Impact of Indian Adaptation of Mediterranean Diet on Dietary Inflammatory Index in Patients with Coronary Artery Disease- A Randomised Clinical Trial

Coronary Artery Disease (CAD) occurs at a younger age and is associated with severe and extensive atherosclerosis in Indians. One of the established risk factors of CAD is an unhealthy diet, which is also related to CAD risk factors- hypertension, Type 2 Diabetes Mellitus, central obesity and dyslipidemia. Indian diets are high in carbohydrates with low energy from proteins and low fruit and vegetable consumption. This dietary profile may contribute to increased CAD risk differently from Western diets where a saturated fat diet, processed food and sugar-sweetened beverages drive the CAD risk. This underscores a need for a detailed analysis of the diet among patients with CAD. One of the recently validated diet indexes, the Dietary Inflammatory Index (DII), has been shown to have a strong association with cardiovascular disease and mortality. The Mediterranean Diet, with its low DII, has been shown to be cardioprotective in clinical trials. In Phase I of the study we developed a diet with ingredients with commonalities or substitutes of the Mediterranean Diet. A 7-day cyclical menu was developed based on a modification of commonly eaten food items in a North Indian Diet with very low (high anti-inflammatory) DII scores. In this Phase II study, we aim to study the impact of this culturally adapted, individually customized, anti-inflammatory diet- Indian Adaptation of Mediterranean Diet versus usual diet prescribed as per current guidelines in patients of stable CAD and see its impact on DII, cardiovascular and inflammatory biomarkers