Mediterranean diet supplemented with nuts reduces waist circumference and shifts lipoprotein subfractions to a less atherogenic pattern in subjects at high cardiovascular risk.

OBJECTIVE: The PREDIMED trial showed that Mediterranean diets supplemented with either extra-virgin olive oil or nuts reduced incident cardiovascular events compared to a control diet. Consumption of both supplemental foods has been associated with reduced LDL-cholesterol, but it is unknown whether they can shift lipoprotein subfractions to a less atherogenic pattern. We investigated changes in adiposity and lipoprotein subfractions after consumption of the PREDIMED diets. METHODS: In a PREDIMED sub-cohort (n = 169), lipoprotein subclasses (particle concentrations and size) were determined by nuclear magnetic resonance spectroscopy at baseline and after intervention for 1 year. RESULTS: Participants allocated to the Mediterranean diet supplemented with nuts showed significant reductions from baseline of waist circumference (mean [95% CI]; -5 cm [-7; -3]) and concentrations of medium-small (-27 nmol/l [-46; -8]) and very small LDL (-111 nmol/l [-180; -42]); decreased LDL particle number (a nuclear magnetic resonance-specific measurement) (-98 nmol/l [-184; -11]); and an increase of large LDL concentrations (54 nmol/l [18; 90]), with a net increase (0.2 nmol/l [0.1; 0.4]) of LDL size. The Mediterranean diets with olive oil and nuts increased large HDL concentrations (0.6 µM [0.0; 1.1] and 1.0 µM [0.4; 1.5], respectively). Compared to the other two intervention groups, participants in the nut-enriched diet showed significantly reduced waist circumference (p ≤ 0.006, both) and increased LDL size (p < 0.05, both). CONCLUSION: Lipoprotein subfractions are shifted to a less atherogenic pattern by consumption of Mediterranean diets enriched with nuts. The results contribute mechanistic evidence for the reduction of cardiovascular events observed in the PREDIMED trial.

LDL pequeña y densa en adultos y su relación con factores de riesgo cardiovascular tradicionales

Objetivos: Establecer la presencia de lipoproteína de baja densidad pequeña y densa (LDLpd) en suero y su relación con factores de riesgo cardiovascular tradicionales en adultos. Métodos: Se estudiaron 78 mujeres y 73 hombres con promedio de edad de 39,9±14,9 años (rango: 20-84 años), los cuales asistieron a un centro de salud del Edo. Carabobo, Venezuela. Se registró hábito tabáquico, presión arterial y medidas antropométricas. Se obtuvo muestra de sangre en ayunas en la que se cuantificó colesterol total y fraccionado y triglicéridos mediante métodos enzimáticos-colorimétricos y se detectó LDLpd a través de electroforesis en gel de poliacrilamida en gradiente. El consumo de alcohol y su patrón de ingesta se registró mediante el Test de Identificación de Desórdenes del Uso del Alcohol (AUDIT). Resultados: Se detectó LDLpd en 45,7% de los individuos, siendo más frecuente en las mujeres que en los hombres (57,7% vs. 32,9%). La presencia de LDLpd se asoció significativamente con el aumento de la edad, índice de masa corporal, circunferencia de cintura, colesterol total, LDL colesterol y triglicéridos así como con la disminución de HDL colesterol. La presencia de LDLpd fue más frecuente entre los fumadores, hipertensos y aquellos individuos que consumieron alcohol en mayor cantidad y frecuencia. La presencia de LDLpd en suero fue predicha significativamente por la edad y los niveles de triglicéridos y HDL colesterol. Conclusiones: En este estudio, la presencia de LDLpd en suero fue frecuente en los individuos estudiados y se encontró relacionada con los factores de riesgo cardiovascular tradicionales evaluados.

Objectives: To establish the presence of small dense Low Density Lipoproteins (sdLDL) in serum and possible relation with traditional cardiovascular risk factors in adult individuals. Methods:We studied 78 women and 73 men with a mean age of 39.9 ± 14.9 years (range: 20-84 years) who attended to a health center of Edo. Carabobo, Venezuela. Measures were recorded smoking habit, blood pressure and anthropometric . After informed consent, patients were clinically evaluated and. Total and fractionated cholesterol and triglycerides were determined in serum by enzymatic-colorimetric methods. The presence of serum sdLDL was detected by polyacrylamide gradient gel electrophoresis. Alcohol consumption and drinking pattern were recorded by Alcohol Use Disorders Identification Test (AUDIT). Results: sdLDL was detected in 45.7% of individuals, being more prevalent in women than in men (57.7% vs. 32.9%). The presence of sdLDL in serum was significantly associated with the increasing age, body mass index, waist circumference, total cholesterol, LDL cholesterol, triglycerides and the decrease of HDL cholesterol. The presence of sdLDL was more common among smokers, hypertensives and those individuals who consumed alcohol in more quantity and frequency. Age, triglyceride and HDL cholesterol significantly predicted the presence of sdLDL. Conclusions: In this study, the presence of serum sdLDL was common in study subjects and related to traditional cardiovascular risk factors.