Bioactive food compounds of Mediterranean and Nordic diets and their effects on nutritional and cardiovascular disease biomarkers

L’objectiu principal de la tesis és valorar l’impacte de certs compostos bioactius de la dieta Mediterrània i Nòrdica, especialment de compostos fenòlics, sobre marcadors nutricionals i moleculars, els quals permetin determinar mecanismes d’acció i efectes biològics saludables involucrats en el desenvolupament de la malaltia cardiovascular (MCV). Un increment de l’excreció total de polifenols en orina, el qual és un marcador del consum total de polifenols, pot reflectir una atenuació del dany oxidatiu. Els efectes beneficiosos en individus sans d’una ingesta rica en verdures i moderada de vi negre, podrien ser explicats en part per l'atenuació del dany oxidatiu associat amb aquests aliments típics de la dieta mediterrània rica en polifenols. Utilitzant la metabolòmica no dirigida, les concentracions plasmàtiques de l’àcid 3-carboxy-4-methyl-5-propyl-2-furanopropionic, els alk(en)ylresorcinols glucosilats i l’àcid hipúric se suggereixen com a nous candidats de marcadors de consum de peix blau, cereals integrals i nabius, respectivament. Alteracions en marcadors moleculars del metabolisme endogen, com ara lípids que contenen àcids grassos poliinsaturats, aminoàcids i metabolits de la betaïna, podrien explicar els efectes beneficiosos de la dieta Nòrdica, rica en cereals integrals, peix blau i nabius. Mitjançant l’aplicació de proteòmica quantitativa confirmem que, el consum d’oli d’oliva verge o d’olis d’oliva verges enriquits amb fenols té un impacte sobre el proteoma de l’HDL d’una manera cardioprotectora que podria millorar la funcionalitat de l’HDL. L’ús de marcadors nutricionals és una eina útil en l’avaluació dels mecanismes d’acció i dels efectes biològics dels compostos bioactius de la dieta sobre el desenvolupament de la MCV. Així, l’ús de les ciències òmiques, tals com la metabolòmica i la proteòmica, afegeixen informació rellevant en el descobriment de nous marcadors nutricionals i moleculars, els quals ens ajuden a avaluar la bioactivitat dels aliments i els efectes d’aquests sobre la salut humana i la prevenció de les malalties.El objetivo principal de la tesis es valorar el impacto de ciertos compuestos bioactivos de la dieta Mediterránea y Nórdica, especialmente de compuestos fenólicos, sobre marcadores nutricionales y moleculares, los cuales permitan determinar mecanismos de acción y efectos biológicos saludables involucrados en el desarrollo de la enfermedad cardiovascular (ECV). Un incremento de la excreción total de polifenoles en orina, el cuál es un marcador del consumo total de polifenoles, puede reflejar atenuación del daño oxidativo. Los efectos beneficiosos en individuos sanos de una ingesta rica en verduras y moderada en vino tinto, podrían ser explicados por la atenuación del daño oxidativo asociado con estos alimentos de la dieta mediterránea rica en polifenoles. Utilizando la metabolómica no dirigida, las concentraciones plasmáticas de ácido 3-carboxy-4-methyl-5-propyl-2-furanopropionic, alk(en)ylresorcinols glicosilados y ácido hipúrico se sugieren como nuevos marcadores de consumo de pescado azul, cereales integrales y arándanos, respectivamente. Alteraciones en marcadores moleculares del metabolismo endógeno, como lípidos con ácidos grasos poliinsaturados, aminoácidos y metabolitos de la betaína, podrían explicar los efectos beneficiosos de la dieta Nórdica, rica en cereales integrales, pescado azul y arándanos. Mediante la aplicación de proteómica cuantitativa confirmamos que, el consumo de aceite de oliva virgen (AOV) o de AOVs enriquecidos con fenoles tiene un impacto sobre el proteoma de la HDL de manera cardioprotectora que podría mejorar su funcionalidad. El uso de marcadores nutricionales es una herramienta útil para evaluar los mecanismos de acción y los efectos biológicos de los compuestos bioactivos de la dieta sobre el desarrollo de la ECV. Así, el uso de ciencias ómicas, tales como la metabolómica y la proteómica, añaden información relevante en el descubrimiento de nuevos marcadores nutricionales y moleculares, los cuales nos ayudan a evaluar la bioactividad de los alimentos y los efectos de éstos sobre la salud humana y la prevención de enfermedades.The main objective of the thesis is to assess the impact of Mediterranean and Nordic dietary bioactive compounds, especially phenolic compounds, on nutritional and molecular biomarkers, which allow to determine mechanisms of action and biological effects involved in the development of CVD. An increased urinary excretion of total polyphenols, which is a biomarker of total polyphenol intake, may reflect an attenuation of oxidative damage. The beneficial effects in healthy individuals of a dietary intake rich in vegetables and moderate red wine, could potentially be explained by the attenuation of oxidative damage associated with these typical food items of the Mediterranean diet rich in polyphenols. By applying a non-targeted metabolite approach, fasting plasma 3-carboxy-4-methyl-5-propyl-2-furanopropionic acid, glucuronidated alk(en)ylresorcinols and hippuric acid are suggested as novel candidate biomarkers of fatty fish, whole grain and bilberries consumption, respectively. Alterations in molecular biomarkers of endogenous metabolism, such as PUFA-containing lipids, amino acids and betaine metabolites could indicate potential effects of a healthy Nordic diet, rich in whole grains, fatty fish and berries. By applying a quantitative proteomic approach we confirm that the consumption of virgin olive oil or phenol-enriched virgin olive oils has an impact on the HDL proteome in a cardioprotective mode that could enhance HDL functionality. The use of nutritional biomarkers is a useful tool in assessing the mechanisms of action and the biological effects of the dietary bioactive compounds on cardiovascular disease development. Thus, the use of omic sciences, such as metabolomics and proteomics, add relevant information in the discovery of novel nutritional and molecular biomarkers, which help us in evaluating the food bioactivity and the food effects on human health and disease prevention

