Carotid intima-media thickness changes with Mediterranean diet: a randomized trial (PREDIMED-Navarra).

OBJECTIVE: Observational studies have reported inverse associations between adherence to the Mediterranean diet (MedDiet) and atherosclerotic disease. We tested the effect of two types of MedDiet on progression of subclinical carotid atherosclerosis. METHODS: We randomized 187 high-cardiovascular-risk asymptomatic subjects (51% women, mean age 67 years) to three treatment arms: MedDiet with supplemental virgin olive oil (VOO), n=66; MedDiet with supplemental nuts, n=59; and control diet, n=62. Participants received nutrition behavioral counseling in quarterly group and individual educational sessions. Free supplemental foods were provided to the MedDiet groups. Changes in mean intima-media thickness (IMT) were measured ultrasonographically in the far wall of bilateral common carotid arteries after 1 year. RESULTS: Overall, no significant between-group differences in IMT progression were observed after 1-year. However, a significant interaction (p=0.03) between baseline IMT and treatment effect was apparent. Among participants with baseline IMT≥0.9 mm, 1-year IMT changes versus control showed significant differences of -0.079 mm (95% confidence interval, -0.145 to -0.012) for the MedDiet with VOO and -0.072 mm (-0.140 to -0.004) for the MedDiet with nuts. No IMT changes occurred in any intervention group among participants with lower baseline IMT values (<0.9 mm). CONCLUSIONS: MedDiets enhanced with VOO or nuts were not effective in inducing ultrasonographic regression of carotid atherosclerosis after 1 year intervention. However, they were effective among subjects with elevated baseline IMT, suggesting that subclinical atherosclerosis may respond to dietary intervention within a relatively short time frame only among subjects with a high initial atherosclerotic burden.

Adherence to the Mediterranean diet in patients with type 2 diabetes mellitus and HbA1c level.

RATIONALE AND OBJECTIVE: The Mediterranean diet (MeDiet) has beneficial effects on cardiovascular risk factors. We analyzed the association between adherence of a MeDiet in patients with type 2 diabetes mellitus (T2DM) and levels of HbA1c. PATIENTS AND METHODS: This was a cross-sectional study in individuals with T2DM participating in the PREDIMED trial at the centre of Pamplona. Information on diet was collected with a validated 14 point scale of adherence to the MeDiet and blood samples were obtained to assess HbA1c levels. RESULTS: We studied 383 participants with T2DM, 53.4% women (mean age 69 ± 6 years). HbA1c data were available in 262 cases (mean 6.9 ± 1.5%). Although there was a potential inverse non-significant association between adherence to MeDiet and HbA1c levels after adjusting for age and sex, it was not statistically significant. Multivariate analysis additionally adjusted for physical activity, smoking, time of evolution of the T2DM, body mass index and insulin treatment found similar findings (OR = 0.69, 95% CI 0.17-2.83). CONCLUSIONS: Although we found not enough evidence to support that a MeDiet is associated with lower levels of HbA1c in patients with T2DM, our results suggested an inverse trend. Future studies with larger sample size are necessary.

Adherence to the Mediterranean diet, long-term weight change, and incident overweight or obesity: the Seguimiento Universidad de Navarra (SUN) cohort.

BACKGROUND: The Mediterranean dietary pattern might be a potential tool for the prevention of obesity. OBJECTIVES: We studied the association between adherence to 6 previously published scores used to assess the adherence to the Mediterranean diet and weight change. We also assessed the risk of relevant weight gain (≥ 5 kg) or the risk of developing overweight or obesity. DESIGN: The study population included 10,376 Spanish men and women who were university graduates (mean age = 38 y) and were followed up for a mean (± SD) of 5.7 ± 2.2 y. Diet was assessed at baseline with a 136-item, previously validated food-frequency questionnaire. Weight was assessed at baseline and biennially during follow-up. RESULTS: Participants with the lowest adherence (≤ 3 points) to the Mediterranean dietary score (MDS) proposed by Trichopoulou et al (range: 0-9; N Engl J Med 2003;348:2599-608) exhibited the highest average yearly weight gain, whereas participants with the highest (≥ 6 points) adherence exhibited the lowest weight gain (adjusted difference: -0.059 kg/y; 95% CI: -0.111, -0.008 kg/y; P for trend = 0.02). This inverse association was extended to other a priori-defined MDSs. The group with the highest adherence to the MDS also showed the lowest risk of relevant weight gain (≥ 5 kg) during the first 4 y of follow-up (odds ratio: 0.76; 95% CI: 0.64, 0.90). CONCLUSIONS: Adherence to the Mediterranean dietary pattern is significantly associated with reduced weight gain. This dietary pattern can be recommended to slow down age-related weight gain.

