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Effect of a traditional Mediterranean diet on lipoprotein oxidation:
a randomized controlled trial.

Fito M, Guxens M, Corella D, Saez G, Estruch R, de la Torre R, Frances F,
Cabezas C, Lopez-Sabater Mdel C, Marrugat J, Garcia-Arellano A, Aros F,
Ruiz-Gutierrez V, Ros E, Salas-Salvado J, Fiol M, Sola R, Covas MI;
for the PREDIMED Study Investigators.

Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigacio Medica, IMIM-Hospital del Mar, Barcelona, Spain

BACKGROUND: Despite the richness in antioxidants of the Mediterranean diet, to our knowledge, no randomized controlled trials have assessed its effect on in vivo lipoprotein oxidation. METHODS: A total of 372 subjects at high cardiovascular risk (210 women and 162 men; age range, 55-80 years), who were recruited into a large, multicenter, randomized, controlled, parallel-group clinical trial (the Prevenci?n con Dieta Mediterr?nea [PREDIMED] Study) directed at testing the efficacy of the traditional Mediterranean diet (TMD) on the primary prevention of coronary heart disease, were assigned to a low-fat diet (n = 121) or one of 2 TMDs (TMD + virgin olive oil or TMD + nuts). The TMD participants received nutritional education and either free virgin olive oil for all the family (1 L/wk) or free nuts (30 g/d). Diets were ad libitum. Changes in oxidative stress markers were evaluated at 3 months. RESULTS: After the 3-month interventions, mean (95% confidence intervals) oxidized low-density lipoprotein (LDL) levels decreased in the TMD + virgin olive oil (-10.6 U/L [-14.2 to -6.1]) and TMD + nuts (-7.3 U/L [-11.2 to -3.3]) groups, without changes in the low-fat diet group (-2.9 U/L [-7.3 to 1.5]). Change in oxidized LDL levels in the TMD + virgin olive oil group reached significance vs that of the low-fat group (P = .02). Malondialdehyde changes in mononuclear cells paralleled those of oxidized LDL. No changes in serum glutathione peroxidase activity were observed. CONCLUSIONS: Individuals at high cardiovascular risk who improved their diet toward a TMD pattern showed significant reductions in cellular lipid levels and LDL oxidation. Results provide further evidence to recommend the TMD as a useful tool against risk factors for CHD.
Trial Registration isrctn.org

Identifier: ISRCTN35739639.

PMID: 17563030 [PubMed - indexed for MEDLINE]

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