Atherosclerosis is the formal term for “hardening of the arteries.” Who cares how hard they are, as long as the arteries deliver blood to our organs, right?
Atherosclerosis in the arteries that supply blood to the heart – essentially a hollow muscle that pumps blood – is called coronary heart disease disease (CHD) or coronary artery disease (CAD).
LDL cholesterol is the “bad cholesterol” that is associated with atherosclerosis. Generally, the higher the LDL, the worse the atherosclerotic complications: plaque build-up leads to poor circulation to vital organs, arterial blood clots, even death of tissue due to blocked arteries. Oxidation of LDL cholesterol facilitates atherosclerosis.
People at high risk for coronary heart disease include type 2 diabetics, smokers, people with high blood pressure or cholesterol abnormalities, and people with a family history of coronary heart disease. Advanced age is another strong risk factor.
The ongoing PREDIMED Study is designed to test the the effects of the traditional Mediterranean diet in primary prevention of coronary heart disease in a high risk population. 9000 study participants will be assigned to one of three diets: 1) low-fat, 2) Mediterranean plus extra olive oil, or 3) Mediterranean plus extra nuts. The Mediterranean diet is moderate in percentage of calories derived from fat, and the main source of fat is olive oil. Virgin olive oil has a particularly high content of antioxidant phenolic compounds. Nuts are also a rich source of antioxidant phytochemicals. These antioxidants can prevent the harmful transmogrification of plain LDL into oxidized LDL.
A group of 372 early study enrollees were randomly assigned to one of the three diet groups. In both of the Mediterranean diet groups, researchers found reduced oxidized LDL, reduced blood pressures, lower total cholesterol, and lower total-HDL cholesterol ratios, more than in the low-fat diet group.
These observed changes would tend to reduce the incidence and severity of atherosclerotic complications. When PREDIMED is completed, we’ll know whether the traditional Mediterranean diet, compared with a low-fat diet, is better at preventing death and disease from coronary heart disease. That’s where the rubber meets the road.
Steve Parker, M.D.
References:
Montserrat, Fito, et al. Effect of a Traditional Mediterranean Diet on Lipoprotein Oxidation: A Randomized Controlled Trial. Archives of Internal Medicine, 167 (2007): 1,195-1,203.
Prevencion con Dieta Mediterranea Study (PREDIMED) http://www.predimed.org
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