Mediterranean diet adherence and tirzepatide: real-world evidence on adiposity indices and insulin resistance beyond weight loss.

Tirzepatide treatment over a median of 3 months produced significant reductions in multiple anthropometric and adiposity measures.

• 53 patients with overweight/obesity (BMI ≥ 30 kg/m² or BMI ≥ 27 kg/m² with comorbidities) were enrolled.
• Significant reductions were observed in weight, BMI, WC (waist circumference), WtHR (waist-to-height ratio), BRI (body roundness index), and VAI (visceral adiposity index), all p < 0.05.
• ABSI (a body shape index) remained unchanged after treatment.
• Tirzepatide was administered at 2.5 mg/week for 1 month, then titrated to 5.0 mg/week.

Tirzepatide treatment was associated with consistent improvements in the glucometabolic profile.

• Significant declines were observed in fasting glucose, insulin, HbA1c, and triglycerides after 3 months of treatment.
• HDL cholesterol increased alongside reductions in the other metabolic markers.
• All glucometabolic improvements occurred over a median treatment period of 3 months.
• These findings are described as part of a real-world clinical assessment.

Mediterranean diet adherence, measured by PREDIMED score, increased substantially during the study period.

• PREDIMED scores increased by a mean of +3.2 points from baseline to 3-month follow-up.
• The increase in PREDIMED scores was statistically significant (p < 0.001).
• All patients received personalized recommendations for a Mediterranean dietary plan alongside tirzepatide.
• The PREDIMED score is described as a validated instrument for assessing Mediterranean diet adherence.

Higher adherence to the Mediterranean diet was independently associated with lower insulin levels, improved HOMA index, and greater reductions in visceral adiposity index.

• The association between higher PREDIMED scores and lower insulin levels, improved HOMA index, and greater VAI reductions persisted after adjusting for age, gender, and BMI.
• Correlations and generalized linear models were applied to explore the relationship between dietary adherence and changes in adiposity indices.
• The authors describe these as providing 'exploratory evidence that adherence to a Mediterranean diet enhances its impact on visceral adiposity.'
• The findings suggest additive benefits from combining pharmacological therapy with diet quality.

The study authors propose that integrating both PREDIMED and VAI assessments in future studies could support more comprehensive cardiometabolic risk stratification.

• The authors note that 'most clinical trials have overlooked the role of diet quality, leaving unclear whether lifestyle factors may modulate pharmacological benefits.'
• The study is characterized as a real-world investigation with a sample of 53 patients.
• The authors suggest the combination of pharmacological therapy and diet quality 'may offer additive benefits.'
• The authors call for integration of both PREDIMED and VAI in future studies for obesity care and cardiometabolic risk stratification.