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Inhibition of circulating immune cell activation: a molecular antiinflammatory effect of the Mediterranean diet^1,2,3

¹ From the Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M-PM, ES, MV-A, MM, RoE, NB, RC, FM, and RE); the Department of Nutrition and Food Science—CeRTA, School of Pharmacy, University of Barcelona, Barcelona, Spain (RML-R); the Human Nutrition Unit, School of Medicine, University Rovira i Virgili, Reus, Spain (JS-S); the Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain (MS-M); the Cardiovascular Epidemiology Unit, Municipal Institute for Medical Research, Barcelona, Spain (MF); the Lipid Clinic, Service of Endocrinology & Nutrition, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, Barcelona, Spain (ER); and CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain (ES, MV-A, MF, RC, RML-R, FM, ER, and RE).

² Supported by grants from the Spanish Ministries of Education (AGL2004-08378-C02-01, AGL 2005-05597ALI, and AGL2006-14228-C03-01/ALI) and Health (PI04/1837, PI05/1519, G03/140, and RTIC RG06/045) and Centro Nacional de Investigarcíon Cardiovascular (CNIC06).

³ Address reprint requests and correspondence to R Estruch, Department of Internal Medicine, Hospital Clinic, Villarroel, 170, 08036 Barcelona, Spain. E-mail: restruch{at}clinic.ub.es.

Background: Adherence to the Mediterranean diet (Med-Diet) is associated with a reduced risk of cardiovascular disease (CVD). However, the molecular mechanisms involved are not fully understood.

Objective: The objective was to compare the effects of 2 Med-Diets with those of a low-fat diet on immune cell activation and soluble inflammatory biomarkers related to atherogenesis in subjects at high risk of CVD.

Design: In a controlled study, we randomly assigned 112 older subjects with diabetes or 3 CVD risk factors to 3 dietary intervention groups: Med-Diet with supplemental virgin olive oil (VOO), Med-Diet with supplemental nuts, and low-fat diet. Changes from baseline in cellular and serum inflammatory biomarkers were assessed at 3 mo.

Results: One hundred six participants (43% women; average age: 68 y) completed the study. At 3 mo, monocyte expression of CD49d, an adhesion molecule crucial for leukocyte homing, and of CD40, a proinflammatory ligand, decreased (P < 0.05) after both Med-Diets but not after the low-fat diet. Serum interleukin-6 and soluble intercellular adhesion molecule-1, inflammatory mediators crucial in firm adhesion of leukocytes to endothelial surfaces, decreased (P < 0.05) in both Med-Diet groups. Soluble vascular cellular adhesion molecule-1 and C-reactive protein decreased only after the Med-Diet with VOO (P < 0.05), whereas interleukin-6, soluble vascular cellular adhesion molecule-1, and soluble intercellular adhesion molecule-1 increased (P < 0.05) after the low-fat diet.

Conclusions: Med-Diets supplemented with VOO or nuts down-regulate cellular and circulating inflammatory biomarkers related to atherogenesis in subjects at high risk of CVD. The results support the recommendation of the Med-Diet as a useful tool against CVD.

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