Mediterranean diet supplemented with nuts reduces waist circumference and shifts lipoprotein subfractions to a less atherogenic pattern in subjects at high cardiovascular risk.
OBJECTIVE
The PREDIMED trial showed that Mediterranean diets supplemented with either extra-virgin olive oil or nuts reduced incident cardiovascular events compared to a control diet. Consumption of both supplemental foods has been associated with reduced LDL-cholesterol, but it is unknown whether they can shift lipoprotein subfractions to a less atherogenic pattern. We investigated changes in adiposity and lipoprotein subfractions after consumption of the PREDIMED diets.


METHODS
In a PREDIMED sub-cohort (n = 169), lipoprotein subclasses (particle concentrations and size) were determined by nuclear magnetic resonance spectroscopy at baseline and after intervention for 1 year.


RESULTS
Participants allocated to the Mediterranean diet supplemented with nuts showed significant reductions from baseline of waist circumference (mean [95% CI]; -5 cm [-7; -3]) and concentrations of medium-small (-27 nmol/l [-46; -8]) and very small LDL (-111 nmol/l [-180; -42]); decreased LDL particle number (a nuclear magnetic resonance-specific measurement) (-98 nmol/l [-184; -11]); and an increase of large LDL concentrations (54 nmol/l [18; 90]), with a net increase (0.2 nmol/l [0.1; 0.4]) of LDL size. The Mediterranean diets with olive oil and nuts increased large HDL concentrations (0.6 μM [0.0; 1.1] and 1.0 μM [0.4; 1.5], respectively). Compared to the other two intervention groups, participants in the nut-enriched diet showed significantly reduced waist circumference (p ≤ 0.006, both) and increased LDL size (p < 0.05, both).


CONCLUSIONS
Lipoprotein subfractions are shifted to a less atherogenic pattern by consumption of Mediterranean diets enriched with nuts. The results contribute mechanistic evidence for the reduction of cardiovascular events observed in the PREDIMED trial.
Lipid Clinic, Endocrinology and Nutrition Service, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.
Nagila R T
NR
Damasceno
Aleix
A
Sala-Vila
Montserrat
M
Cofán
Ana M
AM
Pérez-Heras
Montserrat
M
Fitó
Valentina
V
Ruiz-Gutiérrez
Miguel-Ángel
MÁ
Martínez-González
Dolores
D
Corella
Fernando
F
Arós
Ramon
R
Estruch
Emilio
E
Ros
D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood*; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008077:Lipoproteins, LDL / Q000737:chemistry; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009754:Nuts; D000069463:Olive Oil; D010316:Particle Size; D010938:Plant Oils; D012307:Risk Factors; D013997:Time Factors; D055105:Waist Circumference
D008078:Cholesterol, LDL; D008074:Lipoproteins; D008077:Lipoproteins, LDL; D000069463:Olive Oil; D010938:Plant Oils
HDL size; LDL size; Nuts; Olive oil; PREDIMED; Small-dense LDL; Triglycerides; VLDL size