Inhibition of circulating immune cell activation: a molecular antiinflammatory effect of the Mediterranean diet

Am J Clin Nutr. 2009 Jan;89(1):248-56. doi: 10.3945/ajcn.2008.26094. Epub 2008 Dec 3.


Background: Adherence to the Mediterranean diet (Med-Diet) is associated with a reduced risk of cardiovascular disease (CVD). However, the molecular mechanisms involved are not fully understood.

Objective: The objective was to compare the effects of 2 Med-Diets with those of a low-fat diet on immune cell activation and soluble inflammatory biomarkers related to atherogenesis in subjects at high risk of CVD.

Design: In a controlled study, we randomly assigned 112 older subjects with diabetes or > or =3 CVD risk factors to 3 dietary intervention groups: Med-Diet with supplemental virgin olive oil (VOO), Med-Diet with supplemental nuts, and low-fat diet. Changes from baseline in cellular and serum inflammatory biomarkers were assessed at 3 mo.

Results: One hundred six participants (43% women; average age: 68 y) completed the study. At 3 mo, monocyte expression of CD49d, an adhesion molecule crucial for leukocyte homing, and of CD40, a proinflammatory ligand, decreased (P < 0.05) after both Med-Diets but not after the low-fat diet. Serum interleukin-6 and soluble intercellular adhesion molecule-1, inflammatory mediators crucial in firm adhesion of leukocytes to endothelial surfaces, decreased (P < 0.05) in both Med-Diet groups. Soluble vascular cellular adhesion molecule-1 and C-reactive protein decreased only after the Med-Diet with VOO (P < 0.05), whereas interleukin-6, soluble vascular cellular adhesion molecule-1, and soluble intercellular adhesion molecule-1 increased (P < 0.05) after the low-fat diet.

Conclusions: Med-Diets supplemented with VOO or nuts down-regulate cellular and circulating inflammatory biomarkers related to atherogenesis in subjects at high risk of CVD. The results support the recommendation of the Med-Diet as a useful tool against CVD.

Publication types

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

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / immunology*
  • Cardiovascular Diseases / prevention & control*
  • Cytokines / biosynthesis
  • Cytokines / blood
  • Diet, Fat-Restricted
  • Diet, Mediterranean*
  • Female
  • Humans
  • Immunity, Cellular
  • Inflammation / blood*
  • Inflammation / immunology*
  • Intercellular Adhesion Molecule-1 / blood
  • Leukocytes, Mononuclear / immunology
  • Leukocytes, Mononuclear / physiology
  • Male
  • Middle Aged
  • Nuts
  • Olive Oil
  • Plant Oils / administration & dosage
  • Risk Factors
  • Vascular Cell Adhesion Molecule-1 / blood


  • Biomarkers
  • Cytokines
  • Olive Oil
  • Plant Oils
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein