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Keshani M, Feizi A, Askari G, Sharma M, Bagherniya M. Effects of therapeutic lifestyle change diets on blood lipids, lipoproteins, glycemic parameters, and blood pressure: a systematic review and meta-analysis of clinical trials. Nutr Rev 2024; 82:176-192. [PMID: 37352395 DOI: 10.1093/nutrit/nuad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
CONTEXT Cardiovascular disease is the leading cause of death worldwide. Low-calorie, low-fat therapeutic diets (TDs) developed by the US National Cholesterol Education Program, ie, the Step I and II diets and the therapeutic lifestyle changes diet, are approximately similar and are the initial therapeutic interventional approaches for lifestyle modification. OBJECTIVE This systematic review with meta-analysis was undertaken to evaluate the effects of TDs diet on blood lipids, apolipoprotein A-1, apolipoprotein B, blood pressure, fasting blood glucose, and insulin. DATA SOURCES A comprehensive search of the PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar databases until October 2022 was performed to identify clinical trials investigating the effects of TDs on the aforementioned parameters. DATA EXTRACTION One investigator screened the records and extracted data, and another reviewed the extracted data. DATA ANALYSIS A total of 910 records were retrieved. After records were screened for eligibility, 34 clinical trials met the inclusion criteria. The pooled analysis from the random-effects model revealed a significant reduction in total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-1, and apolipoprotein B in the TD intervention group vs the control group. The overall effects of TDs on fasting blood glucose, insulin, and blood pressure were not significant, but the results of subgroup analysis revealed a significant reduction in fasting blood glucose with the Step II diet and an intervention duration of more than 24 weeks. For blood pressure, the Step I diet and an intervention duration of more than 24 weeks resulted in significant reduction. There was no evidence of publication bias, but strong heterogeneity was observed. CONCLUSION Therapeutic diets have promising effects on lipid profile parameters, glycemic indexes, and blood pressure, which can promote cardiovascular health. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021259355.
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Affiliation(s)
- Mahdi Keshani
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Mohammad Bagherniya
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Niu C, Luo Z, Yu L, Yang Y, Chen Y, Luo X, Lai F, Song Y. Associations of the APOB rs693 and rs17240441 polymorphisms with plasma APOB and lipid levels: a meta-analysis. Lipids Health Dis 2017; 16:166. [PMID: 28874158 PMCID: PMC5586014 DOI: 10.1186/s12944-017-0558-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/31/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The associations of the apolipoprotein B gene (APOB) rs693 and rs17240441 polymorphisms with plasma levels of APOB and lipids have been widely explored, but the results were inconclusive. This meta-analysis aimed to clarify the associations of the rs693 and rs17240441 polymorphisms with fasting APOB and lipid levels. METHODS Sixty-one studies (50,018 subjects) and 23 studies (8425 subjects) were respectively identified for the rs693 and rs17240441 polymorphisms by searching in PubMed, Google Scholar, Web of Science, Cochrane Library, Wanfang, VIP and CNKI databases. The following information was collected for each study: first author, age, gender, ethnicity, health condition, sample size, genotyping, lipid assay method, mean and standard deviation or standard error of APOB and lipid variables by genotypes. A dominant model was used for this meta-analysis. RESULTS The carriers of the rs693 variant allele (T) had higher levels of APOB [standardized mean difference (SMD) = 0.26, 95% confidence interval (CI) = 0.16-0.36, P < 0.01], triglycerides (TG) (SMD = 0.12, 95% CI = 0.05-0.20, P < 0.01), total cholesterol (TC) (SMD = 0.24, 95% CI = 0.17-0.30, P < 0.01) and low-density lipoprotein cholesterol (LDL-C) (SMD = 0.22, 95% CI = 0.14-0.30, P < 0.01), and lower levels of high-density lipoprotein cholesterol (HDL-C) (SMD = -0.06, 95% CI = -0.11-0.01, P = 0.01) than the non-carriers. The carriers of the rs17240441 deletion allele had higher levels of APOB (SMD = 0.13, 95% CI = 0.06-0.20, P < 0.01), TC (SMD = 0.17, 95% CI = 0.07-0.26, P < 0.01) and LDL-C (SMD = 0.15, 95% CI = 0.07-0.23, P < 0.01) than the non-carriers. CONCLUSIONS The rs693 polymorphism is significantly associated with higher levels of APOB, TG, TC and LDL-C, and lower levels of HDL-C. The rs17240441 polymorphism is significantly associated with higher levels of APOB, TC and LDL-C. Further studies are needed to elucidate the underlying mechanisms.
