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Purpose: The aim of the present study was to assess the association between the dietary total antioxidant capacity, the dietary intake of different antioxidants and mortality in a Mediterranean population at high cardiovascular disease risk., Methods: A total of 7,447 subjects from the PREDIMED study (multicenter, parallel group, randomized controlled clinical trial), were analyzed treating data as an observational cohort. Different antioxidant vitamin intake and total dietary antioxidant capacity were calculated from a validated 137-item food frequency questionnaire at baseline and updated yearly. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were fitted to assess the relationship between dietary total antioxidant capacity and mortality. Dietary total antioxidant capacity was estimated using ferric-reducing antioxidant power assays., Results: A total of 319 deaths were recorded after a median follow-up of 4.3 years. Subjects belonging to the upper quintile of antioxidant capacity were younger, ex-smokers, with high educational level, and more active and had higher alcohol intake. Multivariable-adjusted models revealed no statistically significant difference between total dietary antioxidant capacity and mortality (Q5 vs. Q1 ref HR 0.85; 95% CI 0.60-1.20) neither for the intake of all the vitamins studied., Conclusions: No statistically significant association was found between antioxidant capacity and total mortality in elderly subjects at high cardiovascular risk.

Background and Aims: The intake of antioxidant-rich foods may increase the blood levels of non enzymatic antioxidant capacity (NEAC). NEAC takes into account all antioxidants from food and synergistic effects between them. We examined the effect of a 1-year intervention with Mediterranean diet on plasma NEAC and assessed whether it was related to baseline NEAC levels., Methods and Results: Five hundred sixty-four participants at high cardiovascular risk were randomly selected from the PREDIMED (Prevención con DIeta MEDiterránea) Study, a large 3-arm randomized clinical trial. Blood NEAC levels were measured at baseline and after 1-year of dietary intervention with 1) a Mediterranean diet supplemented with virgin olive oil (MED + VOO); 2) a Mediterranean diet supplemented with nuts (MED + nuts), or 3) a control low-fat diet. Plasma NEAC was analyzed using FRAP (ferric reducing antioxidant potential) and TRAP (total radical-trapping antioxidant parameter) assays. Plasma FRAP levels increased after 1-year of intervention with MED + VOO [72.0 μmol/L (95% CI, 34.2-109.9)] and MED + nuts [48.9 μmol/L (24.3-73.5)], but not after the control low-fat diet [13.9 μmol/L (-11.9 to 39.8)]. Participants in the lowest quartile of plasma FRAP at baseline significantly increased their levels after any intervention, while those in the highest quartile decreased. Similar results occurred with TRAP levels., Conclusions: This study shows that a 1-year of MED diet intervention increases plasma TAC level in subjects at high risk for cardiovascular disease. Moreover, the effectiveness of dietary supplementation with antioxidants may be related to baseline levels of plasma NEAC., (© 2013 Elsevier B.V. All rights reserved.)

Objectives: To assess the effect of two similar olive oils, but with differences in their phenolic compounds (powerful antioxidant compounds), on inflammatory markers in stable coronary heart disease patients., Design: Placebo-controlled, crossover, randomized trial., Setting: Cardiology Department of Hospital del Mar and Institut Municipal d'Investigació Mèdica (Barcelona)., Subjects: Twenty-eight stable coronary heart disease patients., Interventions: A raw daily dose of 50 ml of virgin and refined olive oil (ROO) was sequentially administered over two periods of 3-weeks, preceded by 2-week washout periods in which ROO was used., Results: Interleukin-6 (P<0.002) and C-reactive protein (P=0.024) decreased after virgin olive oil intervention. No changes were observed in soluble intercellular and vascular adhesion molecules, glucose and lipid profile., Conclusions: Consumption of virgin olive oil, could provide beneficial effects in stable coronary heart disease patients as an additional intervention to the pharmacological treatment.

