Original Article

European Journal of Clinical Nutrition (2008) 62, 651–659; doi:10.1038/sj.ejcn.1602762; published online 18 April 2007

Components of the mediterranean-type food pattern and serum inflammatory markers among patients at high risk for cardiovascular disease

Guarantor: J Salas-Salvadó.
Contributors: JS-S, MAM-G and RE had primary responsibility for the data analysis and manuscript preparation. RE is the overall coordinator of the PREDIMED study. AGA and MAM-G were responsible for the statistical analysis. JS-S, RE, DC, MF, EG-G, EV, FA, CH, CL, JL and MAM-G were the principal investigators of the centres participating in the data collection. All the coauthors participated in the design and execution of the study and contributed to the critical revision of the manuscript for important intellectual content.

J Salas-Salvadó1, A Garcia-Arellano2, R Estruch3, F Marquez-Sandoval1, D Corella4, M Fiol5, E Gómez-Gracia6, E Viñoles7, F Arós8, C Herrera9, C Lahoz10, J Lapetra11, J S Perona12, D Muñoz-Aguado13, M A Martínez-González2 and E Ros14 for the PREDIMED Investigators15

  1. 1Human Nutrition Unit, Faculty of Medicine, University Rovira i Virgili, Reus, Spain
  2. 2Department of Preventive Medicine and Public Health, Clínica Universitaria de Navarra, University of Navarra, Navarra, Spain
  3. 3Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Barcelona, Spain
  4. 4Department of Preventive Medicine and Public Health, School of Medicine, Instituto de Salud Carlos III, University of Valencia, Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Valencia, Spain
  5. 5University Institute for Health Sciences Investigation, Hospital Son Dureta, Instituto de Salud Carlos III, Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Palma de Mallorca, Spain
  6. 6Department of Epidemiology, School of Medicine, University of Malaga, Malaga, Spain
  7. 7Primary Health Care Division, Barcelona, Barcelona, Spain
  8. 8Department of Cardiology, Hospital Txagorritxu, Vitoria, Spain
  9. 9Department of Epidemiology and Public Health, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
  10. 10Arteriosclerosis Unit, Hospital Carlos III, Madrid, Spain
  11. 11San Pablo Health Center, Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Sevilla, Spain
  12. 12Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Sevilla, Spain
  13. 13Cardiovascular Epidemiology Unit, Municipal Institut for Medical Research (IMIM), Barcelona, Spain
  14. 14Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Barcelona, Spain

Correspondence: Dr J Salas-Salvado, Human Nutrition Unit, Faculty of Medicine, University Rovira i Virgili, 43201 Reus, Spain. E-mail: jordi.salas@urv.cat

15Other members of the PREDIMED Study Group are listed in the Appendix

Received 3 July 2006; Revised 8 March 2007; Accepted 13 March 2007; Published online 18 April 2007.

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Abstract

Objective:

 

To evaluate associations between components of the Mediterranean diet and circulating markers of inflammation in a large cohort of asymptomatic subjects at high risk for cardiovascular disease.

Subjects/Methods:

 

A total of 339 men and 433 women aged between 55 and 80 years at high cardiovascular risk because of presence of diabetes or at least three classical cardiovascular risk factors, food consumption was determined by a semi-quantitative food frequency questionnaire. Serum concentrations of high-sensitivity C-reactive protein (CRP) were measured by immunonephelometry and those of interleukin-6 (IL-6), intracellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) by enzyme-linked immunosorbent assay.

Results:

 

After adjusting for age, gender, body mass index, diabetes, smoking, use of statins, non-steroidal antiinflammatory drugs and aspirin, a higher consumption of fruits and cereals was associated with lower concentrations of IL-6 (P for trend 0.005;both). Subjects with the highest consumption of nuts and virgin olive oil showed the lowest concentrations of VCAM-1, ICAM-1, IL-6 and CRP; albeit only for ICAM-1 was this difference statistically significant in the case of nuts (for trend 0.003) and for VCAM-1 in the case of virgin olive oil (P for trend 0.02). Participants with higher adherence to the Mediterranean-type diet did not show significantly lower concentrations of inflammatory markers (P<0.1 for VCAM-1 and ICAM-1).

Conclusions:

 

The consumption of some typical Mediterranean foods (fruits, cereals, virgin olive oil and nuts) was associated with lower serum concentrations of inflammatory markers especially those related to endothelial function, in subjects with high cardiovascular risk living in a Mediterranean country.

Keywords:

mediterranean diet, virgin olive oil, nuts, fruit, inflammation, PREDIMED study

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