• Jose D Torres-Peña, Antonio Garcia-Rios, Nieves Delgado-Casado, Purificacion Gomez-Luna, Juan F Alcala-Diaz, Elena M Yubero-Serrano, Francisco Gomez-Delgado, Ana Leon-Acuña, Javier Lopez-Moreno, Antonio Camargo, Francisco J Tinahones, Javier Delgado-Lista, Jose M Ordovas, Pablo Perez-Martinez, and Jose Lopez-Miranda.
• Lipid and Atherosclerosis Unit, Department of Internal Medicine / IMIBIC/Reina Sofia University Hospital/University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
• Atherosclerosis. 2018 Feb 1; 269: 50-56.

Background And AimsEndothelial dysfunction (ED) plays a key role in the development of atherosclerotic cardiovascular disease (ASCVD). Likewise, type 2 diabetes (T2D) is a major CVD risk factor. Therefore, our objective was to explore whether long-term consumption of a Mediterranean diet (MedDiet) rich in olive oil or a low-fat diet (LF diet) was associated with an improvement in ED and whether the potential benefits were similar in patients with or without T2D in the CORDIOPREV clinical trial (NCT00924937).MethodsEndothelial function was measured in 805 participants who had completed follow-up ultrasound image studies, using ultrasonography of brachial artery to calculate flow mediated vasodilatation (FMD) before and after 1.5 years of intervention with a MedDiet [35% of calories from fat (22% monounsaturated) and 50% from carbohydrates] and LF diet [28% fat (12% monounsaturated) and 55% of calories from carbohydrates]. We categorized participants as patients with T2D, prediabetes, and without T2D according to the American Diabetes Association (ADA) criteria.ResultsMedDiet increased FMD in patients with T2D [5.2 ± 0.4 at 1.5 years vs. 3.8 ± 0.4 at baseline; p=0.04] and prediabetes [4.9 ± 0.4 vs. 3.8 ± 0.4; p=0.04] and induced an improvement in FMD compared to LF diet in patients with diabetes [5.2 ± 0.4 (MedDiet) vs.3.7 ± 0.4 (LF diet); p=0.01]; whereas both diets maintained FMD stable in patients without diabetes.ConclusionsHabitual consumption of a MedDiet rich in extra virgin olive oil improves endothelial function in patients with prediabetes and diabetes. This takes great importance given that diet must be the cornerstone of treatment of patients with diabetes at high cardiovascular risk.Copyright © 2017 Elsevier B.V. All rights reserved.

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