Background and aims: The use of the "Mediterranean diet" as a means of preventing atherosclerotic vascular disease is gaining increasing acceptance. As early as in the late 1950s, it was found that the inhabitants of Greece and Southern Italy had a very low incidence of coronary artery disease and that, among other components, their diets were very rich in oleic acid, the main constituent of the olive oil, making up about 29% of their daily caloric intake. It is now clear that, in addition to its relatively minor effects on cholesterol levels, oleic acid directly interferes with the inflammatory response characterising early atherogenesis due to the endothelial expression of adhesion molecules for circulating monocytes.
Results: In in vitro models of early atherogenesis based on cytokine-stimulated cultured endothelial cells, we have observed that the incorporation of oleic acid in total cell lipids is accompanied by decreased expression of a number of major pro-inflammatory proteins, such as endothelial leukocyte adhesion molecules.
Conclusions: The results of our investigations indicate that oleic acid has a direct vascular atheroprotective effect, and suggest that it may be possible to prevent atherosclerosis by modulating the vascular response to classical triggers (high levels of cholesterol and the advanced glycation end-products of diabetes) using a strategy that is fundamentally different from, and therefore complementary to, drug-based therapy.