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Rivas-Garcia L, Quintana-Navarro GM, Torres-Peña JD, Arenas-de Larriva AP, Alcala-Díaz JF, Yubero-Serrano EM, Perez Caballero AI, Ortiz-Morales AM, Rangel-Zuñiga OA, López-Moreno A, Ordovas JM, Perez-Martinez P, Lopez-Miranda J, Delgado-Lista J. Dietary antioxidant intake reduces carotid intima-media thickness in coronary heart disease patients: From the CORDIOPREV study. Free Radic Biol Med 2024; 210:221-229. [PMID: 38036071 DOI: 10.1016/j.freeradbiomed.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Atherosclerosis is the leading underlying cause of coronary heart disease (CHD). In patients with CHD, intima-media thickness of common carotid arteries (IMT-CC) is a reliable, validated, and non-invasive marker of the progression of atherosclerosis. Dietary intervention may affect IMT-CC evolution through different pathways. There is a lack of clinical trials evaluating the effect of total dietary antioxidant content of diets on IMT-CC, especially in patients with CHD. OBJECTIVE We evaluated the correlation between the diet's total antioxidant content and the changes in IMT-CC produced after 5 years of dietary intervention following two healthy diet models (Mediterranean diet and low-fat diet). We also evaluated whether the diet's total antioxidant content was related to the total redox capacity of the participants. METHODS From the total participants of the CORDIOPREV study (clinical trial register NCT00924937), 805 participants completed the IMT-CC measurement and the dietary antioxidant evaluation at baseline and after 5 years of dietary intervention. IMT-CC was carried out by ultrasound and the dietary antioxidant evaluation was performed by the Dietary Antioxidant Index (DAI). Additionally, direct redox balance was evaluated in a subset of population by the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSH) by colorimetric assay. RESULTS We observed an inverse correlation between evolution of DAI and IMT-CC after 5-years of dietary intervention. The mean of the DAI index augmented in the Mediterranean Diet group, whereas it decreased in the Low-fat group. DAI was correlated to the GSH/GSSG ratio, supporting DAI as an adequate estimator of diet's antioxidant content. When looking for individual components of the DAI that were associated to the changes in IMT-CC, an inverse correlation was found for carotenoids, vitamin E, vitamin C, and zinc and the IMT-CC. CONCLUSIONS Our study indicates that, after five years of dietary intervention, changes in DAI inversely correlate with changes in IMT-CC in patients with CHD. Overall effect of Mediterranean diet resulted in an increase of DAI, conversely to low-fat. Specific elements included in the DAI index were inversely correlated with IMT-CC.
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Affiliation(s)
- Lorenzo Rivas-Garcia
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain
| | - Gracia M Quintana-Navarro
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain
| | - Jose D Torres-Peña
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain; Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, 14004, Spain
| | - Antonio P Arenas-de Larriva
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain; Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, 14004, Spain
| | - Juan F Alcala-Díaz
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain; Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, 14004, Spain
| | - Elena M Yubero-Serrano
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Ana I Perez Caballero
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain
| | - Ana M Ortiz-Morales
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, 14004, Spain
| | - Oriol Alberto Rangel-Zuñiga
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Alejandro López-Moreno
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, J.M.-US Department of Agriculture Human Nutrition Research Center On Aging at, Tufts University, Boston, 02111, MA, United States; IMDEA Alimentacion, Madrid, Spain; CINC, Madrid, 28049, Spain
| | - Pablo Perez-Martinez
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain; Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, 14004, Spain
| | - Jose Lopez-Miranda
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain; Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, 14004, Spain.
| | - Javier Delgado-Lista
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, 14004, Spain; Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, 14004, Spain; CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain; Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, 14004, Spain.
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