The CORDIOPREV Study

Atherosclerosis. 2017 Dec 8;269:50-56. doi: 10.1016/j.atherosclerosis.2017.12.012.

Mediterranean diet improves endothelial function in patients with diabetes and

prediabetes: A report from the CORDIOPREV study.

Torres-Peña JD1, Garcia-Rios A1, Delgado-Casado N1, Gomez-Luna P1, Alcala-Diaz JF1, Yubero-Serrano EM1, Gomez-Delgado F1, Leon-Acuña A1, Lopez-Moreno J1, Camargo A1, Tinahones FJ2, Delgado-Lista J1, Ordovas JM3, Perez-Martinez P4, Lopez-Miranda J1.

Author information

1
Lipid and Atherosclerosis Unit, Department of Internal Medicine / IMIBIC/Reina Sofia University Hospital/University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
2
CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain; Biomedical Research Institute of Malaga (IBIMA), Virgen de la Victoria Hospital, University of Malaga, Malaga, Spain.
3
Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University School of Medicine, Boston, MA, USA; Madrid Institute of Advanced Studies-Food, Madrid, Spain; National Centre of Cardiovascular Research (CNIC), Madrid, Spain.
4
Lipid and Atherosclerosis Unit, Department of Internal Medicine / IMIBIC/Reina Sofia University Hospital/University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain. Electronic address: pablopermar@yahoo.es.

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:

CORDIOPREV study; Diabetes; Endothelial function; Mediterranean diet; Prediabetes; Secondary prevention

 

 

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