The Mediterranean diet, our traditional food heritage, has healthy effects on morbidity and mortality related to cardiovascular diseases that have been widely described and scientifically proven. In this context, the main objective of our nutritional intervention studies is to determine the effect of diet on cardiovascular risk factors and cardiovascular diseases, as well as to establish the cellular and molecular mechanisms that contribute to these beneficial effects. In addition to bioavailability studies, we would highlight the following large-scale nutritional intervention studies:

  • PREDIMED:  this randomized, parallel, multicentre study of 7447 individuals with elevated cardiovascular risk coordinated by Dr. Estruch of Hospital Clínic in Barcelona. Three intervention groups were studied: two groups followed a Mediterranean diet, one enriched with virgin olive oil and the other with nuts and a control group followed a low-fat diet. The effects on primary and secondary markers of cardiovascular disease were assessed.
  • PREDIMED-plus: multicentre study coordinated by Dr. Salas-Salvador of Universitat Rovira i Virgili in Reus. The study aims at the usefulness of a Mediterranean diet with energy restriction, associated with behavioural support and lifestyle changes, in the primary prevention of cardiovascular events in patients with metabolic syndrome. This study is currently in the intervention phase, which is intended to end the year 2022

The study of the underlying mechanisms the benefit of a healthy diet is focused on the classic risk factors and emerging biomarkers (inflammatory and oxidative state, lipid profile, HDL functionality, LDL atherogenicity, endothelial function and insulin resistance), the nutrigenomic effects promoted by nutrients and their interaction with the intestinal flora. According to this, we highlight 3 emerging research lines:

  1. Role of high density lipoproteins (HDLs): the EUROLIVE and PREDIMED studies show that consuming a Mediterranean diet and virgin olive oil increases HDL cholesterol. However, in recent years, it has been reported that the quality of HDLs could be equally or more important than the quantity of cholesterol they transport. The objective of this line of research is to establish which characteristics of HDLs can be improved by nutritional intervention, such as the capacity to remove cholesterol from human cells, antioxidant capacity, and pro- or anti-inflammatory effects.
  2. Nutrigenomics: our study of changes in gene expression that can be attributed to nutrients. In numerous nutritional intervention studies, we have demonstrated favorable changes in gene expression in peripheral mononuclear cells, particularly related to inflammation, insulin resistance, blood pressure, cholesterol, and atheroschlerosis.
  3. Interaction between diet and intestinal flora: changes in microbiotic intestinal flora produced by a nutritional intervention are studied (Mediterranean diet key food such as olive oil and bread) Researchers are analyzing nutrient absorption, modifications in the structure of phenol compounds and in the metabolism of cholesterol and of fatty acids in general. The permeability of intestinal mucous is modified by the presence and activity of particular microorganisms, affecting the circulatory system’s absorption of nutrients and toxins.

Agüero F, Dégano IR, Subirana I, Grau M, Zamora A, Sala J, Ramos R, Treserras R, Marrugat J, Elosua R

Impact of a partial smoke-free legislation on myocardial infarction incidence, mortality and case-fatality in a population-based registry: the REGICOR Study.

PLoS ONE 2013 8 (1): e53722, PMID: 23372663


Bayés de Luna A, Elosua R

Sudden death.

Rev Esp Cardiol (Engl Ed) 2012 Nov; 65 (11): 1039-52, PMID: 22959179


Marrugat J, Arboix A, García-Eroles L, Salas T, Vila J, Castell C, Tresserras R, Elosua R

[The estimated incidence and case fatality rate of ischemic and hemorrhagic cerebrovascular disease in 2002 in Catalonia].

Rev Esp Cardiol 2007 Jun; 60 (6): 573-80, PMID: 17580045


Gil M, Martí H, Elosua R, Grau M, Sala J, Masiá R, Pérez G, Roset P, Bielsa O, Vila J, Marrugat J

[Analysis of trends in myocardial infarction case-fatality, incidence and mortality rates in Girona, Spain, 1990-1999].

Rev Esp Cardiol 2007 Apr; 60 (4): 349-56, PMID: 17521543


Marrugat J, Sala J, Aboal J

[Epidemiology of cardiovascular disease in women].

Rev Esp Cardiol 2006 Mar; 59 (3): 264-74, PMID: 16712751


Sala J, Rohlfs I, García MM, Masiá R, Marrugat J

[Effect of reactions to symptoms onset on early mortality from myocardial infarction].

Rev Esp Cardiol 2005 Dec; 58 (12): 1396-402, PMID: 16371198


Marrugat J, Elosua R, Martí H

[Epidemiology of ischaemic heart disease in Spain: estimation of the number of cases and trends from 1997 to 2005].

Rev Esp Cardiol 2002 Apr; 55 (4): 337-46, PMID: 11975899


Masiáa R, Sala J, Marrugat J, Pena A

[Prevalence of atrial fibrillation in the province of Girona, Spain: the REGICOR study].

Rev Esp Cardiol 2001 Oct; 54 (10): 1240, PMID: 11591309


Marrugat J, Elosua R, Gil M

[Epidemiology of sudden cardiac death in Spain].

Rev Esp Cardiol 1999 Sep; 52 (9): 717-25, PMID: 10523884


Pérez G, Pena A, Sala J, Roset P, Masiá R, Marrugat J

Acute myocardial infarction case fatality, incidence and mortality rates in a population registry in Gerona, Spain, 1990-1992. REGICOR Investigators.

Int J Epidemiol 1998 Aug; 27 (4): 599-604, PMID: 9758113


Porta M, Marrugat J, Pérez G

Trends in cardiovascular mortality and the quality of vital statistics.

J Clin Epidemiol 1997 Feb; 50 (2): 221-2, PMID: 9120518


Marrugat J, Sala J

[Registries of morbimortality in cardiology: methods].

Rev Esp Cardiol 1997 Jan; 50 (1): 48-57, PMID: 9053947


Pérez G, Marrugat J, Sala J

Myocardial infarction in Girona, Spain: attack rate, mortality rate and 28-day case fatality in 1988. Regicor Study Group.

J Clin Epidemiol 1993 Oct; 46 (10): 1173-9, PMID: 8410101


Pérez G, Marrugat J, Sunyer J, Sala J

[Sudden cardiac death in the counties of Girona].

Med Clin (Barc) 1992 Oct; 99 (13): 489-92, PMID: 1434972