The Mediterranean diet, in which olive oil is the main source of fat, has been associated with a reduced incidence of coronary heart disease (CHD) and low blood pressure levels. Virgin olive oil (VOO), besides containing monounsaturated fat, is rich in phenolic compounds (PC) with antioxidant properties. The aim of this study was to examine the antioxidant and anti-hypertensive effect of two similar olive oils, but with differences in their PC (refined: 14.7 mg/kg versus virgin: 161.0 mg/kg), in 40 males with stable CHD. The study was a placebo controlled, crossover, randomized trial. A raw daily dose of 50 mL of VOO and refined olive oil (ROO) were sequentially administered over two periods of 3 weeks, preceded by 2-week washout periods in which ROO was used. Lower plasma oxidized LDL (p < 0.001) and lipid peroxide levels (p = 0.003), together with higher activities of glutathione peroxidase (p = 0.033), were observed after VOO intervention. Systolic blood pressure decreased after intake of VOO (p = 0.001) in hypertensive patients. No changes were observed in diastolic blood pressure, glucose, lipids, and antibodies against oxidized LDL. Consumption of VOO, rich in PC, could provide beneficial effects in CHD patients as an additional and complementary intervention to the pharmacological treatment.

Olive oil phenolic compounds are generally believed to have beneficial antioxidant effects, but little is known about characteristics of their postprandial bioavailability in natural olive oil at real-life doses. The aim of the present study was to determine the concentrations of olive oil phenolic compounds in urine collected over 24 h (24-h urine) after a bolus ingestion of 25 ml of olive oil with different phenolic content, and to demonstrate the effect of this real-life olive oil dose on postprandial levels of blood lipids and oxidative stress biomarkers, as well as to examine the beneficial effects of olive oil phenols. Oral fat loads of 25 ml olive oil with high, moderate, and low phenolic content were administered to 12 healthy male volunteers in a randomized, controlled, crossover trial. Tyrosol and hydroxytyrosol were absorbed in a dose-dependent manner according to the phenolic content of the olive oil administered. The administered dose of 25 ml, which is close to that used daily in Mediterranean countries, did not induce significant postprandial lipemia nor did it promote an increase of in vivo oxidation markers. With regard to plasma antioxidant enzymes, glutathione peroxidase activity decreased postprandially after low phenolic content olive oil ingestion; however this was not observed after intake of moderate and high phenolic content olive oils. The phenolic content of the olive oils administered may account for the protection of the endogenous antioxidant defenses at postprandial state after ingestion of moderate and high phenolic content olive oils.

Objective: To investigate the absorption of tyrosol and hydroxytyrosol from moderate and sustained doses of virgin olive oil consumption. The study also aimed to investigate whether these phenolic compounds could be used as biomarkers of virgin olive oil intake., Design and Interventions: Ingestion of a single dose of virgin olive oil (50 ml). Thereafter, for a week, participants followed their usual diet which included 25 ml/day of the same virgin olive oil as the source of raw fat., Setting: Unitat de Recerca en Farmacologia. Institut Municipal d'Investigació Mèdica (IMIM)., Subjects: Seven healthy volunteers., Results: An increase in 24 h urine of tyrosol and hydroxytyrosol, after both a single-dose ingestion (50 ml) and short-term consumption (one week, 25 ml/day) of virgin olive oil (P<0.05) was observed. Urinary recoveries for tyrosol were similar after a single dose and after sustained doses of virgin olive oil. Mean recovery values for hydroxytyrosol after sustained doses were 1.5-fold those obtained after a single 50 ml dose., Conclusions: Tyrosol and hydroxytyrosol are absorbed from realistic doses of virgin olive oil. With regard to the dose-effect relationship, 24 h urinary tyrosol seems to be a better biomarker of sustained and moderate doses of virgin olive oil consumption than hydroxytyrosol.