Macronutrient intake and metabolic syndrome in subjects at high cardiovascular risk.

BACKGROUND: The effect of macronutrient intake on the metabolic syndrome (MS) is still controversial. Our aim in this study was to assess the relationships between macronutrient intake and the risk of developing the MS in subjects at high cardiovascular risk. METHODS: In this cross-sectional study, 967 high-risk men and women (55-80 years) were assessed according to the MS criteria defined by the National Cholesterol Education Program Adult Treatment Panel III (ATP3) and those established by the International Diabetes Federation (IDF). A 137-item validated food frequency questionnaire was used. Odds ratios (OR) for macronutrient intake and MS were calculated and adjustments were made for potential confounders. RESULTS: When applying the ATP3 criteria, an inverse association was found for fiber and polyunsaturated fatty acid (PUFAs) intake, with ORs of 0.55 (95% CI: 0.35-0.86) and 0.60 (95% CI: 0.39-0.94), respectively, for the 5th versus the 1st quintile. Using the IDF criteria, an inverse association between fiber intake and the MS was obtained whereas a direct association was found between carbohydrate intake and the MS: OR = 1.71 (95% CI: 1.05-2.79) for the highest versus the lowest quintile. CONCLUSIONS: A diet rich in fiber and PUFAs is correlated with a reduced risk of MS in subjects at high cardiovascular risk.

Prospective study of self-reported usual snacking and weight gain in a Mediterranean cohort: the SUN project.

BACKGROUND & AIMS: It has been hypothesized that snacking could be a major factor in the development of obesity. However, the relationship between snacking and the increment in body weight remains controversial. Moreover, longitudinal studies about this issue are scarce. Thus, our objective was to prospectively assess the relationship between snacking and weight gain and obesity in a middle-aged free-living population. METHODS: Longitudinal prospective Spanish dynamic cohort (10,162 university graduates; mean age: 39 years) followed-up for an average of 4.6 years. Dietary habits were ascertained through a validated 136-item food-frequency questionnaire. Usual snackers were defined as those participants who answered affirmatively when asked in the baseline assessment if they usually eat between meals. Validated self-reported weight and body mass index were collected at baseline and during follow-up. RESULTS: After adjusting for potential confounders, self-reported between-meal snacking was significantly associated with a higher risk of substantial weight gain (> or =3kg/year; p<0.001;> or =5kg/year, p<0.001;> or =10% baseline weight, p<0.001). Among participants with a baseline body mass index lower than 30kg/m(2) (n: 9709) we observed 258 new cases of obesity. Usual snackers presented an adjusted 69% higher risk of becoming obese during follow-up (Hazard Ratio: 1.69; 95% confidence interval: 1.30-2.20). CONCLUSION: Our results support the hypothesis that self-reported between-meal snacking can be a potential risk factor for obesity.

[Population-based study of leisure time physical activity]. / Estudio poblacional de actividad física en tiempo libre.

