Effect of fast-food Mediterranean-type diet on human plasma oxidation

Abstract

Oxidation of lipoproteins, particularly of low-density lipoprotein (LDL), is of prime importance in the initiation and progression of atherosclerosis. The Mediterranean diet has been associated with an unexpectedly low rate of cardiovascular events. Type 2 diabetic patients are at high risk of developing atherosclerosis. Functional alterations in the endothelium, which lead to atherosclerosis, are stimulated by oxidized lipoproteins, particularly oxidized LDL. The present study investigated the effect of Greek quick casual Mediterranean-type diet (fast food Mediterranean-type diet) consumption on the resistance to oxidation in plasma from type 2 diabetic patients and healthy human subjects. Lipids from fast food Mediterranean-type foodstuffs were extracted and tested in vitro for their ability to inhibit copper (Cu2+)-induced LDL oxidation. Foodstuffs that exerted the most potent in vitro antioxidative activity were chosen for the diet of study groups. Eighteen type 2 diabetic patients (group A) and 10 healthy subjects (group B) were fed a 4-week diet contained the chosen foodstuffs, while 17 type 2 diabetic patients (group C) were kept on their regular diet that they were following before the study. Type 2 diabetic patients were treated with sulfonylureas or metformin and were under good glycemic control (hemoglobin A1C < 7%). Serum lipoproteins, triglycerides, glucose, body mass index (BMI), and plasma resistance to Cu2+-induced oxidation before and after the 4-week diet were monitored. At the beginning of the study, no statistical difference was detected in plasma resistance to Cu2+-induced oxidation between type 2 diabetic patients (groups A and C) and healthy human subjects (group B), as this was detected at a time before the oxidation products become detectable, namely, lag time. After the 4-week period on the chosen diet the lag time in groups A and B significantly increased, while it was not changed in group C. In type 2 diabetic patients lag time was increased from 57.3 +/- 13.3 minutes (mean +/- SD) to 103.8 +/- 21.8 minutes (mean +/- SD) (P < .000), while in healthy human subjects there was an increase from 58.0 +/- 8.5 minutes (mean +/- SD) to 85.7 +/- 21.8 minutes (mean +/- SD) (P < .004). In all groups, total cholesterol, high-density lipoprotein-cholesterol, LDL-cholesterol, triglycerides, glucose, and BMI were not changed. Fast food Mediterranean foodstuffs exerted antioxidant activities both in vitro and in vivo after consumption in type 2 diabetic patients and healthy human subjects. Therefore consumption of a fast food Mediterranean-type diet should contribute to prevention against cardiovascular diseases.