parameters. The Control group significantly reduced plasma PAI-1 concentrations but not the RESMENA group. Participants from both nutritional interventions with higher SERPINE1 methylation levels at baseline showed significantly major reductions in body weight, total fat mass, android fat mass, total cholesterol and triglycerides, as compared with those with lower initial SERPINE1 methylation levels. In conclusion, the DNA methylation levels of SERPINE1 transcriptional regulatory region were associated with some metabolic and anthropometric changes in obese subjects with metabolic syndrome under energy restriction, suggesting a complex epigenetic network in the regulation of this recognized pro-inflammatory marker. (www.clinicaltrials.gov; NCT01087086).

[ASSOCIATION BETWEEN HEALTH RELATED QUALITY OF LIFE, BODYWEIGHT STATUS (BMI) AND PHYSICAL ACTIVITY AND FITNESS LEVELS IN CHILEAN ADOLESCENTS]. / ASOCIACIÓN ENTRE LA CALIDAD DE VIDA RELACIONADA CON LA SALUD, EL ESTADO NUTRICIONAL (IMC) Y LOS NIVELES DE ACTIVIDAD FÍSICA Y CONDICIÓN FÍSICA EN ADOLESCENTES CHILENOS.

AIM: the objective of this study was to analyze the potential relationships between Health Related Quality of Life (HRQoL) with weight status, physical activity (PA) and fitness in Chilean adolescents in both, independent and combined analysis. METHOD: a sample of 767 participants (47.5% females) and aged between 12 and 18 (mean age 15.5) was employed. All measurements were carried out using selfreported instruments and Kidscreen-10, iPAQ and IFIS were used to assess HRQoL, PA and Fitness respectively. One factor ANOVA and linear regression models were applied to analyze associations between HRQoL, weight status, PA and fitness using age and sex as confounders. RESULTS: body mass index, level of PA and fitness were independently associated with HRQoL in Chilean adolescents. However, the combined and adjusted by sex and age analysis of these associations showed that only the fitness was significantly related with HRQoL. CONCLUSION: general fitness is associated with HRQoL independently of sex, age, bodyweight status and level of PA. The relationship between nutritional status and weekly PA with HRQoL are mediated by sex, age and general fitness.

Objetivos: el objetivo del presente estudio fue analizar las posibles relaciones entre la Calidad de Vida Relacionada con la Salud (CVRS) con el estado nutricional y los niveles de Actividad Física (AF) y Condición Física (CF) en adolescentes chilenos, de manera independiente e interactiva. Método: se utilizó una muestra de 767 participantes (47,5% chicas) con edades comprendidas entre los 12 y los 18 años de edad (edad media 15,5 años). Todas las medidas utilizadas se obtuvieron mediante instrumentos auto- administrados. Se utilizó el Kidscreen-10, iPAQ e IFIS para evaluar la CVRS, la AF y la CF, respectivamente. Se realizaron análisis de ANOVA de un factor y modelos de regresión lineal para analizar las asociaciones entre la CVRS, el estado nutricional, la AF y la CF utilizando la edad y el sexo como variables confusoras. Resultados: se ha encontrado una asociación independiente del Índice de Masa Corporal, el nivel de AF y de CF con el nivel de CVRS de adolescentes chilenos. Sin embargo, al analizar esta asociación de forma combinada y ajustada por sexo y edad tan solo el nivel de CF general se asocia de forma significativa con la CVRS. Conclusión: el nivel de CF general se asocia con la CVRS en adolescentes chilenos independientemente del sexo, la edad, el estado nutricional y el nivel de AF. La relación entre el estado nutricional y el nivel de AF semanal con la CVRS están mediadas por el sexo, la edad y el nivel de CF general.

Effects of short- and long-term Mediterranean-based dietary treatment on plasma LC-QTOF/MS metabolic profiling of subjects with metabolic syndrome features: The Metabolic Syndrome Reduction in Navarra (RESMENA) randomized controlled trial.

SCOPE: Adherence to the Mediterranean diet has been associated with a reduced risk of metabolic syndrome (MetS). Metabolomics approach may contribute to identify beneficial associations of metabolic changes affected by Mediterranean diet-based interventions with inflammatory and oxidative-stress markers related to the etiology and development of the MetS. METHODS AND RESULTS: Liquid chromatography coupled to quadrupole-time of flight-MS metabolic profiling was applied to plasma from a 6-month randomized intervention with two sequential periods, a 2-month nutritional-learning intervention period, and a 4-month self-control period, with two energy-restricted diets; the RESMENA diet (based on the Mediterranean dietary pattern) and the Control diet (based on the American Heart Association guidelines), in 72 subjects with a high BMI and at least two features of MetS. The major contributing biomarkers of each sequential period were lipids, mainly phospholipids and lysophospholipids. Dependency network analysis showed a different pattern of associations between metabolic changes and clinical variables after 2 and 6 month of intervention, with a highly interconnected network during the nutritional-learning intervention period of the study. CONCLUSION: The 2-month RESMENA diet produced significant changes in the plasma metabolic profile of subjects with MetS features. However, at the end of the 6-month study, most of the associations between metabolic and clinical variables disappeared; suggesting that adherence to healthy dietary habits had declined during the self-control period.

