Diet and exercise as regulators of lipid risk factors

European adolescent ready-to-eat-cereal (RTEC) consumers have a healthier dietary intake and body composition compared with non-RTEC consumers

Purpose

This study aims to analyse the association of European adolescents’ ready-to-eat-cereal (RTEC) consumption frequency with their dietary intake by applying the concept of diet quality index and nutritional status.

Methods

From the multi-centre European HELENA study, relevant data were available in 1,215 adolescents (12.5–17.5 years). RTEC consumption was identified from a food frequency questionnaire. A diet quality index, daily nutrient intakes and daily milk/yoghurt and fruit intake were calculated from two 24-h dietary recalls. BMI, waist and hip circumference and body fat were measured for body composition. Cross-sectional regression analyses were adjusted for sex, age, socio-economic status, city and breakfast skipping. Differences in sub-regions within Europe were explored.

Results

RTEC consumers showed a more favourable daily micronutrient intake (vitamin B2, B5, B7, D, calcium, phosphorus and potassium), a better diet quality index, more frequent fruit (57 vs. 51 %) and milk/yoghurt consumption (81.2 vs. 56 %) and less breakfast skipping (25.1 vs. 36.7 %). No differences in energy and macronutrient intake were observed. Daily RTEC consumers were 57 % less likely to be overweight than RTEC non-consumers but did not differ in glucose and lipid status (N = 387).

Conclusion

This is the first comprehensive pan-European survey elucidating socio-demographic determinants of European adolescents’ RTEC consumption and indicating better dietary habits in RTEC consumers. The improved dietary profile was reflected in a more beneficial body composition. Our results have also shown the advantage of using an all-integrating diet quality index by capturing the diet complexity.

Dietary cardiovascular risk factors and serum cholesterol in an Old Order Mennonite community

OBJECTIVES

Dietary and coronary heart disease risk factors in Old Order Mennonite men and women were examined.

METHODS

A food frequency questionnaire was mailed to 250 Mennonites who had participated in a previous study of coronary heart disease risk factors.

RESULTS

Mennonites consumed a diet high in total fat, saturated fats, and cholesterol. Men had lower average serum cholesterol levels (174 mg/dL) than women (191 mg/dL).

CONCLUSIONS

The Mennonites' diet was similar to that of the overall US population in saturated fat percentage and higher in cholesterol. Serum cholesterol levels, adiposity, and blood pressure were lower than expected among Mennonite men, perhaps because of their higher levels of physical activity.

Regional body composition determined by dual-energy X-ray absorptiometry. Relation to training, sex hormones, and serum lipids in male long-distance runners

This study investigated the regional distribution of fatty and lean tissue in long-distance runners, and the relation to training, sex hormones, and serum lipids. One hundred and twenty lean men (22 elite, 86 recreational runners and 12 non-running controls) aged 32 +/- 8.1 years (mean +/- SD) participated. Body composition (adipose and lean tissue) was measured by dual-energy x-ray absorptiometry in the total body and in the abdomen, the arms and the legs. Regional and total body fat correlated inversely with the performance at an incremental treadmill exercise test (-0.61 < r < -0.52, P < 0.0001), and the fat percentage in the abdomen and in the legs was 42% and 36% lower in the elite runners in comparison with the non-running controls. Sex hormonal status and serum lipids were unrelated to training. After multiple regression analysis the most significant determinant of the fat percentage in the legs was the weekly distance run (partial r = -0.40, P < 0.0001), whereas in the abdominal region the free testosterone index also contributed strongly (partial r = 0.39, P < 0.0001). In conclusion, long-distance runners had very low amounts of fatty tissue in the abdomen and in the extremities, and the fat percentages in the abdomen and in the legs were associated with both the training intensity and androgenic activity. Since the abdominal fatty tissue is a significant risk factor for cardiovascular disease, running may have a positive impact on the long-term risk.

Physical fitness, lipids, and apolipoproteins in the Northern Ireland Health and Activity Survey

The objective of this study was to investigate the relationship between physical fitness, lipids, and apolipoproteins in a cross-sectional study using a two-stage probability sample of the population of Northern Ireland. The main outcome measures were physical fitness using VO2max estimated by extrapolation from submaximal oxygen uptake while walking on a motor driven treadmill, and total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, HDL2 and HDL3, and Lp(a). There were no significant relationships with fitness, after adjustment for possible confounders, with the exception of a positive relationship with HDL2 in males (P < or = 0.01) and Lp(a) in females (P < or = 0.05). There was also a relationship between physical fitness and HDL:apo AI ratio in males and females after adjustment for possible confounders (P < or = 0.05). We concluded that there were few relationships between lipid parameters and physical fitness after adjustment for possible confounders. The relationship between physical fitness and Lp(a) in females suggests a benefit associated with physical fitness and the relationship between physical fitness and HDL:apo AI ratio was in keeping with improved HDL cholesterol transport.

