Energy-restricted Mediterranean diet plus physical activity improves HDL function

An energy-restricted Mediterranean diet combined with physical activity (PA) results in better high-density lipoprotein (HDL) triglyceride metabolism compared with a nonrestrictive diet without PA in older adults with metabolic syndrome (MetS), reports a study.

The authors assessed the effect of a 6-month intervention with an energy-restricted Mediterranean diet plus PA (intensive lifestyle; n=190) relative to a nonrestrictive Mediterranean diet without PA (control; n=201) on a set of HDL functional traits in 391 older adults with MetS (mean age 65 years, mean body mass index 33.3 kg/m²) for one of the Prevención con Dieta Mediterránea-Plus trial centres.

Such traits included cholesterol efflux capacity, HDL oxidative/inflammatory index, HDL oxidation, and levels of complement component 3, serum amyloid A, sphingosine-1-phosphate, triglycerides, and apolipoproteins A-I, A-IV, C-III, and E in apoB-depleted plasma.

Participants in the intensive-lifestyle group showed greater 6-month weight reductions (–3.83 kg, 95 percent confidence interval [CI], –4.57 to –3.09) but no changes in HDL cholesterol compared with control-diet participants.

For HDL functional traits, the intensive lifestyle intervention reduced triglyceride levels (–0.15 mg/g protein, 95 percent CI, –0.29 to –0.014) and apoC-III (–0.11 mg/g protein, 95 percent CI, –0.18 to –0.026) compared to the control diet, with weight loss being the essential mediator: proportions of mediation were 77.4 percent for triglycerides and 72.1 percent for apoC-III levels in HDL.

“Consumption of a Mediterranean diet, adequate levels of PA, and energy-restricted lifestyle interventions have been individually associated with improvements in HDL functions,” the authors said.