La dieta mediterránea mejora la resistencia a la oxidación de las lipoproteínas de baja densidad (LDL)
Mediterranean diet improves low density lipoprotein susceptibility. to oxidative modifications
a Hospital Alto Guadalquivir. Andújar. Jaén.
Purificación Gómez, Pedro Castro, Carmen Marín, Elier Paz, María Dolores Bravo, Julia Blanco, José Jiménez-Perepérez, Francisco Pérez-Jiménez
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fperez@sofia.hrs.sas.cica.es
Correspondencia: Dr. F. Pérez Jiménez. Departamento de Medicina. Facultad de Medicina. Avda. Menéndez Pidal, s/n. 14004 Córdoba.
Correspondencia: Dr. F. Pérez Jiménez. Departamento de Medicina. Facultad de Medicina. Avda. Menéndez Pidal, s/n. 14004 Córdoba.
Unidad de Lípidos y Arteriosclerosis. Hospital Universitario Reina Sofía. Córdoba.
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Andújar. Jaén." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "autoresLista" => "Purificación Gómez, Pedro Castro, Carmen Marín, Elier Paz, María Dolores Bravo, Julia Blanco, José Jiménez-Perepérez, Francisco Pérez-Jiménez" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Purificación" "apellidos" => "Gómez" ] 1 => array:2 [ "nombre" => "Pedro" "apellidos" => "Castro" ] 2 => array:2 [ "nombre" => "Carmen" "apellidos" => "Marín" ] 3 => array:2 [ "nombre" => "Elier" "apellidos" => "Paz" ] 4 => array:2 [ "nombre" => "María" "apellidos" => "Dolores Bravo" ] 5 => array:2 [ "nombre" => "Julia" "apellidos" => "Blanco" ] 6 => array:2 [ "nombre" => "José" "apellidos" => "Jiménez-Perepérez" ] 7 => array:4 [ "nombre" => "Francisco" "apellidos" => "Pérez-Jiménez" "email" => array:1 [ 0 => "fperez@sofia.hrs.sas.cica.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Lípidos y Arteriosclerosis. Hospital Universitario Reina Sofía. Córdoba." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. F. Pérez Jiménez. Departamento de Medicina. Facultad de Medicina. Avda. Menéndez Pidal, s/n. 14004 Córdoba." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Mediterranean diet improves low density lipoprotein susceptibility. to oxidative modifications" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-10-05" "fechaAceptado" => "2000-03-23" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec223085" "palabras" => array:7 [ 0 => "Oxidación" 1 => "Lipoproteínas de baja densidad (LDL)" 2 => "Lipoproteínas de alta densidad (HDL)" 3 => "Acidos grasos monoinsaturados" 4 => "Dietas pobres engrasa" 5 => "Dieta mediterránea" 6 => "Acidos grasos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Numerosos paneles de expertos, en especial de países anglosajones, recomiendan la dieta pobre en grasa para la prevención de enfermedades cardiovasculares. Sin embargo, la tasa de muerte por cardiopatia isquémica es baja en los países del área mediterránea, lo que puede ser debido al alto porcentaje de grasa monoinsaturada proporcionada por el aceite de oliva en la dieta. Por ello hemos comparado el efecto de ambas dietas sobre la susceptibilidad in vitro a la oxidación de las lipoproteínas de baja densidad (LDL), pieza clave en el inicio y desarrollo de la arteriosclerosis.</p> <span class="elsevierStyleSectionTitle">Sujetos y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cuarenta y un sujetos varones sanos normolipémicos fueron sometidos a tres períodos de dieta, de 4 semanas de duración cada uno, consistentes en una dieta rica en grasa saturada (SAT: 38% grasa, 20% saturada), otra pobre en grasa (NCEP-I: 28% grasa, 10% saturada) y una dieta mediterránea (38% grasa, 22% de grasa monoinsaturada). Al final de cada período dietético se determinaron las concentraciones plasmáticas de colesterol total, cLDL, cHDL, triglicéridos, apoproteínas A-I y B, α-tocoferol y la susceptibilidad a la oxidación de las LDL in vitro.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ambas dietas hipolipemiantes produjeron un descenso significativo de las concentraciones plasmáticas de colesterol total, cLDL y apo B, mientras que sólo la dieta NCEP-I disminuyó el cHDL. La sustitución de una dieta rica en grasa saturada o de una dieta rica en hidratos de carbono por una dieta mediterránea aumentó la resistencia a la oxidación de las LDL al prolongarse el tiempo de latencia (p < 0,038) e inducir un descenso (p < 0,001) en la tasa de progresión de la curva de cinética de oxidación de las LDL.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados indican que el consumo de una dieta mediterránea rica en aceite de oliva, además de mejorar el índice aterogénico (colesterol total/cHDL), aumenta la resistencia a la oxidación de las LDL en comparación con la dieta pobre en grasa. Ello nos hace aconsejar el modelo de dieta mediterránea para la prevención de las enfermedades cardiovasculares.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Most experts, specially from Anglo-Saxon countries, recommend a low fat diet in order to prevent cardiovascular diseases. However, mortality rate by ischemic cardiopathy is low in Mediterranean countries, probably because of the consumption of a Mediterranean diet, with a high level of monounsaturated fats provided by the olive oil. We have conducted this study in order to investigate the possible influence of this kind of diet on the oxidation of LDL in vitro, the key element for the development of atherosclerosis.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">41 healthy male subjects were submitted to three consecutive 4-week diets. The first was a saturated fat-rich diet (SAT diet, 38% fat, 20% saturated). This was followed by a low fat diet (NCEP-I, 28% fat, 10% saturated) and after that a Mediterranean diet (38% fat, 22% monounsaturated fat). Plasma levels of total cholesterol, LDL-c, HDL-c, triglycerides, apolipoproteins A-I and B, α-tocopherol, and the in vitro susceptibility to oxidation of LDL particles.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Both hypolipidemic diets produced a significant decrease in total cholesterol, LDL-c, and apo-B plasma levels. However, it was only the NCEP-I diet that revealed a decrease in the HDL-c. The shift from a saturated fat-rich diet, or a diet rich in carbohydrates, to a Mediterranean diet increased the resistance of LDL particles to oxidation increasing the lag time period (p < 0.038), and decreasing (p < 0.001) the progression rate of the curve of oxidation of LDL.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Our results point out two positive consequences of the consumption of a Mediterranean diet by healthy young males, compared with the low fat diet recommended by most Anglo-Saxon experts. On the one hand, the Mediterranean diet increases HDL-c plasma levels, and on the other hand, it decreases the susceptibility of LDL to oxidation. 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