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Affiliation(s)
- Caiqin Niu
- Department of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Zhi Luo
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Liuqin Yu
- Institute of Materia Medica, School of Pharmacy, North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Yang Yang
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Yun Chen
- Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Xin Luo
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Feiya Lai
- School of Clinical Medicine, North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Yongyan Song
- Department of Medical Biochemistry, School of Preclinical Medicine, North Sichuan Medical College, Nanchong, 637000, People's Republic of China.
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Doo M, Won S, Kim Y. Association between the APOB rs1469513 polymorphism and obesity is modified by dietary fat intake in Koreans. Nutrition 2015; 31:653-8. [DOI: 10.1016/j.nut.2014.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/19/2014] [Accepted: 10/19/2014] [Indexed: 01/21/2023]
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Abstract
The Inuit population is often described as being protected against CVD due to their traditional dietary patterns and their unique genetic background. The objective of the present study was to examine gene–diet interaction effects on plasma lipid levels in the Inuit population. Data from the Qanuippitaa Nunavik Health Survey (n553) were analysed via regression models which included the following: genotypes for thirty-five known polymorphisms (SNP) from twenty genes related to lipid metabolism; dietary fat intake including total fat (TotFat) and saturated fat (SatFat) estimated from a FFQ; plasma lipid levels, namely total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and TAG. The results demonstrate that allele frequencies were different in the Inuit population compared with the Caucasian population. Further, seven SNP (APOA1− 75G/A (rs670),APOBXbAI (rs693),AGTM235T (rs699),LIPC480C/T (rs1800588),APOA184T/C (rs5070),PPARG2− 618C/G (rs10865710) andAPOE219G/T (rs405509)) in interaction with TotFat and SatFat were significantly associated with one or two plasma lipid parameters. Another four SNP (APOC33238C>G (rs5128),CETPI405V (rs5882),CYP1A1A4889G (rs1048943) andABCA1Arg219Lys (rs2230806)) in interaction with either TotFat or SatFat intake were significantly associated with one plasma lipid variable. Further, an additive effect of these SNP in interaction with TotFat or SatFat intake was significantly associated with higher TC, LDL-C or TAG levels, as well as with lower HDL-C levels. In conclusion, the present study supports the notion that gene–diet interactions play an important role in modifying plasma lipid levels in the Inuit population.