OBJECTIVE: To estimate the frequency of persons who are physically active in their leisure time and the quantity and intensity of their activities in relation to age, sex, body mass index and socioeconomic status in the adult population of Navarre (Spain). METHODS: We performed a cross-sectional study in an age and sex stratified random sample of the population aged 35-84 years old (1,893 men and 2,275 women). The response rate was 73.4%. The Minnesota Leisure-Time Physical Activity Questionnaire, previously validated for the Spanish population, was used. Two definitions of "physically active" were employed: a) total leisure-time energy expenditure of > 300 metabolic equivalentes (METs)/day, and b) physical exercise in activities expending >or=4 METs for at least 25 min/day for women and 30 min/day for men. RESULTS: When both definitions were applied, approximately half the population aged 35-84 years old were active in their leisure time. The prevalence of physically active persons (> 300 METs/day) decreased after the age of 65 in women and no differences were found according to body mass index, educational level or occupation-based social class. In men, being active in their leisure time was related to age 65-74 years and medium or low social class. CONCLUSIONS: The population subgroups most susceptible to interventions aimed at promoting leisure-time physical activity in Navarre consisted of women over the age of 65 and men of high social class.

Estudio poblacional de actividad física en tiempo libre / Population-based study of leisure time physical activity

Objetivo: Estimar la frecuencia de personas activas en tiempo libre, y la cantidad e intensidad de las actividades que desarrollan según edad, sexo, índice de masa corporal y nivel socioeconómico, en la población adulta de Navarra.Métodos: Estudio transversal en una muestra aleatoria estratificada por edad y sexo de población de 35–84 años: 1.893 hombres y 2.275 mujeres. La tasa de respuesta fue del 73,4%. Se utilizó el cuestionario de actividad física en tiempo libre de Minnesota, validado en población española. Se consideran dos definiciones de persona activa: a) tener un gasto energético total diario en tiempo libre > 300 equivalentes metabólicos (MET) y b) realizar ejercicio físico en actividades ≥ 4 MET al menos 25min diarios las mujeres y 30 los hombres.Resultados: Con ambas definiciones, aproximadamente la mitad de la población de 35–84 años es activa en su tiempo libre. La prevalencia de personas activas (> 300 MET diarios) disminuye a partir de los 65 años en las mujeres, sin diferencias por índice de masa corporal, nivel de estudios ni clase social basada en la ocupación. En hombres, ser activo en el tiempo libre se relaciona con tener 65–74 años y pertenecer a la clase social media o baja.Conclusiones: Las mujeres mayores de 65 años y los hombres de clase social alta son los subgrupos de población más susceptibles de ser objeto de intervenciones de fomento de la práctica de actividad física en su tiempo libre en Navarra (AU)

Objective: To estimate the frequency of persons who are physically active in their leisure time and the quantity and intensity of their activities in relation to age, sex, body mass index and socioeconomic status in the adult population of Navarre (Spain).Methods: We performed a cross-sectional study in an age and sex stratified random sample of the population aged 35–84 years old (1,893 men and 2,275 women). The response rate was 73.4%. The Minnesota Leisure-Time Physical Activity Questionnaire, previously validated for the Spanish population, was used. Two definitions of “physically active” were employed: a) total leisure-time energy expenditure of > 300 metabolic equivalentes (METs)/day, and b) physical exercise in activities expending ≥ 4 METs for at least 25min/day for women and 30min/day for men.Results: When both definitions were applied, approximately half the population aged 35–84 years old were active in their leisure time. The prevalence of physically active persons (> 300 METs/day) decreased after the age of 65 in women and no differences were found according to body mass index, educational level or occupation-based social class. In men, being active in their leisure time was related to age 65–74 years and medium or low social class.Conclusions: The population subgroups most susceptible to interventions aimed at promoting leisure-time physical activity in Navarre consisted of women over the age of 65 and men of high social class (AU)

Inhibition of circulating immune cell activation: a molecular antiinflammatory effect of the Mediterranean diet.

