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Lipids and cardiovascular/metabolic health

Effects of a diet naturally rich in polyphenols on lipid composition of postprandial lipoproteins in high cardiometabolic risk individuals: an ancillary analysis of a randomized controlled trial



Plasma lipoprotein composition, especially in the postprandial state, could be relevant for cardiovascular risk and could be influenced by eating habits. This study evaluated the effects of a polyphenol-rich diet on postprandial lipoprotein composition in individuals at high cardiometabolic risk.


Seventy-eight individuals with high waist circumference and at least another component of the metabolic syndrome were randomized to either a high-polyphenol (HighP) or low-polyphenol (LowP) diet. Before and after the 8-week intervention, chylomicrons, VLDL1, VLDL2, IDL, LDL, HDL particles, and their lipid concentrations were determined over a 6-h high-fat test meal with high or low-polyphenol content, according to the diet assigned.


VLDL1 postprandial areas under the curve (AUCs) were lower for cholesterol (Chol) (1.48 ± 0.98 vs. 1.91 ± 1.13 mmol/L × 6 h, M ± SD, p = 0.014) and triglycerides (Tg) (4.70 ± 2.70 vs. 6.02 ± 3.07 mmol/L × 6 h, p = 0.005) after the HighP than after the LowP diet, with no changes in Chol/Tg ratio. IDL Chol AUCs were higher after the HighP than after the LowP diet (1.29 ± 0.77 vs. 1.01 ± 0.51 mmol/L × 6 h, p = 0.037). LDL Tg AUCs were higher after the HighP than after the LowP diet (1.15 ± 0.33 vs. 1.02 ± 0.35 mmol/L × 6 h, p < 0.001), with a lower Chol/Tg ratio (14.6 ± 4.0 vs. 16.0 ± 3.8, p = 0.007). HDL Tg AUCs were lower after the HighP than after the LowP diet (1.20 ± 0.41 vs. 1.34 ± 0.37 mmol/L × 6 h, p = 0.013).


A high-polyphenol diet reduces the postprandial lipid content of large VLDL and increases IDL cholesterol; it modifies the composition of LDL particles—which become richer in triglycerides, and of HDL—which become instead triglyceride poor. The overall changes in atherogenicity by these effects warrant further investigation on clinical cardiovascular outcomes.

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Parts of this study were presented at the 86th E-Poster session of the EAS Congress, Lisbon, Portugal, 05–08 May 2018.


The research leading to these results received funding from the European Community’s Seventh Framework Programme FP7/2009-2012 under grant agreement FP7-KBBE-222639, Etherpaths Project, and the ‘Ministero Istruzione Università e Ricerca’ PRIN 2010-2011-2010JCWWKM.

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LB, GA, GR, and AAR designed the experiment; LB, GDP, and CV collected and analyzed the data; GDP and CV interpreted the data and wrote the paper. GDP, CV, GC, MV, AM, PC, and LP collected the data. GA, GR, and AAR critically revised the paper and contributed to the conclusions. AAR is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors read and approved the final paper.

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Correspondence to Angela Albarosa Rivellese.

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Trial registered at as NCT01154478.

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Della Pepa, G., Vetrani, C., Vitale, M. et al. Effects of a diet naturally rich in polyphenols on lipid composition of postprandial lipoproteins in high cardiometabolic risk individuals: an ancillary analysis of a randomized controlled trial. Eur J Clin Nutr 74, 183–192 (2020).

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