[Waist-height ratio and risk of metabolic syndrome in Chilean adolescent]. / Ratio cintura-estatura y riesgo de síndrome metabólico en adolescentes chilenos.

OBJECTIVES: the aims of this study are twofold: i) to analyze the prevalence of risk of Metabolic Syndrome (MS) using the waist to height ratio (WHR) in a national representative sample of Chilean adolescents; and ii) to obtain percentile tables of WHR by sex and age for this population. METHODS: cross-sectional study with a sample of 23180 adolescents (boys n=11253; girls n=11927) from 13 to 16 years old. It was obtained anthropometric measures of height, weight and waist circumference. Risk of MS was calculated by the WHR with a cutoff of 0.5. Prevalence for risk of MS was calculated for all Chilean regions. Percentile table of WHR was calculated for this population. RESULTS: participants who had a WHR higher than 0.5 was 22.4%. This prevalence was higher in the most extreme regions (both north and south). Girls aged 15 and 16 showed higher WHR than boys. Results of this study shows higher values in WHR than published in previous international studies. CONCLUSION: It has been calculated the risk of MS for Chilean adolescents using WHR and it is associated to sex and region. Additionally percentile tables of WHR for Chilean adolescents aged 13 to 16 have been calculated.

Objetivos: El propósito de este estudio fue: i)analizar la prevalencia del riesgo de sufrir Síndrome Metabólico (SM) mediante la Relación Cintura-Estatura (RCE) en una muestra de adolescentes chilenos representativa a nivel nacional; y ii) obtener tablas de percentiles de la RCE por sexo y edad para esta población. Métodos: estudio transversal con una muestra de 23.180 adolescentes (chicos n= 11.253; chicas n= 11.927) de 13 a 16 años. Se llevaron a cabo medidas antropométricas de altura, peso y perímetro de cintura. El riesgo de sufrir SM se calculó mediante la RCE estableciendo el punto de corte en 0,5 y se obtuvo su prevalencia para todas las regiones chilenas. Se calcularon los percentiles de la RCE para esta población. Resultados: El 22,4% de los participantes mostraron una RCE superior a 0,5 siendo el riesgo la prevalencia de sufrir SM más elevada en las regiones extremas del país (norte y sur). Las chicas de 15 y 16 años mostraron valores de RCE superior a los chicos. Los resultados obtenidos muestran valores de RCE superiores a los publicados en otros estudios a nivel internacional. Conclusión: Se ha determinado el riesgo de sufrir SM en adolescentes chilenos a partir de la RCE, estando éste asociado al sexo y la región donde se vive. Adicionalmente se han obtenido los percentiles de RCE para los jóvenes chilenos de 13 a 16 años en una muestra representativa a nivel nacional.

[Association between dietary habits and the presence of overweight/obesity in a sample of 21,385 chilean adolescents]. / ASOCIACIÓN ENTRE LOS HÁBITOS DIETÉTICOS Y LA PRESENCIA DE SOBREPESO/OBESIDAD EN UNA MUESTRA DE 21.385 ADOLESCENTES CHILENOS.

AIM: The main aim of the present study was to explore the potential associations between dietary habits and the presence of overweight and obesity in Chilean adolescents. METHODS: For the present study dietary habits of 21,385 Chilean students were analyzed and weight and height assessed, in order to determine potential associations between eating patterns and body mass index (BMI) values. RESULTS: The majority of participants have lunch and a snack in the afternoon every day a week (81% and 71.2%, respectively), although only a 59.5% have breakfast every day and a 22% have dinner every night. To have breakfast is common for thin and normal weight subjects, but only a half of overweight and obese individuals usually have it. The obese is the group having less dairy products. A 50.2% of all subjects have legumes once or never in a week. Around a 15% have sweets all days and nearly a 50% of all the participants consume fizzy drinks every day of the week. Interestingly, having breakfast was found to be associated with less truancy. CONCLUSIONS: Nutritional education strategies should be carried out within students in Chile, since inadequate dietary habits are related to the higher values of BMI.