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Phillips CM, Goumidi L, Bertrais S, Field MR, McManus R, Hercberg S, Lairon D, Planells R, Roche HM. Gene-nutrient interactions and gender may modulate the association between ApoA1 and ApoB gene polymorphisms and metabolic syndrome risk. Atherosclerosis 2010; 214:408-14. [PMID: 21122859 DOI: 10.1016/j.atherosclerosis.2010.10.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2010] [Revised: 10/15/2010] [Accepted: 10/26/2010] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Dyslipidemia is a key feature of the metabolic syndrome (MetS), which is determined by both genetic and dietary factors. METHODS We determined the relationships between ApoA1 and ApoB polymorphisms and MetS risk, and whether dietary fat modulates this in the LIPGENE-SU.VI.MAX study of MetS cases and matched controls (n = 1754). RESULTS ApoB rs512535 and ApoA1 rs670 major G allele homozygotes had increased MetS risk (OR 1.65 [CI 1.24, 2.20], P = 0.0006; OR 1.42 [CI 1.08, 1.87], P = 0.013), which may be, partly, explained by their increased abdominal obesity and impaired insulin sensitivity (P<0.05) but not dyslipidemia. Interestingly these associations derived primarily from the male GG homozygotes (ApoB rs512535 OR 1.92 [CI 1.31, 2.81], P = 0.0008; ApoA1 rs670 OR 1.50 [CI 1.05, 2.12], P = 0.024). MetS risk was exacerbated among the habitual high-fat consumers (>35% energy) (ApoB rs512535 OR 2.00 [CI 1.14, 3.51], P = 0.015; OR 1.58 [CI 1.11, 2.25], P = 0.012 for ApoA1 rs670). In addition a high monounsaturated fat (MUFA) intake (>14% energy) increased MetS risk (OR 1.89 [CI 1.08, 3.30], P = 0.026 and OR 1.57 [CI 1.10, 2.40], P = 0.014 for ApoB rs512535 and ApoA1 rs670, respectively). MetS risk was abolished among the habitual low-fat consumers (<35% energy). Saturated and polyunsaturated fat intake did not modulate MetS risk. CONCLUSION ApoB rs512535 and ApoA1 rs670 may influence MetS risk. Apparent modulation of these associations by gender and dietary fat composition suggests novel gene-gender-diet interactions.
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Affiliation(s)
- Catherine M Phillips
- Nutrigenomics Research Group, UCD Conway Institute, UCD School of Public Health and Population Science, University College Dublin, Belfield, Dublin 4, Ireland
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Wojczynski MK, Gao G, Borecki I, Hopkins PN, Parnell L, Lai CQ, Ordovas JM, Chung BH, Arnett DK. Apolipoprotein B genetic variants modify the response to fenofibrate: a GOLDN study. J Lipid Res 2010; 51:3316-23. [PMID: 20724655 PMCID: PMC2952572 DOI: 10.1194/jlr.p001834] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 08/19/2010] [Indexed: 12/11/2022] Open
Abstract
Hypertriglyceridemia, defined as a triglyceride measurement > 150 mg/dl, occurs in up to 34% of adults. Fenofibrate is a commonly used drug to treat hypertriglyceridemia, but response to fenofibrate varies considerably among individuals. We sought to determine if genetic variation in apolipoprotein B (APOB), an essential core of triglyceride-rich lipoprotein formation, may account for some of the inter-individual differences observed in triglyceride (TG) response to fenofibrate treatment. Participants (N = 958) from the Genetics of Lipid Lowering Drugs and Diet Network study completed a three-week intervention with fenofibrate 160 mg/day. Associations of four APOB gene single nucleotide polymorphisms (SNP) (rs934197, rs693, rs676210, and rs1042031) were tested for association with the TG response to fenofibrate using a mixed growth curve model where the familial structure was modeled as a random effect and cardiovascular risk factors were included as covariates. Three of these four SNPs changed the amino acid sequence of APOB, and the fourth was in the promoter region. TG response to fenofibrate treatment was associated with one APOB SNP, rs676210 (Pro2739Leu), such that participants with the TT genotype of rs676210 had greater TG lowering than those with the CC genotype (additive model, P = 0.0017). We conclude the rs676210 variant may identify individuals who respond best to fenofibrate for TG reduction.
