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Griffin BA, Walker CG, Jebb SA, Moore C, Frost GS, Goff L, Sanders TAB, Lewis F, Griffin M, Gitau R, Lovegrove JA. APOE4 Genotype Exerts Greater Benefit in Lowering Plasma Cholesterol and Apolipoprotein B than Wild Type (E3/E3), after Replacement of Dietary Saturated Fats with Low Glycaemic Index Carbohydrates. Nutrients 2018; 10:nu10101524. [PMID: 30336580 PMCID: PMC6213759 DOI: 10.3390/nu10101524] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 09/27/2018] [Accepted: 10/12/2018] [Indexed: 12/19/2022] Open
Abstract
We examined the impact of APOE genotype on plasma lipids and glucose in a secondary analysis of data from a five-arm, randomised controlled, parallel dietary intervention trial ('RISCK' study), to investigate the impact of replacing saturated fatty acids (SFA) with either monounsaturated fat (MUFA) or carbohydrate of high or low glycaemic index (GI) on CVD risk factors and insulin sensitivity. We tested the impact of APOE genotype (carriage of E2 and E4 alleles versus E3/E3), determined retrospectively, on plasma lipids, lipoproteins and glucose homeostasis at baseline (n = 469), and on the change in these variables after 24 weeks of dietary intervention (n = 389). At baseline, carriers of E2 (n = 70), E4 (n = 125) and E3/E3 (n = 274) expressed marked differences in total plasma cholesterol (TC, p = 0.001), low density lipoprotein cholesterol (LDL-C, p < 0.0001), apolipoprotein B (apo B, p < 0.0001) and total to high density lipoprotein cholesterol ratio (TC:HDL-C, p = 0.002), with plasma concentrations decreasing in the order E4 > E3/E3 > E2. Following intervention, there was evidence of a significant diet x genotype interaction with significantly greater decreases in TC (p = 0.02) and apo B (p = 0.006) among carriers of E4 when SFA was replaced with low GI carbohydrate on a lower fat diet (TC -0.28 mmol/L p = 0.03; apo B -0.1 g/L p = 0.02), and a relative increase in TC (in comparison to E3/E3) when SFA was replaced with MUFA and high GI carbohydrates (TC 0.3 mmol/L, p = 0.03). Among carriers of E2 (compared with E3/E3) there was an increase in triacylglycerol (TAG) when SFA was replaced with MUFA and low GI carbohydrates 0.46 mmol/L p = 0.001). There were no significant interactions between APOE genotype and diet for changes in indices of glucose homeostasis. In conclusion, variations in APOE genotype led to differential effects on the lipid response to the replacement of SFA with MUFA and low GI carbohydrates.
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Affiliation(s)
- Bruce A Griffin
- Department of Nutritional Sciences, University of Surrey, Guildford GU2 7WG, UK.
| | - Celia G Walker
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK.
| | - Susan A Jebb
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK.
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
| | - Carmel Moore
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK.
| | - Gary S Frost
- Nutrition and Dietetic Research Group, Imperial College London, London W12 OHS, UK.
| | - Louise Goff
- Nutrition and Dietetic Research Group, Imperial College London, London W12 OHS, UK.
- Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK.
| | - Tom A B Sanders
- Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK.
| | - Fiona Lewis
- Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK.
| | - Margaret Griffin
- Department of Nutritional Sciences, University of Surrey, Guildford GU2 7WG, UK.
| | - Rachel Gitau
- Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK.
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK.
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Abstract
SummaryFactor VII coagulant activity (FVIIc) is associated with an increased risk of fatal ischaemic heart disease (IHD). Several reports have suggested that dietary fat intake or hypertriglyceridaemia are associated with elevated levels of FVII. This study demonstrates that an intake of long-chain fatty acids sufficient to induce postprandial lipaemia in healthy subjects leads to a substantial elevation in both FVIIc and the concentration of FVII circulating in the activated form. Such an increase in FVIIc could not be induced by medium-chain triglycerides. These results suggest that the consumption of a sufficient amount of long-chain triglycerides to induce postprandial lipaemia induces the activation of FVII.
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Affiliation(s)
- T A B Sanders
- The Nutrition, Food and Health Research Centre, King’s College, University of London
| | - G J Miller
- MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, Medical College of St Bartholomew's Hospital, London, UK
| | - Tamara de Grassi
- The Nutrition, Food and Health Research Centre, King’s College, University of London
| | - Najat Yahia
- The Nutrition, Food and Health Research Centre, King’s College, University of London
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Cottin SC, Alsaleh A, Sanders TAB, Hall WL. Lack of effect of supplementation with EPA or DHA on platelet-monocyte aggregates and vascular function in healthy men. Nutr Metab Cardiovasc Dis 2016; 26:743-751. [PMID: 27105870 DOI: 10.1016/j.numecd.2016.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fish oil are postulated to have favourable effects on platelet, endothelial and vascular function. We investigated whether EPA has differential effects on in vivo platelet aggregation and other markers of cardiovascular risk compared to DHA. METHODS AND RESULTS Following a 2 wk run-in taking encapsulated refined olive oil, 48 healthy young men were randomly allocated using a parallel design to receive EPA-rich (3.1 g EPA/d) or DHA-rich (2.9 g DHA/d) triglyceride concentrates or refined olive oil (placebo), for a total supplementary lipid intake of 5 g/d. The specified primary outcome was change in platelet monocyte aggregates (PMA); secondary outcomes were capillary density, augmentation index, digital pulse volume measurements, 24 h ambulatory BP, plasma 8-isoprostanes-F2α. Changes in the proportions of DHA and EPA in erythrocytes and non-esterified fatty acid composition indicated compliance to the intervention. There was no significant treatment effect on PMA (P = 0.382); mean changes (%) (95% CI) were placebo -0.5 (-2.0, 1.04), EPA 0.4 (-0.8, 1.6), DHA 0.3 (-1.5, 2.0). R-QUICKI, an index of insulin sensitivity, was greater following EPA compared to placebo (P < 0.05). No other significant differences were noted. CONCLUSION Neither EPA- nor DHA-rich fish oil supplementation influence platelet-monocyte aggregation or several markers of vascular function after 6 wk in healthy young males. This trial was registered at clinicaltrials.gov as NCT01735357.
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Affiliation(s)
- S C Cottin
- From King's College London, Diabetes and Nutritional Sciences Division, Faculty of Life Sciences & Medicine, 150 Stamford Street, London, SE1 9NH, UK.
| | - A Alsaleh
- From King's College London, Diabetes and Nutritional Sciences Division, Faculty of Life Sciences & Medicine, 150 Stamford Street, London, SE1 9NH, UK
| | - T A B Sanders
- From King's College London, Diabetes and Nutritional Sciences Division, Faculty of Life Sciences & Medicine, 150 Stamford Street, London, SE1 9NH, UK
| | - W L Hall
- From King's College London, Diabetes and Nutritional Sciences Division, Faculty of Life Sciences & Medicine, 150 Stamford Street, London, SE1 9NH, UK
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AbuAli G, Chaisaklert W, Stelloo E, Pazarentzos E, Hwang MS, Qize D, Harding SV, Al-Rubaish A, Alzahrani AJ, Al-Ali A, Sanders TAB, Aboagye EO, Grimm S. The anticancer gene ORCTL3 targets stearoyl-CoA desaturase-1 for tumour-specific apoptosis. Oncogene 2015; 34:1718-28. [PMID: 24769897 PMCID: PMC4119473 DOI: 10.1038/onc.2014.93] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 01/31/2014] [Accepted: 02/20/2014] [Indexed: 12/19/2022]
Abstract
ORCTL3 is a member of a group of genes, the so-called anticancer genes, that cause tumour-specific cell death. We show that this activity is triggered in isogenic renal cells upon their transformation independently of the cells' proliferation status. For its cell death effect ORCTL3 targets the enzyme stearoyl-CoA desaturase-1 (SCD1) in fatty acid metabolism. This is caused by transmembrane domains 3 and 4, which are more efficacious in vitro than a low molecular weight drug against SCD1, and critically depend on their expression level. SCD1 is found upregulated upon renal cell transformation indicating that its activity, while not impacting proliferation, represents a critical bottleneck for tumourigenesis. An adenovirus expressing ORCTL3 leads to growth inhibition of renal tumours in vivo and to substantial destruction of patients' kidney tumour cells ex vivo. Our results indicate fatty acid metabolism as a target for tumour-specific apoptosis in renal tumours and suggest ORCTL3 as a means to accomplish this.
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Affiliation(s)
- G AbuAli
- Division of Experimental Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - W Chaisaklert
- Division of Experimental Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - E Stelloo
- Division of Experimental Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - E Pazarentzos
- Division of Experimental Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - M-S Hwang
- Division of Experimental Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - D Qize
- Division of Experimental Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - S V Harding
- Diabetes & Nutritional Sciences Division, King's College London, London, UK
| | - A Al-Rubaish
- Prince Mohammed Center for Research & Consultation Studies, College of Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - A J Alzahrani
- Prince Mohammed Center for Research & Consultation Studies, College of Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - A Al-Ali
- Prince Mohammed Center for Research & Consultation Studies, College of Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - T A B Sanders
- Diabetes & Nutritional Sciences Division, King's College London, London, UK
| | - E O Aboagye
- Division of Cancer, Imperial College London, Hammersmith Campus, London, UK
| | - S Grimm
- Division of Experimental Medicine, Imperial College London, Hammersmith Campus, London, UK
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Johns I, Goff L, Bluck LJ, Griffin BA, Jebb SA, Lovegrove JA, Sanders TAB, Frost G, Dornhorst A. Plasma free fatty acids do not provide the link between obesity and insulin resistance or β-cell dysfunction: results of the Reading, Imperial, Surrey, Cambridge, Kings (RISCK) study. Diabet Med 2014; 31:1310-5. [PMID: 25047698 DOI: 10.1111/dme.12550] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 05/13/2014] [Accepted: 07/17/2014] [Indexed: 12/15/2022]
Abstract
AIMS To investigate the relationship between adiposity and plasma free fatty acid levels and the influence of total plasma free fatty acid level on insulin sensitivity and β-cell function. METHODS An insulin sensitivity index, acute insulin response to glucose and a disposition index, derived from i.v. glucose tolerance minimal model analysis and total fasting plasma free fatty acid levels were available for 533 participants in the Reading, Imperial, Surrey, Cambridge, Kings study. Bivariate correlations were made between insulin sensitivity index, acute insulin response to glucose and disposition index and both adiposity measures (BMI, waist circumference and body fat mass) and total plasma free fatty acid levels. Multivariate linear regression analysis was performed, controlling for age, sex, ethnicity and adiposity. RESULTS After adjustment, all adiposity measures were inversely associated with insulin sensitivity index (BMI: β = -0.357; waist circumference: β = -0.380; body fat mass: β = -0.375) and disposition index (BMI: β = -0.215; waist circumference: β = -0.248; body fat mass: β = -0.221) and positively associated with acute insulin response to glucose [BMI: β = 0.200; waist circumference: β = 0.195; body fat mass β = 0.209 (P values <0.001)]. Adiposity explained 13, 4 and 5% of the variation in insulin sensitivity index, acute insulin response to glucose and disposition index, respectively. After adjustment, no adiposity measure was associated with free fatty acid level, but total plasma free fatty acid level was inversely associated with insulin sensitivity index (β = -0.133), acute insulin response to glucose (β = -0.148) and disposition index [β = -0.218 (P values <0.01)]. Plasma free fatty acid concentration accounted for 1.5, 2 and 4% of the variation in insulin sensitivity index, acute insulin response to glucose and disposition index, respectively. CONCLUSIONS Plasma free fatty acid levels have a modest negative association with insulin sensitivity, β-cell secretion and disposition index but no association with adiposity measures. It is unlikely that plasma free fatty acids are the primary mediators of obesity-related insulin resistance or β-cell dysfunction.
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Affiliation(s)
- I Johns
- Nutrition and Dietetic Research Group, Imperial College London, London, UK
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MacLaughlin HL, Hall WL, Patel AG, Blacklock RM, Swift PA, Phanish MK, Dew T, Chowdhury P, Sanders TAB, Macdougall IC. Weight loss, adipokines, and quality of life after sleeve gastrectomy in obese patients with stages 3-4 CKD: a randomized controlled pilot study. Am J Kidney Dis 2014; 64:660-3. [PMID: 25085646 DOI: 10.1053/j.ajkd.2014.06.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 06/09/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Helen L MacLaughlin
- King's College Hospital NHS Foundation Trust, London, United Kingdom; Diabetes and Nutritional Sciences Division, King's College London, London, United Kingdom.
| | - Wendy L Hall
- Diabetes and Nutritional Sciences Division, King's College London, London, United Kingdom
| | - Ameet G Patel
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Pauline A Swift
- Epsom and St Helier University Hospitals NHS Trust, Surrey, United Kingdom
| | - Mysore K Phanish
- Epsom and St Helier University Hospitals NHS Trust, Surrey, United Kingdom
| | - Tracy Dew
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Paramit Chowdhury
- Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Tom A B Sanders
- Diabetes and Nutritional Sciences Division, King's College London, London, United Kingdom
| | - Iain C Macdougall
- King's College Hospital NHS Foundation Trust, London, United Kingdom
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Anderson SG, Hutchings DC, Heald AH, Anderson CD, Sanders TAB, Cruickshank JK. Haemostatic factors, lipoproteins and long-term mortality in a multi-ethnic population of Gujarati, African-Caribbean and European origin. Atherosclerosis 2014; 236:62-72. [PMID: 25014036 DOI: 10.1016/j.atherosclerosis.2014.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 05/14/2014] [Accepted: 06/07/2014] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the relations between haemostatic factors and lipoproteins with mortality in British Europeans, African-Caribbeans (AfC) and Gujarati Indians. METHODS A prospective cohort study of 331 subjects (40-79 years), followed-up over 26 years for mortality. Apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), factor VII coagulant activity (FVIIc), fibrinogen and von Willebrand Factor (vWF) were measured at baseline in 118 Europeans, 100 AfC and 113 Gujaratis. Aortic pulse wave velocity (aPWV) was measured in 174 participants. RESULTS 147 (44.4%) subjects died during a median of 24 years follow-up with 69 cardiovascular deaths. Women at baseline had higher, and AfC males the lowest FVIIc and Apo-A1 levels. Baseline age-sex and ethnicity adjusted FVIIc levels were higher in those who died (131.0 vs. 117.4%; P = 0.048). In similarly adjusted partial correlations, Apo-A1 was inversely related to arterial stiffness (ρ = -0.23, P = 0.04). Over the 26 years follow-up, participants below the median (i.e. with lower concentration) of FVIIc, Fibrinogen, Apo-B and vWF had better survival rates than those with higher concentrations; those with higher concentrations of Apo-A1 had better survival. In Cox multivariable regression analyses including sex, ethnicity and aPWV, independently increased risk of all-cause mortality came only from SBP (per 5 mmHg); P = 0.011), age (per year); P < 0.0001 and FVIIc at 7% (per 10-unit; HR 1.07 (1.02, 1.12); P = 0.008. Separately, Apo-A1 (HR 0.12 (0.02, 0.75; P = 0.029) was independently associated with a very significant 88% reduction in all-cause mortality. CONCLUSIONS Despite a relatively small sample size, long-term follow-up suggests an independent effect of the prothrombotic state (via FVIIc) and apo-A1 (a constituent of HDL) on mortality.
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Affiliation(s)
- S G Anderson
- Institute of Cardiovascular Sciences, Core Technology Facility (3rd Floor), University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK.
| | - D C Hutchings
- Institute of Cardiovascular Sciences, Core Technology Facility (3rd Floor), University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK
| | - A H Heald
- Institute of Cardiovascular Sciences, Core Technology Facility (3rd Floor), University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK
| | - C D Anderson
- Institute of Cardiovascular Sciences, Core Technology Facility (3rd Floor), University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK
| | - T A B Sanders
- Diabetes, Cardiovascular Medicine & Nutrition, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - J K Cruickshank
- Diabetes, Cardiovascular Medicine & Nutrition, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
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de Brito-Ashurst I, Perry L, Sanders TAB, Thomas JE, Dobbie H, Yaqoob MM. Applying research in nutrition education planning: a dietary intervention for Bangladeshi chronic kidney disease patients. J Hum Nutr Diet 2012; 26:403-13. [PMID: 23240718 DOI: 10.1111/jhn.12022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Effective nutrition health interventions are theory-based, as well as being drawn from practice and research, aiming to successfully accomplish dietary behavioural changes. However, the integration of theory, research and practice to develop community dietary educational programmes is a challenge that many interventionists feel ill equipped to achieve. METHODS In the present study, a community-based education programme was designed for Bangladeshi patients with chronic kidney disease and hypertension. The goal of this programme was to reduce dietary salt intake in this population group, with a view to reducing their blood pressure and slowing kidney disease progression. RESULTS The present study sets out the first four steps of a six-step model for creating a behaviour change programme. CONCLUSIONS These four steps were concerned with the translation of theory and evidence into intervention objectives, and illustrate how a practical, community-based intervention was developed from behavioural theory, relevant research, knowledge of practice and the target patient group. Steps 5 and 6, which are concerned with implementation and evaluation, will be reported separately.
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Affiliation(s)
- I de Brito-Ashurst
- Department of Nutrition and Dietetics, The Royal Brompton & Harefield NHS Foundation Trust, London, UK.
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9
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Walker CG, Loos RJF, Olson AD, Frost GS, Griffin BA, Lovegrove JA, Sanders TAB, Jebb SA. Genetic predisposition influences plasma lipids of participants on habitual diet, but not the response to reductions in dietary intake of saturated fatty acids. Atherosclerosis 2011; 215:421-7. [PMID: 21292264 PMCID: PMC3407860 DOI: 10.1016/j.atherosclerosis.2010.12.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 12/21/2010] [Accepted: 12/22/2010] [Indexed: 12/15/2022]
Abstract
OBJECTIVE SNPs identified from genome-wide association studies associate with lipid risk markers of cardiovascular disease. This study investigated whether these SNPs altered the plasma lipid response to diet in the 'RISCK' study cohort. METHODS Participants (n=490) from a dietary intervention to lower saturated fat by replacement with carbohydrate or monounsaturated fat, were genotyped for 39 lipid-associated SNPs. The association of each individual SNP, and of the SNPs combined (using genetic predisposition scores), with plasma lipid concentrations was assessed at baseline, and on change in response to 24 weeks on diets. RESULTS The associations between SNPs and lipid concentrations were directionally consistent with previous findings. The genetic predisposition scores were associated with higher baseline concentrations of plasma total (P=0.02) and LDL (P=0.002) cholesterol, triglycerides (P=0.001) and apolipoprotein B (P=0.004), and with lower baseline concentrations of HDL cholesterol (P<0.001) and apolipoprotein A-I (P<0.001). None of the SNPs showed significant association with the reduction of plasma lipids in response to the dietary interventions and there was no evidence of diet-gene interactions. CONCLUSION Results from this exploratory study have shown that increased genetic predisposition was associated with an unfavourable plasma lipid profile at baseline, but did not influence the improvement in lipid profiles by the low-saturated-fat diets.
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Affiliation(s)
- C G Walker
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK.
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10
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de Brito-Ashurst I, Perry L, Sanders TAB, Thomas JE, Yaqoob MM, Dobbie H. Barriers and facilitators of dietary sodium restriction amongst Bangladeshi chronic kidney disease patients. J Hum Nutr Diet 2010; 24:86-95. [PMID: 21114553 DOI: 10.1111/j.1365-277x.2010.01129.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND People of Bangladeshi origin have the highest mortality ratio from coronary heart disease of any minority ethnic group in UK and their rate of kidney disease is three- to five-fold higher than that of the European UK population. However, there is little information regarding their dietary customs or knowledge, beliefs and attitudes towards health and nutrition. This multi-method qualitative study aimed to identify: (i) barriers and facilitators to dietary sodium restriction; (ii) traditional and current diet in the UK; and (iii) beliefs and attitudes towards development of hypertension, and the role of sodium. METHODS Methods included focus group discussions, vignettes and food diaries. Twenty female chronic kidney disease patients attended four focus group discussions and maintained food diaries; ten responded to vignettes during telephone interviews. Triangulation of the results obtained from the three methods identified categories and themes from qualitative thematic analysis. RESULTS Identified barriers to sodium restriction were deeply-rooted dietary beliefs, attitudes and a culturally-established taste for salt. Facilitators of change included acceptable strategies for cooking with less salt without affecting palatability. Dietary practices were culturally determined but modified by participants' prosperity in the UK relative to their previous impoverished agrarian lifestyles in Bangladesh. CONCLUSIONS Cultural background and orientation were strong determinants of the group's dietary practices and influenced their reception and response to health communication messages. Efforts to understand their cultural mores, interpret and convey health-promotion messages in culturally-appropriate ways met with a positive response.
