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.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to AtherosclerosisAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Adherence to a Mediterranean diet and survival in a Greek population.N Engl J Med. 2003; 348: 2599-2608
- Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial.Ann Intern Med. 2006; 145: 1-11
- Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study: a case–control study).Lancet. 2008; 372: 224-233
- The joint effects of apolipoprotein B, apolipoprotein A-I, LDL cholesterol, and HDL cholesterol on risk: 3510 cases of acute myocardial infarction and 9805 controls.Eur Heart J. 2009; 30: 2137-2146
- Stroke mortality and the apoB/apo-A-I ratio: results of the AMORIS prospective study.J Int Med. 2006; 259: 259-266
- Relationship between Mediterranean Diet Score and atherothromboyic risk: findings from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994.Atherosclerosis. 2010; 2: 630-636
- Effects of extra virgin olive oil supplementation at two different low doses on lipid profile in mild hypercholesterolemic subjects: a randomised clinical trial.J Endocrinol Invest. 2009; 32: 794-796
- Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes.J Nutr. 2009; 139: 1333-1338
- Development of a short dietary questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet.Eur J Clin Nutr. 2004; 58: 1550-1552
- Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain.Br J Nutr. 2010; 103: 1808-1816
- Validation of the Minnesota Leisure time physical activity questionnaire in Spanish women.Med Sci Sports Med. 2000; 32: 1431-1437
- Cohort profile: design and methods of the PREDIMED study.Int J Epidemiol. 2010; ([December 20; Epub ahead of print])
- Validity of an adaptation of the Framingham cardiovascular risk function: the VERIFICA Study.J Epidemiol Community Health. 2007; 61 ([Erratum in: J Epidemiol Community Health 2007;61:655]): 40-47
- The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy—a review of the evidence.J Int Med. 2006; 259: 493-519
- Lipoprotein management in patients with cardiometabolic risk: Consensus Conference Report from the American Diabetes Association and the American College of Cardiology Foundation.J Am Coll Cardiol. 2008; 51: 1512-1524
- Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men.Ann Int Med. 2001; 134: 1115-1119
- Using apolipoprotein B to manage dyslipidemic patients: time for a change?.Mayo Clin Proc. 2010; 85: 440-445
- Apo B versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirty-person/ten-country panel.J Int Med. 2006; 259: 437-446
- Apolipoprotein B/A-I and risk of cardiovascular disease.Lancet. 2008; 372: 185-186
- Impact of follow-up time and re-measurement of the electrocardiogram and conventional cardiovascular risk factors on their predictive value for myocardial infarction.J Intern Med. 2006; 260: 22-30
- Differential influence of different dietary fatty acids on very low-density lipoprotein secretion when delivered to hepatocytes in chylomicron remnants.Metabolism. 2009; 58: 186-195
- Differential modulation of hepatic very low-density lipoprotein secretion by triacylglycerol-rich lipoproteins derived from different oleic-acid rich dietary oils.Br J Nutr. 2008; 99: 29-36
- Effects of dietary fat amount and saturation on the regulation of hepatic mRNA and plasma apolipoprotein A-I in rats.Atherosclerosis. 2000; 152: 69-78
- Cacao polyphenols influence the regulation of apolipoprotein in HepG2 and Caco2 cells.J Agric Food Chem. 2011; 59: 1470-1476
- Hypolipidemic effects of proanthocyanidins and their underlying biochemical and molecular mechanisms.Mol Nutr Res. 2010; 54: 37-59
- Hepatocyte apoB-containing lipoprotein secretion is decreased by the grapefruit flavonoid, naringenin, via inhibition of MTP-mediated microsomal triglyceride accumulation.Biochemistry. 2003; 42: 1283-1291
- Effect of soy nuts on blood pressure and lipid levels in hypertensive, prehypertensive, and normotensive postmenopausal women.Arch Intern Med. 2007; 167: 1060-1067
- Soy protein reduces serum LDL cholesterol and the LDL cholesterol: HDL cholesterol and apolipoprotein B: apolipoprotein A-I ratios in adults with type 2 diabetes.J Nutr. 2009; 139: 1700-1706
- Concentrated grape juice exerts antioxidant, hypolipidemic and anti-inflammatory effects in both hemodialysis patients and healthy subjects.Am J Clin Nutr. 2006; 84: 252-256
- The curcuma antioxidants: pharmacological effects and prospects for future clinical use: a review.Arch Gerontol Geriatr. 2002; 34: 37-46
Article info
Publication history
Published online: June 06, 2011
Accepted:
April 23,
2011
Received in revised form:
April 20,
2011
Received:
November 24,
2010
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
