Low intake of extra-virgin olive oil within whole-food, plant-based diet may lower LDL
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Key takeaways:
- Whole-food, plant-based diets with low extra-virgin olive oil improved LDL for participants at risk for ASCVD.
- Addition of extra-virgin olive oil after following a low intake pattern may impede risk reduction.
Decreased intake of extra-virgin olive oil within a whole-food, plant-based diet may help to lower LDL among individuals at risk for atherosclerotic CVD, according to a study published in Journal of the American Heart Association.
“Studies have been conflicting on the benefits of individual components of Mediterranean diets, and it is unclear whether extra-virgin olive oil confers LDL-C lowering when consuming a whole-food, plant-based diet at varying CVD risk,” Andrea M. Krenek, PhD, RDN, of the food science and human nutrition department at University of Florida and a research fellow at the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH, and colleagues wrote.
To compare the effects of consuming a high vs. low amount of extra-virgin olive oil (EVOO) within a whole-food, plant-based vegan diet pattern on LDL and other cardiometabolic markers, Krenek and colleagues conducted a prospective, open-label, controlled crossover trial that included 40 adults (mean age, 64.4 years; 75% women; 72.5% white) at borderline to high risk for ASCVD.
From May 2021 to April 2022, participants alternated between a high (4 tablespoons/day) to low (< 1 teaspoon/day) or low to high EVOO, whole-food, plant-based diet for 4 weeks each, with a 1-week washout period between.
Participants also attended weekly virtual group culinary medicine cooking classes led by a dietitian or chef during both diet intervention periods.
The primary outcome of the study was change in LDL levels from baseline and between diet periods, assessed using linear mixed models, which allowed researchers to evaluate differences in diets, order and their interaction for LDL.
Secondary outcomes included change from baseline postintervention periods in other cardiometabolic biomarkers, BP and anthropometrics.
Across participants, fat intake comprised 48% of energy during the high EVOO period and 32% during the low period.
The researchers found that both diets combined resulted in reductions in LDL, total cholesterol, apolipoprotein B, HDL, glucose and high-sensitivity C-reactive protein (P < .05 for all).
However, sensitivity analyses showed reductions in total cholesterol (–33.8 mg/dL vs. –19 mg/dL; P = .035), HDL (10.5 mg/dL vs. –5 mg/dL; P = .025), ApoB (–14.8 mg/dL vs. –5.5 mg/dL; P = .053) and glucose (–17.8 mg/dL vs. –8.8 mg/dL; P = .082) were greater with the low vs. high EVOO diet.
The low EVOO diet also conferred larger LDL reductions than the high EVOO diet, but the difference was not statistically significant (–25.5 mg/dL vs. –16.7 mg/dL), and it diminished after the second diet period.
However, researchers did observe a significant difference in LDL between diets related to which diet participants underwent first, where those assigned the high to low pattern showed a decrease of 12.7 mg/dL, compared with an increase of 15.8 mg/dL among those assigned the low to high pattern (P = .02).
The low to high pattern also led to increased glucose (15.3 mg/dL; P = .004), total cholesterol (29.4 mg/dL; P = .0002) and HDL (9.8 mg/dL; P < .0001).
“Dietary changes resulted in lower cardiovascular risk factors compared with baseline levels, with a greater difference in optimal directions following the transition to a low EVOO diet, suggesting that EVOO may not be the beneficial additive of a Mediterranean diet,” Krenek and colleagues wrote.
The researchers acknowledged several limitations to their study, including that there may have still been carryover effects of the diets despite the washout period, and that the study period was relatively short and may have missed metabolic changes that occur with longer EVOO intake.
Nonetheless, the results “may assist in informing future larger investigations,” they wrote.
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