Dietary effects on cardiovascular disease risk biomarkers

La tesis consta de 4 proyectos: dos estudios de intervención, aleatorizados, paralelos y controlados, uno sobre los efectos de productos del cacao y otro sobre los de fibra soluble, Plantago ovata husk (Po-husk), sobre biomarcadores de enfermedad cardiovascular (ECV) en sujetos hipercolesterolémicos. El tercero es la identificación de compuestos fenólicos del aceite de oliva virgen (AOV) en plasma humano (en ayunas y en fase postprandial) y el cuarto, el desarrollo de una aplicación informática para implementar los criterios CONSORT.Los productos del cacao y Po-husk reducen las concentraciones plasmáticas de c-LDL y ejercen efectos beneficiosos sobre otros biomarcadores de ECV.Además se han detectado hasta 10 compuestos fenólicos del AOV, incluido el 3,4-DHPEA-EDA, en plasma humano postprandrial.Finalmente, la incorporación de productos del cacao o Po-husk o el AOV o su combinación a una dieta cardiosaludable se adecuará al perfil de biomarcadores de riesgo de ECV de cada paciente.The thesis is based on 4 projects: 2 randomised, controlled, interventional studies, one of the cocoa cream products and the other of the soluble fibre (Plantago ovata husk (Po-husk) on biomarkers of CVD. Third, the virgin olive oil (VOO) phenolic compounds identification in fasting and postprandial human plasma, and fourth, designed a technology application to facilitate the implementation of criteria CONSORT statement.The cocoa cream products and Po-husk reduced in plasma LDL-c and also, had beneficial effects on other CVD biomarkers and risk factors.Also, had been detected until 10 phenolic compounds from VOO, including 3,4-DHPEA-EDA, in human postprandial plasma.Finally, applying cocoa products or Po-husk or VOO or in combination in a cardio-protective diet warrants consideration as individualised therapeutic measures based on the individual's CVD risk factor profile

Genetic variants of LDLR and PCSK9 associated with variations in response to antihypercholesterolemic effects of Armolipid Plus with berberine

Background: Armolipid Plus (AP) is a nutraceutical that contains policosanol, fermented rice with red yeast, berberine, coenzyme Q10, folic acid, and astaxanthin. It has been shown to be effective in reducing plasma LDL cholesterol (LDLc) levels. In the multicenter randomized trial NCT01562080, there was large interindividual variability in the plasma LDLc response to AP supplementation. We hypothesized that the variability in LDLc response to AP supplementation may be linked to LDLR and PCSK9 polymorphisms. Material and Methods: We sequenced the LDLR 30 and 50 untranslated regions (UTR) and the PCSK9 50 UTR of 102 participants with moderate hypercholesterolemia in trial NCT01562080. In this trial, 50 individuals were treated with AP supplementation and the rest with placebo. Results: Multiple linear regression analysis, using the response of LDLc levels to AP as the dependent variable, revealed that polymorphisms rs2149041 (c.-3383C>G) in the PCSK9 50 UTR and rs14158 (c.∗52G>A) in the LDLR 30 UTR explained 14.1%and 6.4%, respectively, of the variability after adjusting for gender, age, and BMI of individuals. Combining polymorphisms rs2149041 and rs14158 explained 20.5%of this variability (p < 0.004). Conclusions: Three polymorphisms in the 30 UTR region of LDLR, c.∗52G>A, c.∗504G>A, and c. ∗773A>G, and two at the 50 UTR region of PCSK9, c.-3383C>G and c.-2063A>G, were associated with response to AP. These results could explain the variability observed in the response to berberine among people with moderate hypercholesterolemia, and they may be useful in identifying patients who could potentially benefit from supplementation with AP

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