BACKGROUND: Adherence to the Mediterranean diet (Med-Diet) is associated with a reduced risk of cardiovascular disease (CVD). However, the molecular mechanisms involved are not fully understood. OBJECTIVE: The objective was to compare the effects of 2 Med-Diets with those of a low-fat diet on immune cell activation and soluble inflammatory biomarkers related to atherogenesis in subjects at high risk of CVD. DESIGN: In a controlled study, we randomly assigned 112 older subjects with diabetes or > or =3 CVD risk factors to 3 dietary intervention groups: Med-Diet with supplemental virgin olive oil (VOO), Med-Diet with supplemental nuts, and low-fat diet. Changes from baseline in cellular and serum inflammatory biomarkers were assessed at 3 mo. RESULTS: One hundred six participants (43% women; average age: 68 y) completed the study. At 3 mo, monocyte expression of CD49d, an adhesion molecule crucial for leukocyte homing, and of CD40, a proinflammatory ligand, decreased (P < 0.05) after both Med-Diets but not after the low-fat diet. Serum interleukin-6 and soluble intercellular adhesion molecule-1, inflammatory mediators crucial in firm adhesion of leukocytes to endothelial surfaces, decreased (P < 0.05) in both Med-Diet groups. Soluble vascular cellular adhesion molecule-1 and C-reactive protein decreased only after the Med-Diet with VOO (P < 0.05), whereas interleukin-6, soluble vascular cellular adhesion molecule-1, and soluble intercellular adhesion molecule-1 increased (P < 0.05) after the low-fat diet. CONCLUSIONS: Med-Diets supplemented with VOO or nuts down-regulate cellular and circulating inflammatory biomarkers related to atherogenesis in subjects at high risk of CVD. The results support the recommendation of the Med-Diet as a useful tool against CVD.

[Role of tobacco use on the incidence of depression in the SUN cohort study]. / Efecto del tabaco en la incidencia de depresión en la cohorte SUN (Seguimiento Universidad de Navarra).

BACKGROUND AND OBJECTIVE: Several investigations, most of them cross-sectional, have analyzed the association between smoking and depression, but there are not enough evidences to establish the direction of the association. Our objective was to prospectively assess the association between smoking habit and depression incidence in the SUN (Seguimiento Universidad de Navarra) cohort. SUBJECTS AND METHOD: Dynamic cohort study (recruitment permanently open) based on 8,556 graduate participants where depression incidence was ascertained during 6 years of follow-up. Depression was defined as the presence of a self-reported physician diagnosis and/or use of antidepressant medication in at least one of the 2-year, 4-year or 6-year follow-up questionnaires. The association between smoking and depression incidence was estimated through the calculation of hazard ratios (HR) and their 95% confidence intervals (CI) using Cox regression models (proportional hazards). RESULTS: The mean follow-up period was 47.4 months. One hundred and ninety participants initially free of depression reported a physician diagnosis of depression during follow-up. A significantly higher risk was found for smokers (HR = 1.39; 95% CI, 1.00-1.93) when they were compared to non smokers, whereas an inverse association was found for ex-smokers who had quit smoking more than 10 years ago (HR = 0.42; 95% CI, 0.19-0.94). CONCLUSIONS: This study supports, with a prospective design, an increased risk of depression associated to smoking.

Efecto del tabaco en la incidencia de depresión en la cohorte SUN (Seguimiento Universidad de Navarra) / Role of the tobacco use on the depression incidence in the SUN cohort study

Fundamento y objetivo: Numerosos estudios, en su mayoría transversales, han analizado la asociación entre hábito tabáquico y depresión, pero hasta el momento no hay evidencias suficientes para establecer el sentido de esta posible asociación. El objetivo de este trabajo ha sido realizar un análisis prospectivo de la asociación entre hábito tabáquico e incidencia de depresión en la cohorte SUN (Seguimiento Universidad de Navarra). Sujetos y método: Se ha realizado un estudio de cohortes dinámico (reclutamiento permanentemente abierto), basado en 8.556 participantes universitarios, en quienes se valoró la incidencia de depresión en un período de 6 años de seguimiento prospectivo. La depresión se definió por el diagnóstico médico y/o consumo de antidepresivos referidos por el propio participante en al menos uno de los cuestionarios de seguimiento realizados a los 2, 4 y 6 años. La asociación entre el hábito tabáquico y la incidencia de depresión se estimó calculando los cocientes de riesgos (hazard ratios [HR]) y sus intervalos de confianza (IC) del 95% mediante modelos de regresión de Cox (riesgos proporcionales). Resultados: El tiempo medio de seguimiento de los participantes fue de 47,4 meses. Durante el seguimiento 190 participantes inicialmente exentos de depresión refirieron un diagnóstico médico de depresión. Se encontró un riesgo significativamente superior en fumadores (HR = 1,39; IC del 95%, 1,00-1,93) comparados con no fumadores, mientras que la relación era inversa en exfumadores que hacía más de 10 años que habían dejado el tabaco (HR = 0,42; IC del 95%, 0,19-0,94). Conclusiones: Este estudio indica una relación directa entre el consumo de tabaco y la incidencia de depresión

