Yearly attained adherence to Mediterranean diet, estimated trajectories of lipid profile from 60 to 80 years, and onset of clinical dyslipidemias in older adults at high cardiovascular risk

PURPOSE: To investigate the association between yearly attained adherence to a Mediterranean diet (MedDiet) and trajectories of triglycerides, high-density lipoprotein cholesterol (HDL-C), and the low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio, as well as the risk of clinically relevant dyslipidemias, in adults aged 60-80 at high cardiovascular risk. METHODS: In 4,954 participants (68.1 ± 5.5 years, 62% women, median follow-up: 4 years) from the Prevención con Dieta Mediterránea trial, trajectories of triglycerides, HDL-C, and LDL-C/HDL-C were compared between participants with high or low cumulative adherence to the MedDiet (≥ 10 vs. <10 points) over time. The association between high MedDiet adherence and the risk of five dyslipidemias (triglycerides ≥ 150 or ≥ 200 mg/dL; low HDL-C; LDL-C ≥ 130 or ≥ 160 mg/dL) was examined using multivariable Cox regressions. RESULTS: Compared with low adherence to the MedDiet, high adherence was associated with lower triglycerides (differences in the range: -6 to -12 mg/dL), particularly among individuals using triglyceride-lowering medications (-17 to -41 mg/dL). High adherence was also associated with higher HDL-C (+ 0.8 to + 2.3 mg/dL) and lower LDL-C/HDL-C ratio. High adherence to the MedDiet was associated with a lower risk of all dyslipidemias (range: -21% to -45%). One-point increases in adherence were associated with a 48-91% lower dyslipidemia risk among individuals with low adherence (< 8 points). CONCLUSION: In adults aged 60-80 at high cardiovascular risk, greater long-term adherence to a MedDiet was associated with a better lipid profile and a lower risk of clinically relevant dyslipidemias. TRIAL REGISTRATION NUMBER: ISRCTN35739639 (registration date: Oct 5, 2005).