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

Ann Intern Med. 2001 Jun 19;134(12):1115-9. doi: 10.7326/0003-4819-134-12-200106190-00011.


Background: The regulatory function of the endothelium is altered in hypercholesterolemia, and the subsequent endothelial dysfunction plays a central role in the development of atherosclerosis.

Objective: To determine whether endothelial function in hypercholesterolemic patients is affected by replacing a saturated fat-enriched diet with a low-fat, low-saturated fat diet (the U.S. National Cholesterol Education Program stage 1 [NCEP-1] diet) or a diet rich in monounsaturated fat (such as that common in Mediterranean countries).

Design: Intervention dietary study with a baseline phase and two randomized crossover dietary periods.

Setting: Hospital Universitario Reina Sofía, Córdoba, Spain.

Patients: 22 hypercholesterolemic men.

Intervention: Patients followed a diet high in saturated fat, then were assigned in a crossover design to the NCEP-1 diet or a Mediterranean diet. Each dietary period lasted 28 days.

Measurements: Plasma P-selectin levels, lipid concentrations, and endothelial function.

Results: Compared with the saturated fat diet, flow-mediated dilatation increased during the Mediterranean diet but not during the NCEP-1 diet. In addition, levels of plasma cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, and P-selectin decreased during the NCEP-1 and Mediterranean diets.

Conclusion: In hypercholesterolemic men, diets low in fat (especially saturated fat) and diets rich in monounsaturated fats improve endothelial function.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Cross-Over Studies
  • Dietary Fats / administration & dosage*
  • Endothelium, Vascular / physiology*
  • Fatty Acids / administration & dosage
  • Fatty Acids, Monounsaturated / administration & dosage*
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / diet therapy*
  • Hypercholesterolemia / physiopathology*
  • Lipids / blood
  • Male
  • Middle Aged
  • P-Selectin / blood
  • Vasodilation


  • Dietary Fats
  • Fatty Acids
  • Fatty Acids, Monounsaturated
  • Lipids
  • P-Selectin