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Affiliation(s)
- Mary K. Wojczynski
- Section on Statistical Genetics, Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Guimin Gao
- Section on Statistical Genetics, Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Ingrid Borecki
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, MO
| | - Paul N. Hopkins
- Cardiovascular Genetics, Cardiology Division, University of Utah, Salt Lake City, UT
| | - Laurence Parnell
- Nutrition and Genomics Laboratory, Jean Mayer-US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Chao-Qiang Lai
- Nutrition and Genomics Laboratory, Jean Mayer-US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Jose M. Ordovas
- Nutrition and Genomics Laboratory, Jean Mayer-US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - B. Hong Chung
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, AL
| | - Donna K. Arnett
- Department of Epidemiology, School of Public Health and Clinical Nutrition Research Center, University of Alabama at Birmingham, Birmingham, AL
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Rudkowska I, Vohl MC. Interaction between diets, polymorphisms and plasma lipid levels. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/clp.10.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lairon D, Lopez-Miranda J, Williams C. Methodology for studying postprandial lipid metabolism. Eur J Clin Nutr 2007; 61:1145-61. [PMID: 17457341 DOI: 10.1038/sj.ejcn.1602749] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Postprandial lipid metabolism in humans has deserved much attention during the last two decades. Although fasting lipid and lipoprotein parameters reflect body homeostasis to some extent, the transient lipid and lipoprotein accumulation that occurs in the circulation after a fat-containing meal highlights the individual capacity to handle an acute fat input. An exacerbated postprandial accumulation of triglyceride-rich lipoproteins in the circulation has been associated with an increased cardiovascular risk. METHODS The important number of studies published in this field raises the question of the methodology used for such postprandial studies, as reviewed. RESULTS Based on our experiences, the present review reports and discuss the numerous methodological issues involved to serve as a basis for further works. These aspects include aims of the postprandial tests, size and nutrient composition of the test meals and background diets, pre-test conditions, characteristics of subjects involved, timing of sampling, suitable markers of postprandial lipid metabolism and calculations. CONCLUSION In conclusion, we stress the need for standardization of postprandial tests.
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Affiliation(s)
- D Lairon
- UMR INSERM 476 Nutrition Humaine et lipides, Faculté de médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France.
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Perez-Martinez P, Perez-Jimenez F, Ordovas JM, Bellido C, Moreno JA, Gomez P, Marin C, Fernandez de la Puebla RA, Paniagua JA, Lopez-Miranda J. The APOB -516C/T polymorphism has no effect on lipid and apolipoprotein response following changes in dietary fat intake in a healthy population. Nutr Metab Cardiovasc Dis 2007; 17:224-229. [PMID: 17367707 DOI: 10.1016/j.numecd.2005.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Revised: 11/02/2005] [Accepted: 11/02/2005] [Indexed: 10/24/2022]
Abstract
Our goal was to determine whether the presence of the -516C/T polymorphism in the APOB gene promoter modifies the lipid response to changes in the amount and quality of dietary fat. We studied 97 young healthy volunteers (70 males and 27 females), 62 homozygotes for the -516C allele (C/C) (47 males and 15 females), 34 heterozygotes for the -516T allele (C/T) (22 males and 12 females) and one male homozygote for the -516T allele (T/T). Subjects consumed three different diets in successive 4-week dietary periods. During the first 28 days, all subjects consumed a saturated fatty acid (SFA)-rich diet (38% fat and 20% SFA). Then, using a randomized crossover design, subjects were assigned a carbohydrate (CHO)-rich diet (30% fat and 55% carbohydrate) or a monounsaturated fatty acid (MUFA)-rich diet (38% fat and 22% MUFA). At the end of each dietary period, plasma concentrations of triacylglycerols and of total, LDL, and HDL cholesterol were measured. No differences in plasma lipid and apolipoprotein response were found after changes in dietary fat intake in relation to the -516C/T polymorphism in our study population. In conclusion, our data suggest that the APOB -516C/T polymorphism has no effect on the lipid profile after changes in dietary fat intake in a healthy population.
