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CLINICAL RESEARCH: DIET AND ENDOTHELIAL FUNCTION

Acute Effects of High-Fat Meals Enriched With Walnuts or Olive Oil on Postprandial Endothelial Function

Berenice Cortés, BS^_*,,1, Isabel Núñez, MD^,1, Montserrat Cofán, PhD, Rosa Gilabert, MD, PhD, Ana Pérez-Heras, RD, Elena Casals, MD, PhD, Ramón Deulofeu, PhD and Emilio Ros, MD, PhD^,_*

^_* Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
Secció d’Ecografia, Centre de Diagnòstic per l’Imatge, Barcelona, Spain
Unitat de Lípids, Institut Clínic de Malalties Digestives i Metabòliques, Barcelona, Spain
Centre de Diagnòstic Biològic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain.

Manuscript received March 22, 2006; revised manuscript received May 31, 2006, accepted June 6, 2006.

^_* Reprint requests and correspondence: Dr. Emilio Ros, Unitat de Lípids, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain. (Email: eros{at}clinic.ub.es).

OBJECTIVES: We sought to investigate whether the addition of walnuts or olive oil to a fatty meal have differential effects on postprandial vasoactivity, lipoproteins, markers of oxidation and endothelial activation, and plasma asymmetric dimethylarginine (ADMA).

BACKGROUND: Compared with a Mediterranean diet, a walnut diet has been shown to improve endothelial function in hypercholesterolemic patients. We hypothesized that walnuts would reverse postprandial endothelial dysfunction associated with consumption of a fatty meal.

METHODS: We randomized in a crossover design 12 healthy subjects and 12 patients with hypercholesterolemia to 2 high-fat meal sequences to which 25 g olive oil or 40 g walnuts had been added. Both test meals contained 80 g fat and 35% saturated fatty acids, and consumption of each meal was separated by 1 week. Venipunctures and ultrasound measurements of brachial artery endothelial function were performed after fasting and 4 h after test meals.

RESULTS: In both study groups, flow-mediated dilation (FMD) was worse after the olive oil meal than after the walnut meal (p = 0.006, time-period interaction). Fasting, but not postprandial, triglyceride concentrations correlated inversely with FMD (r = –0.324; p = 0.024). Flow-independent dilation and plasma ADMA concentrations were unchanged, and the concentration of oxidized low-density lipoproteins decreased (p = 0.051) after either meal. The plasma concentrations of soluble inflammatory cytokines and adhesion molecules decreased (p < 0.01) independently of meal type, except for E-selectin, which decreased more (p = 0.033) after the walnut meal.

CONCLUSIONS: Adding walnuts to a high-fat meal acutely improves FMD independently of changes in oxidation, inflammation, or ADMA. Both walnuts and olive oil preserve the protective phenotype of endothelial cells.

Abbreviations and Acronyms   ADMA = asymmetric dimethylarginine   ALA = -linolenic acid   FID = flow-independent dilation   FMD = flow-mediated dilation   MUFA = monounsaturated fatty acids   NO = nitric oxide   PUFA = polyunsaturated fatty acids   sICAM-1 = soluble intercellular adhesion molecule 1   SFA = saturated fatty acids   sTNF-R = soluble tumor necrosis factor receptors   sVCAM-1 = soluble vascular cell adhesion molecule 1

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