The article titled “Dietary Interventions and Their Impact on Genetic Factors in Endothelial Dysfunction: Insights from the CORDIOPREV Study,” was  published in PLOS Medicine, which is a reputable and peer-reviewed scientific journal. This study explores the intricate relationship between diet, genetics, and endothelial dysfunction. The study, part of the ongoing CORonary Diet Intervention with Olive oil and cardiovascular PREVention (CORDIOPREV) trial, focuses on 1,002 coronary heart disease (CHD) patients, aiming to compare the effects of two distinct dietary patterns – a low-fat diet and a Mediterranean diet – on cardiovascular events.

Endothelial dysfunction is involved in the development of arteriosclerotic disease, which can be directly linked to the risk of cardiovascular recurrence. The study aims to provide the influence of dietary interventions on not only endothelial function, but also on epigenetic and proteomic factors.

In the CORDIOPREV study, 805 participants completed baseline endothelial function assessments and were then randomized to either a Mediterranean diet or a low fat diet. For reference, a mediterranean diet consists of: 35% fats, 22% monounsaturated fatty acids, and 43% carbohydrates, whereas a low fat diet consists of: 28% fats, 12% monounsaturated fatty acids, and 60% carbohydrates. After one year, the study will analyze the specific impact of each diet on the endothelial function, which will be measured by the FMD (flow-mediated dilation) of the brachial artery. A secondary outcome will also be measured by 24 preselected participants’ endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs),  and conducting in vitro experiments on cellular processes related to endothelial damage and repair. 

Results from this study indicated that participants who followed a Mediterranean diet showed a higher FMD compared to those who followed the low fat diet. Though, with only a 2.63% difference between the diets, this observation shows a potential approach for improving endothelial function and cardiovascular health. Additionally, participants on the Mediterranean diet exhibited higher endothelial progenitor cell (EPC) levels, lower endothelial microparticles (EMPs), reduced intracellular reactive oxygen species (ROS) production, less cellular apoptosis and senescence, and increased cellular proliferation and angiogenesis compared to the low-fat diet.

Beyond strengthening endothelial function, the Mediterranean diet represents crucial modifications in genetic and molecular factors linked to the biological processes related to endothelial dysfunction. This research contributes to the understanding of the complexity among genetics, diet, and cardiovascular health. Overall, this study’s approach emphasizes the potential of personalized diets to manage and prevent cardiovascular diseases, while embracing certain genetic aspects and disease susceptibility.  

Yubero-Serrano, E. M., et al. Mediterranean diet and endothelial function in patients with coronary heart disease: An analysis of the CORDIOPREV randomized controlled trial. PLoS medicine, 17 (9), https://doi.org/10.1371/journal.pmed.1003282 (2020)