Effectiveness of a Motivational Nutritional Intervention through Social Networks 2.0 to Increase Adherence to the Mediterranean Diet and Improve Lung Function in Active Smokers: The DIET Study, a Randomized, Controlled and Parallel Clinical Trial in Primary Care

Background: Diet can help preserve lung function in smokers, as well as aid individuals who avoid smoking. This study aimed to evaluate the effectiveness of a nutritional intervention, using the Social Networks 2.0 tool, to increase adherence to the Mediterranean diet (MD) and improve lung function in smokers without prior respiratory disease. Methods: A randomized controlled parallel design was used. The participants were assigned to either the intervention or control group. Data from representative smokers without respiratory disease (n = 77) aged 18–70 years were analyzed. The participants completed a validated semi-quantitative food-frequency questionnaire, and their adherence to the diet was evaluated by using the questionnaire called the Mediterranean Diet Adherence Score (MEDAS, with 14 items), which considers ≥9 points to indicate high adherence. The lung function was assessed by spirometry. Associations among variables were determined by logistic regression. Results: A comparison of the variables at the end of the study between the control and intervention groups showed that the intervention significantly increased adherence to the MD based on the MEDAS questionnaire (0.69 (2.1) vs. 2.05 (2.03); p = 0.009). Specifically, the consumption of fruits was increased after two years in both groups; however, a more significant increase was detected in the intervention group (121 (178) vs. 12.7 (167) in the control group; p-value = 0.008). In the unadjusted analysis, the intervention only showed a statistical significant increase in the score of adherence to the MD (β: 1.36; 95% CI 0.35; 2.3; p = 0.009), and this increase was maintained after adjusting for age and sex (β: 1.15; 95% CI 0.05; 2.2; p = 0.040) and after adjusting for various sociodemographic, lifestyle and anthropometric variables (β: 1.17; 95% CI 0.02; 2.31; p = 0.046). The pulmonary function parameters improved more in the intervention group; however, no significant differences were observed between the two groups. Conclusions: A nutritional intervention based on a dietetic-nutritional education program resulted in a significant increase in adherence to the MD. However, some evidence suggests that an MD dietary intervention can improve lung function, but in our study, we were not able to demonstrate this. Further research is needed to obtain more robust data and confirm a possible benefit of the program before it can be extended to general practice