DIET, OXIDATIVE STRESS STATUS AND INFLAMMATION IN PATIENTS WITH CARDIOVASCULAR DISEASE: IN SEARCH FOR A LINK

BACKGROUND. Previous studies have provided a rationale for understanding the health benefits of Mediterranean Diet (MD) against a variety of chronic diseases. OBJECTIVES AND EVIDENCE ANALYZED. We have used new data from the IMPROVE Study -a multicenter, longitudinal, observational study, carried out in five European countries- and fresh information from the RISMED, a study carried out in our Institution in subjects with a recent history of coronary revascularization to address: 1) the relationship between MD adherence and carotid intima-media thickness (c-IMT) progression; 2) whether such relationship is similar in populations with different nutritional patterns, and 3) whether the relationship between MD, baseline carotid IMT, and clinical events involves changes in inflammation, oxidative stress, and fatty acid [FA] composition. FINDINGS. In the analysis of the IMPROVE Study we have found: 1) a significant negative trend between most of the c-IMT-progression variables and a new relatively simple food frequency questionnaire to evaluate a Mediterranean-like dietary pattern (MLPD) score, validated a priori vs VEs in different European Countries; 2) that the significant association between MLDP adherence and VEs is independent of baseline c-IMT and c-IMT progression, and 3) that MLDP score adherence is associated to changes both in inflammatory markers and white blood cells counts. Information from the RISMED Study documented that: 1) MD adherence significantly affects indices of inflammation and oxidative stress balance; 2) blood FA profile is an index of the quality of food intake which might be used to estimate diet quality and compliance with nutritional advices; 3) it is possible to favorably modify patients’ plasma FA profiles by consuming a MD, and 4) a relationship exists between inflammatory markers/oxidative stress status and modifications of the blood FA pattern. CONCLUSIONS AND RELEVANCE. MD adherence is key to reduce oxidative stress, inflammation and VEs in subjects at risk of cardiovascular events. Since common approaches that simultaneously target old and new risk factors for cardiovascular disease enhance cardio-protection and longevity, the need for evaluating MD as a strategy for a better health at older ages should be explored thoroughly.