Chitosan improves insulin sensitivity as determined by the euglycemic-hyperinsulinemic clamp technique in obese subjects

In accordance with obesity is associated with insulin resistance and dyslipidemia and chitosan decrease weight and lipids, but its effect on insulin sensitivity is unknown. Our hypothesis for the research was that chitosan improves insulin sensitivity estimated with the euglycemic-hyperinsulinemic clamp technique in obesity. We undertook this study with the objective to determine the effect of chitosan on insulin sensitivity using the euglycemic-hyperinsulinemic clamp technique in obese patients during a 3-month period. A randomized, double-blind clinical trial was carried out in 12 obese adults without diabetes mellitus. During a 3-month period, 6 patients received chitosan (750 mg, 3 times per day) 30 minutes before meals, and the other 6 subjects received placebo. Serum glucose, total cholesterol, high-density lipoprotein cholesterol, and triglycerides (TG) were measured. Insulin sensitivity was estimated with the euglycemic-hyperinsulinemic clamp technique before and after the intervention. Insulin sensitivity increased significantly with the administration of chitosan (2.4 ± 1.4 vs 3.6 ± 1.4 mg kg⁻¹ min⁻¹; P = .043). In addition, there was a decrease in weight (90.7 ± 14.2 vs 84.7 ± 13.7 kg; P = .027), body mass index (34.3 ± 2.7 vs 31.6 ± 2.2 kg/m²; P = .028), waist circumference (106 ± 12 vs 99 ± 9 cm; P = .028) and TG (2.4 ± 0.9 vs 1.6 ± 0.9 mmol/L; P = .028) in the chitosan group. In conclusion, 3-month administration of chitosan increased insulin sensitivity in obese patients and demonstrated a decrease in weight, body mass index, waist circumference, and TG.     

Poor diet quality and food habits are related to impaired nutritional status in 13- to 18-year-old adolescents in Jeddah

In recent decades, diets have changed rapidly in the Kingdom of Saudi Arabia (KSA) because the Western diet is replacing the traditional Arabic diet. This has resulted in an alarming increase in the number of overweight and obese children and adolescents in KSA. It is well documented that lifestyle is strongly associated with the development of obesity. Nevertheless, this remains to be demonstrated in adolescents from a rapidly developing country in the Middle East such as Saudi Arabia. This study tested the hypothesis that the new current dietary habits are related to the increase in overweight and obese Saudi Arabian adolescents. In 2006, a cross-sectional study was conducted among 239 adolescents (13-18 years old) who were selected by cluster sampling from schools in Jeddah, KSA. The nutritional status was assessed by anthropometric and biochemical parameters at the Saudi German Hospitals Group, Jeddah. Dietary habits were evaluated by a 3-day dietary recall (food diary) and a food frequency questionnaire. The mean age of the participants was 15.5 ± 2.5 years. The mean body mass index was 27.43 ± 4.61 kg/m². A total of 44.6% of the adolescents were overweight, and 56.6%, 30.5%, and 13.0% of energy was derived from carbohydrates, fats, and proteins, respectively. Compared with the Dietary Reference Intake, carbohydrate and fat intakes were higher, and calcium, iron, and zinc intakes were lower. Higher cholesterol and lower hemoglobin levels were found in 30.5% and 53.6% of the adolescents, respectively. In summary, increased weight status of 13- to 18-year-old Saudi adolescents was related to their inadequate dietary habits. This indicates the importance of rapidly promoting a healthier lifestyle among Saudi Arabian adolescents.     

Fortification of flours with folic acid reduces homocysteine levels in Brazilian women

Our hypothesis is that the fortification of flour with folic acid contributes to the reduction of plasma homocysteine (Hcy). We conducted a cross-sectional study covering 2 periods, before and after fortification (2002-2003 and 2008-2009, respectively), to assess the influence of the consumption of corn and wheat flours prefortification and postfortification with folic acid on Hcy levels and other biomarkers. In the total, 93 women (38 prefortification and 55 postfortification) were included. Levels of lipids and glucose, total Hcy and serum folate, and cobalamin were determined using commercial kits by colorimetric method, competitive immunoassay, and chemiluminescence, respectively The participants' average age was 48.1 ± 9.5 years for the prefortification group and 39.1 ± 4.1 years for the postfortification group (P < .001) but adjusted statistical tests by age. Both groups presented obesity class 1. In the prefortification group, 71.1% (n = 27) of women had a dietary intake of folate, which was lower than the current recommended for adults (<400 μg/d), whereas in the postfortification group, only 16.4% (n = 9) of women had lower intakes than recommended. In the prefortification group, 42.1% (n = 16) of women had hyperhomocysteinemia (>10 mmol/L) compared with only 9.1% (n = 5) in the postfortification group. Moreover, statistically significant differences were found between the 2 groups in total cholesterol, high-density lipoprotein, triglycerides, and dietary fiber. Our findings corroborate the hypothesis that fortification of wheat and corn flours with folic acid can possibly be associated with lower concentrations of plasma Hcy, providing probable greater cardiovascular protection in this group.     

