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Law HG, Stanhope KL, Zhang W, Myagmarsuren M, Jamshed ZM, Khan MA, Bang H, Havel PJ, Berglund L, Enkhmaa B. Lipoprotein(a) and diet: consuming sugar-sweetened beverages lowers lipoprotein(a) levels in obese and overweight adults. J Lipid Res 2024; 65:100588. [PMID: 38969065 PMCID: PMC11345294 DOI: 10.1016/j.jlr.2024.100588] [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] [Received: 04/04/2024] [Revised: 06/12/2024] [Accepted: 06/28/2024] [Indexed: 07/07/2024] Open
Abstract
Lipoprotein(a) [Lp(a)] contributes to cardiovascular disease risk. A genetically determined size polymorphism in apolipoprotein(a) [apo(a)], determined by the number of Kringle (K) repeats, inversely regulates Lp(a) levels. Nongenetic factors including dietary saturated fat influence Lp(a) levels. However, less is known about the effects of carbohydrates including dietary sugars. In this double-blind, parallel arm study among 32 overweight/obese adults, we investigated the effect of consuming glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks on Lp(a) level and assessed the role of the apo(a) size polymorphism. The mean (±SD) age of participants was 54 ± 8 years, 50% were women, and 75% were of European descent. Following the 10-week intervention, Lp(a) level was reduced by an average (±SEM) of -13.2% ± 4.3% in all participants (P = 0.005); -15.3% ± 7.8% in the 15 participants who consumed glucose (P = 0.07); and -11.3% ± 4.5% in the 17 participants who consumed fructose (P = 0.02), without any significant difference in the effect between the two sugar groups. Relative changes in Lp(a) levels were similar across subgroups of lower versus higher baseline Lp(a) level or carrier versus noncarrier of an atherogenic small (≤22K) apo(a) size. In contrast, LDL-C increased. In conclusion, in older, overweight/obese adults, consuming sugar-sweetened beverages reduced Lp(a) levels by ∼13% independently of apo(a) size variability and the type of sugar consumed. The Lp(a) response was opposite to that of LDL-C and triglyceride concentrations. These findings suggest that metabolic pathways might impact Lp(a) levels.
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Affiliation(s)
- Hayley G Law
- Department of Internal Medicine, University of California Davis, Davis, CA, USA
| | - Kimber L Stanhope
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California Davis, Davis, CA, USA
| | - Wei Zhang
- Department of Internal Medicine, University of California Davis, Davis, CA, USA
| | | | - Zahraa M Jamshed
- Department of Internal Medicine, University of California Davis, Davis, CA, USA
| | - Muhammad A Khan
- Department of Internal Medicine, University of California Davis, Davis, CA, USA
| | - Heejung Bang
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Peter J Havel
- Department of Molecular Biosciences, School of Veterinary Medicine and Department of Nutrition, University of California Davis, Davis, CA, USA
| | - Lars Berglund
- Department of Internal Medicine, University of California Davis, Davis, CA, USA
| | - Byambaa Enkhmaa
- Department of Internal Medicine, University of California Davis, Davis, CA, USA.
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Nuotio P, Lankinen MA, Meuronen T, de Mello VD, Sallinen T, Virtanen KA, Pihlajamäki J, Laakso M, Schwab U. Dietary n-3 alpha-linolenic and n-6 linoleic acids modestly lower serum lipoprotein(a) concentration but differentially influence other atherogenic lipoprotein traits: A randomized trial. Atherosclerosis 2024; 395:117562. [PMID: 38714425 DOI: 10.1016/j.atherosclerosis.2024.117562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND AND AIMS Lipoprotein(a) [Lp(a)] is a causal, genetically determined cardiovascular risk factor. Limited evidence suggests that dietary unsaturated fat may increase serum Lp(a) concentration by 10-15 %. Linoleic acid may increase Lp(a) concentration through its endogenous conversion to arachidonic acid, a process regulated by the fatty acid desaturase (FADS) gene cluster. We aimed to compare the Lp(a) and other lipoprotein trait-modulating effects of dietary alpha-linolenic (ALA) and linoleic acids (LA). Additionally, we examined whether FADS1 rs174550 genotype modifies Lp(a) responses. METHODS A genotype-based randomized trial was performed in 118 men homozygous for FADS1 rs174550 SNP (TT or CC). After a 4-week run-in period, the participants were randomized to 8-week intervention diets enriched with either Camelina sativa oil (ALA diet) or sunflower oil (LA diet) 30-50 mL/day based on their BMI. Serum lipid profile was measured at baseline and at the end of the intervention. RESULTS ALA diet lowered serum Lp(a) concentration by 7.3 % (p = 0.003) and LA diet by 9.5 % (p < 0.001) (p = 0.089 for between-diet difference). Both diets led to greater absolute decreases in individuals with higher baseline Lp(a) concentration (p < 0.001). Concentrations of LDL cholesterol (LDL-C), non-HDL-C, remnant-C, and apolipoprotein B were lowered more by the ALA diet (p < 0.01). Lipid or lipoprotein responses were not modified by the FADS1 rs174550 genotype. CONCLUSIONS A considerable increase in either dietary ALA or LA from vegetable oils has a similar Lp(a)-lowering effect, whereas ALA may lower other major atherogenic lipids and lipoproteins to a greater extent than LA. Genetic differences in endogenous PUFA conversion may not influence serum Lp(a) concentration.
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Affiliation(s)
- Petrus Nuotio
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland.
| | - Maria A Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland
| | - Topi Meuronen
- Food Sciences Unit, Department of Life Technologies, Faculty of Technology, University of Turku, 20500, Turku, Finland
| | - Vanessa D de Mello
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland
| | - Taisa Sallinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland
| | - Kirsi A Virtanen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029, Kuopio, Finland; Turku PET Centre, University of Turku, 20520, Turku, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029, Kuopio, Finland
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, 70029, Kuopio, Finland; Kuopio University Hospital, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029, Kuopio, Finland
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3
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Riley TM, Sapp PA, Kris-Etherton PM, Petersen KS. Effects of saturated fatty acid consumption on lipoprotein (a): a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2024:S0002-9165(24)00591-4. [PMID: 38964657 DOI: 10.1016/j.ajcnut.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/10/2024] [Accepted: 06/28/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND An inverse relationship between saturated fatty acid (SFA) intake and Lp(a) concentration has been observed; however, there has been no quantification of this effect. OBJECTIVES The objective was to determine whether SFA consumption alters Lp(a) concentrations among adults without atherosclerotic cardiovascular disease (ASCVD). METHODS A systematic review and meta-analysis of randomized controlled trials contrasting a lower SFA diet(s) with a higher SFA diet(s) among adults without ASCVD was conducted. PubMed, Cochrane Central Register of Clinical Trials, clinicaltrials.gov, and Web of Science databases and registers were searched through October 2023. The standardized mean difference (SMD) in Lp(a) between diets lower and higher in SFA [percentage of energy (%E)] was determined using random-effects meta-analysis. Analyses were also conducted to examine the effect of replacing SFA with carbohydrates (CHO), monounsaturated (MUFAs), polyunsaturated (PUFAs), or trans fatty acids (TFAs). RESULTS In total, 6255 publications were identified in the systematic search. Twenty-six publications reporting 27 randomized controlled trials, including 1325 participants and 49 diet comparisons, were included. The mean difference in SFA between lower and higher SFA diets was 7.6%E (3.7%-17.8%E). After lower SFA diets, Lp(a) concentration was higher (SMD: 0.14; 95% confidence interval [CI]: 0.03, 0.24) than after higher SFA diets. Subgroup analyses showed higher Lp(a) following diets where SFA was replaced by CHO (trials = 8; n = 539; SMD: 0.21; 95% CI: 0.02, 0.40) or TFAs (trials = 8; n = 300; SMD: 0.32; 95% CI: 0.17, 0.48). No differences in Lp(a) were observed when MUFA (trials = 16; n = 641; SMD: 0.04; 95% CI: -0.08, 0.16) or PUFA (trials = 8; n = 415; SMD: 0.09; 95% CI: -0.04, 0.22) replaced SFA. CONCLUSIONS Lower SFA diets modestly increase Lp(a) compared to higher SFA diets among individuals without ASCVD. This effect appeared to be driven by replacement of SFA with CHO or TFA. Research investigating the atherogenicity of diet-induced Lp(a) changes is needed to inform dietary management of lipid/lipoprotein disorders. This trial was registered with PROSPERO as CRD42020154169.
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Affiliation(s)
- Terrence M Riley
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States; Department of Nutritional Sciences, The Pennsylvania State University, PA, United States.
| | - Philip A Sapp
- Department of Nutritional Sciences, The Pennsylvania State University, PA, United States; Research, Nutrition, and Innovation, Athletic Greens International, Carson City, NV, United States
| | - Penny M Kris-Etherton
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Kristina S Petersen
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
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Volgman AS, Koschinsky ML, Mehta A, Rosenson RS. Genetics and Pathophysiological Mechanisms of Lipoprotein(a)-Associated Cardiovascular Risk. J Am Heart Assoc 2024; 13:e033654. [PMID: 38879448 PMCID: PMC11255763 DOI: 10.1161/jaha.123.033654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/19/2024]
Abstract
Elevated lipoprotein(a) is a genetically transmitted codominant trait that is an independent risk driver for cardiovascular disease. Lipoprotein(a) concentration is heavily influenced by genetic factors, including LPA kringle IV-2 domain size, single-nucleotide polymorphisms, and interleukin-1 genotypes. Apolipoprotein(a) is encoded by the LPA gene and contains 10 subtypes with a variable number of copies of kringle -2, resulting in >40 different apolipoprotein(a) isoform sizes. Genetic loci beyond LPA, such as APOE and APOH, have been shown to impact lipoprotein(a) levels. Lipoprotein(a) concentrations are generally 5% to 10% higher in women than men, and there is up to a 3-fold difference in median lipoprotein(a) concentrations between racial and ethnic populations. Nongenetic factors, including menopause, diet, and renal function, may also impact lipoprotein(a) concentration. Lipoprotein(a) levels are also influenced by inflammation since the LPA promoter contains an interleukin-6 response element; interleukin-6 released during the inflammatory response results in transient increases in plasma lipoprotein(a) levels. Screening can identify elevated lipoprotein(a) levels and facilitate intensive risk factor management. Several investigational, RNA-targeted agents have shown promising lipoprotein(a)-lowering effects in clinical studies, and large-scale lipoprotein(a) testing will be fundamental to identifying eligible patients should these agents become available. Lipoprotein(a) testing requires routine, nonfasting blood draws, making it convenient for patients. Herein, we discuss the genetic determinants of lipoprotein(a) levels, explore the pathophysiological mechanisms underlying the association between lipoprotein(a) and cardiovascular disease, and provide practical guidance for lipoprotein(a) testing.
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Affiliation(s)
| | - Marlys L. Koschinsky
- Robarts Research Institute, Schulich School of Medicine and DentistryWestern UniversityLondonONCanada
| | | | - Robert S. Rosenson
- Metabolism and Lipids Program, Mount Sinai Fuster Heart HospitalIcahn School of Medicine at Mount SinaiNew YorkNYUSA
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5
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Kaur G, Abdelrahman K, Berman AN, Biery DW, Shiyovich A, Huck D, Garshick M, Blankstein R, Weber B. Lipoprotein(a): Emerging insights and therapeutics. Am J Prev Cardiol 2024; 18:100641. [PMID: 38646022 PMCID: PMC11033089 DOI: 10.1016/j.ajpc.2024.100641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/08/2024] [Accepted: 02/24/2024] [Indexed: 04/23/2024] Open
Abstract
The strong association between lipoprotein (a) [Lp(a)] and atherosclerotic cardiovascular disease has led to considerations of Lp(a) being a potential target for mitigating residual cardiovascular risk. While approximately 20 % of the population has an Lp(a) level greater than 50 mg/dL, there are no currently available pharmacological lipid-lowering therapies that have demonstrated substantial reduction in Lp(a). Novel therapies to lower Lp(a) include antisense oligonucleotides and small-interfering ribonucleic acid molecules and have shown promising results in phase 2 trials. Phase 3 trials are currently underway and will test the causal relationship between Lp(a) and ASCVD and whether lowering Lp(a) reduces cardiovascular outcomes. In this review, we summarize emerging insights related to Lp(a)'s role as a risk-enhancing factor for ASCVD, association with calcific aortic stenosis, effects of existing therapies on Lp(a) levels, and variations amongst patient populations. The evolving therapeutic landscape of emerging therapeutics is further discussed.
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Affiliation(s)
- Gurleen Kaur
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Adam N. Berman
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - David W. Biery
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Albert Einstein College of Medicine, New York, NY, USA
| | - Arthur Shiyovich
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Daniel Huck
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Ron Blankstein
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Brittany Weber
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
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6
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Ma T, Ren R, Lv J, Yang R, Zheng X, Hu Y, Zhu G, Wang H. Transdifferentiation of fibroblasts into muscle cells to constitute cultured meat with tunable intramuscular fat deposition. eLife 2024; 13:RP93220. [PMID: 38771186 PMCID: PMC11108645 DOI: 10.7554/elife.93220] [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: 05/22/2024] Open
Abstract
Current studies on cultured meat mainly focus on the muscle tissue reconstruction in vitro, but lack the formation of intramuscular fat, which is a crucial factor in determining taste, texture, and nutritional contents. Therefore, incorporating fat into cultured meat is of superior value. In this study, we employed the myogenic/lipogenic transdifferentiation of chicken fibroblasts in 3D to produce muscle mass and deposit fat into the same cells without the co-culture or mixture of different cells or fat substances. The immortalized chicken embryonic fibroblasts were implanted into the hydrogel scaffold, and the cell proliferation and myogenic transdifferentiation were conducted in 3D to produce the whole-cut meat mimics. Compared to 2D, cells grown in 3D matrix showed elevated myogenesis and collagen production. We further induced fat deposition in the transdifferentiated muscle cells and the triglyceride content could be manipulated to match and exceed the levels of chicken meat. The gene expression analysis indicated that both lineage-specific and multifunctional signalings could contribute to the generation of muscle/fat matrix. Overall, we were able to precisely modulate muscle, fat, and extracellular matrix contents according to balanced or specialized meat preferences. These findings provide new avenues for customized cultured meat production with desired intramuscular fat contents that can be tailored to meet the diverse demands of consumers.
