The 3-Year Effect of the Mediterranean Diet Intervention on Inflammatory Biomarkers Related to Cardiovascular Disease

Abstract

The intervention with the Mediterranean diet (MD) pattern has evidenced short-term anti-inflammatory effects, but little is known about its long-term anti-inflammatory properties at molecular level. This study aims to investigate the 3-year effect of MD interventions compared to low-fat diet (LFD) on changes on inflammatory biomarkers related to atherosclerosis in a free-living population with a high-risk of cardiovascular disease (CD). Participants (n = 285) in the PREDIMED trial were randomly assigned into three intervention groups: MD with extra-virgin olive oil (EVOO) or MD-Nuts, and a LFD. Fourteen plasma inflammatory biomarkers were determined by Luminex assays. An additional pilot study of gene expression (GE) was determined by RT-PCR in 35 participants. After 3 years, both MDs showed a significant reduction in the plasma levels of IL-1β, IL-6, IL-8, TNF-α, IFN-γ, hs-CRP, MCP-1, MIP-1β, RANTES, and ENA78 (p < 0.05; all). The decreased levels of IL-1β, IL-6, IL-8, and TNF-α after MD significantly differed from those in the LFD (p < 0.05). No significant changes were observed at the gene level after MD interventions, however, the GE of CXCR2 and CXCR3 tended to increase in the control LFD group (p = 0.09). This study supports the implementation of MD as a healthy long-term dietary pattern in the prevention of CD in populations at high cardiovascular risk.

Higher Adherence to a Mediterranean Diet Is Associated with Improved Insulin Sensitivity and Selected Markers of Inflammation in Individuals Who Are Overweight and Obese without Diabetes

“…The ATTICA study reported that greater adherence to the MedDiet was independently associated with lower markers of inflammation and coagulation including CRP and IL-6 [ 45 ]. The PREDIMED sub-study conducted in Spain, using data collected from 285 participants at risk of coronary heart disease, reported a reduction in plasma levels of IL-1β, consistent with our study [ 46 ]. This improvement in inflammation can be explained by the high polyphenol content, a key component of the MedDiet, which is known to inhibit proinflammatory markers such as IL-1β and NF-κB activation [ 47 ].…”

Walnut inclusion in a palm oil-based atherogenic diet promotes traits predicting stable atheroma plaque in Apoe-deficient mice

“…Similar results were observed for oral-administered colchicine ( 30 ), a drug that affects NLRP3 inflammasome activation. When it comes to nuts, a significant reduction of circulating IL-1β has been reported after the dietary supplementation with mixed nuts (compared to the advised low-fat diet) ( 31 ) or walnuts (compared to walnut-free diet) ( 32 ). The main novelty of our approach (unethical in humans) is that dietary inclusion of walnuts within an unhealthy diet promoting NLRP3 inflammasome activation ( 33 ) tackles such activation, hence attenuating the production of pro-inflammatory mediators.…”

Interconnections between Inflammageing and Immunosenescence during Ageing

“…Most notably, the Mediterranean diet, rich in plant-based foods and olive oil, has been shown to have both short-term and long-term anti-inflammatory effects. For example, a sustained reduction in plasma levels of inflammatory mediators IL-1β, IL-6, IL-8, and TNF-α has been described over a period of 3 years in a free-living population with a high-risk of cardiovascular disease [402]. This reduction in inflammation seen in subjects adhering to the Mediterranean diet may occur through the lowering of oxidative stress [403].…”