TY - JOUR
T1 - A lifestyle intervention with an energy-restricted Mediterranean diet and physical activity enhances HDL function
T2 - a substudy of the PREDIMED-Plus randomized controlled trial
AU - Sanllorente, Albert
AU - Soria-Florido, María Trinidad
AU - Castañer, Olga
AU - Lassale, Camille
AU - Salas-Salvadó, Jordi
AU - Martínez-González, Miguel Ángel
AU - Subirana, Isaac
AU - Ros, Emilio
AU - Corella, Dolores
AU - Estruch, Ramón
AU - Tinahones, Francisco J.
AU - Hernáez, Álvaro
AU - Fitó, Montserrat
N1 - Funding Information:
This work was supported by the Instituto de Salud Carlos III (grant numbers: CB06/03/0028, CD17/00122, IFI16/00012, PI15/00047, PI18/00020, and P19/00017), Fundació La Marató de TV3 (grant number: 201512.31), Agència de Gestió d'Ajuts Universitaris i de Recerca (grant number: 2017 BP 00021, 2017 SGR 222, SLT002/16/00088), and the European Regional Development Fund.
Publisher Copyright:
© 2021 The Author(s).
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Background: Consumption of a Mediterranean diet, adequate levels of physical activity, and energy-restricted lifestyle interventions have been individually associated with improvements in HDL functions. Evidence of intensive interventions with calorie restriction and physical activity is, however, scarce. Objectives: To determine whether an intensive lifestyle intervention with an energy-restricted Mediterranean diet plus physical activity enhanced HDL function compared to a non-hypocaloric Mediterranean eating pattern without physical activity. Methods: In 391 older adults with metabolic syndrome (mean age, 65 years; mean BMI, 33.3 kg/m2) from 1 of the Prevención con Dieta Mediterránea-Plus trial centers, we evaluated the impact of a 6-month intervention with an energy-restricted Mediterranean diet plus physical activity (intensive lifestyle; n = 190) relative to a nonrestrictive Mediterranean diet without physical activity (control; n = 201) on a set of HDL functional traits. These included cholesterol efflux capacity, HDL oxidative/inflammatory index, HDL oxidation, and levels of complement component 3, serum amyloid A, sphingosine-1-phosphate, triglycerides, and apolipoproteins A-I, A-IV, C-III, and E in apoB-depleted plasma. Results: The intensive-lifestyle intervention participants displayed greater 6-month weight reductions (-3.83 kg; 95% CI: -4.57 to -3.09 kg) but no changes in HDL cholesterol compared with control-diet participants. Regarding HDL functional traits, the intensive lifestyle decreased triglyceride levels (-0.15 mg/g protein; 95% CI: -0.29 to -0.014 mg/g protein) and apoC-III (-0.11 mg/g protein; 95% CI: -0.18 to -0.026 mg/g protein) compared to the control diet, with weight loss being the essential mediator (proportions of mediation were 77.4% and 72.1% for triglycerides and apoC-III levels in HDL, respectively). Conclusions: In older adults with metabolic syndrome, an energy-restricted Mediterranean diet plus physical activity improved the HDL triglyceride metabolism compared with a nonrestrictive Mediterranean diet without physical activity.
AB - Background: Consumption of a Mediterranean diet, adequate levels of physical activity, and energy-restricted lifestyle interventions have been individually associated with improvements in HDL functions. Evidence of intensive interventions with calorie restriction and physical activity is, however, scarce. Objectives: To determine whether an intensive lifestyle intervention with an energy-restricted Mediterranean diet plus physical activity enhanced HDL function compared to a non-hypocaloric Mediterranean eating pattern without physical activity. Methods: In 391 older adults with metabolic syndrome (mean age, 65 years; mean BMI, 33.3 kg/m2) from 1 of the Prevención con Dieta Mediterránea-Plus trial centers, we evaluated the impact of a 6-month intervention with an energy-restricted Mediterranean diet plus physical activity (intensive lifestyle; n = 190) relative to a nonrestrictive Mediterranean diet without physical activity (control; n = 201) on a set of HDL functional traits. These included cholesterol efflux capacity, HDL oxidative/inflammatory index, HDL oxidation, and levels of complement component 3, serum amyloid A, sphingosine-1-phosphate, triglycerides, and apolipoproteins A-I, A-IV, C-III, and E in apoB-depleted plasma. Results: The intensive-lifestyle intervention participants displayed greater 6-month weight reductions (-3.83 kg; 95% CI: -4.57 to -3.09 kg) but no changes in HDL cholesterol compared with control-diet participants. Regarding HDL functional traits, the intensive lifestyle decreased triglyceride levels (-0.15 mg/g protein; 95% CI: -0.29 to -0.014 mg/g protein) and apoC-III (-0.11 mg/g protein; 95% CI: -0.18 to -0.026 mg/g protein) compared to the control diet, with weight loss being the essential mediator (proportions of mediation were 77.4% and 72.1% for triglycerides and apoC-III levels in HDL, respectively). Conclusions: In older adults with metabolic syndrome, an energy-restricted Mediterranean diet plus physical activity improved the HDL triglyceride metabolism compared with a nonrestrictive Mediterranean diet without physical activity.
KW - Mediterranean diet
KW - calorie restriction
KW - high-density lipoprotein
KW - physical activity
KW - randomized controlled trial
UR - https://www.scopus.com/pages/publications/85121947440
UR - http://hdl.handle.net/20.500.14342/4741
U2 - 10.1093/ajcn/nqab246
DO - 10.1093/ajcn/nqab246
M3 - Article
C2 - 34582548
AN - SCOPUS:85121947440
SN - 0002-9165
VL - 114
SP - 1666
EP - 1674
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 5
ER -