Mediterranean Diet and atherothrombosis biomarkers: a randomized controlled trial
ABSTRACTScopeTo assess whether following a Mediterranean diet (MedDiet) improves atherothrombosis biomarkers in high cardiovascular risk individuals.Methods and resultsIn 358 random volunteers from the PREDIMED trial (Prevención con Dieta Mediterránea), we assessed the 1-year effects on atherothrombosis markers of an intervention with MedDiet, enriched with virgin olive oil (MedDiet-VOO; N=120) or nuts (MedDiet-Nuts; N=119) versus a low-fat control diet (N=119). In a secondary, observational approach, we studied whether volunteers with large increments in MedDiet adherence (>2 score points) were associated with 1-year improvements in biomarkers (relative to those worsening their adherence). The MedDiet-VOO intervention increased platelet activating factor-acetylhydrolase activity in high-density lipoproteins (HDLs) by 7.5% [95% confidence interval: 0.17; 14.8] and decreased HDL-bound α1-antitrypsin levels by 6.1% [−11.8; −0.29]. The MedDiet-Nuts one reduced non-esterified fatty acid concentrations by 9.3% [−18.1; −0.53]. Only the low-fat diet was associated with increases in platelet factor-4 and prothrombin factor1+2 levels versus baseline (P=0.012 and P=0.003, respectively, according to Wilcoxon signed-rank tests). Finally, large MedDiet increments were associated with less fibrinogen (−9.5% [−18.3; −0.60]) and non-esterified fatty acid concentrations (−16.7% [−31.7; −1.74]).ConclusionFollowing a MedDiet improves atherothrombosis biomarkers in high cardiovascular risk individuals.