Background and objective: Several investigations, most of them cross-sectional, have analyzed the association between smoking and depression, but there are not enough evidences to establish the direction of the association. Our objective was to prospectively assess the association between smoking habit and depression incidence in the SUN (Seguimiento Universidad de Navarra) cohort. Subjects and method: Dynamic cohort study (recruitment permanently open) based on 8,556 graduate participants where depression incidence was ascertained during 6 years of follow-up. Depression was defined as the presence of a self-reported physician diagnosis and/or use of antidepressant medication in at least one of the 2-year, 4-year or 6-year follow-up questionnaires. The association between smoking and depression incidence was estimated through the calculation of hazard ratios (HR) and their 95% confidence intervals (CI) using Cox regression models (proportional hazards). Results: The mean follow-up period was 47.4 months. One hundred and ninety participants initially free of depression reported a physician diagnosis of depression during follow-up. A significantly higher risk was found for smokers (HR = 1.39; 95% CI, 1.00-1.93) when they were compared to non smokers, whereas an inverse association was found for ex-smokers who had quit smoking more than 10 years ago (HR = 0.42; 95% CI, 0.19-0.94). Conclusions: This study supports, with a prospective design, an increased risk of depression associated to smoking

Carotid intima-media thickness is inversely associated with olive oil consumption.

BACKGROUND: Intima-media thickness (IMT) is a valid marker for generalized vascular disease whose main risk factors are associated with food habits and lifestyle. A Mediterranean food pattern may have a protective effect on cardiovascular mortality. OBJECTIVE: To assess the relationship between carotid IMT and olive oil consumption. METHODS: One hundred and ninety nine patients were randomly extracted from 1055 asymptomatic high cardiovascular risk participants at the AP-UNAV recruitment center of the PREDIMED (PREvención con DIeta MEDiterránea) project. Demographic and clinical variables were collected, and a validated semiquantitative food frequency questionnaire (137 items) was administered at the inclusion interview. A B-mode ultrasound imaging technique was used to measure the mean common carotid IMT. RESULTS: The mean age was 67.3 years and 53.3% were women. Energy-adjusted olive oil consumption quintiles were assessed as the main exposure after adjusting for potential dietary and non-dietary confounders. Using continuous carotid IMT as the outcome in an ANCOVA analysis, the adjusted IMT means throughout quintiles showed an inverse association with a plateau after the second quintile, with statistical differences when the adjusted IMT mean of the merged four upper quintiles were compared with the lowest quintile (p<0.05). The averaged (both sides) mean IMT of the common carotid was dichotomised and values above the median (0.804 mm) were used to identify carotid atherosclerotic damage. We also found an inverse association of olive oil consumption with high IMT, throughout the second to the fifth quintile as compared with the lowest quintile. The adjusted OR was of 0.08 (95% confidence interval, CI, of 0.02-0.37; p=0.001) after merging the four upper quintiles. CONCLUSION: The inverse association between the olive oil consumption and the carotid IMT could suggest a protective role of olive oil against the development of carotid atherosclerosis in persons at high cardiovascular risk.

[Incidence of hypertension in a cohort of Spanish university graduates: the SUN study]. / Incidencia de hipertensión arterial en una cohorte de graduados universitarios españoles: el estudio SUN.