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Affiliation(s)
- Tongtong Ma
- College of Animal Science and Technology, Key Laboratory of Efficient Utilization of Non-Grain Feed Resources, Ministry of Agriculture and Rural Affairs, Shandong Agricultural UniversityTaianChina
| | - Ruimin Ren
- College of Animal Science and Technology, Key Laboratory of Efficient Utilization of Non-Grain Feed Resources, Ministry of Agriculture and Rural Affairs, Shandong Agricultural UniversityTaianChina
- College of Animal Science and Technology, Huazhong Agricultural UniversityWuhanChina
| | - Jianqi Lv
- College of Animal Science and Technology, Key Laboratory of Efficient Utilization of Non-Grain Feed Resources, Ministry of Agriculture and Rural Affairs, Shandong Agricultural UniversityTaianChina
| | - Ruipeng Yang
- College of Animal Science and Technology, Key Laboratory of Efficient Utilization of Non-Grain Feed Resources, Ministry of Agriculture and Rural Affairs, Shandong Agricultural UniversityTaianChina
| | - Xinyi Zheng
- College of Animal Science and Technology, Key Laboratory of Efficient Utilization of Non-Grain Feed Resources, Ministry of Agriculture and Rural Affairs, Shandong Agricultural UniversityTaianChina
| | - Yang Hu
- College of Food Science and Technology, Huazhong Agricultural UniversityWuhanChina
| | - Guiyu Zhu
- College of Animal Science and Technology, Key Laboratory of Efficient Utilization of Non-Grain Feed Resources, Ministry of Agriculture and Rural Affairs, Shandong Agricultural UniversityTaianChina
| | - Heng Wang
- College of Animal Science and Technology, Key Laboratory of Efficient Utilization of Non-Grain Feed Resources, Ministry of Agriculture and Rural Affairs, Shandong Agricultural UniversityTaianChina
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7
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Bess C, Mehta A, Joshi PH. All we need to know about lipoprotein(a). Prog Cardiovasc Dis 2024; 84:27-33. [PMID: 38759878 DOI: 10.1016/j.pcad.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 05/19/2024]
Abstract
Lipoprotein(a) [Lp(a)], a genetically determined macromolecular complex, is independently and causally associated with atherosclerotic cardiovascular disease (ASCVD) and calcific aortic stenosis via proposed proinflammatory, prothrombotic, and proatherogenic mechanisms. While Lp(a) measurement standardization issues are being resolved, several guidelines now support testing Lp(a) at least once in each adult's lifetime for ASCVD risk prediction which can foster implementation of more aggressive primary or secondary prevention therapies. Currently, there are several emerging targeted Lp(a) lowering therapies in active clinical investigation for safety and cardiovascular benefit among both primary and secondary prevention populations. First degree relatives of patients with high Lp(a) should be encouraged to undergo cascade screening. Primary prevention patients with high Lp(a) should consider obtaining a coronary calcium score for further risk estimation and to guide further ASCVD risk factor management including consideration of low dose aspirin therapy. Secondary prevention patients with high Lp(a) levels should consider adding PCSK9 inhibition to statin therapy.
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Affiliation(s)
- Courtney Bess
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern, Dallas, TX, United States of America; Parkland Health and Hospital System, Dallas, TX, United States of America
| | - Anurag Mehta
- VCU Health Pauley Health Center, Richmond, VA, United States of America
| | - Parag H Joshi
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern, Dallas, TX, United States of America; Parkland Health and Hospital System, Dallas, TX, United States of America.
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Cedeno-Sanchez V, Perez-Santana M, Mehta D, Godinez S, Gu L, Miller VM, MacIntosh AJ. Thermomechanical Properties of High Oleic Palm Oil Assessed Using Differential Scanning Calorimetry, Texture Analysis, Microscopy, and Shear Rheology. Gels 2023; 9:798. [PMID: 37888371 PMCID: PMC10606909 DOI: 10.3390/gels9100798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
Standard Palm Oil (SPO) is widely used as a food ingredient partially due to its unique thermophysical properties. However, the American Heart Association recommends a saturated fat consumption of <5% of the caloric intake per day. The OxG Palm hybrid yields oil known as "palm oil with a higher content of oleic acid" (HOPO), with <35% SFA and >50% oleic acid. Characterizing novel high oleic oils is the starting point to find processes that can functionalize them such as oleogelation. This study compared the thermophysical properties of HOPO to SPO using Differential Scanning Calorimetry, shear rheology, polarized light microscopy, and texture analysis to characterize the differences between these oils. HOPO had a lower onset crystallization temperature (Δ7 °C) and its rheological behavior followed similar trends to SPO; however, large viscosity offsets were observed and were correlated to differences in crystallization temperatures. The maximum peak force of SPO was an order of magnitude higher than that of HOPO. Overall similar trends between the oils were observed, but differences in firmness, crystal morphology, and viscosity were not linearly correlated with the offset in crystallization temperature. This study quantified differences between these oils that will better enable industry to use HOPO in specific applications.
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Affiliation(s)
- Victor Cedeno-Sanchez
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
| | - Melissa Perez-Santana
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
| | - Devanshu Mehta
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
| | - Scarlett Godinez
- Department of Chemistry, University of Florida, Gainesville, FL 32611, USA
| | - Liwei Gu
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
| | - Victoria M. Miller
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Andrew J. MacIntosh
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
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9
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Law HG, Khan MA, Zhang W, Bang H, Rood J, Most M, Lefevre M, Berglund L, Enkhmaa B. Reducing saturated fat intake lowers LDL-C but increases Lp(a) levels in African Americans: the GET-READI feeding trial. J Lipid Res 2023; 64:100420. [PMID: 37482217 PMCID: PMC10445453 DOI: 10.1016/j.jlr.2023.100420] [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] [Received: 04/18/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/25/2023] Open
Abstract
Reducing dietary saturated fatty acids (SFA) intake results in a clinically significant lowering of low-density lipoprotein cholesterol (LDL-C) across ethnicities. In contrast, dietary SFA's role in modulating emerging cardiovascular risk factors in different ethnicities remains poorly understood. Elevated levels of lipoprotein(a) [Lp(a)], an independent cardiovascular risk factor, disproportionally affect individuals of African descent. Here, we assessed the responses in Lp(a) levels to dietary SFA reduction in 166 African Americans enrolled in GET-READI (The Gene-Environment Trial on Response in African Americans to Dietary Intervention), a randomized controlled feeding trial. Participants were fed two diets in random order for 5 weeks each: 1) an average American diet (AAD) (37% total fat: 16% SFA), and 2) a diet similar to the Dietary Approaches to Stop Hypertension (DASH) diet (25% total fat: 6% SFA). The participants' mean age was 35 years, 70% were women, the mean BMI was 28 kg/m2, and the mean LDL-C was 116 mg/dl. Compared to the AAD diet, LDL-C was reduced by the DASH-type diet (mean change: -12 mg/dl) as were total cholesterol (-16 mg/dl), HDL-C (-5 mg/dl), apoA-1 (-9 mg/dl) and apoB-100 (-5 mg/dl) (all P < 0.0001). In contrast, Lp(a) levels increased following the DASH-type diet compared with AAD (median: 58 vs. 44 mg/dl, P < 0.0001). In conclusion, in a large cohort of African Americans, reductions in SFA intake significantly increased Lp(a) levels while reducing LDL-C. Future studies are warranted to elucidate the mechanism(s) underlying the SFA reduction-induced increase in Lp(a) levels and its role in cardiovascular risk across populations.
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Affiliation(s)
- Hayley G Law
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Muhammad A Khan
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Wei Zhang
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Heejung Bang
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Marlene Most
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Michael Lefevre
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Nutrition, Utah State University, Logan, UT, USA
| | - Lars Berglund
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Byambaa Enkhmaa
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA; Center for Precision Medicine and Data Sciences, School of Medicine, University of California Davis, Davis, CA, USA.
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10
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Brosolo G, Da Porto A, Marcante S, Picci A, Capilupi F, Capilupi P, Bulfone L, Vacca A, Bertin N, Vivarelli C, Comand J, Catena C, Sechi LA. Lipoprotein(a): Just an Innocent Bystander in Arterial Hypertension? Int J Mol Sci 2023; 24:13363. [PMID: 37686169 PMCID: PMC10487946 DOI: 10.3390/ijms241713363] [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] [Received: 08/07/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Elevated plasma lipoprotein(a) [Lp(a)] is a relatively common and highly heritable trait conferring individuals time-dependent risk of developing atherosclerotic cardiovascular disease (CVD). Following its first description, Lp(a) triggered enormous scientific interest in the late 1980s, subsequently dampened in the mid-1990s by controversial findings of some prospective studies. It was only in the last decade that a large body of evidence has provided strong arguments for a causal and independent association between elevated Lp(a) levels and CVD, causing renewed interest in this lipoprotein as an emerging risk factor with a likely contribution to cardiovascular residual risk. Accordingly, the 2022 consensus statement of the European Atherosclerosis Society has suggested inclusion of Lp(a) measurement in global risk estimation. The development of highly effective Lp(a)-lowering drugs (e.g., antisense oligonucleotides and small interfering RNA, both blocking LPA gene expression) which are still under assessment in phase 3 trials, will provide a unique opportunity to reduce "residual cardiovascular risk" in high-risk populations, including patients with arterial hypertension. The current evidence in support of a specific role of Lp(a) in hypertension is somehow controversial and this narrative review aims to overview the general mechanisms relating Lp(a) to blood pressure regulation and hypertension-related cardiovascular and renal damage.
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Affiliation(s)
- Gabriele Brosolo
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Andrea Da Porto
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- Diabetes and Metabolism Unit, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Stefano Marcante
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Alessandro Picci
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Filippo Capilupi
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Patrizio Capilupi
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Luca Bulfone
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Antonio Vacca
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Nicole Bertin
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- Thrombosis and Hemostasis Unit, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Cinzia Vivarelli
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
| | - Jacopo Comand
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Cristiana Catena
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
| | - Leonardo A. Sechi
- Department of Medicine, University of Udine, 33100 Udine, Italy; (A.D.P.); (S.M.); (A.P.); (F.C.); (P.C.); (L.B.); (A.V.); (N.B.); (C.V.); (J.C.); (C.C.)
- European Hypertension Excellence Center, Clinica Medica, University of Udine, 33100 Udine, Italy
- Diabetes and Metabolism Unit, Clinica Medica, University of Udine, 33100 Udine, Italy
- Thrombosis and Hemostasis Unit, Clinica Medica, University of Udine, 33100 Udine, Italy
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11
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Nora CL, Zhang L, Castro RJ, Marx A, Carman HB, Lum T, Tsimikas S, Hong MY. Effects of mixed nut consumption on LDL cholesterol, lipoprotein(a), and other cardiometabolic risk factors in overweight and obese adults. Nutr Metab Cardiovasc Dis 2023; 33:1529-1538. [PMID: 37263914 DOI: 10.1016/j.numecd.2023.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND AIMS Elevated LDL-C, lipoprotein(a) [Lp(a)], and inflammation are associated with greater risk for atherosclerotic cardiovascular events. Consumption of individual nut types decreases these risk factors but knowledge about the effect of mixed nuts on Lp(a) is limited. The objective of this study was to determine the effects of consuming 42.5 g/day of mixed nuts on LDL-C, Lp(a), and inflammatory markers in individuals with overweight or obesity. METHODS AND RESULTS In a 16-week randomized control trial, 29 participants with overweight or obesity (BMI 25-40 kg/m2) consumed either 42.5 g/day of mixed nuts (cashews, almonds, macadamia nuts, Brazil nuts, pecans, pistachios, walnuts, and peanuts) or 69 g/day isocaloric pretzels. Blood samples were collected at baseline, week 8, and week 16 for analysis on total cholesterol (TC), LDL-C, Lp(a), inflammation markers, glucose, insulin, adiponectin and liver function enzymes. No significant differences were seen in TC, LDL-C, HDL-C, Lp(a), or liver function enzymes between the two groups. Participants consuming mixed nuts had significantly lower body fat percentage and diastolic blood pressure, and higher adiponectin (all P ≤ 0.05). C-reactive protein (CRP) and 8-oxo-deoxyguanosis (8-oxodG) showed non-significant decreasing trends and total antioxidant capacity (TAC) had a non-significant increasing trend in the mixed nut group. CONCLUSION Consumption of mixed nuts had no evidence of an effect on LDL-C or Lp(a) throughout the intervention. Notably, mixed nut consumption lowered body fat percentage without significant changes in body weight or BMI. Future studies with larger sample sizes investigating the changing trends of CRP, 8-oxodG, and TAC are warranted. CLINICAL TRIAL REGISTER NCT03375866.
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Affiliation(s)
- Chelsea L Nora
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Liyue Zhang
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Robert J Castro
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Amanda Marx
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Hannah B Carman
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Tiffany Lum
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Sotirios Tsimikas
- School of Medicine, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Mee Young Hong
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA.
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12
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Berk KA, Borgeraas H, Narverud I, Mulder MT, Øyri LKL, Verhoeven AJM, Småstuen MC, Bogsrud MP, Omland T, Hertel JK, Gjevestad E, Nordstrand N, Holven KB, Hjelmesæth J. Differential effects of bariatric surgery and lifestyle interventions on plasma levels of Lp(a) and fatty acids. Lipids Health Dis 2022; 21:145. [PMID: 36577984 PMCID: PMC9795629 DOI: 10.1186/s12944-022-01756-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Limited evidence suggests that surgical and non-surgical obesity treatment differentially influence plasma Lipoprotein (a) [Lp(a)] levels. Further, a novel association between plasma arachidonic acid and Lp(a) has recently been shown, suggesting that fatty acids are a possible target to influence Lp(a). Here, the effects of bariatric surgery and lifestyle interventions on plasma levels of Lp(a) were compared, and it was examined whether the effects were mediated by changes in plasma fatty acid (FA) levels. METHODS The study includes two independent trials of patients with overweight or obesity. Trial 1: Two-armed intervention study including 82 patients who underwent a 7-week low energy diet (LED), followed by Roux-en-Y gastric bypass and 52-week follow-up (surgery-group), and 77 patients who underwent a 59-week energy restricted diet- and exercise-program (lifestyle-group). Trial 2: A clinical study including 134 patients who underwent a 20-week very-LED/LED (lifestyle-cohort). RESULTS In the surgery-group, Lp(a) levels [median (interquartile range)] tended to increase in the pre-surgical LED-phase [17(7-68)-21(7-81)nmol/L, P = 0.05], but decreased by 48% after surgery [21(7-81)-11(7-56)nmol/L, P < 0.001]. In the lifestyle-group and lifestyle-cohort, Lp(a) increased by 36%[14(7-77)-19(7-94)nmol/L, P < 0.001] and 14%[50(14-160)-57(19-208)nmol/L, P < 0.001], respectively. Changes in Lp(a) were independent of weight loss. Plasma levels of total saturated FAs remained unchanged after surgery, but decreased after lifestyle interventions. Arachidonic acid and total n-3 FAs decreased after surgery, but increased after lifestyle interventions. Plasma FAs did not mediate the effects on Lp(a). CONCLUSION Bariatric surgery reduced, whereas lifestyle interventions increased plasma Lp(a), independent of weight loss. The interventions differentially influenced changes in plasma FAs, but these changes did not mediate changes in Lp(a). TRIAL REGISTRATION Trial 1: Clinicaltrials.gov NCT00626964. Trial 2: Netherlands Trial Register NL2140 (NTR2264).
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Affiliation(s)
- Kirsten A. Berk
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, the Netherlands ,grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Dietetics, Erasmus Medical Center, Rotterdam, The Netherlands, Erasmus University MC, Rotterdam, The Netherlands
| | - Heidi Borgeraas
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Ingunn Narverud
- grid.55325.340000 0004 0389 8485Norwegian National Advisory Unit On Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Monique T. Mulder
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Linn K. L. Øyri
- grid.5510.10000 0004 1936 8921Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Adrie J. M. Verhoeven
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Milada Cvancarova Småstuen
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway ,grid.412414.60000 0000 9151 4445Department of Nutrition and Management, Oslo Metropolitan University, Oslo, Norway
| | - Martin P. Bogsrud
- grid.55325.340000 0004 0389 8485Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Omland
- grid.411279.80000 0000 9637 455XDepartment of Cardiology, Akershus University Hospital, Lørenskog, Norway ,grid.5510.10000 0004 1936 8921K.G. Jebsen Center of Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jens Kristoffer Hertel
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Espen Gjevestad
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway ,grid.417292.b0000 0004 0627 3659Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway ,grid.446099.60000 0004 0448 0013Norwegian Police University College, Stavern, Norway
| | - Njord Nordstrand
- grid.411279.80000 0000 9637 455XDepartment of Cardiology, Akershus University Hospital, Lørenskog, Norway
| | - Kirsten B. Holven
- grid.55325.340000 0004 0389 8485Norwegian National Advisory Unit On Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jøran Hjelmesæth
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway ,grid.5510.10000 0004 1936 8921Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Bhatia HS, Wilkinson MJ. Lipoprotein(a): Evidence for Role as a Causal Risk Factor in Cardiovascular Disease and Emerging Therapies. J Clin Med 2022; 11:6040. [PMID: 36294361 PMCID: PMC9604626 DOI: 10.3390/jcm11206040] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/20/2022] [Accepted: 10/07/2022] [Indexed: 08/03/2023] Open
Abstract
Lipoprotein(a) (Lp(a)) is an established risk factor for multiple cardiovascular diseases. Several lines of evidence including mechanistic, epidemiologic, and genetic studies support the role of Lp(a) as a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic stenosis/calcific aortic valve disease (AS/CAVD). Limited therapies currently exist for the management of risk associated with elevated Lp(a), but several targeted therapies are currently in various stages of clinical development. In this review, we detail evidence supporting Lp(a) as a causal risk factor for ASCVD and AS/CAVD, and discuss approaches to managing Lp(a)-associated risk.
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14
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Cho AR, Hong KW, Kwon YJ, Choi JE, Lee HS, Kim HM, Bae SJ, Ahn SG, Jeong J, Lee JW. Effects of Single Nucleotide Polymorphisms and Mediterranean Diet in Overweight or Obese Postmenopausal Women With Breast Cancer Receiving Adjuvant Hormone Therapy: A Pilot Randomized Controlled Trial. Front Nutr 2022; 9:882717. [PMID: 35845810 PMCID: PMC9284001 DOI: 10.3389/fnut.2022.882717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022] Open
Abstract
Background and Aims Weight management is recommended in overweight or obese breast cancer patients, as they have an increased risk of cancer recurrence and poor prognosis. Furthermore, identifying the relationships between genetic factors and nutrition could help suggest possible individualized nutritional solutions in weight management. The objective of this pilot randomized controlled trial was to investigate the influence of two obesity-associated single nucleotide polymorphisms and the Mediterranean diet intervention on weight loss and modification of nutrient intake and metabolic parameters in overweight or obese, postmenopausal, breast cancer patients receiving adjuvant hormone therapy. Methods Seventy-eight breast cancer patients were randomly assigned to the Mediterranean diet (MeDiet) group or control group, and seventy-one were finally analyzed. Body composition, nutrient intake, and metabolic parameters were assessed at baseline and after the 8-week intervention. Fat mass and obesity-associated (FTO) rs7185735 and melanocortin-4 receptor (MC4R) rs476828 variants were genotyped. Results We found that both variants did not influence weight loss or improvement of metabolic parameters within the Mediterranean diet intervention. Intake of saturated fatty acid (SFA) and trans fat was significantly increased in C carriers compared with the TT genotype of MC4R rs476828 only in the control group (p = 0.002 for SFA; p = 0.016 for trans fat), whereas no significant difference was observed between genotypes in the MeDiet group. There were statistically significant interactions between MC4R rs476828 and dietary intervention for changes in SFA intake (p = 0.009) and trans fat intake (p = 0.049). Conclusion Our data suggest that considering the effects of genotype may be more necessary when the Mediterranean diet is not followed and that this diet may have a protective role against the effects of certain genotypes. Further studies are required to determine the potential mechanism of the observed gene-diet interaction. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT04045392].
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Affiliation(s)
- A-Ra Cho
- Chaum Life Center, CHA University, Seoul, South Korea
| | - Kyung-Won Hong
- Theragen Etex Bio Institute Co., Ltd., Suwon, South Korea
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Ja-Eun Choi
- Theragen Etex Bio Institute Co., Ltd., Suwon, South Korea
| | - Hye-Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyung-Mi Kim
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, South Korea
| | - Soong June Bae
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Gwe Ahn
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Joon Jeong,
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Ji-Won Lee,
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15
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Abstract
An elevated level of lipoprotein(a) [Lp(a)] is a genetically regulated, independent, causal risk factor for cardiovascular disease. However, the extensive variability in Lp(a) levels between individuals and population groups cannot be fully explained by genetic factors, emphasizing a potential role for non-genetic factors. In this review, we provide an overview of current evidence on non-genetic factors influencing Lp(a) levels with a particular focus on diet, physical activity, hormones and certain pathological conditions. Findings from randomized controlled clinical trials show that diets lower in saturated fats modestly influence Lp(a) levels and often in the opposing direction to LDL cholesterol. Results from studies on physical activity/exercise have been inconsistent, ranging from no to minimal or moderate change in Lp(a) levels, potentially modulated by age and the type, intensity, and duration of exercise modality. Hormone replacement therapy (HRT) in postmenopausal women lowers Lp(a) levels with oral being more effective than transdermal estradiol; the type of HRT, dose of estrogen and addition of progestogen do not modify the Lp(a)-lowering effect of HRT. Kidney diseases result in marked elevations in Lp(a) levels, albeit dependent on disease stages, dialysis modalities and apolipoprotein(a) phenotypes. In contrast, Lp(a) levels are reduced in liver diseases in parallel with the disease progression, although population studies have yielded conflicting results on the associations between Lp(a) levels and nonalcoholic fatty liver disease. Overall, current evidence supports a role for diet, hormones and related conditions, and liver and kidney diseases in modifying Lp(a) levels.
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Affiliation(s)
- Byambaa Enkhmaa
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA; Center for Precision Medicine and Data Sciences, School of Medicine, University of California Davis, Davis, CA, USA.
| | - Lars Berglund
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
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Dietary Pistachio (Pistacia vera L.) Beneficially Alters Fatty Acid Profiles in Streptozotocin-Induced Diabetic Rat. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Type 1 Diabetes (T1D) onset has been associated with diet, among other environmental factors. Adipose tissue and the gut have an impact on β-cell biology, influencing their function. Dietary ingredients affect fatty acid profiles of visceral adipose tissue (VAT) and plasma, as well as SCFAs production after microbial fermentation. Pistachios are a rich source of oleic acid, known for their anti-inflammatory actions and favorably affect gut microbiota composition. The purpose of the study was to examine plasma and VAT fatty acids profiles as well as fecal SCFAs after dietary intervention with pistachio nuts in streptozotocin-induced diabetic rats. Plasma and VAT fatty acids were determined by GC-MS and SCFAs by HPLC. After 4 weeks of pistachio consumption, MUFA and especially oleic acid were increased in plasma and VAT of diabetic rats while PUFA, total ω6 and especially 18:2ω6, were decreased. Lactic acid, the major end-product of beneficial intestinal microorganisms, such as lactobacilli, was elevated in healthy groups, while decreased levels of isovaleric acid were recorded in healthy and diabetic groups following the pistachio diet. Our results reveal possible beneficial relationships between pistachio nut consumption, lipid profiles and intestinal health in the disease state of T1D.
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Adams O O, Oyesola O, Tony E, Blessing O, Kukoyi BI. Effects of combined Garcinia kola and Kigelia africana on Insulin and Paraoxonase 1 (PON1) levels in type 2 diabetic rats. Curr Drug Discov Technol 2022; 19:e080422203277. [PMID: 35400345 DOI: 10.2174/1570163819666220408100011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/30/2022] [Accepted: 02/22/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Several reports of individual extracts of Garcina kola and Kigelia africana beneficial effects against several factors related with development of diabetes mellitus abound. However, there is still lack of information about the combined effects of these extracts on Insulin and Paraoxonase 1 (PON-1) in Streptozotocin-Nicotinamide induced type-2 diabetic Wistar rats. METHODS Forty-two young male rats (180-200g) were randomly divided into six groups (n=7/group). Diabetes was intraperitoneally induced with 110 mg/kg of nicotinamide constituted in distilled water andfifteen minutes after with 65mg/kg of streptozocin freshly prepared in 0.1M citrate buffer (pH of 4.5) and treated for six weeks as follows: the control rats received either 0.9% normal saline (NS) or 250mg/kg extract by gavage. The remaining animals were diabetic induced and subsequently treated with either NS, graded doses of the extract (250mg/kg and 500mg/kg) or 5mg/kg Glibenclamide + 100mg/kg Metformin. Gas chromatography mass spectrometry (GCMS) of the combined extracts was also analyzed to identify the bioactive compounds present. Insulin, PON-1 levels, lipid profiles and atherogenic index were assessed. RESULTS Our findings show that Insulin and PON-1 levels in the plasma of diabetic rats treated with the combined extracts were significantly increased when compared to the control rats. Moreover, the GCMS of the extract show the presence of both monosaturated (oleic acid) and polyunsaturated (linoleic acid) fatty acids. CONCLUSION The current findings suggest that the extract may help improve glucose homeostasis, prevent atherosclerosis through established mechanism of the identified bioactive compounds.
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Affiliation(s)
- Omoaghe Adams O
- Department of Physiology, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria.,Department of Physiology, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
| | - Oyesola O
- Department of Physiology, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
| | - Ezike Tony
- Department of Physiology, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
| | - Omizu Blessing
- Department of Physiology, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
| | - Boone I Kukoyi
- Department of Physiology, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
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18
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Host-microbial interactions in the metabolism of different dietary fats. Cell Metab 2021; 33:857-872. [PMID: 33951472 DOI: 10.1016/j.cmet.2021.04.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/29/2021] [Accepted: 04/14/2021] [Indexed: 02/06/2023]
Abstract
Although generally presumed to be isocaloric, dietary fats can differ in their energetic contributions and metabolic effects. Here, we show how an explicit consideration of the gut microbiome and its interactions with human physiology can enrich our understanding of dietary fat metabolism. We outline how variable human metabolic responses to different dietary fats, such as altered ileal digestibility or bile acid production, have downstream effects on the gut microbiome that differentially promote energy gain and inflammation. By incorporating host-microbial interactions into energetic models of human nutrition, we can achieve greater insight into the underlying mechanisms of diet-driven metabolic disease.
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Bakaloudi DR, Chrysoula L, Kotzakioulafi E, Theodoridis X, Chourdakis M. Impact of the Level of Adherence to Mediterranean Diet on the Parameters of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2021; 13:1514. [PMID: 33946280 PMCID: PMC8146502 DOI: 10.3390/nu13051514] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 12/18/2022] Open
Abstract
High adherence to the Mediterranean diet (MD) has been associated with a lower prevalence of Metabolic Syndrome (MetS). The present study aimed to investigate the impact of MD adherence on parameters of MetS. A systematic literature search was performed in PubMed, Cochrane Central Registry of Clinical Trials (CENTRAL), Scopus, EMBASE, Web of Science and Google Scholar databases. Observational studies that recorded adherence to MD and components/measures of the MetS, such as waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG), high-density lipoprotein (HDL) cholesterol and triglycerides (TG), were included in this study. A total of 58 studies were included in our study. WC and TG were significantly lower in the high adherence MD group (SMD: -0.20, (95%CI: -0.40, -0.01), SMD: -0.27 (95%CI: -0.27, -0.11), respectively), while HDL cholesterol was significantly higher in the same group (SMD: -0.28 (95%CI: 0.07, 0.50). There was no difference in FBG and SBP among the two groups (SMD: -0.21 (95%CI: -0.54, 0.12) & SMD: -0.15 (95%CI: -0.38, 0.07), respectively). MD may have a positive impact on all parameters of MetS. However, further research is needed in this field.
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Affiliation(s)
| | | | | | | | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (L.C.); (E.K.); (X.T.)
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20
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Lichtenstein AH, Petersen K, Barger K, Hansen KE, Anderson CAM, Baer DJ, Lampe JW, Rasmussen H, Matthan NR. Perspective: Design and Conduct of Human Nutrition Randomized Controlled Trials. Adv Nutr 2021; 12:4-20. [PMID: 33200182 PMCID: PMC7849995 DOI: 10.1093/advances/nmaa109] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/25/2020] [Accepted: 08/12/2020] [Indexed: 12/19/2022] Open
Abstract
In the field of human nutrition, randomized controlled trials (RCTs) are considered the gold standard for establishing causal relations between exposure to nutrients, foods, or dietary patterns and prespecified outcome measures, such as body composition, biomarkers, or event rates. Evidence-based dietary guidance is frequently derived from systematic reviews and meta-analyses of these RCTs. Each decision made during the design and conduct of human nutrition RCTs will affect the utility and generalizability of the study results. Within the context of limited resources, the goal is to maximize the generalizability of the findings while producing the highest quality data and maintaining the highest levels of ethics and scientific integrity. The aim of this document is to discuss critical aspects of conducting human nutrition RCTs, including considerations for study design (parallel, crossover, factorial, cluster), institutional ethics approval (institutional review boards), recruitment and screening, intervention implementation, adherence and retention assessment, and statistical analyses considerations. Additional topics include distinguishing between efficacy and effectiveness, defining the research question(s), monitoring biomarker and outcome measures, and collecting and archiving data. Addressed are specific aspects of planning and conducting human nutrition RCTs, including types of interventions, inclusion/exclusion criteria, participant burden, randomization and blinding, trial initiation and monitoring, and the analysis plan.
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Affiliation(s)
- Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | | | - Kathryn Barger
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Karen E Hansen
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Cheryl A M Anderson
- Division of Preventive Medicine, Department of Family Medicine of Public Health, University of California, San Diego, La Jolla, CA, USA
| | - David J Baer
- Food Components and Health Laboratory, Beltsville Human Nutrition Research Center, USDA Agricultural Research Service, Beltsville, MD, USA
| | - Johanna W Lampe
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Helen Rasmussen
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Nirupa R Matthan
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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21
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Abstract
PURPOSE OF REVIEW To provide an update on dietary measures to lower levels of LDL-C and triglyceride and reduce cardiovascular (CVD) outcomes. RECENT FINDINGS Fifty-year follow-up in the Seven Countries Study confirmed that cholesterol levels correlate with saturated fat intake and all-cause mortality and age at death. In the PURE study, refined carbohydrate increased CVD risk whereas saturated fat did not despite increasing LDL-C levels; limitations are discussed. Reports on CVD risk with eggs provide conflicting results. Plant-based diets with healthful complex carbohydrates reduced CVD. The REDUCE-IT trial lowered triglyceride 21.6% and reduced CVD events 26.1% with an omega-3 fatty acid, An omega-3 fatty acid index at least 4% with EPA and docosahexaenoic acid prevented coronary plaque progression. A clinician guide to counsel patients on nutrition and heart healthy diets was recently published. SUMMARY Based on the evidence, individuals should continue to minimize saturated fats and refined carbohydrates, eliminate trans-fat and increase fruits, vegetables, whole grains, low-fat dairy, and fish or other omega-3 fatty acids. Adhering to a Mediterranean diet is strongly recommended because of lowering CVD and total mortality. High-dose omega-3 fatty acids lower triglyceride, reduce CVD and prevent coronary plaque progression.
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Affiliation(s)
- Francine K Welty
- Division of Cardiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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22
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Kris-Etherton PM, Stewart PW, Ginsberg HN, Tracy RP, Lefevre M, Elmer PJ, Berglund L, Ershow AG, Pearson TA, Ramakrishnan R, Holleran SF, Dennis BH, Champagne CM, Karmally W. The Type and Amount of Dietary Fat Affect Plasma Factor VIIc, Fibrinogen, and PAI-1 in Healthy Individuals and Individuals at High Cardiovascular Disease Risk: 2 Randomized Controlled Trials. J Nutr 2020; 150:2089-2100. [PMID: 32492148 PMCID: PMC7398773 DOI: 10.1093/jn/nxaa137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/12/2019] [Accepted: 04/21/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Factor VIIc, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) are cardiovascular disease (CVD) risk factors and are modulated, in part, by fat type and amount. OBJECTIVE We evaluated fat type and amount on the primary outcomes: factor VIIc, fibrinogen, and PAI-1. METHODS In the Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA) Trial, 2 controlled crossover feeding studies evaluated substituting carbohydrate or MUFAs for SFAs. Study 1: healthy participants (n = 103) were provided with (8 wk) an average American diet [AAD; designed to provide 37% of energy (%E) as fat, 16% SFA], a Step 1 diet (30%E fat, 9% SFA), and a diet low in SFA (Low-Sat; 26%E fat, 5% SFA). Study 2: participants (n = 85) at risk for CVD and metabolic syndrome (MetSyn) were provided with (7 wk) an AAD, a step 1 diet, and a high-MUFA diet (designed to provide 37%E fat, 8% SFA, 22% MUFA). RESULTS Study 1: compared with AAD, the Step 1 and Low-Sat diets decreased mean factor VIIc by 1.8% and 2.6% (overall P = 0.0001), increased mean fibrinogen by 1.2% and 2.8% (P = 0.0141), and increased mean square root PAI-1 by 0.0% and 6.0% (P = 0.0037), respectively. Study 2: compared with AAD, the Step 1 and high-MUFA diets decreased mean factor VIIc by 4.1% and 3.2% (overall P < 0.0001), increased mean fibrinogen by 3.9% and 1.5% (P = 0.0083), and increased mean square-root PAI-1 by 2.0% and 5.8% (P = 0.1319), respectively. CONCLUSIONS Replacing SFA with carbohydrate decreased factor VIIc and increased fibrinogen in healthy and metabolically unhealthy individuals and also increased PAI-1 in healthy subjects. Replacing SFA with MUFA decreased factor VIIc and increased fibrinogen but less than carbohydrate. Our results indicate an uncertain effect of replacing SFA with carbohydrate or MUFA on cardiometabolic risk because of small changes in hemostatic factors and directionally different responses to decreasing SFA. This trial was registered at https://clinicaltrials.gov/ct2/show/NCT00000538?term=NCT00000538&rank=1 as NCT00000538.
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Affiliation(s)
- Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA,Address correspondence to PMK-E (e-mail: )
| | - Paul W Stewart
- Department of Biostatistics, Collaborative Studies Coordinating Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Henry N Ginsberg
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Russell P Tracy
- Colchester Research Facility, University of Vermont, Colchester, VT, USA
| | - Michael Lefevre
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA,Present address for ML: Department of Nutrition, Dietetics and Food Sciences, Utah State University, 9815 Old Main Hill, Logan, UT 84322-9815
| | - Patricia J Elmer
- Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, MN, USA,Present address for PJE: Portland, OR
| | - Lars Berglund
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA,Present address for LB: Clinical and Translational Science Center, UC-Davis, School of Medicine, Sacramento, CA
| | - Abby G Ershow
- Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA,Present address for AGE: Office of Dietary Supplements, National Institutes of Health, Bethesda, MD
| | - Thomas A Pearson
- The Mary Imogene Bassett Research Institute, Cooperstown, NY, USA,School of Public Health, State University of New York at Albany, Albany, NY, USA,Columbia University College of Physicians and Surgeons, New York, NY, USA,Department of Community and Preventive Medicine, University of Rochester, Rochester, NY, USA,Present address for TAP: Department of Epidemiology, University of Florida, Gainesville, FL
| | - Rajasekhar Ramakrishnan
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Stephen F Holleran
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Barbara H Dennis
- Department of Biostatistics, Collaborative Studies Coordinating Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Present address for BHD: Chapel Hill, NC
| | - Catherine M Champagne
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Wahida Karmally
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - for the DELTA Investigators
GinsbergHenryMDPrincipal Investigator12RamakrishnanRajasekharDSc12KarmallyWahidaDrPH RD, CDE12BerglundLarsMD, PhD12SiddiquiMalihaMS, RD12ChenNiem-TzuMS12HolleranSteveBS12JohnsonColleenRD12HolemanRoberta12ChirgwinKaren12StennettKellye12GangaLencey12TowolawaiTajsudeenMBA12MyersMinnieBS12NgaiColleenBS12FontenezNelsonBS12JonesJeffBS12RodriguezCarmen12UsecheNorma12LefevreMichaelPhD13RoheimPaul SMDCo-Principal Investigators13
Deceased RyanDonnaMD13MostMarlenePhD, RD13ChampagneCatherinePhD, RD13WilliamsonDonaldPhD13TulleyRichardPhD13BrockRickyRN13BodinDeonneBS, MT13KennedyBettyMPA13BarkateMichelleMS, RD13FoustElizabethBS13YorkDeshoinBS13Kris-EthertonPennyPhD, RDPrincipal Investigator14JonnalagaddaSatyaPhD14DerrJanicePhD14Farhat-WoodAbirMS14MustadVikkiePhD14MeakerKateMS14MillsEdwardPhD14TilleyMary-AnnMS, RD14Smiciklas-WrightHelenPhD14Sigman-GrantMadeleinePhD, RD14YuShaomeiMS, PhD14GuinardJean-XavierPhD14SechevichPamelaMS14ReddyC ChannaPhD14MastroAndrea MPhD14CooperAllen DMD14ElmerPatriciaPhDPrincipal Investigator15FolsomAaronMD15Van HeelNancyMS, RD15WoldChristineRD15FritzKayMA, RD15SlavinJoannePhD15JacobsDavidPhD15DennisBarbaraPhDFirst Principal Investigator16StewartPaulPhDSecond Principal Investigator16DavisCPhD16HoskingJamesPhD16AndersonNancyMSPH16BlackwellSusanBS16MartinLynnMS16BryanHopeMS16StewartW BrianBS16AbolafiaJeffreyMA16FoleyMalachyBS16ZienConroyBA16LeuSzu-YunMS16YoungbloodMarstonMPH16GoodwinThomasMAT16MilesMonica16WehbieJennifer16PearsonThomasMD, PhD17ReedRobertaPhD17TracyRussellPhD18CornellElaineBS18StewartKentPhD19PhillipsKatherinePhD19McGeeBernestinePhD, RD20WilliamsBrendaBS20BeecherGaryPhD21HoldenJoanneMS21DavisCarolBS21ErshowAbbyScD22GordonDavidMD, PhD22ProschanMichaelPhD22RifkindBasilMD, FRCP22Deceased
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23
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Diet and Lp(a): Does Dietary Change Modify Residual Cardiovascular Risk Conferred by Lp(a)? Nutrients 2020; 12:nu12072024. [PMID: 32646066 PMCID: PMC7400957 DOI: 10.3390/nu12072024] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 02/06/2023] Open
Abstract
Lipoprotein(a) [Lp(a)] is an independent, causal, genetically determined risk factor for cardiovascular disease (CVD). We provide an overview of current knowledge on Lp(a) and CVD risk, and the effect of pharmacological agents on Lp(a). Since evidence is accumulating that diet modulates Lp(a), the focus of this paper is on the effect of dietary intervention on Lp(a). We identified seven trials with 15 comparisons of the effect of saturated fat (SFA) replacement on Lp(a). While replacement of SFA with carbohydrate, monounsaturated fat (MUFA), or polyunsaturated fat (PUFA) consistently lowered low-density lipoprotein cholesterol (LDL-C), heterogeneity in the Lp(a) response was observed. In two trials, Lp(a) increased with carbohydrate replacement; one trial showed no effect and another showed Lp(a) lowering. MUFA replacement increased Lp(a) in three trials; three trials showed no effect and one showed lowering. PUFA or PUFA + MUFA inconsistently affected Lp(a) in four trials. Seven trials of diets with differing macronutrient compositions showed similar divergence in the effect on LDL-C and Lp(a). The identified clinical trials show diet modestly affects Lp(a) and often in the opposing direction to LDL-C. Further research is needed to understand how diet affects Lp(a) and its properties, and the lack of concordance between diet-induced LDL-C and Lp(a) changes.
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24
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Leong WYA, Ngiam JN, Tan RS, Lim SL, Poh KK. Controversies and discrepancies in the effect of dietary fat and cholesterol on cardiovascular risk. Singapore Med J 2020; 62:56-62. [PMID: 32312028 DOI: 10.11622/smedj.2020065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide. The top ten causes of death in Singapore include many cardiovascular-related diseases such as ischaemic heart disease. The increasing prevalence of CVD poses a burden to both the economy and healthcare system of a country. Dietary habits, in particular dietary fats and cholesterol intake, have been shown to greatly influence CVD risks. Therefore, reference and adherence to relevant dietary guidelines could be crucial in CVD prevention. Recent research findings have provided novel insights into the relationship between certain dietary fats or cholesterol intake and CVD risks, challenging or reinforcing previous guidelines. These findings may, however, be conflicting, and there are still controversies over the effects of dietary fats and cholesterol as well as their association with cardiovascular risk. This review paper aims to evaluate common controversies, identify gaps in relevant research areas and summarise evidence-based dietary recommendations.