Objetivos: El principal objetivo del presente trabajo fue evaluar las posibles asociaciones entre los hábitos dietéticos y la presencia de sobrepeso y obesidad en adolescentes Chilenos. Método: Para este trabajo se analizaron los hábitos dietéticos de 21.385 estudiantes Chilenos y se determinaron el peso y la talla, con el fin de explorar posibles asociaciones entre los patrones de alimentación y los valores de índice de masa corporal (IMC). Resultados: La mayoría de los participantes realiza la toma del almuerzo (81%) y de la merienda (71,2%) todos los días de la semana. Sólo el 59,5% de los encuestados toma desayuno cada día y un 22% cena todas las noches. Desayunar es común entre los sujetos delgados y con peso normal, pero únicamente la mitad de los individuos con sobrepeso u obesidad desayuna habitualmente. Los obesos son el grupo que consume menos productos lácteos. Un 50,2% de todos los participantes nunca toma legumbres o lo hace una vez por semana. En torno a un 15% toma dulces todos los días y casi la mitad de los encuestados ingiere bebidas carbonatadas cada día de la semana. Además, tomar desayuno de forma habitual se asoció inversamente con el absentismo escolar. Conclusión: Se necesitan llevar a cabo estrategias de educación nutricional entre los estudiantes chilenos, ya que los hábitos dietéticos inadecuados se encuentran asociados con valores más elevados de IMC.

Vitamin C in the treatment and/or prevention of obesity.

Obesity has emerged as one of the major health threats worldwide. Moreover, an excessive body fat accumulation, which defines this disease, could lead to several associated clinical manifestations such as cardiovascular events, type 2 diabetes, inflammation, and some types of cancer. The appearance of these co-morbidities has been often related to an unbalanced oxidative stress. Therefore, antioxidant-based treatments could be considered as interesting approaches to possibly counteract obesity fat accumulation complications. In this context, it has been observed that vitamin C intake (ascorbic acid) is negatively associated with the occurrence of several conditions such as hypertension, gallbladder disease, stroke, cancers, and atherosclerosis, and also with the onset of obesity in humans and animals. Among the possible beneficial effects of ascorbic acid on obesity-related mechanisms, it has been suggested that this vitamin may: (a) modulate adipocyte lipolysis; (b) regulate the glucocorticoid release from adrenal glands; (c) inhibit glucose metabolism and leptin secretion on isolated adipocytes; (d) lead to an improvement in hyperglycemia and decrease glycosylation in obese-diabetic models; and (e) reduce the inflammatory response. Possibly, all these features could be related with the outstanding antioxidant characteristics of this vitamin. Thus, the present article reviews the up-to-date evidence regarding in vitro and in vivo effects of vitamin C in obesity and its co-morbidities.

The influence of Mediterranean, carbohydrate and high protein diets on gut microbiota composition in the treatment of obesity and associated inflammatory state.

The role of the gut microbiota in understanding the onset and development of obesity is gaining importance. Dietary strategies are the main tool employed to counteract obesity, and nowadays they are focused on a wide range of different aspects of diet and not only on calorie restriction. Additionally, diet is known to be a major factor influencing modification of the gut microbiota. Therefore the influence of both macronutrient and micronutrient content of any dietary strategy to treat obesity on gut bacterial composition should now be taken into consideration, in addition to energy restriction. This review aims to collect the available data regarding the influence of different dietary components on gut microbiota in relation to obesity and inflammatory states in humans. Although more work is needed, specific dietary factors (carbohydrate, protein and Mediterranean foods) have been shown to have an influence on the gut microbiome composition, meaning that there is an opportunity to prevent and treat obesity based on microbiota outcomes.

Longitudinal relationship of diet and oxidative stress with depressive symptoms in patients with metabolic syndrome after following a weight loss treatment: the RESMENA project.

BACKGROUND & AIM: Metabolic syndrome and depression seem to share some common underlying mechanisms, although less is known about the impact of metabolic syndrome dietary treatments on depression. This study examined the association between a hypocaloric treatment designed to reduce metabolic syndrome features in self-perceived depression and the potential involvement of dietary components and oxidative stress changes. METHODS: Analyses were based on volunteers (n = 55) with metabolic syndrome (age 50 ± 1 y.o.; 38M/17F), where depressive symptoms were assessed using the Beck Depression Inventory. Participants followed two hypocaloric diets (control diet and RESMENA diet) with the same energy restriction (-30% TCV) for six months. Depressive symptoms, dietary records, anthropometrical measurements, biochemical parameters and oxidative stress levels were analysed. RESULTS: Both diets improved self-perceived depression similarly (p = 0.528). Participants with lower depressive symptoms at baseline reported a significantly higher intake of omega-3 polyunsaturated fatty acids (p trend = 0.002). Interestingly, after adjusting for potential confounders, the increase in folate consumption (p = 0.011) and the decrease in plasma malondialdehyde levels (p = 0.012) throughout the intervention, were associated with the improvement in depressive symptoms. CONCLUSIONS: A higher intake of folate and a decline in malondialdehyde plasma levels during a weight loss intervention, were related to improvements in manifestations of depression (www.clinicaltrials.gov; NCT01087086).

