Mediterranean Diet and atherothrombosis biomarkers: a randomized controlled trial

ABSTRACT Scope To assess whether following a Mediterranean diet (MedDiet) improves atherothrombosis biomarkers in high cardiovascular risk individuals. Methods and results In 358 random volunteers from the PREDIMED trial ( Prevención con Dieta Mediterránea ), we assessed the 1-year effects on atherothrombosis markers of an intervention with MedDiet, enriched with virgin olive oil (MedDiet-VOO; N =120) or nuts (MedDiet-Nuts; N =119) versus a low-fat control diet ( N =119). In a secondary, observational approach, we studied whether volunteers with large increments in MedDiet adherence (>2 score points) were associated with 1-year improvements in biomarkers (relative to those worsening their adherence). The MedDiet-VOO intervention increased platelet activating factor-acetylhydrolase activity in high-density lipoproteins (HDLs) by 7.5% [95% confidence interval: 0.17; 14.8] and decreased HDL-bound α 1 -antitrypsin levels by 6.1% [−11.8; −0.29]. The MedDiet-Nuts one reduced non-esterified fatty acid concentrations by 9.3% [−18.1; −0.53]. Only the low-fat diet was associated with increases in platelet factor-4 and prothrombin factor 1+2 levels versus baseline ( P =0.012 and P =0.003, respectively, according to Wilcoxon signed-rank tests). Finally, large MedDiet increments were associated with less fibrinogen (−9.5% [−18.3; −0.60]) and non-esterified fatty acid concentrations (−16.7% [−31.7; −1.74]). Conclusion Following a MedDiet improves atherothrombosis biomarkers in high cardiovascular risk individuals.