title: The Mediterranean Diet decreases LDL atherogenicity in high cardiovascular risk individuals: a randomized controlled trial.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.|PhD Program in Food Sciences and Nutrition, Universitat de Barcelona, Barcelona, Spain.|CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Hernáez
authors.affiliation: Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.|CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Castañer
authors.affiliation: Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.|CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Goday
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Estruch
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Human Nutrition Department, Institut d'Investigació Sanitaria Pere Virgili, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Preventive Medicine, Universidad de Valencia, Valencia, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Martínez-González
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Balearic Islands Institute for Health Research, Hospital Son Espases, Palma de Mallorca, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Fiol
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Lapetra
authors.affiliation: Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.|CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Human Pharmacology and Neurosciences Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: de la Torre
authors.affiliation: CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.|Department of Nutrition and Bromatology, Faculty of Pharmacy, Universitat de Barcelona, Barcelona, Spain.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: López-Sabater
authors.affiliation: Cardiovascular Risk and Nutrition Research Group, REGICOR-Study Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.|CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fitó
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002478:Cells, Cultured; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000378:metabolism* / Q000633:toxicity; D008297:Male; D008875:Middle Aged; D009754:Nuts; D010316:Particle Size; D012306:Risk
chemical_list: D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein
keywords: LDL cytotoxicity; LDL oxidation; LDL size; Low density lipoproteins; Mediterranean diet