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Affiliation(s)
- I de Brito-Ashurst
- Department of Nutrition & Dietetics, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
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11
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Gilsing AMJ, Crowe FL, Lloyd-Wright Z, Sanders TAB, Appleby PN, Allen NE, Key TJ. Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study. Eur J Clin Nutr 2010; 64:933-9. [PMID: 20648045 PMCID: PMC2933506 DOI: 10.1038/ejcn.2010.142] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Vegans, and to a lesser extent vegetarians, have low average circulating concentrations of vitamin B12; however, the relation between factors such as age or time on these diets and vitamin B12 concentrations is not clear. The objectives of this study were to investigate differences in serum vitamin B12 and folate concentrations between omnivores, vegetarians and vegans and to ascertain whether vitamin B12 concentrations differed by age and time on the diet. SUBJECTS/METHODS A cross-sectional analysis involving 689 men (226 omnivores, 231 vegetarians and 232 vegans) from the European Prospective Investigation into Cancer and Nutrition Oxford cohort. RESULTS Mean serum vitamin B12 was highest among omnivores (281, 95% CI: 270-292 pmol/l), intermediate among vegetarians (182, 95% CI: 175-189 pmol/l) and lowest among vegans (122, 95% CI: 117-127 pmol/l). In all, 52% of vegans, 7% of vegetarians and one omnivore were classified as vitamin B12 deficient (defined as serum vitamin B12 <118 pmol/l). There was no significant association between age or duration of adherence to a vegetarian or a vegan diet and serum vitamin B12. In contrast, folate concentrations were highest among vegans, intermediate among vegetarians and lowest among omnivores, but only two men (both omnivores) were categorized as folate deficient (defined as serum folate <6.3 nmol/l). CONCLUSION Vegans have lower vitamin B12 concentrations, but higher folate concentrations, than vegetarians and omnivores. Half of the vegans were categorized as vitamin B12 deficient and would be expected to have a higher risk of developing clinical symptoms related to vitamin B12 deficiency.
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Affiliation(s)
- A M J Gilsing
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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12
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Peacock E, Stanley J, Calder PC, Jebb SA, Thies F, Seal CJ, Woodside JV, Sanders TAB. UK Food Standards Agency Workshop Report: carbohydrate and cardiovascular risk. Br J Nutr 2010; 103:1688-94. [PMID: 20236556 PMCID: PMC3359681 DOI: 10.1017/s0007114510000735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This report summarises a workshop convened by the UK Food Standards Agency (FSA) on 14 October 2008 to discuss current FSA-funded research on carbohydrates and cardiovascular health. The objective of this workshop was to discuss the results of recent research and to identify any areas which could inform future FSA research calls. This workshop highlighted that the FSA is currently funding some of the largest, well-powered intervention trials investigating the type of fat and carbohydrate, whole grains and fruit and vegetables, on various CVD risk factors. Results of these trials will make a substantive contribution to the evidence on diet and cardiovascular risk.
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Affiliation(s)
- Emma Peacock
- Nutrition Division, Food Standards Agency, London, UK.
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Moore C, Gitau R, Goff L, Lewis FJ, Griffin MD, Chatfield MD, Jebb SA, Frost GS, Sanders TAB, Griffin BA, Lovegrove JA. Successful manipulation of the quality and quantity of fat and carbohydrate consumed by free-living individuals using a food exchange model. J Nutr 2009; 139:1534-40. [PMID: 19549752 PMCID: PMC3594744 DOI: 10.3945/jn.108.103374] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Our objective in this study was to develop and implement an effective intervention strategy to manipulate the amount and composition of dietary fat and carbohydrate (CHO) in free-living individuals in the RISCK study. The study was a randomized, controlled dietary intervention study that was conducted in 720 participants identified as higher risk for or with metabolic syndrome. All followed a 4-wk run-in reference diet [high saturated fatty acids (SF)/high glycemic index (GI)]. Volunteers were randomized to continue this diet for a further 24 wk or to 1 of 4 isoenergetic prescriptions [high monounsaturated fatty acids (MUFA)/high GI; high MUFA/low GI; low fat (LF)/high GI; and LF/low GI]. We developed a food exchange model to implement each diet. Dietary records and plasma phospholipid fatty acids were used to assess the effectiveness of the intervention strategy. Reported fat intake from the LF diets was significantly reduced to 28% of energy (%E) compared with 38%E from the HM and LF diets. SF intake was successfully decreased in the HM and LF diets to < or =10%E compared with 17%E in the reference diet (P = 0.001). Dietary MUFA in the HM diets was approximately 17%E, significantly higher than in the reference (12%E) and LF diets (10%E) (P = 0.001). Changes in plasma phospholipid fatty acids provided further evidence for the successful manipulation of fat intake. The GI of the HGI and LGI arms differed by approximately 9 points (P = 0.001). The food exchange model provided an effective dietary strategy for the design and implementation across multiple sites of 5 experimental diets with specific targets for the proportion of fat and CHO.
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Affiliation(s)
- Carmel Moore
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Rachel Gitau
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Louise Goff
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Fiona J. Lewis
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Margaret D. Griffin
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Mark D. Chatfield
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Susan A. Jebb
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Gary S. Frost
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Tom A. B. Sanders
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Bruce A. Griffin
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK
| | - Julie A. Lovegrove
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK; Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6AP, UK; Nutrition and Dietetic Research Group, Hammersmith Hospital, London W12 0HS, UK; Nutritional Sciences Division, Kings College London, London WC2R 2LS, UK; Centre for Food Safety and Nutrition, University of Surrey, Guildford GU2 7XH, UK; and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK,To whom correspondence should be addressed. E-mail:
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Abstract
Abstract
Background: Haptocorrin (HC) carries the major part of circulating cobalamin, but whether HC is altered on treatment with vitamin B12 remains unknown.
Methods: Our study included 3 populations: a population of vegan men (n = 174; vegan population), of whom 63 were treated daily with 5 mg of oral vitamin B12 for 3 months; a group of patients with a previous methylmalonic acid (MMA) concentration >0.4 μmol/L (n = 140; population with suspected deficiency), of which 69 were treated with weekly vitamin B12 injections (1 mg) for 4 weeks; and a subgroup of participants in a vitamin B intervention study (n = 88; nondeficient population), of whom 45 were treated daily with 0.4 mg of oral vitamin B12 for 3 months. Total HC and holoHC were measured by ELISA. Cobalamin was measured by an intrinsic factor (IF)-based assay. Samples were collected at baseline and 3 months after start of treatment.
Results: Compared with baseline results for the 3 study populations, total HC and holoHC increased 30 pmol/L for every 100 pmol/L increase in cobalamin. After treatment with vitamin B12, holoHC (P <0.0001) and total HC (P <0.0001) increased significantly in the vegan population. Only holoHC increased in the population with suspected deficiency (P <0.0001), whereas no alteration was observed in the nondeficient population.
Conclusions: The HC concentration is decreased in severely cobalamin-deficient individuals and increases on treatment. The concentration of cobalamin also relates significantly to the HC concentration in nondeficient individuals.
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Affiliation(s)
- Anne L Mørkbak
- Department of Clinical Biochemistry, Aarhus Sygehus, Denmark.
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Abstract
Published data suggest that the cholesterol-lowering effect of dietary plant sterol esters is less marked in longer-term than in short-term studies, whereas plant stanol esters maintain their efficacy. To investigate this further, healthy subjects and patients with familial hypercholesterolemia (FH) receiving statins were randomized to receive plant sterol ester 1.6 g/day or plant stanol ester 1.6 g/day or 2.6 g/day for 2 months. There was no difference among the 3 groups in the pooled low-density lipoprotein (LDL)-lowering response of FH patients and healthy subjects, but the effect of plant sterol diminished at 2 months and was not significantly different from baseline. This was accompanied by increases in serum plant sterols and a significant decrease in 7alpha-hydroxy-4-cholesten-3-one, a marker of bile acid synthesis, especially in FH patients not taking bile acid sequestrants. In contrast, plant stanol esters lowered significantly both LDL cholesterol and plant sterols at 2 months and had no effect on bile acid synthesis. Slight decreases in serum lipid-soluble antioxidants occurred with both plant sterol and stanol esters. Our findings suggest that absorption of dietary plant sterols downregulates bile acid synthesis, which attenuates their cholesterol-lowering efficacy. We conclude that plant stanol esters are preferable for the long-term management of hypercholesterolemia.
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Affiliation(s)
- Frans H O'Neill
- Department of Metabolic Medicine, Division of Investigative Science, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom
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Pufulete M, Al-Ghnaniem R, Khushal A, Appleby P, Harris N, Gout S, Emery PW, Sanders TAB. Effect of folic acid supplementation on genomic DNA methylation in patients with colorectal adenoma. Gut 2005; 54:648-53. [PMID: 15831910 PMCID: PMC1774481 DOI: 10.1136/gut.2004.054718] [Citation(s) in RCA: 156] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 10/19/2004] [Accepted: 10/26/2004] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIMS A low dietary folate intake can cause genomic DNA hypomethylation and may increase the risk of colorectal neoplasia. The hypothesis that folic acid supplementation increases DNA methylation in leucocytes and colorectal mucosa was tested in 31 patients with histologically confirmed colorectal adenoma using a randomised, double blind, placebo controlled, parallel design. METHODS Subjects were randomised to receive either 400 microg/day folic acid supplement (n = 15) or placebo (n = 16) for 10 weeks. Genomic DNA methylation, serum and erythrocyte folate, and plasma homocysteine concentrations were measured at baseline and post intervention. RESULTS Folic acid supplementation increased serum and erythrocyte folate concentrations by 81% (95% confidence interval (CI) 57-104%; p<0.001 v placebo) and 57% (95% CI 40-74%; p<0.001 v placebo), respectively, and decreased plasma homocysteine concentration by 12% (95% CI 4-20%; p = 0.01 v placebo). Folic acid supplementation resulted in increases in DNA methylation of 31% (95% CI 16-47%; p = 0.05 v placebo) in leucocytes and 25% (95% CI 11-39%; p = 0.09 v placebo) in colonic mucosa. CONCLUSIONS These results suggest that DNA hypomethylation can be reversed by physiological intakes of folic acid.
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Affiliation(s)
- M Pufulete
- Nitritional Sciences Research Division, Department of Nutrition and Dietetics, King's College London, Franklin Wilkins Building, 150 Stamford St, London SE1 9NH, UK.
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Affiliation(s)
- Tom A B Sanders
- Nutrition Food & Health Research Centre, King's College London, UK
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Affiliation(s)
- Zouë Lloyd-Wright
- Nutrition Food and Health Research Centre, King's College London, Franklin-Wilkins Bldg., 150 Stamford St., Waterloo, London SE1 9NN, United Kingdom
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Abstract
Impaired clearance of chylomicron remnants is associated with increased risk of atherosclerosis and cardiovascular disease. An intake of 40 to 50 g of fat in a meal results in significant lipemia in healthy adults, with consecutive fat-containing meals enhancing the lipemia. This would suggest that limiting fat intake to approximately 30 g on each eating occasion would minimize postprandial lipemia. Sedentary behavior and obesity independently impair the postprandial metabolism of lipids. Postprandial lipemia causes endothelial dysfunction and results in a transient increase in factor VII activated (FVIIa) concentration. Plasminogen activator inhibitor type-1 activity is associated with fasting plasma triacylglycerol concentration, but is not influenced by postprandial lipemia. Trans-18:1 acid appears to increase cholesterol ester transfer activity acutely compared with oleate. Randomized stearic acid-rich fats result in less postprandial lipemia and a lower postprandial increase in FVIIa, whereas unrandomized cocoa butter results in similar postprandial lipemia and increases in FVIIa compared with oleate. A background diet containing in excess of 3 g/d of long-chain omega-3 fatty acids decreases postprandial lipemia by stimulating lipoprotein lipase expression and decreasing very low-density lipoprotein synthesis, but a diet enriched in alpha-linolenic acid (up to 9.5 g/d) does not show these effects. Future research on diet and postprandial lipids needs to exploit newly gained knowledge on the regulation of adipocyte metabolism by adipokines and nuclear hormone receptors, particularly with regard to fat patterning and reverse cholesterol transport.
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Affiliation(s)
- Tom A B Sanders
- Nutrition Food and Health Research Centre, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NN, United Kingdom.
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Abstract
OBJECTIVE Although psychiatrists are aware of weight gain induced by atypical antipsychotics, only few studies on behavioural interventions in this patient group are published. This review aims to summarize the evidence on effectiveness of behavioural interventions for weight gain in the general population and in-patients treated with atypical antipsychotics. METHOD Medline and Cochrane databases search for evidence on effectiveness of behavioural interventions. RESULTS In general, behavioural approaches including, diet, exercise and drug treatments may be effective. There were only 13 studies of behavioural interventions for patients taking antipsychotic medication. No study met the criteria for a RCT. Calorie restriction in a controlled ward environment, structured counselling combined with cognitive behavioural therapy and counselling on life style and provision of rewards may potentially lead to weight loss. CONCLUSION Currently only limited, methodologically flawed, evidence is available that behavioural interventions in overweight patients treated with antipsychotics, although intuitively appealing, actually work.
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Affiliation(s)
- U Werneke
- Centre for the Economics in Mental Health, Institute of Psychiatry, Maudsley Hospital, London, UK.
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Costarelli V, Sanders TAB. Plasma bile acids and risk of breast cancer. IARC Sci Publ 2003; 156:305-6. [PMID: 12484193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- V Costarelli
- School of Applied Science, South Bank University, 103 Borough Road, London SE1 0AA, UK
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Abstract
PURPOSE OF REVIEW To evaluate the evidence with regard to high-versus low-fat diets in the context of the prevention and management of obesity, type 2 diabetes and coronary heart disease. RECENT FINDINGS Despite the increasing prevalence of obesity, there is no evidence to support the view that this is caused by an increased intake of fat. Fat sensors play an important role in regulating energy balance and lipid metabolism, and hypoenergetic diets containing 30-35% energy from fat promote weight loss. High intakes of carbohydrates with a high glycaemic index can result in insulin resistance, but this effect can be modulated by increased physical activity. SUMMARY Although arguments to decrease the intake of trans and saturated fatty acids are cogent, the scientific basis for a reduction in the proportion of energy from fat below 30% energy is not supported by experimental evidence. A modest reduction in fat intake to 30-35% energy, with the bulk of carbohydrates being derived from complex carbohydrates from unrefined sources, would appear to be the best option for the prevention of obesity and cardiovascular disease. Increased physical activity appears to be particularly important in modulating the adverse effects associated with high-carbohydrate low-fat diets.
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Affiliation(s)
- Tom A B Sanders
- Nutrition Food and Health Research Centre, King's College London, London, UK.
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Costarelli V, Sanders TAB. Plasma deoxycholic acid concentration is elevated in postmenopausal women with newly diagnosed breast cancer. Eur J Clin Nutr 2002; 56:925-7. [PMID: 12209383 DOI: 10.1038/sj.ejcn.1601396] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2001] [Revised: 11/23/2001] [Accepted: 11/28/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE High concentrations of plasma deoxycholic acid (DCA) are found in human breast cyst fluid and it has been hypothesised that this may be related to risk of breast cancer. The aim of this pilot study was to ascertain whether plasma bile acid concentrations were greater in women with breast cancer. DESIGN A case-control study comparing postmenopausal women with breast cancer with healthy controls was conducted. SUBJECTS Twenty Caucasian postmenopausal breast cancer patients were recruited at the time of diagnosis together with 20 healthy controls matched for age and body mass index. Exclusion criteria included any treatment for breast cancer, use of hormone replacement therapy in the last 12 months, diabetes mellitus, a history of liver or gall bladder disease or abnormal liver function. MEASUREMENTS Fasting plasma bile acid concentrations were determined by gas-liquid chromatography/mass spectrometry. RESULTS The mean plasma DCA concentration was 52% higher (P=0.012) in patients with breast cancer compared with controls. CONCLUSION These results support the hypothesis that DCA may be involved in the aetiology of breast cancer.
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Affiliation(s)
- V Costarelli
- Nutrition Food and Health Research Centre, King's College London, London, UK.
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Abstract
Obesity is associated with considerable morbidity and decreased life expectancy. Weight gain is a commonly encountered problem associated with antipsychotic treatment. We reviewed the literature regarding the mechanisms of weight gain in response to these agents and eight substances implicated as potential obesity prevention or treatment: orlistat, sibutramine, fluoxetine, topiramate, amantadine, nizatidine and cimetidine, and metformin. Weight gain in response to antipsychotic treatment may be mediated through serotonergic, dopaminergic, adrenergic, cholinergic, histaminergic and glutaminergic receptors. Sex hormone dysregulation and altered insulin sensitivity have also been implicated. Two compounds, orlistat and sibutramine, have been shown to help prevent weight gain following a hypocaloric diet, but orlistat requires compliance with a fat-reduced diet, and sibutramine is unsuitable for patients taking serotonergic agents. The weight reducing effect of fluoxetine, even in conjunction with a hypocaloric diet, is only transient. Topiramate, amantadine and metformin may have adverse side-effects potentially outweighing the weight reducing potential. The effectiveness of cimetidine and nizatedine remains unclear. The hazards of these agents in a psychiatric population are discussed. It is concluded that the current evidence does not support the general use of pharmacological interventions for overweight patients treated with antipsychotic medication, although individually selected patients may benefit.
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Affiliation(s)
- U Werneke
- Pharmacy Department, Maudsley Hospital, London, UK
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Costarelli V, Key TJ, Appleby PN, Allen DS, Fentiman IS, Sanders TAB. A prospective study of serum bile acid concentrations and colorectal cancer risk in post-menopausal women on the island of Guernsey. Br J Cancer 2002; 86:1741-4. [PMID: 12087460 PMCID: PMC2375402 DOI: 10.1038/sj.bjc.6600340] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2002] [Revised: 03/30/2002] [Accepted: 04/03/2002] [Indexed: 12/02/2022] Open
Abstract
Secondary bile acids produced by the action of the colonic microflora may increase risk of colorectal cancer. Serum bile acid concentrations reflect the faecal bile acid profile and may be of value as biomarkers of risk of colorectal cancer. In a pilot investigation we examined: (i) the reproducibility of measurements of serum bile acids in two blood samples collected several years apart; and (ii) the hypothesis that relatively high levels of secondary bile acids, particularly deoxycholic acid, would be positively associated with an increased risk of colorectal cancer in a prospective study of 3680 women in Guernsey. There was poor reproducibility between repeat measurements of absolute serum concentrations of bile acids, but there was moderately good reproducibility for the ratios of serum concentrations of deoxycholic/cholic acid, lithocholic/chenodeoxycholic and secondary/primary bile acid concentrations (duplicate blood samples were available for 30 women). There were no significant differences in ratios of serum secondary to primary bile acids or in absolute concentrations of bile acids between the 46 women who developed colorectal cancer and their matched controls, although there was a suggestion that an increased risk was associated with a high ratio of deoxycholic/cholic acid (relative risk in top third compared to lower third=3.92 (95% CI 0.91-17.0, P for trend=0.096). These findings suggest that the ratios of serum bile acid concentrations are sufficiently reproducible for epidemiological studies, but that a larger study than our own is needed to adequately test the hypothesis of their relation to cancer risk.
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Affiliation(s)
- V Costarelli
- Nutrition Food & Health Research Centre, King's College London, Franklin Wilkins Building, London SE1 8WA, UK.
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