The protein type within a hypocaloric diet affects obesity-related inflammation: the RESMENA project.

OBJECTIVES: The aim of this study was to compare the effect of two energy-restricted, differing with regard to protein content, on the inflammation state of obese individuals with features of metabolic syndrome. METHODS: Ninety-six participants completed an 8-wk randomized intervention trial that compared the RESMENA diet (-30% energy, with 30% energy from protein) with a control diet (-30% energy, with 15% energy from protein) that was based on American Heart Association criteria. RESULTS: The mean body weight losses were 7.09 ± 0.82 kg and 6.73 ± 0.71 kg, respectively, with no differences seen between the groups. The endpoint inflammation score-which was based on high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, and plasminogen activator inhibitor-1 levels-was significantly lower (P = 0.012) in the low-protein group (6.81 ± 2.32 versus 7.94 ± 1.94). The linear regression analyses revealed that total protein intake was positively associated with inflammation (P = 0.007) as well as with animal protein (P = 0.025) and meat protein (P = 0.015), but neither vegetable- nor fish-derived proteins were found to influence inflammatory status. CONCLUSIONS: Our results suggest that the type of protein consumed (more than the total protein consumed) within an energy-restricted diet influences the inflammation status associated with obesity-related comorbidities.

Association between circulating irisin levels and the promotion of insulin resistance during the weight maintenance period after a dietary weight-lowering program in obese patients.

OBJECTIVE: Weight regain is associated with the promotion of insulin resistance. The newly discovered myokine irisin, which was proposed to be involved in the management of insulin sensitivity, could play a role in this process. This study aimed to investigate the association between irisin and reduced insulin sensitivity induced by weight regain. MATERIALS/METHODS: Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) in 136 obese patients who followed an eight-week hypocaloric diet (30% reduced energy expenditure) to lose weight and was re-evaluated four or six months after treatment. Irisin plasma levels, as well as the levels of leptin, adiponectin, ghrelin and TNF-α, were quantified in a sub-cohort (n=73) from the initially studied patients at baseline (T0), at the diet endpoint (T1) and after the follow-up period (T2). RESULTS: After a successful dietary intervention to lose weight, 50% of the patients who regained the lost weight during the follow-up period were categorized as insulin resistant (HOMA-IR≥2.5) compared with only 25% of patients who maintained the weight loss (p=0.018). Importantly, in addition to the well-studied hormones leptin and adiponectin, irisin plasma levels were statistically associated with several risk factors for insulin resistance. Indeed, the increased risk of insulin resistance during the follow-up period was related to high irisin levels at baseline (odds ratio=4.2; p=0.039). CONCLUSIONS: Circulating irisin predicts the insulin resistance onset in association with weight regain. Therefore, irisin could be secreted as an adaptive response to counteract the deleterious effect of excess adiposity on glucose homeostasis.

Short-term role of the dietary total antioxidant capacity in two hypocaloric regimes on obese with metabolic syndrome symptoms: the RESMENA randomized controlled trial.

BACKGROUND: Dietary strategies seem to be the most prescribed therapy in order to counteract obesity regarding not only calorie restriction, but also bioactive ingredients and the composition of the consumed foods. Dietary total antioxidant capacity (TAC) is gaining importance in order to assess the quality of the diet. METHODS: Ninety-six obese adults presenting metabolic syndrome (MetS) symptoms completed an 8-week intervention trial to evaluate the effects of a novel dietary program with changes in the nutrient distribution and meal frequency and to compare it with a dietary pattern based on the American Heart Association (AHA) guidelines.Anthropometric and biochemical parameters were assessed at baseline and at the endpoint of the study, in addition to 48-hours food dietary records. RESULTS: Both diets equally (p > 0.05) improved MetS manifestations. Dietary TAC was the component which showed the major influence on body weight (p = 0.034), body mass index (p = 0.026), waist circumference (p = 0.083) and fat mass (p = 0.015) reductions. Transaminases (ALT and AST) levels (p = 0.062 and p = 0.004, respectively) were associated with lower TAC values. CONCLUSION: RESMENA diet was as effective as AHA pattern for reducing MetS features. Dietary TAC was the most contributing factor involved in body weight and obesity related markers reduction. TRIAL REGISTRATION: http://www.clinicaltrials.gov; NCT01087086.