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Affiliation(s)
| | | | - Ru San Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Su Lin Lim
- Department of Dietetics, National University Hospital, Singapore
| | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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25
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Tindall AM, Kris-Etherton PM, Petersen KS. Replacing Saturated Fats with Unsaturated Fats from Walnuts or Vegetable Oils Lowers Atherogenic Lipoprotein Classes Without Increasing Lipoprotein(a). J Nutr 2020; 150:818-825. [PMID: 31909809 PMCID: PMC7138686 DOI: 10.1093/jn/nxz313] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/01/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Walnuts have established lipid-/lipoprotein-lowering properties; however, their effect on lipoprotein subclasses has not been investigated. Furthermore, the mechanisms by which walnuts improve lipid/lipoprotein concentrations are incompletely understood. OBJECTIVES We aimed to examine, as exploratory outcomes of this trial, the effect of replacing SFAs with unsaturated fats from walnuts or vegetable oils on lipoprotein subclasses, cholesterol efflux, and proprotein convertase subtilisin/kexin type 9 (PCSK9). METHODS A randomized, crossover, controlled-feeding study was conducted in individuals at risk of cardiovascular disease (CVD) (n = 34; 62% men; mean ± SD age 44 ± 10 y; BMI: 30.1 ± 4.9 kg/m2). After a 2-wk run-in diet (12% SFAs, 7% PUFAs, 12% MUFAs), subjects consumed the following diets, in randomized order, for 6 wk: 1) walnut diet (WD) [57-99 g/d walnuts, 7% SFAs, 16% PUFAs [2.7% α-linolenic acid (ALA)], 9% MUFAs]; 2) walnut fatty acid-matched diet [7% SFAs, 16% PUFAs (2.6% ALA), 9% MUFAs]; and 3) oleic acid replaces ALA diet (ORAD) [7% SFAs, 14% PUFAs (0.4% ALA); 12% MUFAs] (all percentages listed are of total kilocalories ). Serum collected after the run-in (baseline) and each diet period was analyzed for lipoprotein classes and subclasses (vertical auto profile), cholesterol efflux, and PCSK9. Linear mixed models were used for data analysis. RESULTS Compared with the ORAD, total cholesterol (mean ± SEM -8.9± 2.3 mg/dL; -5.1%; P < 0.001), non-HDL cholesterol (-7.4 ± 2.0 mg/dL; -5.4%; P = 0.001), and LDL cholesterol (-6.9 ± 1.9 mg/dL; -6.5%; P = 0.001) were lower after the WD; no other pairwise differences existed. There were no between-diet differences for HDL-cholesterol or LDL-cholesterol subclasses. Lipoprotein(a) [Lp(a)], cholesterol efflux, and PCSK9 were unchanged after the diets. CONCLUSIONS In individuals at risk of CVD, replacement of SFAs with unsaturated fats from walnuts or vegetable oils improved lipid/lipoprotein classes, including LDL-cholesterol, non-HDL cholesterol, and total cholesterol, without an increase in Lp(a). These improvements were not explained by changes in cholesterol efflux capacity or PCSK9. This trial was registered at clinicaltrials.gov as NCT01235832.
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Affiliation(s)
- Alyssa M Tindall
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Kristina S Petersen
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA,Address correspondence to KSP (e-mail: )
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26
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Kaur D, Tallman DA, Khosla P. The health effects of saturated fats - the role of whole foods and dietary patterns. Diabetes Metab Syndr 2020; 14:151-153. [PMID: 32087567 DOI: 10.1016/j.dsx.2020.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 01/29/2023]
Abstract
The effects of saturated fat on cardiovascular health have been studied for more than half a century. While simple public health messages have been to avoid and/or limit their intake, the underlying research is more complex. It is apparent that the effects of saturated fat on health are dependent both on the presence of other nutrients as well as the associated dietary pattern.
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Affiliation(s)
- Deepinder Kaur
- Dept of Nutrition and Food Science, Wayne State University, Detroit, MI, USA.
| | - Dina A Tallman
- Dept of Nutrition and Food Science, Wayne State University, Detroit, MI, USA.
| | - Pramod Khosla
- Dept of Nutrition and Food Science, Wayne State University, Detroit, MI, USA.
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27
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Abstract
The effect of dietary fats on cardiometabolic diseases, including cardiovascular diseases and type 2 diabetes mellitus, has generated tremendous interest. Many earlier investigations focused on total fat and conventional fat classes (such as saturated and unsaturated fats) and their influence on a limited number of risk factors. However, dietary fats comprise heterogeneous molecules with diverse structures, and growing research in the past two decades supports correspondingly complex health effects of individual dietary fats. Moreover, health effects of dietary fats might be modified by additional factors, such as accompanying nutrients and food-processing methods, emphasizing the importance of the food sources. Accordingly, the rapidly increasing scientific findings on dietary fats and cardiometabolic diseases have generated debate among scientists, caused confusion for the general public and present challenges for translation into dietary advice and policies. This Review summarizes the evidence on the effects of different dietary fats and their food sources on cell function and on risk factors and clinical events of cardiometabolic diseases. The aim is not to provide an exhaustive review but rather to focus on the most important evidence from randomized controlled trials and prospective cohort studies and to highlight current areas of controversy and the most relevant future research directions for understanding how to improve the prevention and management of cardiometabolic diseases through optimization of dietary fat intake.
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28
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Bozzetto L, Della Pepa G, Vetrani C, Rivellese AA. Dietary Impact on Postprandial Lipemia. Front Endocrinol (Lausanne) 2020; 11:337. [PMID: 32733374 PMCID: PMC7358426 DOI: 10.3389/fendo.2020.00337] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/29/2020] [Indexed: 12/14/2022] Open
Abstract
Abnormalities in postprandial lipemia (PPL), particularly those related to triglyceride-rich lipoproteins, are considered an independent cardiovascular risk factor. As diet is known to be one of the main modulators of PPL, the aim of this review was to summarize and discuss current knowledge on the impact of diet and its components on PPL in humans; specifically, the impact of weight loss, different nutrients (quantity and quality of dietary fats, carbohydrates, and proteins), alcohol and other bioactive dietary components (i.e., polyphenols), as well as the effect of different dietary patterns. The possible mechanisms behind the metabolic effects of each dietary component were also discussed.
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29
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Sudha V, Lakshmipriya N, Gayathri R, Shanmugam S, Srinivasan R, Krishnaswamy K, Jeevan R, Unnikrishnan R, Anjana R, Mohan V. Dietary fatty-acid profile of south Indian adults and its association with type 2 diabetes––CURES 151. JOURNAL OF DIABETOLOGY 2020. [DOI: 10.4103/jod.jod_23_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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30
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Pallazola VA, Davis DM, Whelton SP, Cardoso R, Latina JM, Michos ED, Sarkar S, Blumenthal RS, Arnett DK, Stone NJ, Welty FK. A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention. Mayo Clin Proc Innov Qual Outcomes 2019; 3:251-267. [PMID: 31485563 PMCID: PMC6713921 DOI: 10.1016/j.mayocpiqo.2019.05.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 04/20/2023] Open
Abstract
Despite continued advances in health care, the cardiovascular disease (CVD) mortality rate has plateaued in recent years and appears to be trending upward. Poor diet is a leading cause of obesity and type 2 diabetes mellitus, which are leading contributors to CVD morbidity and mortality. Although dietary modification is a cornerstone of CVD prevention, implementation in clinical practice is limited by inadequate formal training in nutrition science. In this report, we review the individual components of a heart-healthy diet, evidence-based dietary recommendations, and the impact of diet on CVD risk factor prevention and management. Furthermore, we examine the unique difficulties of dietary counseling in low-socioeconomic-status environments and provide an evidence-based approach to better serve these populations. We utilized PubMed searches in adults with no date restriction with the following search terms: "carbohydrate," "fat," protein," "DASH," "Mediterranean," "plant-based," "vegetarian," "cardiovascular disease," "obesity," "weight loss," "diabetes," "socioeconomic status," and "race." In this review, we demonstrate that patients should focus on implementing a general diet plan that is high in fruits, whole grains, legumes, and nonstarchy vegetables while low in trans-fats, saturated fats, sodium, red meat, refined carbohydrates, and sugar-sweetened beverages. The Dietary Approaches to Stop Hypertension, Mediterranean, and vegetarian diets have the most evidence for CVD prevention. Clinicians should understand the barriers that patients may face in terms of access to healthy dietary choices. Further research is needed to determine the dietary changes that are most economically, socioculturally, and logistically feasible to reduce these barriers. Improvement in diet is a public health priority that can lead to a significant population-level reduction in CVD morbidity and mortality. It is imperative that clinicians understand current dietary practice guidelines and implement evidence-based dietary counseling in those at high risk for CVD.
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Key Words
- ACC, American College of Cardiology
- AHA, American Heart Association
- CHD, coronary heart disease
- CVD, cardiovascular disease
- DASH, Dietary Approaches to Stop Hypertension
- HDL-C, high-density lipoprotein cholesterol
- LCHF, low-carbohydrate high-protein/fat
- LDL-C, low-density lipoprotein cholesterol
- MI, myocardial infarction
- PURE, Prospective Urban Rural Epidemiology
- RCT, randomized control trial
- SBP, systolic blood pressure
- SES, socioeconomic status
- SSB, sugar-sweetened beverage
- USDA, US Department of Agriculture
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Affiliation(s)
- Vincent A. Pallazola
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
| | - Dorothy M. Davis
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
| | - Seamus P. Whelton
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
| | - Rhanderson Cardoso
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
| | - Jacqueline M. Latina
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
| | - Erin D. Michos
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
| | - Sudipa Sarkar
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Roger S. Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD
| | - Donna K. Arnett
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Neil J. Stone
- Cardiology Division, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Francine K. Welty
- Cardiology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- Correspondence: Address to Francine K. Welty, MD, PhD, Harvard Medical School, Specialized Center of Clinically Oriented Research in Vascular Injury, Repair, and Remodeling, Preventive Cardiology, Women's Health, Cardiovascular Division, 330 Brookline Ave, SL 423, Boston, MA 02215.
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31
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Lipoprotein(a) concentration is associated with plasma arachidonic acid in subjects with familial hypercholesterolaemia. Br J Nutr 2019; 122:790-799. [PMID: 31262370 DOI: 10.1017/s0007114519001600] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Elevated lipoprotein(a) (Lp(a)) is associated with CVD and is mainly genetically determined. Studies suggest a role of dietary fatty acids (FA) in the regulation of Lp(a); however, no studies have investigated the association between plasma Lp(a) concentration and n-6 FA. We aimed to investigate whether plasma Lp(a) concentration was associated with dietary n-6 FA intake and plasma levels of arachidonic acid (AA) in subjects with familial hypercholesterolaemia (FH). We included FH subjects with (n 68) and without (n 77) elevated Lp(a) defined as ≥75 nmol/l and healthy subjects (n 14). Total FA profile was analysed by GC-flame ionisation detector analysis, and the daily intake of macronutrients (including the sum of n-6 FA: 18 : 2n-6, 20 : 2n-6, 20 : 3n-6 and 20 : 4n-6) were computed from completed FFQ. FH subjects with elevated Lp(a) had higher plasma levels of AA compared with FH subjects without elevated Lp(a) (P = 0·03). Furthermore, both FH subjects with and without elevated Lp(a) had higher plasma levels of AA compared with controls (P < 0·001). The multivariable analyses showed associations between dietary n-6 FA intake and plasma levels of AA (P = 0·02) and between plasma levels of Lp(a) and AA (P = 0·006). Our data suggest a novel link between plasma Lp(a) concentration, dietary n-6 FA and plasma AA concentration, which may explain the small diet-induced increase in Lp(a) levels associated with lifestyle changes. Although the increase may not be clinically relevant, this association may be mechanistically interesting in understanding more of the role and regulation of Lp(a).
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Yang F, Chen G, Ma M, Qiu N, Zhu L, Li J. Fatty acids modulate the expression levels of key proteins for cholesterol absorption in Caco-2 monolayer. Lipids Health Dis 2018; 17:32. [PMID: 29463265 PMCID: PMC5819267 DOI: 10.1186/s12944-018-0675-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 02/07/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Fatty acids have been shown to modulate intestinal cholesterol absorption in cells and animals, a process that is mediated by several transporter proteins. Of these proteins, Niemann-Pick C1-Like 1 (NPC1L1) is a major contributor to this process. The current study investigates the unknown mechanism by which fatty acids modulate cholesterol absorption. METHODS We evaluated the effects of six fatty acids palmitic acid (PAM), oleic acid (OLA), linoleic acid (LNA), arachidonic acid (ARA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on cholesterol uptake and transport in human enterocytes Caco-2 cells, and on the mRNA expression levels of NPC1L1, others proteins (ABCG5, ABCG8, ABCA1, ACAT2, MTP, Caveolin 1, Annexin-2) involved in cholesterol absorption, and SREBP-1 and SREBP-2 that are responsible for lipid metabolism. RESULTS The polyunsaturated fatty acids (PUFAs), especially for EPA and DHA, dose-dependently inhibited cholesterol uptake and transport in Caco-2 monolayer, while saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) had no inhibitory effects. EPA and DHA inhibited cholesterol absorption in Caco-2 monolayer might be caused by down-regulating NPC1L1 mRNA and protein levels, which were associated with inhibition of SREBP-1/- 2 mRNA expression levels. CONCLUSION Results from this study indicate that functional food containing high PUFAs may have potential therapeutic benefit to reduce cholesterol absorption. Further studies on this topic may provide approaches to control lipid metabolism and to promote health.