Physical activity, lipids, apolipoproteins, and Lp(a) in the Northern Ireland Health and Activity Survey

In a cross-sectional study using a two-stage probability sample (N = 1,600) of the population of Northern Ireland, there was an inverse association between the highest recorded recent activity and total cholesterol (P < or = 0.01), LDL (P < or = 0.01), triglyceride (P < or = 0.05) and Chol:HDL ratio (P < or = 0.001) in males, and total cholesterol (P < or = 0.001), LDL (P < or = 0.001), and triglyceride (P < or = 0.01) in females; between habitual activity and HDL (P < or = 0.05) in males and total cholesterol (P < or = 0.05) and triglyceride (P < or = 0.01) in females. There was a relationship between the highest recorded activity and apoAI (P < or = 0.01) and apoB (P < or = 0.01) in males and with apoB (P < or = 0.001) in females; between habitual activity and apoAI (P < or = 0.01) and apoAII (P < or = 0.05) in males and apoB (P < or = 0.01) in females; between past activity and Lp(a) in females (P < or = 0.05). After adjustment for possible confounding factors, total cholesterol (P < or = 0.05) and LDL (P < or = 0.05) were unexpectedly higher in males who were active throughout life. Total cholesterol (P < or = 0.05) and LDL (P < or = 0.001) were higher in females with highest recorded activity and triglycerides lower (P < or = 0.05) in those habitually active. An association between highest recorded activity and apoAI (P < or = 0.01), and past activity and apoAI:apoB ratio (P < or = 0.05) was shown in males and in females, after adjustment, and between apoB (P < or = 0.05) and highest recorded activity.

Effects of a simplified programme for dietary treatment of hyperlipdaemia in primary health care

OBJECTIVE

To evaluate a model for dietary treatment of hyperlipidaemia in primary health care.

DESIGN

The participating men received their initial dietary instructions from a dietitian, in a group, together with their wives. Thereafter the nurses used a checklist to evaluate dietary compliance throughout the year. The participants completed a simplified food frequency questionnaire six times during the study period.

RESULTS

Throughout the year the total body weight, body mass index (BMI), total cholesterol, LDL cholesterol and LDL/HDL cholesterol ratio decreased significantly. HDL cholesterol was significantly increased after one year.

SETTING

The Industrial Health Care Centre, Ovansiljans Företagshälsovård AB in Mora, Sweden.

PARTICIPANTS

35 men, aged 39-63 years (mean 51), with hyperlipidaemia, discovered at a health survey of persons attending an industrial health care centre.

CONCLUSION

A simplified model for treatment of hyperlipidaemic patients can improve the dietary habits in the long term.

The triglyceride connection in atherosclerosis

OBJECTIVE

To examine the proposed mechanism of triglyceride-induced atherogenesis, to address the controversy surrounding serum triglycerides as a coronary heart disease (CHD) risk factor, and to recommend an appropriate therapeutic approach to hypertriglyceridemia.

DATA SOURCES

Studies, review articles, and editorials published since 1976. A MEDLINE search of English-language literature was conducted using the terms triglyceride and hypertriglyceridemia.

STUDY SELECTION

Studies, review articles, and editorials were selected for detailed review if they addressed the pathogenesis of triglyceride-induced atherosclerosis, the controversy associated with elevated serum triglyceride as a CHD risk factor, and hypertriglyceridemia treatment options.

DATA EXTRACTION

Data were reviewed that described the atherogenicity of chylomicron and very low-density lipoprotein (VLDL) remnants, the inverse relationship that exists between high-density lipoprotein (HDL) and serum triglyceride, the hypertriglyceridemia treatment controversy, and the treatment options of diet, exercise, weight control, alcohol restriction, and medication.

DATA SYNTHESIS

Hypertriglyceridemia is a well-known risk factor for pancreatitis. However, its role in atherogenesis is less well defined. Several proposed connections appear to exist between hypertriglyceridemia and atherosclerosis, including the inverse correlation between triglycerides and HDL, the presumed atherogenicity of triglyceride-rich lipoprotein remnant particles, the potential resultant increase in the serum concentration and atherogenicity of low-density lipoprotein (LDL), and the proposed interaction between serum triglyceride and the fibrinolytic/coagulation system. Clinical trials addressing this issue offer mixed results that are subject to interpretation. Diet, exercise, weight control, alcohol restriction, and certain lipid-lowering medications are effective at reducing serum triglyceride.

CONCLUSIONS

Hypertriglyceridemia is a theoretical risk factor for CHD because of the increased production of atherogenic chylomicron and VLDL remnants, the inverse relationship present between serum triglyceride and HDL, the possible resultant increase in LDL attributable to remnant-reduced hepatic LDL-receptors as well as the formation of more dense and, therefore, more atherogenic LDL, and to the interaction between serum triglyceride and the fibrinolytic/coagulation system. However, most clinical trials that have found hypertriglyceridemia to be a risk factor for CHD do not include other CHD risk factors in their analyses. Therapeutic intervention to lower serum triglyceride with diet, exercise, and/or drugs is definitely recommended in the treatment and/or prevention of pancreatitis; however, the role of triglyceride-lowering to reduce CHD risk remains controversial.