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Abstract
A strict adherence to the Mediterranean Diet (MedDiet) has repeatedly been linked to a low risk of cardiovascular disease in several situations. Initially, the mechanisms considered as possible causes of this were based on the effects of this dietary pattern on the so-called traditional risk factors (especially lipids and blood pressure). However, the high relative reduction in the prevalence of cardiovascular morbidity and mortality were not proportional to the limited findings about regulation of those traditional risk factors. In addition to several studies confirming the above effects, current research on the MedDiet is being focused on defining its effects on non-traditional risk factors, such as endothelial function, inflammation, oxidative stress, or on controlling the conditions which predispose people to cardiovascular events, such as obesity, metabolic syndrome or type 2 diabetes mellitus. In the current article, after briefly reviewing the known effects of the MedDiet on the traditional risk factors, we will mainly focus on reviewing the current evidence about the effects that this dietary pattern exerts on alternative factors, including postprandial lipemia or coagulation, among others, as well as providing a short review on future directions.
FUNDING
Supported partly by public funding through research grants from the Spanish Ministry of Science and Innovation (AGL2009–12270 to J L-M, SAF07–62005 to F. Perez-Jimenez and FIS PI10/01041 to P. Perez-Martinez, PI10/02412 to F. Perez-Jimenez); Consejería de Economía, Innovación y Ciencia, Proyectos de Investigación de Excelencia, Junta de Andalucía (P06-CTS-01425 to J. Lopez-Miranda, CTS5015 and AGR922 to F. Perez-Jimenez); Consejería de Salud, Junta de Andalucía (07/43, and PI0193/09 to J. Lopez-Miranda, PI-0252/09 to J. Delgado-Lista, and PI-0058/10 to P. Perez-Martinez); Fondo Europeo de Desarrollo Regional (FEDER). The CIBEROBN is an initiative of the Instituto de Salud Carlos III, Madrid, Spain. Also supported by Ministerio de Economia y Competitividad (AGL2012/39615 to J L-M).
ABBREVIATIONS
| ADP | = | Adenosine diphosphate |
| ASA | = | Acetylsalicylic acid |
| EDHF | = | Endothelium-Derived Hyperpolarizing Factor |
| FDA | = | Food and Drug Administration |
| FMD | = | Flow-mediated dilation |
| HDL | = | High density lipoprotein |
| HUVECs | = | Human umbilical vascular endothelial cells |
| ICAM | = | Intercellular adhesion molecules |
| IL-6 | = | Interleukin-6 |
| LDL | = | Low density lipoprotein |
| MedDiet | = | Mediterranean Diet |
| MUFAs | = | Monounsaturated fatty acids |
| NOx | = | Oxido Nitrico |
| Nrf2 | = | Nuclear factor-E(2)-related factor-2 |
| PUFAs | = | Polyunsaturated fatty acids |
| SFA | = | Saturated fatty acids |
| VCAM | = | Vascular cell adhesion proteins |