Tyrosol is a phenolic compound present in two of the traditional components of the Mediterranean diet: wine and virgin olive oil. The presence of tyrosol has been described in red and white wines. Tyrosol is also present in vermouth and beer. Tyrosol has been shown to be able to exert antioxidant activity in in vitro studies. Oxidation of low-density lipoprotein (LDL) appears to occur predominantly in arterial intima in microdomains sequestered from antioxidants of plasma. The antioxidant content of the LDL particle is critical for its protection. Thus, phenolics, which are able to bind LDL, could be effective in preventing lipid peroxidation and atherosclerotic processes. The ability of tyrosol to bind human LDL has been reported. We have demonstrated the bioavailability of tyrosol in humans from virgin olive oil in its natural form. Urinary tyrosol increased, reaching a peak at 0-4 h after virgin olive oil administration. Men and women showed a different pattern of urinary excretion of tyrosol. Moreover, tyrosol is absorbed in a dose-dependent manner after sustained and moderate doses of virgin olive oil. In summary, our results suggest that tyrosol from wine or virgin olive oil could exert beneficial effects on human health in vivo if its biological properties are confirmed in in vivo studies.

Alongside the French paradox, the REGICOR Study (Girona, Spain) has shown another paradox in the Mediterranean area: a high prevalence of cardiovascular risk factors with low incidence of myocardial infarction in the population of Girona, Spain. The antioxidant effects associated with olive oil consumption could explain part of this 'Mediterranean Paradox'. Virgin olive oils processed by two centrifugation phases and with low fruit ripeness have the highest levels of antioxidant content. The total content of phenolic compounds (PC) from virgin olive oil could delay LDL oxidation. The content and nature of olive oil PC have a high influence in the antioxidant capacity of an olive oil. PC from diet could bind human LDL in non-supplemented volunteers. PC from virgin olive oil could bind LDL and tyrosol is bioavailable in humans from ingestion of virgin olive oil in its natural form.

Background: To investigate the protective effect of several olive oils with different phenolic composition on low density lipoprotein susceptibility to oxidation., Patients and Methods: Refined olive oil (phenolic content: 0 mg/l caffeic acid equivalents [CAE]), common olive oil (0.1 and 0.3 mg/l CAE), and virgin olive oil diluted with refined olive oil (0.1 y 0.3 mg/l CAE), were added to isolated low density lipoprotein. Conjugated dienes formation was monitored after copper-mediated low density lipoprotein oxidation., Results: An increase in the lag time of conjugated dienes formation after copper-mediated low density lipoprotein oxidation was observed linked to olive oil phenolic content (p < 0.0001, ANOVA). Multiple regression analysis showed that phenolics were the most significant antioxidants with 0.1 mg/l--increase in phenolic concentration, adjusted for alpha-tocopherol and beta-carotene, was 72 minutes (95% confidence interval [CI] 64 to 80 min) for common olive oil, and 111 min (CI 95%: 100-123 min) for virgin olive oil. In common olive oil alpha-tocopherol levels were significatively associated with the increase in the lag time (p = 0.003), reaching in virgin olive oil a borderline significant (p = 0.084)., Conclusions: Olive oil containing phenolics showed more antioxidant effect on low density lipoprotein oxidation than refined olive in relation to its phenolic content. The nature of the phenolic content influences the antioxidant capacity of an olive oil.

A correction to the article "Dietary Total Antioxidant Capacity and Mortality in the PREDIMED Study" by P. Henríquez-Sánchez et al. which appeared in the December 8, 2021 issue is presented.

Several lines of evidence suggest that patients with essential hypertension have impaired endothelial nitric oxide activity and increased superoxide anion production. However, the mechanisms underlying these abnormalities remain unknown. We measured enzymatic superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities in erythrocytes and whole blood, respectively, in 30 newly-diagnosed, normolipidaemic untreated mild hypertensive patients and in 164 age-matched healthy controls. SOD and GPX activities in hypertensive patients (806 ± 225 U/Hb.g and 5491 ± 2073 U/L, respectively) were significantly lower than in the control group (931 ± 202 U/Hb.g and 6669 ± 1560 U/L, respectively) (P < 0.005). No significant association was found between these antioxidant enzyme activities and blood pressure in normotensive controls. In the hypertensives, only log-transformed SOD activity showed a significant negative correlation with systolic and diastolic blood pressure (r = 0.37, P < 0.05; r = 0.64, P < 0.0001, respectively). The low endogenous antioxidant enzyme activities observed may in turn result in decreased superoxide anion removal leading to nitric oxide inactivation. [ABSTRACT FROM AUTHOR]