Exercise attenuates the increase in plasma monounsaturated fatty acids and high-density lipoprotein cholesterol but not high-density lipoprotein 2b cholesterol caused by high-oleic ground beef in women

We hypothesized that dietary monounsaturated fatty acids (MUFA) and exercise increase high-density lipoprotein cholesterol (HDL-C) by independent mechanisms, so there would be additive effects between a single, intensive session of exercise and high-MUFA ground beef on HDL-C and blood risk factors for cardiovascular disease. Seventeen postmenopausal women completed a 2-way crossover design in which they consumed five 114-g ground beef patties per week for two 6-week periods separated by a 4-week washout (habitual diet) period. The ground beef patties contained 21% total fat with either 9.97 (low-MUFA) or 12.72 (high-MUFA) g total MUFA. Blood was taken at entry, at the end of each 6-week diet period, after the 4-week washout period, and 24 hours after aerobic exercise sessions (75% VO_2peak, 2.07 MJ). After the ground beef intervention, the high-MUFA ground beef increased plasma palmitoleic acid and oleic acid, low-density lipoprotein (LDL) particle density, HDL-C, and HDL_2b-C (all P < .05), whereas the low-MUFA ground beef increased LDL density. After the washout (habitual diet) period, the single exercise session increased serum LDL cholesterol, HDL-C, and HDL_2a and decreased TAG and oleic acid. After the low-MUFA ground beef diet, exercise increased LDL size and HDL density and decreased LDL density and very low-density lipoprotein cholesterol, but had no effect on HDL-C fractions. After the high-MUFA ground beef intervention, exercise decreased palmitioleic acid, oleic acid, HDL-C, and HDL_2a-C, but not HDL_2b-C. Contrary to our hypothesis, the effects of exercise and a high-MUFA diet were not additive; instead, exercise attenuated the effects of the high-MUFA ground beef on HDL-C and plasma MUFAs. The differential effects of high-MUFA ground beef and exercise on HDL_2a-C and HDL_2b-C indicate that diet and exercise affect HDL-C by different mechanisms.     

Fermented kimchi reduces body weight and improves metabolic parameters in overweight and obese patients

Kimchi is a traditional fermented Korean food that has garnered international interest due to its various beneficial effects. Focusing on the effect of fermentation, this study hypothesized that consumption of fermented kimchi would have more beneficial effects compared with that of fresh kimchi on metabolic parameters that are related to cardiovascular disease and metabolic syndrome risks in overweight and obese subjects. Twenty-two overweight and obese patients with body mass indexes greater than 25 kg/m² were randomly assigned to two 4-week diet phases separated by a 2-week washout period (crossover design). During each diet phase, the subjects consumed either fresh or fermented kimchi. Anthropometric data showed significant decreases in body weight, body mass index, and body fat in both groups, and the fermented kimchi group showed a significant decrease in the waist-hip ratio and fasting blood glucose. Net differences in the systolic blood pressure, diastolic blood pressure, percent body fat, fasting glucose, and total cholesterol in the fermented kimchi group were significantly greater than those in the fresh kimchi group. There was also a tendency for a decrease in fasting insulin after consumption of fermented kimchi. Therefore, the ingestion of fermented kimchi had positive effects on various factors associated with metabolic syndrome, including systolic and diastolic blood pressures, percent body fat, fasting glucose, and total cholesterol, compared with the fresh kimchi. These results suggest that the maturity of kimchi (fresh vs fermented) may affect obesity, lipid metabolism, and inflammatory processes.     