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Affiliation(s)
- Fang Yang
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, 430070, Wuhan, Hubei, People's Republic of China
- School of Laboratory Medicine, Hubei University of Chinese Medicine, 1 Huangjia Lake West Road, Wuhan, 430065, China
| | - Guoxun Chen
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, TN, USA
| | - Meihu Ma
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, 430070, Wuhan, Hubei, People's Republic of China.
| | - Ning Qiu
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, 430070, Wuhan, Hubei, People's Republic of China
| | - Lingjiao Zhu
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, 430070, Wuhan, Hubei, People's Republic of China
| | - Jing Li
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, 430070, Wuhan, Hubei, People's Republic of China
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Liu Y, Hwang HJ, Ryu H, Lee YS, Kim HS, Park H. The effects of daily intake timing of almond on the body composition and blood lipid profile of healthy adults. Nutr Res Pract 2017; 11:479-486. [PMID: 29209458 PMCID: PMC5712498 DOI: 10.4162/nrp.2017.11.6.479] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/18/2017] [Accepted: 09/21/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/OBJECTIVES Timing of almond intake during a day may result differently in the perspectives of body composition and changes of lipid profile. The current study was conducted to compare the effects of daily almond intake as a preload versus as a snack on body composition, blood lipid profile, and oxidative and inflammation indicators among young Korean adults aged 20-39 years old. SUBJECTS/METHODS Participants were randomly assigned to one of three groups: a pre-meal almond group (PM), a snack almond group (SN) in which participants were instructed to consume 56 g of almonds either as a preload before meals or as a snack between meals, respectively, and a control group (CL) in which participants were provided high-carbohydrate iso-caloric control food. Measurements were performed at baseline, weeks 8 and 16. RESULTS A total of 169 (M 77/F 92) out of the 227 participants completed the study between June 2014 and June 2015 (n = 58 for PM; 55 for SN; and 56 for CL). A significant decrease in body fat mass was observed in the PM group at both weeks 8 and 16 compared with the CL. There were significant intervention effects on changes of body fat mass (P = 0.025), body fat percentages (P = 0.019), and visceral fat levels (P < 0.001). Consuming almonds as a daily snack reduced the levels of total cholesterol (P = 0.043) and low-density lipoprotein (LDL) cholesterol (P = 0.011) without changing high-density lipoprotein (HDL) cholesterol compared with the CL. CONCLUSION Almond consumption as a preload modified body fat percentages, whereas snacking on almonds between meals improved blood lipid profiles. This trial was registered at ClinicalTrials.gov as NCT03014531.
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Affiliation(s)
- Yanan Liu
- Department of Food and Nutrition, College of Human Ecology, Sookmyung Women's University, Chungpa-Dong 2-Ka, Yongsan-Ku, Seoul 04310, Korea
| | - Hyo-Jeong Hwang
- ICAN Nutrition Education and Research, 20, Gukjegeumyung-ro, Yeongdeungpo-gu, Seoul 07327, Korea
| | - Hyesook Ryu
- Department of Food and Nutrition, Sangji University, Gangwon 26339, Korea
| | - You-Suk Lee
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Gyeonggi 13120, Korea
| | - Hyun-Sook Kim
- Department of Food and Nutrition, College of Human Ecology, Sookmyung Women's University, Chungpa-Dong 2-Ka, Yongsan-Ku, Seoul 04310, Korea
| | - Hyunjin Park
- ICAN Nutrition Education and Research, 20, Gukjegeumyung-ro, Yeongdeungpo-gu, Seoul 07327, Korea
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Bamberger C, Rossmeier A, Lechner K, Wu L, Waldmann E, Stark RG, Altenhofer J, Henze K, Parhofer KG. A Walnut-Enriched Diet Reduces Lipids in Healthy Caucasian Subjects, Independent of Recommended Macronutrient Replacement and Time Point of Consumption: a Prospective, Randomized, Controlled Trial. Nutrients 2017; 9:E1097. [PMID: 28984822 PMCID: PMC5691297 DOI: 10.3390/nu9101097] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/22/2017] [Accepted: 09/29/2017] [Indexed: 01/10/2023] Open
Abstract
Studies indicate a positive association between walnut intake and improvements in plasma lipids. We evaluated the effect of an isocaloric replacement of macronutrients with walnuts and the time point of consumption on plasma lipids. We included 194 healthy subjects (134 females, age 63 ± 7 years, BMI 25.1 ± 4.0 kg/m²) in a randomized, controlled, prospective, cross-over study. Following a nut-free run-in period, subjects were randomized to two diet phases (8 weeks each). Ninety-six subjects first followed a walnut-enriched diet (43 g walnuts/day) and then switched to a nut-free diet. Ninety-eight subjects followed the diets in reverse order. Subjects were also randomized to either reduce carbohydrates (n = 62), fat (n = 65), or both (n = 67) during the walnut diet, and instructed to consume walnuts either as a meal or as a snack. The walnut diet resulted in a significant reduction in fasting cholesterol (walnut vs. CONTROL -8.5 ± 37.2 vs. -1.1 ± 35.4 mg/dL; p = 0.002), non-HDL cholesterol (-10.3 ± 35.5 vs. -1.4 ± 33.1 mg/dL; p ≤ 0.001), LDL-cholesterol (-7.4 ± 32.4 vs. -1.7 ± 29.7 mg/dL; p = 0.029), triglycerides (-5.0 ± 47.5 vs. 3.7 ± 48.5 mg/dL; p = 0.015) and apoB (-6.7 ± 22.4 vs. -0.5 ± 37.7; p ≤ 0.001), while HDL-cholesterol and lipoprotein (a) did not change significantly. Neither macronutrient replacement nor time point of consumption significantly affected the effect of walnuts on lipids. Thus, 43 g walnuts/d improved the lipid profile independent of the recommended macronutrient replacement and the time point of consumption.
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Affiliation(s)
- Charlotte Bamberger
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
| | - Andreas Rossmeier
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
| | - Katharina Lechner
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
| | - Liya Wu
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
| | - Elisa Waldmann
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
| | - Renée G Stark
- Helmholtz Centrum Munich, Institute for Health Economics and Healthcare Management, 85764 Neuherberg, Germany.
| | - Julia Altenhofer
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
| | - Kerstin Henze
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
| | - Klaus G Parhofer
- Department of Internal Medicine 4, Ludwig-Maximilians University Munich, 81377 Munich, Germany.
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Abstract
Whereas primary prevention seeks to forestall development of disease in individuals with elevated risk, primordial prevention seeks to preempt the development of risk factors. Health behaviors-characterized as "lifestyle" factors-are key interventional targets in primordial prevention of cardiovascular disease. Appropriate dietary intake, including limiting salt and saturated fat consumption, can reduce the risk of developing hypertension and dyslipidemias. Regular physical activity is associated with lower blood pressure and healthier lipid profiles. Diet and exercise are critical to maintaining weight conducive to cardiovascular health. Behavioral factors such as stress management, sleep duration, portion control, and meal timing may play a role in weight management and offer additional routes of intervention. Any smoking elevates cardiovascular risk. Although lifestyle modification programs can be instrumental in reaching public health goals, maintaining cardiovascular health should not be a matter solely of willpower. Ideally, structural and social forces should make healthy lifestyles the default option.
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Affiliation(s)
- Steven A Claas
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Donna K Arnett
- Dean's Office, College of Public Health, University of Kentucky, Lexington, KY, USA.
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Sacks FM, Lichtenstein AH, Wu JHY, Appel LJ, Creager MA, Kris-Etherton PM, Miller M, Rimm EB, Rudel LL, Robinson JG, Stone NJ, Van Horn LV. Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation 2017; 136:e1-e23. [PMID: 28620111 DOI: 10.1161/cir.0000000000000510] [Citation(s) in RCA: 768] [Impact Index Per Article: 109.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cardiovascular disease (CVD) is the leading global cause of death, accounting for 17.3 million deaths per year. Preventive treatment that reduces CVD by even a small percentage can substantially reduce, nationally and globally, the number of people who develop CVD and the costs of caring for them. This American Heart Association presidential advisory on dietary fats and CVD reviews and discusses the scientific evidence, including the most recent studies, on the effects of dietary saturated fat intake and its replacement by other types of fats and carbohydrates on CVD. In summary, randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced CVD by ≈30%, similar to the reduction achieved by statin treatment. Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of CVD and of other major causes of death and all-cause mortality. In contrast, replacement of saturated fat with mostly refined carbohydrates and sugars is not associated with lower rates of CVD and did not reduce CVD in clinical trials. Replacement of saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of CVD in populations and in clinical trials. Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of CVD. This recommended shift from saturated to unsaturated fats should occur simultaneously in an overall healthful dietary pattern such as DASH (Dietary Approaches to Stop Hypertension) or the Mediterranean diet as emphasized by the 2013 American Heart Association/American College of Cardiology lifestyle guidelines and the 2015 to 2020 Dietary Guidelines for Americans.
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Berk KA, Yahya R, Verhoeven AJM, Touw J, Leijten FP, van Rossum EF, Wester VL, Lips MA, Pijl H, Timman R, Erhart G, Kronenberg F, Roeters van Lennep JE, Sijbrands EJG, Mulder MT. Effect of diet-induced weight loss on lipoprotein(a) levels in obese individuals with and without type 2 diabetes. Diabetologia 2017; 60:989-997. [PMID: 28386638 PMCID: PMC5423997 DOI: 10.1007/s00125-017-4246-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/20/2017] [Indexed: 12/28/2022]
Abstract
AIMS/HYPOTHESIS Elevated levels of lipoprotein(a) [Lp(a)] are an independent risk factor for cardiovascular disease (CVD), particularly in individuals with type 2 diabetes. Although weight loss improves conventional risk factors for CVD in type 2 diabetes, the effects on Lp(a) are unknown and may influence the long-term outcome of CVD after diet-induced weight loss. The aim of this clinical study was to determine the effect of diet-induced weight loss on Lp(a) levels in obese individuals with type 2 diabetes. METHODS Plasma Lp(a) levels were determined by immunoturbidimetry in plasma obtained before and after 3-4 months of an energy-restricted diet in four independent study cohorts. The primary cohort consisted of 131 predominantly obese patients with type 2 diabetes (cohort 1), all participants of the Prevention Of Weight Regain in diabetes type 2 (POWER) trial. The secondary cohorts consisted of 30 obese patients with type 2 diabetes (cohort 2), 37 obese individuals without type 2 diabetes (cohort 3) and 26 obese individuals without type 2 diabetes who underwent bariatric surgery (cohort 4). RESULTS In the primary cohort, the energy-restricted diet resulted in a weight loss of 9.9% (95% CI 8.9, 10.8) and improved conventional CVD risk factors such as LDL-cholesterol levels. Lp(a) levels increased by 14.8 nmol/l (95% CI 10.2, 20.6). In univariate analysis, the change in Lp(a) correlated with baseline Lp(a) levels (r = 0.38, p < 0.001) and change in LDL-cholesterol (r = 0.19, p = 0.033). In cohorts 2 and 3, the weight loss of 8.5% (95% CI 6.5, 10.6) and 6.5% (95% CI 5.7, 7.2) was accompanied by a median increase in Lp(a) of 13.5 nmol/l (95% CI 2.3, 30.0) and 11.9 nmol/l (95% CI 5.7, 19.0), respectively (all p < 0.05). When cohorts 1-3 were combined, the diet-induced increase in Lp(a) correlated with weight loss (r = 0.178, p = 0.012). In cohort 4, no significant change in Lp(a) was found (-7.0 nmol/l; 95% CI -18.8, 5.3) despite considerable weight loss (14.0%; 95% CI 12.2, 15.7). CONCLUSIONS/INTERPRETATION Diet-induced weight loss was accompanied by an increase in Lp(a) levels in obese individuals with and without type 2 diabetes while conventional CVD risk factors for CVD improved. This increase in Lp(a) levels may potentially antagonise the beneficial cardiometabolic effects of diet-induced weight reduction.
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Affiliation(s)
- Kirsten A Berk
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Reyhana Yahya
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Adrie J M Verhoeven
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Jeanette Touw
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Frank P Leijten
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Elisabeth F van Rossum
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Vincent L Wester
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Mirjam A Lips
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Hanno Pijl
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Gertraud Erhart
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jeanine E Roeters van Lennep
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Eric J G Sijbrands
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Monique T Mulder
- Department of Internal Medicine, Erasmus Medical Center, Office Ee800, PO Box 2040, 3000, CA, Rotterdam, the Netherlands.
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Abdullah MMH, Jew S, Jones PJH. Health benefits and evaluation of healthcare cost savings if oils rich in monounsaturated fatty acids were substituted for conventional dietary oils in the United States. Nutr Rev 2017; 75:163-174. [PMID: 28158733 PMCID: PMC5914363 DOI: 10.1093/nutrit/nuw062] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 10/15/2016] [Accepted: 11/20/2016] [Indexed: 12/29/2022] Open
Abstract
The impact of nutritional behaviors on health is beyond debate and has the potential to affect the economic outputs of societies in significant ways. Dietary fatty acids have become a central theme in nutrition research in recent years, and the popularity of dietary oils rich in healthy fatty acids, such as monounsaturated fatty acid (MUFA), for cooking applications and use in food products has increased. Here, the objective is to summarize the health effects of MUFA-rich diets and to systematically estimate the potential healthcare and societal cost savings that could be realized by increasing MUFA intakes compared with other dietary fat intakes in the United States. Using a scoping review approach, the literature of randomized controlled clinical trials was searched and a 4-step cost-of-illness analysis was developed, which included estimates of success rate, disease biomarker reduction, disease incidence reduction, and cost savings. Findings revealed improvements in established biomarkers and in incidence of coronary heart disease and type 2 diabetes, along with potentially substantial annual healthcare and societal cost savings when recommendations for daily MUFA intake were followed. In summary, beyond the beneficial health effects of MUFA-rich diets, potential economic benefits suggest practical implications for consumers, food processors, and healthcare authorities alike.