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Affiliation(s)
- Pablo Perez-Martinez
- Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n. 14004 Cordoba, Spain
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Boekholdt SM, Peters RJG, Fountoulaki K, Kastelein JJP, Sijbrands EJG. Molecular variation at the apolipoprotein B gene locus in relation to lipids and cardiovascular disease: a systematic meta-analysis. Hum Genet 2003; 113:417-25. [PMID: 12942366 DOI: 10.1007/s00439-003-0988-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2002] [Accepted: 06/02/2003] [Indexed: 10/26/2022]
Abstract
Apolipoprotein B (apoB) is the sole protein component of low-density lipoprotein (LDL) and is thought to play an important role in atherogenesis. We performed a meta-analysis of the associations between the three most frequently investigated polymorphisms (XbaI, signal peptide insertion/deletion, EcoRI) in the apolipoprotein B (APOB) gene, lipid parameters, and the risk of ischemic heart disease (IHD). We restricted our analysis to Caucasians. Homozygotes for the XbaI X+ allele had significantly elevated levels of LDL cholesterol (LDL-C) and apoB, but a decreased risk (OR=0.80; 95%CI: 0.66-0.96) of IHD. Homozygosity for the signal peptide deletion allele was associated with similarly increased levels of LDL-C and apoB, and with an increased risk of IHD (OR=1.30; 95%CI: 1.08-1.58). Subjects homozygous for the rare EcoRI allele had significantly decreased levels of total and LDL cholesterol, but unaltered risk of IHD. We conclude that all three polymorphic apoB sites are associated with altered lipid levels, but not necessarily with a consistently altered risk of IHD. These data suggest that the relationship between apoB levels, hypercholesterolemia and IHD risk cannot have a simple molecular basis in the apoB gene.
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Affiliation(s)
- S Matthijs Boekholdt
- Department of Cardiology, Room F3-241, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
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Masson LF, McNeill G, Avenell A. Genetic variation and the lipid response to dietary intervention: a systematic review. Am J Clin Nutr 2003; 77:1098-111. [PMID: 12716659 DOI: 10.1093/ajcn/77.5.1098] [Citation(s) in RCA: 149] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There is wide interindividual variation in the lipid and lipoprotein responses to dietary change, and the existence of consistent hypo- and hyperresponders supports the hypothesis that responsiveness is related to genetic variation. Many studies have investigated the possibility that the heterogeneity in responsiveness to changes in dietary fat, cholesterol, and fiber intake is explained by variation in genes whose products affect lipoprotein metabolism, eg, apolipoproteins, enzymes, and receptors. A systematic review of the literature was carried out to investigate the effect of genetic variation on the lipid response to dietary intervention. A search strategy for the MEDLINE database retrieved 2540 articles from 1966 to February 2002. This strategy was adapted and performed on the EMBASE database, which retrieved 2473 articles from 1980 to week 9, 2002. Reference lists from relevant journal articles were also checked. This is the first systematic review of the literature, and it summarizes results available from 74 relevant articles. There is evidence to suggest that variation in the genes for apolipoprotein (apo) A-I, apo A-IV, apo B, and apo E contributes to the heterogeneity in the lipid response to dietary intervention. However, the effects of genetic variation are not consistently seen and are sometimes conflicting. Future studies need to have much larger sample sizes based on power calculations and carefully controlled dietary interventions and should investigate the effects of polymorphisms in multiple genes instead of the effects of polymorphisms in single genes.
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Affiliation(s)
- Lindsey F Masson
- Department of Public Health, University of Aberdeen, Aberdeen, United Kingdom.
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Abstract
Research in the field of gene-diet interactions as determinants of plasma lipid response to dietary interventions has accumulated a substantial body of evidence during the past decade. Several candidate genes have shown some promise as potential markers of individual dietary responsiveness. Among the best characterized are the APOE, APOA4, APOB, APOC3, and LPL loci. Other genes are being continuously incorporated to this most interesting search. However, in very few cases has consensus been achieved about the usefulness of genetic markers as clinically significant predictors of dietary response. The increased ability to generate genotypic information, in combination with the knowledge from the human genome project and more comprehensive experimental designs, will dramatically improve our capacity to answer many of our current questions. It will also help to prove that knowledge of an individual's genetic background will facilitate more precise dietary counseling and intervention, and more efficacious primary and secondary coronary heart disease prevention.
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Affiliation(s)
- J M Ordovas
- JM-USDA-Human Nutrition Research Center on Aging, Tufts University School of Medicine, 711 Washington Street, Boston, MA 02111, USA.
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