A Mediterranean Diet-Based Culinary Intervention in Adults With Metabolic Syndrome

Impact of a Mediterranean Diet-based Culinary Medicine Intervention on the Reversal of Metabolic Syndrome and Biomarkers of Inflammation, Oxidative Stress, and Aging

Metabolic syndrome is a major public health concern associated with an increased risk of cardiovascular disease, type 2 diabetes, and premature mortality. The Mediterranean diet has consistently demonstrated beneficial effects on metabolic health and is recommended as a dietary strategy for the prevention and management of metabolic syndrome. However, most interventions have focused on conventional nutritional counseling and have paid limited attention to the culinary and gastronomic skills required to translate dietary recommendations into sustainable eating behaviors.

This randomized controlled trial will evaluate the effectiveness of a Mediterranean diet-based nutritional intervention complemented by culinary medicine training sessions compared with a nutritional intervention alone in Spanish adults with metabolic syndrome. The culinary medicine component is designed to enhance participants' food preparation skills, confidence in cooking, and ability to incorporate Mediterranean dietary principles into their daily lives.

Participants will be followed for 6 months to assess changes in metabolic syndrome components and other metabolic health indicators. The study aims to determine whether the integration of culinary medicine education enhances the effectiveness of conventional nutritional counseling in improving metabolic syndrome outcomes and promoting long-term adherence to a Mediterranean dietary pattern

Inclusion Criteria:

• Men and women

• Age between 30 and 60 years

• Body mass index (BMI) between 20 and 35 kg/m²

• Presence of metabolic syndrome defined as having at least three of the following criteria:

  1. HDL cholesterol <40 mg/dL in men and <50 mg/dL in women
  2. Fasting glucose >100 mg/dL or use of hypoglycemic agents
  3. Triglycerides ≥150 mg/dL or use of lipid-lowering medication
  4. Blood pressure ≥130/85 mmHg
  5. Waist circumference ≥102 cm in men and ≥88 cm in women

Exclusion Criteria:

• Food allergies or intolerances to foods typical of the Mediterranean diet
• Gluten intolerance or celiac disease
• Adherence to a vegetarian or vegan diet
• Eating disorders (including anorexia nervosa, bulimia nervosa, and binge eating disorder)
• Moderate to severe psychiatric disorders that may compromise adherence to the intervention
• History of cardiovascular events
• BMI >35 kg/m²
• Extreme dietary patterns in the last 3 months (e.g., Atkins diet, very high-protein diets)
• Excessive alcohol consumption (>30 g/day for men and >20 g/day for women)
• Pregnancy or lactation
• Previous culinary training or formal culinary education