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Affiliation(s)
- Mohammad M. H. Abdullah
- M.M.H. Abdullah, S. Jew, and P.J.H. Jones are with the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada. M.M.H. Abdullah and P.J.H. Jones are with the Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephanie Jew
- M.M.H. Abdullah, S. Jew, and P.J.H. Jones are with the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada. M.M.H. Abdullah and P.J.H. Jones are with the Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Peter J. H. Jones
- M.M.H. Abdullah, S. Jew, and P.J.H. Jones are with the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada. M.M.H. Abdullah and P.J.H. Jones are with the Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Guess N. Dietary intake in people consuming a reduced-carbohydrate diet in the National Diet and Nutrition Survey. J Hum Nutr Diet 2016; 30:360-368. [DOI: 10.1111/jhn.12429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- N. Guess
- Division of Diabetes and Nutritional Sciences; Kings College London; London UK
- Department of Medicine; Imperial College London; London UK
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40
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Celada P, Sánchez-Muniz FJ, Delgado-Pando G, Bastida S, Rodilla ME, Jiménez-Colmenero F, Olmedilla-Alonso B. Effects of improved fat meat products consumption on emergent cardiovascular disease markers of male volunteers at cardiovascular risk. J Physiol Biochem 2016; 72:669-678. [PMID: 27376533 DOI: 10.1007/s13105-016-0505-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/27/2016] [Indexed: 01/12/2023]
Abstract
High meat-product consumption has been related to cardiovascular disease (CVD). However, previous results suggest the benefits of consuming improved fat meat products on lipoprotein-cholesterol and anthropometric measurements. Present study aims to assess the effect of consuming different Pâté and Frankfurter formulations on emergent CVD biomarkers in male volunteers at increased CVD risk. Eighteen male volunteers with at least two CVD risk factors were enrolled in a sequentially controlled study where different pork-products were tested: reduced-fat (RF), omega-3-enriched-RF (n-3RF), and normal-fat (NF). Pork-products were consumed during 4-week periods separated by 4-week washout. The cardiometabolic index (CI), oxidized low density lipoproteins (oxLDL), apolipoproteins (Apo) A1 and B, homocysteine (tHcys), arylesterase (AE), C-reactive Protein (CRP), tumor necrotic factor-alpha (TNFα), and lipoprotein (a) (Lp(a)) were tested and some other related ratios calculated. AE, oxLDL and Lp(a), AE/HDLc, LDLc/Apo B, and AE/oxLDL rate of change were differently affected (P<0.01) by pork-products consumption. RF increased (P < 0.05) AE, AE/HDLc and AE/oxLDL ratios and decreased TNFα, tHcys; n-3RF increased (P < 0.001) AE, AE/HDLc and AE/oxLDL ratios and decreased (P < 0.05) Lp(a); while NF increased (P<0.05) oxLDL and Lp(a) levels. In conclusion, RF and n-3RF products affected positively the level of some emergent CVD markers. The high regular consumption of NF-products should be limited as significantly increased Lp(a) and oxLDL values. The high variability in response observed for some markers suggests the need to perform more studies to identify targets for RF- and n-3RF-products. Graphical Abstract Emergent CVD markers.
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Affiliation(s)
- Paloma Celada
- Departamento de Nutrición y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense, 28040, Madrid, Spain
| | - Francisco J Sánchez-Muniz
- Departamento de Nutrición y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense, 28040, Madrid, Spain.
| | - Gonzalo Delgado-Pando
- Instituto de Ciencia y Tecnología de los Alimentos y Nutrición (ICTAN), CSIC, 28040, Madrid, Spain
| | - Sara Bastida
- Departamento de Nutrición y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense, 28040, Madrid, Spain
| | | | | | - Begoña Olmedilla-Alonso
- Instituto de Ciencia y Tecnología de los Alimentos y Nutrición (ICTAN), CSIC, 28040, Madrid, Spain
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Ruiz E, Ávila JM, Valero T, Del Pozo S, Rodriguez P, Aranceta-Bartrina J, Gil Á, González-Gross M, Ortega RM, Serra-Majem L, Varela-Moreiras G. Macronutrient Distribution and Dietary Sources in the Spanish Population: Findings from the ANIBES Study. Nutrients 2016; 8:177. [PMID: 27011202 PMCID: PMC4808903 DOI: 10.3390/nu8030177] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/22/2015] [Accepted: 03/15/2016] [Indexed: 11/16/2022] Open
Abstract
Our aim was to analyze dietary macronutrient intake and its main sources according to sex and age. Results were derived from the ANIBES ("Anthropometry, Intake and Energy Balance in Spain") cross-sectional study using a nationally-representative sample of the Spanish population (9-75 years old). Mean dietary protein intake was 74.5 ± 22.4 g/day, with meat and meat products as the main sources (33.0%). Mean carbohydrate intake was 185.4 ± 60.9 g/day and was higher in children and adolescents; grains (49%), mainly bread, were the main contributor. Milk and dairy products (23%) ranked first for sugar intake. Mean lipid intake was 78.1 ± 26.1 g/day and was higher in younger age groups; contributions were mainly from oils and fats (32.5%; olive oil 25.6%) and meat and meat products (22.0%). Lipid profiles showed relatively high monounsaturated fatty acid intake, of which olive oil contributed 38.8%. Saturated fatty acids were mainly (>70%) combined from meat and meat products, milk and dairy products and oils and fats. Polyunsaturated fatty acids were mainly from oils and fats (31.5%). The macronutrient intake and distribution in the Spanish population is far from population reference intakes and nutritional goals, especially for children and adolescents.
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Affiliation(s)
- Emma Ruiz
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1 pta, Madrid 28010, Spain.
| | - José Manuel Ávila
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1 pta, Madrid 28010, Spain.
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1 pta, Madrid 28010, Spain.
| | - Susana Del Pozo
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1 pta, Madrid 28010, Spain.
| | - Paula Rodriguez
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1 pta, Madrid 28010, Spain.
| | - Javier Aranceta-Bartrina
- Department of Preventive Medicine and Public Health, University of Navarra, C/Irunlarrea 1, Pamplona 31008, Spain.
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Sciences, University of Granada. Campus de la Salud, Avda. del Conocimiento, Armilla, Granada 18100, Spain.
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, C/Martín Fierro 7, Madrid 28040, Spain.
| | - Rosa M Ortega
- Department of Nutrition, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, Madrid 28040, Spain.
| | - Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences, Universidad de Las Palmas de Gran Canaria, Facultad de Ciencias de la Salud, C/Doctor Pasteur s/n Trasera del Hospital, Las Palmas de Gran Canaria, Las Palmas 35016, Spain.
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1 pta, Madrid 28010, Spain.
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, Crta. Boadilla Km 53, Boadilla del Monte, Madrid 28668, Spain.
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Abstract
Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes mellitus. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not only blood lipids or obesity; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (eg, sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on the cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to date supports the cardiometabolic relevance of other popular priorities: eg, local, organic, grass-fed, farmed/wild, or non-genetically modified. Evidence-based personalized nutrition appears to depend more on nongenetic characteristics (eg, physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies targeting economic incentives, schools and workplaces, neighborhood environments, and the food system. Scientific advances provide crucial new insights on optimal targets and best practices to reduce the burdens of diet-related cardiometabolic diseases.
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Affiliation(s)
- Dariush Mozaffarian
- From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA.
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Intake of Meals Containing High Levels of Carbohydrates or High Levels of Unsaturated Fatty Acids Induces Postprandial Dysmetabolism in Young Overweight/Obese Men. BIOMED RESEARCH INTERNATIONAL 2015; 2015:147196. [PMID: 26609520 PMCID: PMC4644820 DOI: 10.1155/2015/147196] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/23/2015] [Accepted: 10/13/2015] [Indexed: 12/23/2022]
Abstract
Postprandial metabolic response depends on the meals' components and can be different in normal weight and obese people. However, there are some discrepancies between various reports. The aim of this study was to determine the metabolic response after intake of standardised meals with various fat and carbohydrate contents and to determine the differences among normal weight and overweight/obese individuals. The study group comprised 46 healthy men. The participants were divided into two groups and study was carried out using a crossover method. Group I received high- and normal-carbohydrate meals, whereas group II received high-carbohydrate and high-fat meals. Glucose, insulin, triglyceride, and free fatty acids levels were measured at fasting state and at 30, 60, 120, 180, and 240 minutes after meal intake. Despite the lack of differences in glucose levels, insulin levels were higher among overweight/obese individuals after each meal. TG and FFA levels were higher after normal-carbohydrate and high-fat meals. Moreover, in overweight/obese young men after high-fat meal intake postprandial hypertriglyceridemia was observed, even if meals contained predominantly unsaturated fatty acids, and fasting triglycerides levels were in normal range. The conducted study showed that postprandial metabolic response depends not only on the meal macronutrient content but also on the current body mass index (BMI).
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Ruiz E, Ávila JM, Valero T, del Pozo S, Rodriguez P, Aranceta-Bartrina J, Gil Á, González-Gross M, Ortega RM, Serra-Majem L, Varela-Moreiras G. Energy Intake, Profile, and Dietary Sources in the Spanish Population: Findings of the ANIBES Study. Nutrients 2015; 7:4739-62. [PMID: 26076230 PMCID: PMC4488811 DOI: 10.3390/nu7064739] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 05/18/2015] [Accepted: 05/28/2015] [Indexed: 11/16/2022] Open
Abstract
Energy intake, and the foods and beverages contributing to that, are considered key to understanding the high obesity prevalence worldwide. The relative contributions of energy intake and expenditure to the obesity epidemic, however, remain poorly defined in Spain. The purpose of this study was to contribute to updating data of dietary energy intake and its main sources from food and beverages, according to gender and age. These data were derived from the ANIBES ("Anthropometry, Intake, and Energy Balance in Spain") study, a cross-sectional study of a nationally representative sample of the Spanish population (from 9-75 years old). A three-day dietary record, collected by means of a tablet device, was used to obtain information about food and beverage consumption and leftovers. The final sample comprised 2009 individuals (1,013 men, 996 women). The observed mean dietary energy intake was 7.6 ± 2.11 MJ/day (8.2 ± 2.22 MJ/day for men and 6.9 ± 1.79 MJ/day for women). The highest intakes were observed among adolescents aged 13-17 years (8.4 MJ/day), followed by children 9-12 years (8.2 ± 1.80 MJ/day), adults aged 18-64 (7.6 ± 2.14 MJ/day) and older adults aged 65-75 years (6.8 ± 1.88 MJ/day). Cereals or grains (27.4%), meats and derivatives (15.2%), oils and fats (12.3%), and milk and dairy products (11.8%) contributed most to daily energy intake. Energy contributions from non-alcoholic beverages (3.9%), fish and shellfish (3.6%), sugars and sweets (3.3%) and alcoholic beverages (2.6%) were moderate to minor. Contributions to caloric profile were 16.8%E from proteins; 41.1%E from carbohydrates, including 1.4%E from fiber; 38.5%E from fats; and 1.9%E from alcohol intake. We can conclude that energy intake is decreasing in the Spanish population. A variety of food and beverage groups contribute to energy intake; however, it is necessary to reinforce efforts for better adherence to the traditional Mediterranean diet.
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Affiliation(s)
- Emma Ruiz
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain.
| | - José Manuel Ávila
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain.
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain.
| | - Susana del Pozo
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain.
| | - Paula Rodriguez
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain.
| | - Javier Aranceta-Bartrina
- Department of Preventive Medicine and Public Health, University of Navarra, C/Irunlarrea 1, 31008 Pamplona, Spain.
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II and Institute of Nutrition and Food Sciences, University of Granada, Campus de la Salud, Avda. del Conocimiento, 18100 Armilla, Granada, Spain.
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, C/Martín Fierro 7, 28040 Madrid, Spain.
| | - Rosa M Ortega
- Department of Nutrition, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
| | - Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences, Universidad de Las Palmas de Gran Canaria, Facultad de Ciencias de la Salud, C/Doctor Pasteur s/n Trasera del Hospital, 35016 Las Palmas de Gran Canaria, Spain.
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), C/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain.
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, Crta. Boadilla Km. 5.3, 28668 Boadilla del Monte, Madrid, Spain.
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Kris-Etherton PM, Fleming JA. Emerging nutrition science on fatty acids and cardiovascular disease: nutritionists' perspectives. Adv Nutr 2015; 6:326S-37S. [PMID: 25979506 PMCID: PMC4424771 DOI: 10.3945/an.114.006981] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Recent dietary guidance for heart health recommends a reduction (by ∼50%) in saturated fatty acid (SFA) intake to reduce LDL cholesterol and to decrease risk of cardiovascular disease (CVD). The 2010 Dietary Guidelines for Americans recommends substituting unsaturated fat [both polyunsaturated and monounsaturated fatty acids (PUFAs and MUFAs, respectively)] for SFAs. There are many dietary options that can be implemented to replace SFAs, given the different sources of unsaturated fats in the food supply. Compelling evidence exists for the cardioprotective benefits of n-3 (ω-3) PUFAs, both marine- and plant-derived. In addition, the evidence of cardioprotective benefits of n-6 (ω-6) PUFAs is strong, whereas that for MUFAs is mixed, although there is emerging evidence of benefits. Quantitatively, lowering SFAs by 50% will require, in part, substituting food sources of n-6 and n-3 PUFAs and MUFAs for food sources of SFAs. The use of n-3 PUFAs as a replacement for SFAs will result in a shortfall in reaching the SFA goal because of the relatively low amounts that can be incorporated in the diet, even with very high n-3 PUFA substitution. SFAs also can be replaced with dietary carbohydrate and/or protein. Replacing SFAs with carbohydrate, specifically refined sources, however, has little impact on reducing CVD risk. There is evidence about the health benefits of dietary protein on CVD risk, which merits study. Dietary guidelines have advanced considerably with the "replacement of SFA with unsaturated fat message" instead of recommending decreasing SFAs alone. A key question that remains is what is the optimal mix of macronutrients to maximally reduce CVD risk.