Hypertension is a major public health problem. However, no estimates of age- and sex-specific incidences are available for the Spanish population. Our objective was to estimate the incidence of hypertension in a cohort of university graduates in Spain. We followed up 5648 individuals aged 25-65 years who were initially free of hypertension, diabetes, and cardiovascular disease for a median of 30 months. New diagnoses of hypertension were identified using mailed questionnaires. We verified all self-reported diagnoses of hypertension. In 18 250 person-years of follow-up, we identified 248 new cases of hypertension. The unadjusted incidences of hypertension in women and men were 8.2 per 1000 person-years (95% CI, 6.7-10.1) and 21.8 per 1000 person-years (95% CI, 18.6-25.4), respectively. The cumulative probability of receiving a medical diagnosis of hypertension by the age of 65 years was 50% among women and 72% among men. In conclusion, we have provided new evidence confirming that hypertension is one of the most important public health problems in Spain.

Incidencia de hipertensión arterial en una cohorte de graduados universitarios españoles: el estudio SUN / Incidence of hypertension in a cohort of spanish university graduates: the SUN study

La hipertensión arterial (HTA) es un importante problema de salud pública. Sin embargo, no hay estimaciones en España de su incidencia específica por edad y sexo. Nuestro objetivo fue estimar la incidencia de HTA en una cohorte de universitarios. Se incluyó a 5.648 individuos de 25-65 años de edad inicialmente libres de HTA, diabetes y enfermedad cardiovascular, a los que se siguió durante 30 meses. Se determinaron los nuevos diagnósticos de HTA mediante cuestionarios. Se validaron los diagnósticos autorreferidos de HTA. De 18.250 personas-año de seguimiento identificamos 248 nuevos casos de HTA. La incidencia bruta en mujeres (edad media, 33 años) y varones (edad media, 38 años) fue, respectivamente, 8,2 (intervalo de confianza [IC] del 95%, 6,7-10,1) y 21,8 (IC del 95%, 18,6-25,4) por 1.000 personas-año. La probabilidad acumulada de recibir un diagnóstico médico de HTA a los 65 años fue del 50% en mujeres y del 70% en varones

Hypertension is a major public health problem. However, no estimates of age- and sex-specific incidences are available for the Spanish population. Our objective was to estimate the incidence of hypertension in a cohort of university graduates in Spain. We followed up 5648 individuals aged 25-65 years who were initially free of hypertension, diabetes, and cardiovascular disease for a median of 30 months. New diagnoses of hypertension were identified using mailed questionnaires. We verified all self-reported diagnoses of hypertension. In 18 250 person-years of follow-up, we identified 248 new cases of hypertension. The unadjusted incidences of hypertension in women and men were 8.2 per 1000 person-years (95% CI, 6.7-10.1) and 21.8 per 1000 person-years (95% CI, 18.6-25.4), respectively. The cumulative probability of receiving a medical diagnosis of hypertension by the age of 65 years was 50% among women and 72% among men. In conclusion, we have provided new evidence confirming that hypertension is one of the most important public health problems in Spain

Diagnostic performance of urinary resveratrol metabolites as a biomarker of moderate wine consumption.

BACKGROUND: Nutritional biomarkers may be better measures of dietary exposure than self-reported dietary data. We evaluated resveratrol metabolites, potential biomarkers of wine consumption, in humans after moderate consumption of sparkling, white, or red wines. METHODS: We performed 2 randomized, crossover trials and a cohort study. In the first study, 10 healthy men consumed 30 g of ethanol/day as sparkling wine or gin for 28 days. In the second trial, 10 healthy women consumed 20 g of ethanol/day as white or red wine for 28 days. We also evaluated 52 participants in a study on the effects of a Mediterranean diet on primary prevention of cardiovascular disease (the PREDIMED Study). We used liquid chromatography-tandem mass spectrometry to analyze urinary total resveratrol metabolites (TRMs) and predictive values and ROC curve analyses to assess the diagnostic accuracy. RESULTS: We observed significant increases in TRMs [72.4 (95% confidence interval, 48.5-96.2; P = 0.005), 211.5 (166.6-256.3; P = 0.005), and 560.5 nmol/g creatinine (244.9-876.1; P = 0.005)] after consumption of sparkling, white, or red wine, respectively, but no changes after the washout or gin periods. In the cohort study, the reported daily dose of wine consumption correlated directly with TRMs (r = 0.654; P < 0.001). Using a cutoff of 90 nmol/g, we were able to use TRMs to differentiate wine consumers from abstainers with a sensitivity of 72% (60%-84%); and a specificity of 94% (87%-100%). CONCLUSIONS: Resveratrol metabolites in urine may be useful biomarkers of wine intake in epidemiologic and intervention studies.

