ccd2d64e05a6229fd7218d4522b1a056 pmc_10817060.pdf b3bfd3dd321d93e71eb10310a63c37f10d4d267b pmc_10817060.pdf 7147036e0ec53d90b8b119225fea35d62f3f593105edf330affe42d21149c453 pmc_10817060.pdf Title: The Impact of the Mediterranean Diet and Lifestyle Intervention on Lipoprotein Subclass Profiles among Metabolic Syndrome Patients: Findings of a Randomized Controlled Trial Subject: Metabolic syndrome (MetS) is associated with alterations of lipoprotein structure and function that can be characterized with advanced lipoprotein testing (ADLT). The effect of the Mediterranean diet (MedDiet) and weight loss on the lipoprotein subclass profile has been scarcely studied. Within the PREDIMED-Plus randomized controlled trial, a sub-study conducted at Bellvitge Hospital recruiting center evaluated the effects of a weight loss program based on an energy-reduced MedDiet (er-MedDiet) and physical activity (PA) promotion (intervention group) compared with energy-unrestricted MedDiet recommendations (control group) on ADLT-assessed lipoprotein subclasses. 202 patients with MetS (n = 107, intervention; n = 95, control) were included. Lipid profiles were determined, and ADLT was performed at baseline, 6, and 12 months. Linear mixed models were used to assess the effects of intervention on lipoprotein profiles. Compared to the control diet, at 12 months, the er-MedDiet+PA resulted in a significant additional 4.2 kg of body weight loss, a decrease in body mass index by 1.4 kg/m2, reduction in waist circumference by 2.2 cm, decreased triglycerides, LDL-cholesterol and non-HDL-cholesterol, and increased HDL-cholesterol. In er-MedDiet+PA participants, ADLT revealed a decrease in small dense-LDL-cholesterol (sd-LDL-C), intermediate-density lipoproteins, VLDL-triglyceride, and HDL-Triglyceride, and an increase in large LDL and large VLDL particles. In conclusion, compared to an ad libitum MedDiet (control group), er-MedDiet+PA decreased plasma triglycerides and the triglyceride content in HDL and VLDL particles, decreased sd-LDL-C, and increased large LDL particles, indicating beneficial changes against cardiovascular disease.20pt Keywords: metabolic syndrome; Mediterranean diet; lipoprotein precipitation; nuclear magnetic resonance lipid profile; advanced lipoprotein tests; small dense LDL Author: Beatriz Candás-Estébanez, Bárbara Fernández-Cidón, Emili Corbella, Cristian Tebé, Marta Fanlo-Maresma, Virginia Esteve-Luque, Jordi Salas-Salvadó, Montserrat Fitó, Antoni Riera-Mestre, Emilio Ros and Xavier Pintó Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Jan 23 03:26:57 2024 CET ModDate: Tue Jan 23 03:32:53 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 889310 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ZZTQUO+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 GAJMJS+VnURWPalladioL Type 1 Custom yes yes yes 16 0 JPWIBQ+URWPalladioL-Bold Type 1 Custom yes yes yes 21 0 ZBUWFV+URWPalladioL-Roma Type 1 Custom yes yes yes 27 0 MJNVQA+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 48 0 CKUPDE+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 51 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes yes 71 0 RWBCRL+CMSY10 Type 1 Builtin yes yes yes 76 0 EUQOAW+EURM7 Type 1 Builtin yes yes yes 87 0 OVNEXW+EURM10 Type 1 Builtin yes yes yes 95 0 NFNIDC+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 103 0 NFNIDD+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 109 0 NFNIHD+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 115 0 NFNIIE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 121 0 NFNIIF+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 124 0 NFNIIG+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 127 0 NFNIJH+PalatinoLinotype-Roman TrueType MacRoman yes yes no 130 0 NFNIDC+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 140 0 NFNIDD+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 146 0 NFNIHD+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 152 0 NFNIIE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 158 0 NFNIIF+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 161 0 NFNIIG+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 164 0 NFNIJH+PalatinoLinotype-Roman TrueType MacRoman yes yes no 167 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-05-28 02:10:03 CEST RepresentationInformation: pmc_10817060.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-05-27 13:01:54 CEST Size: 889310 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 448 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Children: Item: Title: Effect of MedDiet and er-MedDiet+PA Based Intervention on Anthropometric Characteristics and Lipid Profile Destination: subsection.2.1 Children: Item: Title: Anthropometric Variables Destination: subsubsection.2.1.1 Item: Title: Lipid Profile Destination: subsubsection.2.1.2 Item: Title: Advanced Lipoprotein Tests Destination: subsubsection.2.1.3 Item: Title: Discussion Destination: section.3 Children: Item: Title: Anthropometric Variables Destination: subsection.3.1 Item: Title: Conventional Lipid Profile Destination: subsection.3.2 Item: Title: Advanced Lipid Profile Destination: subsection.3.3 Item: Title: Materials and Methods Destination: section.4 Children: Item: Title: Study Design Destination: subsection.4.1 Item: Title: Study Subjects Destination: subsection.4.2 Item: Title: Methods Destination: subsection.4.3 Children: Item: Title: Conventional Lipid Profile Destination: subsubsection.4.3.1 Item: Title: Advanced Lipoprotein Precipitation Assays Destination: subsubsection.4.3.2 Item: Title: Advanced Lipoprotein Profile by NMR Spectroscopy Destination: subsubsection.4.3.3 Item: Title: Statistical Analyses Destination: subsubsection.4.3.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: The Impact of the Mediterranean Diet and Lifestyle Intervention on Lipoprotein Subclass Profiles among Metabolic Syndrome Patients: Findings of a Randomized Controlled Trial Author: Beatriz Candás-Estébanez, Bárbara Fernández-Cidón, Emili Corbella, Cristian Tebé, Marta Fanlo-Maresma, Virginia Esteve-Luque, Jordi Salas-Salvadó, Montserrat Fitó, Antoni Riera-Mestre, Emilio Ros and Xavier Pintó Subject: Metabolic syndrome (MetS) is associated with alterations of lipoprotein structure and function that can be characterized with advanced lipoprotein testing (ADLT). The effect of the Mediterranean diet (MedDiet) and weight loss on the lipoprotein subclass profile has been scarcely studied. Within the PREDIMED-Plus randomized controlled trial, a sub-study conducted at Bellvitge Hospital recruiting center evaluated the effects of a weight loss program based on an energy-reduced MedDiet (er-MedDiet) and physical activity (PA) promotion (intervention group) compared with energy-unrestricted MedDiet recommendations (control group) on ADLT-assessed lipoprotein subclasses. 202 patients with MetS (n = 107, intervention; n = 95, control) were included. Lipid profiles were determined, and ADLT was performed at baseline, 6, and 12 months. Linear mixed models were used to assess the effects of intervention on lipoprotein profiles. Compared to the control diet, at 12 months, the er-MedDiet+PA resulted in a significant additional 4.2 kg of body weight loss, a decrease in body mass index by 1.4 kg/m2, reduction in waist circumference by 2.2 cm, decreased triglycerides, LDL-cholesterol and non-HDL-cholesterol, and increased HDL-cholesterol. In er-MedDiet+PA participants, ADLT revealed a decrease in small dense-LDL-cholesterol (sd-LDL-C), intermediate-density lipoproteins, VLDL-triglyceride, and HDL-Triglyceride, and an increase in large LDL and large VLDL particles. 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