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Affiliation(s)
- Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Jennifer A Fleming
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
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Siri-Tarino PW, Chiu S, Bergeron N, Krauss RM. Saturated Fats Versus Polyunsaturated Fats Versus Carbohydrates for Cardiovascular Disease Prevention and Treatment. Annu Rev Nutr 2015; 35:517-43. [PMID: 26185980 PMCID: PMC4744652 DOI: 10.1146/annurev-nutr-071714-034449] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effects of saturated fatty acids (SFAs) on cardiovascular disease (CVD) risk are modulated by the nutrients that replace them and their food matrices. Replacement of SFAs with polyunsaturated fatty acids has been associated with reduced CVD risk, although there is heterogeneity in both fatty acid categories. In contrast, replacement of SFAs with carbohydrates, particularly sugar, has been associated with no improvement or even a worsening of CVD risk, at least in part through effects on atherogenic dyslipidemia, a cluster of traits including small, dense low-density lipoprotein particles. The effects of dietary SFAs on insulin sensitivity, inflammation, vascular function, and thrombosis are less clear. There is growing evidence that SFAs in the context of dairy foods, particularly fermented dairy products, have neutral or inverse associations with CVD. Overall dietary patterns emphasizing vegetables, fish, nuts, and whole versus processed grains form the basis of heart-healthy eating and should supersede a focus on macronutrient composition.
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Affiliation(s)
- Patty W. Siri-Tarino
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
| | - Sally Chiu
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
| | - Nathalie Bergeron
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
- College of Pharmacy, Touro University California, Vallejo, California 94594
| | - Ronald M. Krauss
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
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Haring B, Wyler von Ballmoos MC, Appel LJ, Sacks FM. Healthy dietary interventions and lipoprotein (a) plasma levels: results from the Omni Heart Trial. PLoS One 2014; 9:e114859. [PMID: 25506933 PMCID: PMC4266632 DOI: 10.1371/journal.pone.0114859] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/21/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Increased lipoprotein(a) [Lp(a)] levels are associated with atherosclerotic cardiovascular disease. Studies of dietary interventions on changes in Lp(a) are sparse. We aimed to compare the effects of three healthy dietary interventions differing in macronutrient content on Lp(a) concentration. METHODS Secondary analysis of a randomized, 3-period crossover feeding study including 155 (89 blacks; 66 whites) individuals. Participants were given DASH-type healthy diets rich in carbohydrates [Carb], in protein [Prot] or in unsaturated fat [Unsat Fat] for 6 weeks each. Plasma Lp(a) concentration was assessed at baseline and after each diet. RESULTS Compared to baseline, all interventional diets increased mean Lp(a) by 2 to 5 mg/dl. Unsat Fat increased Lp(a) less than Prot with a difference of 1.0 mg/dl (95% CI, -0.5, 2.5; p = 0.196) in whites and 3.7 mg/dl (95% CI, 2.4, 5.0; p < 0.001) in blacks (p-value between races = 0.008); Unsat Fat increased Lp(a) less than Carb with a difference of -0.6 mg/dl, 95% CI, -2.1, 0.9; p = 0.441) in whites and -1.5 mg/dl (95% CI, -0.2, -2.8; p = 0.021) in blacks (p-value between races = 0.354). Prot increased Lp(a) more than Carb with a difference of 0.4 mg/dl (95% CI, -1.1, 1.9; p = 0.597) in whites and 2.2 mg/dl (95%CI, 0.9, 3.5; p = 0.001) in blacks (p-value between races = 0.082). CONCLUSION Diets high in unsaturated fat increased Lp(a) levels less than diets rich in carbohydrate or protein with greater changes in blacks than whites. Our results suggest that substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets may be preferable over protein or carbohydrates with regards to Lp(a). TRIAL REGISTRATION Clinicaltrials.gov NCT00051350.
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Affiliation(s)
- Bernhard Haring
- Department of Internal Medicine I, Comprehensive Heart Failure Ctr, University of Würzburg, Bavaria, Germany
| | - Moritz C. Wyler von Ballmoos
- Department of Cardiothoracic Surgery, Froedtert Memorial Hospital & Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Lawrence J. Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Frank M. Sacks
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
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48
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Jones PJH, Senanayake VK, Pu S, Jenkins DJA, Connelly PW, Lamarche B, Couture P, Charest A, Baril-Gravel L, West SG, Liu X, Fleming JA, McCrea CE, Kris-Etherton PM. DHA-enriched high-oleic acid canola oil improves lipid profile and lowers predicted cardiovascular disease risk in the canola oil multicenter randomized controlled trial. Am J Clin Nutr 2014; 100:88-97. [PMID: 24829493 PMCID: PMC4144116 DOI: 10.3945/ajcn.113.081133] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is well recognized that amounts of trans and saturated fats should be minimized in Western diets; however, considerable debate remains regarding optimal amounts of dietary n-9, n-6, and n-3 fatty acids. OBJECTIVE The objective was to examine the effects of varying n-9, n-6, and longer-chain n-3 fatty acid composition on markers of coronary heart disease (CHD) risk. DESIGN A randomized, double-blind, 5-period, crossover design was used. Each 4-wk treatment period was separated by 4-wk washout intervals. Volunteers with abdominal obesity consumed each of 5 identical weight-maintaining, fixed-composition diets with one of the following treatment oils (60 g/3000 kcal) in beverages: 1) conventional canola oil (Canola; n-9 rich), 2) high-oleic acid canola oil with docosahexaenoic acid (CanolaDHA; n-9 and n-3 rich), 3) a blend of corn and safflower oil (25:75) (CornSaff; n-6 rich), 4) a blend of flax and safflower oils (60:40) (FlaxSaff; n-6 and short-chain n-3 rich), or 5) high-oleic acid canola oil (CanolaOleic; highest in n-9). RESULTS One hundred thirty individuals completed the trial. At endpoint, total cholesterol (TC) was lowest after the FlaxSaff phase (P < 0.05 compared with Canola and CanolaDHA) and highest after the CanolaDHA phase (P < 0.05 compared with CornSaff, FlaxSaff, and CanolaOleic). Low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol were highest, and triglycerides were lowest, after CanolaDHA (P < 0.05 compared with the other diets). All diets decreased TC and LDL cholesterol from baseline to treatment endpoint (P < 0.05). CanolaDHA was the only diet that increased HDL cholesterol from baseline (3.5 ± 1.8%; P < 0.05) and produced the greatest reduction in triglycerides (-20.7 ± 3.8%; P < 0.001) and in systolic blood pressure (-3.3 ± 0.8%; P < 0.001) compared with the other diets (P < 0.05). Percentage reductions in Framingham 10-y CHD risk scores (FRS) from baseline were greatest after CanolaDHA (-19.0 ± 3.1%; P < 0.001) than after other treatments (P < 0.05). CONCLUSION Consumption of CanolaDHA, a novel DHA-rich canola oil, improves HDL cholesterol, triglycerides, and blood pressure, thereby reducing FRS compared with other oils varying in unsaturated fatty acid composition. This trial was registered at www.clinicaltrials.gov as NCT01351012.
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Affiliation(s)
- Peter J H Jones
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Vijitha K Senanayake
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Shuaihua Pu
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - David J A Jenkins
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Philip W Connelly
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Benoît Lamarche
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Patrick Couture
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Amélie Charest
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Lisa Baril-Gravel
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Sheila G West
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Xiaoran Liu
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Jennifer A Fleming
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Cindy E McCrea
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
| | - Penny M Kris-Etherton
- From the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Canada (PJHJ, VKS, and SP); the Risk Factor Modification Centre (DJAJ) and the Keenan Research Centre for Biomedical Science (PWC), St. Michaels Hospital, University of Toronto, Toronto, Canada; the Institute of Nutrition and Functional Foods, Laval University, Québec City, Canada (BL, PC, AC, and LB-G); the Department of Nutritional Sciences (SGW, XL, JAF, and PMK-E) and the Department of Biobehavioral Health (SGW and CEM), Pennsylvania State University, University Park, PA
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Silver HJ, Kang H, Keil CD, Muldowney JA, Kocalis H, Fazio S, Vaughan DE, Niswender KD. Consuming a balanced high fat diet for 16 weeks improves body composition, inflammation and vascular function parameters in obese premenopausal women. Metabolism 2014; 63:562-73. [PMID: 24559846 PMCID: PMC4306330 DOI: 10.1016/j.metabol.2014.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 01/10/2014] [Accepted: 01/12/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Inflammation, insulin resistance and vascular dysfunction characterize obesity and predict development of cardiovascular disease (CVD). Although women experience CVD events at an older age, vascular dysfunction is evident 10years prior to coronary artery disease. Questions remain whether replacing SFA entirely with MUFA or PUFA is the optimal approach for cardiometabolic benefits. This study tested the hypotheses that: a) body composition, inflammation and vascular function would improve with a high fat diet (HFD) when type of fat is balanced as 1/3 SFA, 1/3 MUFA and 1/3 PUFA; and b) body composition, inflammation and vascular function would improve more when balanced HFD is supplemented with 18C fatty acids, in proportion to the degree of 18C unsaturation. METHODS Obese premenopausal women were stabilized on balanced HFD and randomized to consume 9g/d of encapsulated stearate (18:0), oleate (18:1), linoleate (18:2) or placebo. RESULTS Significant improvements occurred in fat oxidation rate (↑6%), body composition (%fat: ↓2.5±2.1%; %lean: ↑2.5±2.1%), inflammation (↓ IL-1α, IL-1β, 1L-12, Il-17, IFNγ, TNFα, TNFβ) and vascular function (↓BP, ↓PAI-1, ↑tPA activity). When compared to HFD+placebo, HFD+stearate had the greatest effect on reducing IFNγ (↓74%) and HFD+linoleate had the greatest effect on reducing PAI-1 (↓31%). CONCLUSIONS Balancing the type of dietary fat consumed (SFA/MUFA/PUFA) is a feasible strategy to positively affect markers of CVD risk. Moreover, reductions in inflammatory molecules involved in vascular function might be enhanced when intake of certain 18C fatty acids is supplemented. Long term effects need to be determined for this approach.
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Affiliation(s)
- Heidi J Silver
- Vanderbilt University, Department of Medicine, Nashville, TN, USA.
| | - Hakmook Kang
- Vanderbilt University, Department of Biostatistics, Nashville, TN, USA
| | - Charles D Keil
- Vanderbilt University, Department of Medicine, Nashville, TN, USA
| | | | - Heidi Kocalis
- Vanderbilt University, Department of Medicine, Nashville, TN, USA
| | - Sergio Fazio
- Vanderbilt University, Department of Cardiology, Nashville, TN, USA
| | | | - Kevin D Niswender
- Vanderbilt University, Department of Medicine, Nashville, TN, USA; Tennessee Valley Healthcare System, Nashville, TN, USA
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Kien CL, Bunn JY, Stevens R, Bain J, Ikayeva O, Crain K, Koves TR, Muoio DM. Dietary intake of palmitate and oleate has broad impact on systemic and tissue lipid profiles in humans. Am J Clin Nutr 2014; 99:436-45. [PMID: 24429541 PMCID: PMC3927687 DOI: 10.3945/ajcn.113.070557] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Epidemiologic evidence has suggested that diets with a high ratio of palmitic acid (PA) to oleic acid (OA) increase risk of cardiovascular disease (CVD). OBJECTIVE To gain additional insights into the relative effect of dietary fatty acids and their metabolism on CVD risk, we sought to identify a metabolomic signature that tracks with diet-induced changes in blood lipid concentrations and whole-body fat oxidation. DESIGN We applied comprehensive metabolomic profiling tools to biological specimens collected from 18 healthy adults enrolled in a crossover trial that compared a 3-wk high-palmitic acid (HPA) with a low-palmitic acid and high-oleic acid (HOA) diet. RESULTS A principal components analysis of the data set including 329 variables measured in 15 subjects in the fasted state identified one factor, the principal components analysis factor in the fasted state (PCF1-Fasted), which was heavily weighted by the PA:OA ratio of serum and muscle lipids, that was affected by diet (P < 0.0001; HPA greater than HOA). One other factor, the additional principal components analysis factor in the fasted state (PCF2-Fasted), reflected a wide range of acylcarnitines and was affected by diet in women only (P = 0.0198; HPA greater than HOA). HOA lowered the ratio of serum low-density lipoprotein to high-density lipoprotein (LDL:HDL) in men and women, and adjustment for the PCF1-Fasted abolished the effect. In women only, adjustment for the PCF2-Fasted eliminated the HOA-diet effect on serum total- and LDL-cholesterol concentrations. The respiratory exchange ratio in the fasted state was lower with the HPA diet (P = 0.04), and the diet effect was eliminated after adjustment for the PCF1-Fasted. The messenger RNA expression of the cholesterol regulatory gene insulin-induced gene-1 was higher with the HOA diet (P = 0.008). CONCLUSIONS These results suggest that replacing dietary PA with OA reduces the blood LDL concentration and whole-body fat oxidation by modifying the saturation index of circulating and tissue lipids. In women, these effects are also associated with a higher production and accumulation of acylcarnitines, possibly reflecting a shift in fat catabolism.
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Affiliation(s)
- C Lawrence Kien
- Departments of Pediatrics (CLK), Medicine (CLK and KC), and Medical Biostatistics (JYB), University of Vermont, Burlington, VT, and the Stedman Nutrition and Metabolism Center (RS, JB, OI, TRK, and DMM) and Departments of Medicine (TRK and DMM) and Pharmacology and Cancer Biology (DMM), Duke University, Durham, NC
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