Dietary antioxidant intake reduces carotid intima-media thickness in coronary heart disease patients: from the CORDIOPREV study

Authors: RIVAS-GARCIA, LORENZO - Universidad De Cordoba; QUINTANA-NAVARRO, GRACIA - Universidad De Cordoba; TORRES-PENA, JOSE - Universidad De Cordoba; ARENAS-DE LARRIVA, ANTONIO - Universidad De Cordoba; ALCALA-DIAZ, JUAN - Universidad De Cordoba; YUBERO-SERRANO, ELENA - Universidad De Cordoba; PEREZ-CABALLERO, ANA - Universidad De Cordoba; ORTIZ-MORALES, ANA - University Hospital Reina Sofia; RANGEL-ZUNIGA, ORIOL ALBERTO - Maimonides Biomedical Research Institute Of Cordoba (IMIBIC); LOPEZ-MORENO, ALEJANDRO - Maimonides Biomedical Research Institute Of Cordoba (IMIBIC); ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; PEREZ-MARTINEZ, PABLO - Universidad De Cordoba; LOPEZ-MIRANDA, JOSE - Universidad De Cordoba; DELGADO-LISTA, JAVIER - Universidad De Cordoba

Submitted to: Free Radicals in Biology and Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/24/2023
Publication Date: 11/29/2023
Citation: Rivas-Garcia, L., Quintana-Navarro, G.M., Torres-Pena, J.D., Arenas-de Larriva, A.P., Alcala-Diaz, J.F., Yubero-Serrano, E.M., Perez-Caballero, A.I., Ortiz-Morales, A.M., Rangel-Zuniga, O., Lopez-Moreno, A., Ordovas, J.M., Perez-Martinez, P., Lopez-Miranda, J., Delgado-Lista, J. 2023. Dietary antioxidant intake reduces carotid intima-media thickness in coronary heart disease patients: from the CORDIOPREV study. Free Radicals in Biology and Medicine. https://doi.org/10.1016/j.freeradbiomed.2023.11.026.
DOI: https://doi.org/10.1016/j.freeradbiomed.2023.11.026

Interpretive Summary: Researchers found that eating a diet rich in antioxidants-like the Mediterranean diet full of fruits, vegetables, and nuts-can help slow down the thickening of artery walls in people with heart disease. This thickening is a sign of worsening heart problems. They followed people for 5 years, comparing those on a Mediterranean diet to those on a low-fat diet, and measured the antioxidants in their diets and the health of their arteries. Those eating the Mediterranean diet had better results, meaning their arteries didn't thicken as much, which was attributed to more antioxidants in their meals. This study suggests eating foods high in antioxidants might be good for heart health.

Technical 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.