A Mediterranean dietary style influences TNF-alpha and VCAM-1 coronary blood levels in unstable angina patients.

BACKGROUND: A Mediterranean dietary pattern has been associated with a reduced risk of coronary heart disease, as well as a reduction of oxidative stress, but studies indicating possible interactions between food intake and inflammatory mediators production at specific sites are lacking. AIM OF THE STUDY: To assess the relationship between Mediterranean diet consumption and inflammatory related molecules production in coronary vessels. METHODS: A previously reported Mediterranean-diet score was computed summing-up the quintiles of eight dietary components from a validated food frequency questionnaire in 24 patients with unstable angina. Tumor necrosis factor (TNF-alpha) and vascular cell adhesion molecule (VCAM-1) concentrations were measured in coronary sinus blood. RESULTS: Both biomarkers showed an inverse association with the Mediterraneandiet score. The association between VCAM-1 and the Mediterranean-diet score had an adjusted beta coefficient of -35.1 ng/ml (95% coefficient interval, CI: -63.5 to -6.7). The adjusted beta coefficient using TNF-alpha as the dependent variable was -41.6 pg/ml (95 % CI: -76.2 to -7.1). The consumption of olive oil as a single item showed a significant inverse association, and a Mediterranean-diet score excluding olive oil was also inversely associated with TNF-alpha and VCAM-1 serum levels in coronary venous blood. CONCLUSIONS: Adherence to a Mediterranean dietary pattern may protect against coronary artery wall production of inflammatory mediators. This finding could provide a novel mechanistic explanation for the recognized lower coronary risk associated with a Mediterranean diet.

[Fish omega-3 fatty acids and risk of coronary heart disease]. / Acidos grasos omega-3 de pescado y riesgo de enfermedad coronaria.

A great amount of evidence from epidemiological studies and clinical trials supports a protective effect against coronary heart disease for fish consumption and intake of marine omega-3 fatty acids. Biological pathways for this risk reduction include membrane stabilization in the cardiac myocite, inhibition of platelet aggregation, favourable modifications of the lipid profile, decrease in blood pressure and reduction of the inflammatory response of the endothelium. Results from epidemiological studies suggest a threshold effect for the consumption of fish and omega-3 fatty acids. Risk reduction is especially important for cardiac sudden death. Nevertheless, protection against non-fatal coronary heart disease has also been observed. Recently published studies have shown that mercury intake, present in high concentrations in fish, could counteract the beneficial effect from fish consumption.

Ácidos grasos omega-3 de pescado y riesgode enfermedad coronaria / Fish omega-3 fatty acids and risk of coronary heart disease

Existen numerosas evidencias procedentes de estudios epidemiológicos y ensayos clínicos a favor del efecto cardioprotector del consumo de pescado y de los ácidos grasos omega-3. Los mecanismos biológicos por los que se podría producir esta reducción de riesgo coronario son: la estabilización de la membrana del miocito cardíaco, la disminución de la agregación plaquetaria, mejora del perfil lipídico, disminución de la presión arterial y reducción de los mecanismos inflamatorios a endoteliales. Los resultados epidemiológicos sugieren que hay un valor umbral en el consumo de pescado o ácidos grasos omega-3 a partir del cual se produce la reducción de riesgo. La protección cardiovascular es especialmente importante para la muerte súbita, aunque también se ha observado que estos nutrientes otorgan protección frente a la enfermedad coronaria no letal. Estudios recientemente publicados han llevado a pensar que el consumo de mercurio, presente en altas concentraciones en algunos tipos de pescado, podría contrarrestar su efecto beneficioso (AU)