Effect of a Multifactorial Weight Loss Intervention on HDL Cholesterol Efflux Capacity and Immunosenescence: A Randomized Controlled Trial.

Javier Martinez-Botas, Diego Gómez-Coronado, Gema de la Peña, Jordi Salas-Salvado, M A Martínez-González, Esther Cuadrado-Soto, Jose Ordovas, Laura Díez-Ricote, Lidia Daimiel, Olga Castañer, Andrés Pastor-Fernández, Pablo J Fernández-Marcos

Journal: Journal of the American Nutrition Association 2025;44(2):166-179

PMID: 39384179

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Plain Language Summary

High-density lipoprotein (HDL) cholesterol efflux capacity (CEC), which is a measure of how well HDL cholesterol can remove fat from cells, and immunosenescence, the gradual deterioration of the immune system, are associated with ageing. This 3-year, randomised control trial of 56 individuals examined how a lifestyle intervention, which included a reduced-calorie Mediterranean diet (erMedDiet), physical activity, and behavioural support, affects these health markers related to ageing and heart health.

The results showed that the lifestyle changes positively influenced HDL functionality and may help in managing aspects of ageing and cardiovascular health.

It was concluded that dietary and lifestyle modifications involving a erMED diet, activity, and support can have beneficial effects on important health markers This study could be used by healthcare professionals to understand that ageing is influenced by diet and lifestyle and that recommending an erMED may be beneficial for healthy ageing, immune function, and heart health.

Abstract

OBJECTIVE

Life expectancy and obesity prevalence are increasing worldwide, leading to an increase in the prevalence of cardiovascular disease. High-density lipoprotein (HDL) functionality and immunosenescence play key roles in cardiovascular disease, longevity, and quality of aging. Both molecular hallmarks of aging are impacted by obesity and metabolic syndrome and can be modulated by lifestyle. We aimed to evaluate the effect of a lifestyle intervention focused on an energy-reduced Mediterranean diet (erMedDiet), physical activity (PA), and behavioral support on HDL cholesterol efflux capacity (CEC) and immunosenescence.

METHOD

CEC and immunosenescent T cells were determined in 60 participants from the control group (CG) and 56 from the intervention group (IG) of the PREDIMED-Plus trial at baseline and after 1 and 3 years of follow-up. PREDIMED-Plus is a randomized, controlled, parallel-group trial with an IG of erMedDiet, PA promotion, and behavioral support for weight loss and a CG of usual primary care advice. The sample included 116 volunteers from the PREDIMED-Plus-IMDEA subsample of the PREDIMED-Plus trial. Men aged 55 to 75 years and women aged 60 to 75 years with a body mass index between 27 and 40 kg/m and metabolic syndrome were included.

RESULTS

Participants within the IG had significantly improved CEC (2.42% and 10.69% after 1 and 3 years of follow-up) and a decreased in senescent T cell profile (-3.32% ± 12.54% and -6.74% ± 11.2%, < 0.001, after 1 and 3 years of follow-up). Baseline obesity status impacted the response to the intervention.

CONCLUSIONS

A weight loss intervention program with erMedDiet and PA ameliorated senescence markers.

Address: Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM+CSIC, Madrid, Spain.; Metabolic Syndrome Group-BIOPROMET, Madrid Institute for Advanced Studies-IMDEA Food, CEI UAM+CSIC, Madrid, Spain.; Servicio de Bioquímica-Investigación, Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain.; Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, Madrid, Spain.; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain.; Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, Madrid, Spain.; Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain.; Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, Madrid, Spain.; Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain.; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain.; Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, Madrid, Spain.; Nutritional Genomics and Epigenomics Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM+CSIC, Madrid, Spain.; Nutrition and Genomics Laboratory, JM_USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA.

DOI: 10.1080/27697061.2024.2407942

Patient Centred Factor

Mediators

Clinical Imbalances

Detoxification and Biotransformation Immune and inflammation

Laboratory Testing

Blood Imaging

Modifiable Lifestyle Factors

Diet Relationships and network Exercise and movement

Jadad Score

Allocation Concealment

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https://www.tandfonline.com/doi/10.1080/27697061.2...

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MeSH Terms: Aged, Female, Humans, Male, Middle Aged, Cholesterol, HDL, Diet, Mediterranean, Exercise, Immunosenescence, Metabolic Syndrome, Obesity, Weight Loss, Weight Reduction Programs