Abstract P3097: Cardiometabolic Changes by Presence of Lipid Lowering Medications when Following a Vegan Diet High or Low in Extra Virgin Olive Oil

Introduction: Lipid levels are influenced by diet composition, pharmacotherapy, and severity of cardiovascular disease (CVD) risk both alone and in combination. Objective: To compare changes in apolipoprotein B (apoB), low-density lipoprotein cholesterol (LDL-C), and additional lipid biomarkers by treatment with lipid lowering medications (LLM) when following a vegan diet high or low in extra virgin olive oil (EVOO). We hypothesized greater lipid reduction among those not taking LLM compared to those taking LLM. Methods: In a secondary analysis from a 9-week randomized crossover trial in which adults at >5% risk for atherosclerotic CVD followed a high or low EVOO vegan diet for 4 weeks each (comprised of 48% and 32% dietary fat, respectively), we evaluated changes in blood lipids/lipoproteins from baseline by medication status. Independent t-tests compared levels between those taking and not taking LLM. Results: Of 40 participants (75% female, BMI 32 + 7 kg/m 2 , age 64 + 9 years mean + SD), 53% reported taking an LLM. Among those taking an LLM, apoB decreased -13.7 + 3.5 (mean + SEM) vs -2.8 + 3.2 mg/dl in absence of LLM during the low EVOO (p=0.03) and -3.2 + 3.7 vs -7.1 + 3.3 mg/dl during the high EVOO (p=0.4) diets. LDL-C reductions were comparable during the low EVOO diet (-13.6 + 4.9 with LLM vs -10.8 + 4.8 mg/dl without LLM, p=0.7). During the high EVOO diet, LDL-C decreased -8.4 + 3.9 with LLM vs -14 + 5.4 mg/dl without LLM, p=0.4. Minimal differences were observed in total cholesterol, high density lipoprotein cholesterol, and triglycerides between LLM and no LLM. Conclusions: A combination of a low EVOO vegan diet with LLM yielded the greatest lipid lowering effects, while the most potentially meaningful lipid reduction during a high EVOO vegan diet occurred without LLM. These differences may reflect individuals’ ability to effectively manage dietary fat intake that can occur with more severe lipid dysregulation warranting an LLM.