Effects of Supplemented Mediterranean Diets on Plasma-Phospholipid Fatty Acid Profiles and Risk of Cardiovascular Disease after 1 Year of Intervention in the PREDIMED Trial

Cristina Razquin; Miguel Ruiz-Canela; Andreas Wernitz; Estefania Toledo; Dolores Corella; Ángel Alonso-Gómez; Montse Fitó; Enrique Gómez-Gracia; Ramón Estruch; Miquel Fiol; José Lapetra; Lluis Serra-Majem; Emilio Ros; Fernando Arós; Jordi Salas-Salvadó; Matthias B Schulze; Miguel A Martinez-Gonzalez

doi:10.1093/clinchem/hvac221

Effects of Supplemented Mediterranean Diets on Plasma-Phospholipid Fatty Acid Profiles and Risk of Cardiovascular Disease after 1 Year of Intervention in the PREDIMED Trial

Clin Chem. 2023 Mar 1;69(3):283-294. doi: 10.1093/clinchem/hvac221.

Authors

Cristina Razquin^{1

2}, Miguel Ruiz-Canela^{1

2}, Andreas Wernitz³, Estefania Toledo^{1

2}, Dolores Corella^{2

4}, Ángel Alonso-Gómez^{2

5}, Montse Fitó^{2

6}, Enrique Gómez-Gracia^{2

7}, Ramón Estruch^{2

8}, Miquel Fiol^{2

9}, José Lapetra^{2

10}, Lluis Serra-Majem^{2

11}, Emilio Ros^{2

12}, Fernando Arós^{2

5}, Jordi Salas-Salvadó^{13

2

14}, Matthias B Schulze^{3

15

16}, Miguel A Martinez-Gonzalez^{1

2

17}

Affiliations

¹ Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain.
² Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
³ Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
⁴ Department of Preventive Medicine, Universidad de Valencia, Valencia, Spain.
⁵ Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain.
⁶ Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
⁷ Department of Endocrinology, Virgen de la Victoria Hospital, Biomedical Research Institute of Málaga, University of Málaga, Málaga, Spain.
⁸ Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques Augist Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
⁹ Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, Palma de Mallorca, Spain.
¹⁰ Department of Family Medicine-Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain.
¹¹ Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain.
¹² Lipid Clinic, Department of Endocrinology and Nutrition, Agust Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain.
¹³ Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.
¹⁴ Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain.
¹⁵ Unit of Cardiovascular Risk and Nutrition, German Center for Diabetes Research (DZD), Neuherberg, Germany.
¹⁶ Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
¹⁷ Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA.

PMID: 36683466
DOI: 10.1093/clinchem/hvac221

Abstract

Background: Plasma fatty acids (FAs) have been associated with cardiovascular disease (CVD) risk. Diet and endogenous metabolism influence the FA profile of the plasma phospholipid (PL) fraction. In the PREDIMED trial, we examined 1-year changes in the FA profile of plasma PL according to a nutritional intervention with Mediterranean diets, either supplemented with extra-virgin olive oil (MedDiet + EVOO) or mixed nuts (MedDiet + nuts), in a high cardiovascular risk population. We also analyzed if 1-year changes in PL FAs were associated with subsequent cardiovascular risk.

Methods: We included 779 participants in our case-cohort study: 185 incident cases and 594 participants in the subcohort (including 31 overlapping cases). The end point was the incidence of CVD. We measured the FAs of plasma PL at baseline and after 1 year of intervention.

Results: MedDiet + EVOO increased C17:0 and C20:3n9 in linear regression models [β coefficientperSD : 0.215 (95% CI, 0.032-0.399) and 0.271 (0.107-0.434), respectively] and decreased 16:1n7 and C22:4n6 [βperSD: -0.239 (95% CI, -0.416 to -0.061) and -0.287 (95% CI, -0.460 to -0.113), respectively] vs the control group. MedDiet + nuts increased C18:3n3 [βperSD: 0.382 (95% CI, 0.225 - 0.539)], C18:2n6 [βper SD: 0.250 (95% CI, 0.073 - 0.428)], C18:0 [βperSD: 0.268 (95% CI, 0.085-0.452)], and C22:0 [βper SD: 0.216 (95% CI, 0.031-0.402)]; and decreased the sum of six n6 FAs [βper SD: -0.147 (95% CI, -0.268 to -0.027)] vs the control group. The 1-year increase in C18:2n6 was inversely associated with the subsequent CVD risk (HRperSD: 0.64 (95% CI, 0.44-0.92)).

Conclusions: MedDiet interventions changed n6 FAs and C16:1n7c; other changes were specific for each group: MedDiet + EVOO increased C17:0 and C20:3n9, and MedDiet + Nuts C18:3n3, C18:2n6, C18:0, and C22:0 FAs.

Keywords: Mediterranean diet; PREDIMED; cardiovascular risk; fatty acids; phospholipid fraction.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Cardiovascular Diseases*
Cohort Studies
Diet, Mediterranean*
Fatty Acids
Humans
Phospholipids
Risk Factors

Substances

Fatty Acids
Phospholipids