Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men

Background: The regulatory function of the endothelium is altered in hyperc holesterolemia, and the subsequent endothelial dysfunction plays a central role in the development of atherosclerosis. Objective: To determine whether endothelial function in hypercholesterolemi c patients is affected by replacing a saturated fat-enriched diet with a lo w-fat, low-saturated fat diet (the U,S, National Cholesterol Education Prog ram stage 1 [NCEP-1] diet) or a diet rich in monounsaturated fat (such as t hat common in Mediterranean countries). Design: Intervention dietary study with a baseline phase and two randomized crossover dietary periods. Setting: Hospital Universitario Reina Sofia, Cordoba, Spain, Patients: 22 hypercholesterolemic men. Intervention: Patients followed a diet high in saturated fat, then were ass igned in a crossover design to the NCEP-1 diet or a Mediterranean diet. Eac h dietary period lasted 28 days. Measurements: Plasma P-seledin levels, lipid concentrations, and endothelia l function, Results: Compared with the saturated fat diet, flow-mediated dilatation inc reased during the Mediterranean diet but not during the NCEP-1 diet In addi tion, levels of plasma cholesterol, low-density lipoprotein cholesterol, ap olipoprotein B, and P-selectin decreased during the NCEP-1 and Mediterranea n diets. Conclusion: In hypercholesterolemic men, diets low in fat (especially satur ated fat) and diets rich in monounsaturated fats improve endothelial functi on.