Effect of a traditional Mediterranean diet on apolipoproteins B, A-I, and their ratio: A randomized, controlled trial

• Published in: Atherosclerosis 2011-09, Vol.218 (1), p.174-180
• Main Authors: Solá, Rosa, Fitó, Montserrat, Estruch, Ramón, Salas-Salvadó, Jordi, Corella, Dolores, de La Torre, Rafael, Muñoz, Miguel Angel, del Carmen López-Sabater, María, Martínez-González, Miguel-Angel, Arós, Fernando, Ruiz-Gutierrez, Valentina, Fiol, Miquel, Casals, Elena, Wärnberg, Julia, Buil-Cosiales, Pilar, Ros, Emilio, Konstantinidou, Valentini, Lapetra, José, Serra-Majem, Lluis, Covas, María-Isabel
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anthropometry - methods; Apolipoprotein A-I; Apolipoprotein A-I - blood; Apolipoprotein B; Apolipoprotein B/A-I ratio; apolipoproteins; Apolipoproteins B - blood; atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiometabolic risk; Cardiovascular; Cardiovascular system; clinical trials; Cohort Studies; coronary disease; Coronary Disease - blood; Coronary Disease - diet therapy; Coronary Disease - prevention & control; Diet, Mediterranean; disease prevention; Female; Humans; Lipids - blood; low fat diet; Male; Medical sciences; Mediterranean diet; men; Middle Aged; nutrition education; Nuts; Olive Oil; Pharmacology. Drug treatments; Plant Oils; Risk; risk factors; Vasodilator agents. Cerebral vasodilators; Virgin olive oil; women
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2011.04.026

Abstract Objectives Apolipoprotein (Apo)B, ApoA-I, and their ratio could predict coronary heart disease (CHD) risk more accurately than conventional lipid measurements. Our aim was to assess the effect of a traditional Mediterranean diet (TMD) on apolipoproteins. Methods High-cardiovascular risk subjects ( n = 551, 308 women and 243 men), aged 55–80 years, were recruited into a large, multicenter, randomized, controlled, parallel-group, clinical trial (The PREDIMED Study) aimed at testing the efficacy of TMD on primary cardiovascular disease prevention. Participants assigned to a low-fat diet (control) ( n = 177), or TMDs (TMD + virgin olive oil (VOO), n = 181 or TMD + nuts, n = 193) received nutritional education and either free VOO (ad libitum) or nuts (dose: 30 g/day). A 3-month evaluation was performed. Results Both TMDs promoted beneficial changes on classical cardiovascular risk factors. ApoA-I increased, and ApoB and ApoB/ApoA-I ratio decreased after TMD + VOO, the changes promoting a lower cardiometabolic risk. Changes in TMD + VOO versus low-fat diet were −2.9 mg/dL (95% CI, −5.6 to −0.08), 3.3 mg/dL (95% CI, 0.84 to 5.8), and −0.03 mg/dL (−0.05 to −0.01) for ApoB, ApoA-I, and ApoB/ApoA-I ratio, respectively. Conclusions Individuals at high-cardiovascular risk who improved their diet toward a TMD pattern rich in virgin olive oil, reduced their Apo B and ApoB/ApoA-I ratio and improved ApoA-I concentrations.