Highlights
- •Long-term consumption of a MedDiet improves endothelial function in patients with prediabetes and diabetes.
- •MedDiet is associated with an improvement of endothelial function compared to LF diet in patients with diabetes.
- •Our findings advocate use of the MedDiet in patients with prediabetes and diabetes to prevent cardio-metabolic complications.
Abstract
Background and aims
Endothelial dysfunction (ED) plays a key role in the development of atherosclerotic
cardiovascular disease (ASCVD). Likewise, type 2 diabetes (T2D) is a major CVD risk
factor. Therefore, our objective was to explore whether long-term consumption of a
Mediterranean diet (MedDiet) rich in olive oil or a low-fat diet (LF diet) was associated
with an improvement in ED and whether the potential benefits were similar in patients
with or without T2D in the CORDIOPREV clinical trial (NCT00924937).
Methods
Endothelial function was measured in 805 participants who had completed follow-up
ultrasound image studies, using ultrasonography of brachial artery to calculate flow
mediated vasodilatation (FMD) before and after 1.5 years of intervention with a MedDiet
[35% of calories from fat (22% monounsaturated) and 50% from carbohydrates] and LF
diet [28% fat (12% monounsaturated) and 55% of calories from carbohydrates]. We categorized
participants as patients with T2D, prediabetes, and without T2D according to the American
Diabetes Association (ADA) criteria.
Results
MedDiet increased FMD in patients with T2D [5.2 ± 0.4 at 1.5 years vs. 3.8 ± 0.4 at baseline; p=0.04] and prediabetes [4.9 ± 0.4 vs. 3.8 ± 0.4; p=0.04] and induced an improvement in FMD compared to LF diet in patients with diabetes
[5.2 ± 0.4 (MedDiet) vs.3.7 ± 0.4 (LF diet); p=0.01]; whereas both diets maintained FMD stable in patients without diabetes.
Conclusions
Habitual consumption of a MedDiet rich in extra virgin olive oil improves endothelial
function in patients with prediabetes and diabetes. This takes great importance given
that diet must be the cornerstone of treatment of patients with diabetes at high cardiovascular
risk.
Keywords
Abbreviations:
ADA (American Diabetes Association), ASCVD (atherosclerotic cardiovascular disease), BMI (body mass index), CVD (cardiovascular disease), CHD (coronary heart disease), FMD (flow mediated vasodilation), HDL-C (high-density lipoprotein cholesterol), LDL-C (low density lipoprotein), LF (low fat), MedDiet (Mediterranean diet), NO (nitric oxide), TC (total cholesterol), TG (triglycerides), T2D (type 2 diabetes)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 08, 2017
Accepted:
December 7,
2017
Received in revised form:
December 5,
2017
Received:
October 3,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
