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Mediterranean and Low-Fat Diets Improve Endothelial Function in Hypercholesterolemic Men

Francisco Fuentes, MD, PhD; José López-Miranda, MD, PhD; Elias Sánchez, MD, PhD; Francisco Sánchez, MD, PhD; José Paez, MD; Elier Paz-Rojas, BSc; Carmen Marín, PhD; Purificación Gómez, BSc; José Jimenez-Perepérez, MD, PhD; José M. Ordovás, MD, PhD; and Francisco Pérez-Jiménez, MD, PhD

19 June 2001 | Volume 134 Issue 12 | Pages 1115-1119

Background: The regulatory function of the endothelium is altered in hypercholesterolemia, and the subsequent endothelial dysfunction plays a central role in the development of atherosclerosis.

Objective: To determine whether endothelial function in hypercholesterolemic patients is affected by replacing a saturated fat–enriched diet with a low-fat, low–saturated fat diet (the U.S. National Cholesterol Education Program stage 1 [NCEP-1] diet) or a diet rich in monounsaturated fat (such as that common in Mediterranean countries).

Design: Intervention dietary study with a baseline phase and two randomized crossover dietary periods.

Setting: Hospital Universitario Reina Sofía, Córdoba, Spain.

Patients: 22 hypercholesterolemic men.

Intervention: Patients followed a diet high in saturated fat, then were assigned in a crossover design to the NCEP-1 diet or a Mediterranean diet. Each dietary period lasted 28 days.

Measurements: Plasma P-selectin levels, lipid concentrations, and endothelial function.

Results: Compared with the saturated fat diet, flow-mediated dilatation increased during the Mediterranean diet but not during the NCEP-1 diet. In addition, levels of plasma cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, and P-selectin decreased during the NCEP-1 and Mediterranean diets.

Conclusion: In hypercholesterolemic men, diets low in fat (especially saturated fat) and diets rich in monounsaturated fats improve endothelial function.

Author and Article Information

From Hospital Universitario Reina Sofía, Córdoba, Spain, and Jean Mayer–U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts.

Acknowledgments: The authors thank Beatriz Pérez for help in preparing the manuscript.

Grant Support: By research grants from the Comisión Interministerial de Ciencia y Tecnologia (OLI 96/2146) (Dr. Pérez-Jiménez), the Spanish Ministry of Health (FIS 96/1540, 98/1531 [Dr. López-Miranda], FIS 99/0949 [Dr. Pérez-Jiménez]), Fundación Cultural "Hospital Reina Sofía-Cajasur" (Dr. Marin and Ms. Gómez), Agencia Española de Cooperación Internacional (Mr. Paz-Rojas), Consejería de Salud, Servicio Andaluz de Salud (PAI 97/58, 98/126, 99/116), Consejería de Agricultura y Pesca de la Junta de Andalucía, Patrimonio Comunal Olivarero (Dr. Pérez-Jiménez), and the National Institutes of Health (HL 54776) (Dr. Ordovás).

Requests for Reprints: Francisco Pérez-Jiménez, MD, PhD, Unidad de Lípidos y Arteriosclerosis, Hospital Universitario Reina Sofía, Avda Menéndez Pidal, s/n 14004 Córdoba, Spain; e-mail, fperez{at}sofia.hrs.sas.cica.es.

Current Author Addresses: Drs. Fuentes, López-Miranda, Sánchez, Marín, Jimenez-Perepérez, and Pérez-Jiménez, Mr. Paz-Rojas, and Ms. Gómez: Unidad de Lípidos y Arteriosclerosis, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal, s/n 14004 Córdoba, Spain.

Drs. Sánchez and Paez: Servicio de Radiodiagnóstico, Hospital Universitario Reina Sofía, Avenida Menendez Pedal, s/n 14004 Córdoba, Spain.

Dr. Ordovás: Lipid Metabolism Laboratory, Jean Mayer–U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111.

Author Contributions: Conception and design: F. Fuentes, J. López-Miranda, J.M. Ordovás, F. Pérez-Jiménez.

Analysis and interpretation of the data: F. Fuentes, J. López-Miranda, E. Sánchez, E. Paz-Rojas, C. Marin, P. Gómez, J.M. Ordovás, F. Pérez-Jiménez.

Drafting of the article: F. Fuentes, J. López-Miranda, J. Jimenez-Perepérez, J.M. Ordovás, F. Pérez-Jiménez.

Critical revision of the article for important intellectual content: J. López-Miranda, J. Jimenez-Perepérez, J.M. Ordovás, F. Pérez-Jiménez.

Final approval of the article: J. López-Miranda, E. Paz-Rojas, C. Marin, P. Gómez, J.M. Ordovás, F. Pérez-Jiménez.

Provision of study materials or patients: F. Fuentes, J. López-Miranda, E. Sánchez, F. Sánchez, J. Paez.

Statistical expertise: J. López-Miranda, E. Paz-Rojas, P. Gómez.

Obtaining of funding: J. López-Miranda, F. Pérez-Jiménez.

Administrative, technical, or logistic support: F. Sánchez, J. Paez, E. Paz-Rojas, C. Marin, P. Gómez.

Collection and assembly of data: F. Fuentes, E. Sánchez, F. Sánchez, J. Paez, E. Paz-Rojas, C. Marin, P. Gómez.

Related articles in Annals:

Summaries for Patients
Two Types of Diets Improve Blood Vessel Function in Men with High Cholesterol

Annals 2001 134: S15. [Full Text]  

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