The Mediterranean Diet decreases LDL atherogenicity in high cardiovascular risk individuals: a randomized controlled trial

5 years ago

The Mediterranean Diet decreases LDL atherogenicity in high cardiovascular risk individuals: a randomized controlled trial

José Lapetra, Miquel Fiol, Alberto Goday, Lluis Serra-Majem, M. Carmen López-Sabater, Rafael la Torre, Ramón Estruch, Emilio Ros, Montserrat Fitó, Jordi Salas-Salvadó, Fernando Arós, Miguel Ángel Martínez-González, Olga Castañer, Dolores Corella, Xavier Pintó, Álvaro Hernáez

Scope Traditional Mediterranean diet (TMD) protects against cardiovascular disease through several mechanisms such as decreasing LDL cholesterol levels. However, evidence regarding TMD effects on LDL atherogenic traits (resistance against oxidation, size, composition, cytotoxicity) is scarce. Methods and results We assessed the effects of a 1-year intervention with a TMD on LDL atherogenic traits in a random sub-sample of individuals from the PREDIMED study (N = 210). We compared two TMDs: one enriched with virgin olive oil (TMD-VOO, N = 71) and another with nuts (TMD-Nuts, N = 68), versus a low-fat control diet (N = 71). After the TMD-VOO intervention, LDL resistance against oxidation increased (+6.46%, p = 0.007), the degree of LDL oxidative modifications decreased (−36.3%, p<0.05), estimated LDL particle size augmented (+3.06%, p = 0.021), and LDL particles became cholesterol-rich (+2.41% p = 0.013) relative to the low-fat control diet. LDL lipoproteins became less cytotoxic for macrophages only relative to baseline (−13.4%, p = 0.019). No significant effects of the TMD-Nuts intervention on LDL traits were observed versus the control diet. Conclusion Adherence to a TMD, particularly when enriched with virgin olive oil, decreased LDL atherogenicity in high cardiovascular risk individuals. The development of less atherogenic LDLs could contribute to explaining some of the cardioprotective benefits of this dietary pattern. Some LDL traits make lipoproteins more atherogenic (low resistance against oxidation, small size, low cholesterol content, etc.). This sub-study of the PREDIMED Study reveals that one year of adherence to a Traditional Mediterranean diet enriched with virgin olive oil turns LDL particles into less atherogenic ones. A less atherogenic LDL phenotype could contribute to explaining some of the cardioprotective benefits of this dietary pattern.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/mnfr.201601015