Álvaro Hernáez1,2,3, Olga Castañer2,3, Anna Tresserra-Rimbau2,4,5,6, Xavier Pintó2,7, Montserrat Fitó2,3, Rosa Casas1,2, Miguel Ángel Martínez-González2,8,9, Dolores Corella2,10, Jordi Salas-Salvadó2,4,5,6, José Lapetra2,11, Enrique Gómez-Gracia2,12, Fernando Arós2,13, Miquel Fiol2,14, Lluis Serra-Majem2,15, Emilio Ros1,2,16, Ramón Estruch1,2,17. 1. Cardiovascular Risk, Nutrition and Aging Research Unit, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, 08003, Spain. 2. CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain. 3. Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 08003, Spain. 4. Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain. 5. Hospital Universitari Sant Joan de Reus, Reus, 43204, Spain. 6. Institut d'Investigació Pere Virgili (IISPV), Reus, 43204, Spain. 7. Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, 08907, Spain. 8. Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, 31009, Spain. 9. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA. 10. Department of Preventive Medicine, Universidad de Valencia, Valencia, 46100, Spain. 11. Department of Family Medicine. Research Unit., Distrito Sanitario Atención Primaria Sevilla, Sevilla, 41013, Spain. 12. Department of Preventive Medicine and Public Health, Universidad de Málaga, Málaga, 29010, Spain. 13. Department of Cardiology, Hospital Universitario de Álava, Vitoria, 01009, Spain. 14. Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, Palma de Mallorca, 07120, Spain. 15. Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas, 35016, Spain. 16. Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona, 08036, Spain. 17. Internal Medicine Service, Hospital Clínic, Barcelona, 08036, Spain.
Abstract
SCOPE: To assess whether following a Mediterranean diet (MedDiet) improves atherothrombosis biomarkers in high cardiovascular risk individuals. METHODS AND RESULTS: In 358 random volunteers from the PREvención con DIeta MEDiterránea trial, the 1-year effects on atherothrombosis markers of an intervention with MedDiet, enriched with virgin olive oil (MedDiet-VOO; n = 120) or nuts (MedDiet-Nuts; n = 119) versus a low-fat control diet (n = 119), and whether large increments in MedDiet adherence (≥3 score points, versus compliance decreases) and intake changes in key food items are associated with 1-year differences in biomarkers. Differences are observed between 1-year changes in the MedDiet-VOO intervention and control diet on the activity of platelet activating factor acetylhydrolase in high-density lipoproteins (HDLs) (+7.5% [95% confidence interval: 0.17; 14.8]) and HDL-bound α1 -antitrypsin levels (-6.1% [-11.8; -0.29]), and between the MedDiet-Nuts intervention and the control arm on non-esterified fatty acid concentrations (-9.3% [-18.1; -0.53]). Large MedDiet adherence increments are associated with less fibrinogen (-9.5% [-18.3; -0.60]) and non-esterified fatty acid concentrations (-16.7% [-31.7; -1.74]). Increases in nut, fruit, vegetable, and fatty fish consumption, and decreases in processed meat intake are linked to enhancements in biomarkers. CONCLUSION:MedDiet improves atherothrombosis biomarkers in high cardiovascular risk individuals.
RCT Entities:
SCOPE: To assess whether following a Mediterranean diet (MedDiet) improves atherothrombosis biomarkers in high cardiovascular risk individuals. METHODS AND RESULTS: In 358 random volunteers from the PREvención con DIeta MEDiterránea trial, the 1-year effects on atherothrombosis markers of an intervention with MedDiet, enriched with virgin olive oil (MedDiet-VOO; n = 120) or nuts (MedDiet-Nuts; n = 119) versus a low-fat control diet (n = 119), and whether large increments in MedDiet adherence (≥3 score points, versus compliance decreases) and intake changes in key food items are associated with 1-year differences in biomarkers. Differences are observed between 1-year changes in the MedDiet-VOO intervention and control diet on the activity of platelet activating factor acetylhydrolase in high-density lipoproteins (HDLs) (+7.5% [95% confidence interval: 0.17; 14.8]) and HDL-bound α1 -antitrypsin levels (-6.1% [-11.8; -0.29]), and between the MedDiet-Nuts intervention and the control arm on non-esterified fatty acid concentrations (-9.3% [-18.1; -0.53]). Large MedDiet adherence increments are associated with less fibrinogen (-9.5% [-18.3; -0.60]) and non-esterified fatty acid concentrations (-16.7% [-31.7; -1.74]). Increases in nut, fruit, vegetable, and fatty fish consumption, and decreases in processed meat intake are linked to enhancements in biomarkers. CONCLUSION: MedDiet improves atherothrombosis biomarkers in high cardiovascular risk individuals.