Dietary intervention with emphasis on folate intake reduces serum lipids but not plasma homocysteine levels in hyperlipidemic patients

Hyperlipidemia and hyperhomocysteinemia are regarded as major risk factors for cardiovascular disease. Medical nutrition therapy (MNT), which involves a combination of nutritional diagnosis, therapy, and counseling for at-risk patients, has been proposed as a protocol to control these risk factors. The purpose of this study was to investigate the effect of an intensive MNT, specifically tailored to Korean hyperlipidemic patients, on levels of serum lipids and plasma homocysteine. Forty hyperlipidemic patients with blood levels of total cholesterol ≥200 mg/dL or triacylglycerol ≥150 mg/dL were recruited from the Kyung Hee University Medical Center (Seoul, Korea). They were randomly divided into control (no treatment) or experimental (MNT treatment) groups. A registered dietitian performed MNT, emphasizing dietary folate intake based on the guidelines for Korean hyperlipidemic patients; this was performed 5 times during the 12 weeks of the experiment. After the MNT period, we observed that body mass index (P < .001) and fat percentage (P < .05) was significantly decreased in the experimental group but not in the control group. Daily energy consumption, as well as carbohydrate, fat, and cholesterol intakes, all decreased significantly (P < .05) in the MNT group, whereas folate intake increased (P < .05). Blood levels of triacylglycerol (−30.8%), total cholesterol (−20.9%), low-density lipoprotein cholesterol (−14.5%), and ratio of low-density lipoprotein/high-density lipoprotein (−17.1%) were significantly lower in the experimental group after MNT (P < .001) compared with the control group. Plasma homocysteine levels were unchanged (P = .98); however, the levels of folate (P < .01), vitamin B₆ (P < .01), and vitamin B₁₂ (P < .05) increased significantly in the experimental group. These results indicate that MNT, with an emphasis on folate intake, can be effective at reducing blood levels of lipids and improving the blood levels of folate, vitamin B₆, and vitamin B₁₂ in Korean hyperlipidemic patients.     

Long-term nutrition education reduces several risk factors for type 2 diabetes mellitus in Brazilians with impaired glucose tolerance

The aim of this study was to evaluate the effects of a nutrition education program (NEP) on anthropometric, dietetic, and metabolic parameters in high-risk subjects for type 2 diabetes mellitus. Fifty-one participants, both sexes, were randomly assigned to either the control (58.8%) or the intervention (NEP) group. The intervention group received frequent individual and group nutritional counseling from a team of nutritionists. Participants were assessed at baseline (M0) and after 12 months (M1) for anthropometric, dietetic, and metabolic parameters. The hypothesis was that high-risk subjects for type 2 diabetes mellitus participating in NEP would show an improvement in these parameters. At M1, the intervention group showed a significant decline in body weight (−3.4%), body mass index (−5.7%), cholesterol intake (−49.5%), fasting glycemia (−14.0%), fasting insulin (−9.0%), postprandial glycemia (−21.0%), postprandial insulin (−71.0%), total serum cholesterol (−23.0%), and glycated hemoglobin (−24.0%). A decrease in energy intake (5%, P = .06) and low-density lipoprotein cholesterol (25%, P = .07) was observed in the interventional group, although it did not reach statistical significance. In contrast, the control group presented a significantly higher energy intake (19%, P = .04) and a nonsignificant increase in consumption of all macronutrients. The long-term NEP was found to improve anthropometric, dietary, and metabolic parameters in high-risk subjects for type 2 diabetes mellitus.     

Supplementation of Korean fermented soy paste doenjang reduces visceral fat in overweight subjects with mutant uncoupling protein-1 allele

The purpose of this study was to examine the hypothesis that the antiobesity effect of doenjang, a Korean fermented soy paste is different between the mutant and the wild-type alleles of a polymorphism upstream of the uncoupling protein-1 (UCP-1) gene in overweight subjects. In our randomized, double-blind, placebo-controlled trial, a total of 51 subjects with a body mass index of 23 kg/m² or greater and a waist-to-hip ratio of 0.90 or greater for men or 0.85 or greater for women were randomly assigned to take 9.9 g/d of either a placebo or doenjang for 12 weeks. The relative frequency of the mutant G allele of the UCP-1 polymorphism was 0.60 in the placebo group and 0.62 in the doenjang group. Supplementation of doenjang had no significant effect on the visceral fat area compared with that of the placebo group, but there was a significantly reduced amount of visceral fat in subjects with the G allele of UCP-1 polymorphism. Doenjang supplementation was found to significantly increase the free fatty acid concentration in subjects with both the A allele and the G allele. There was a significant association between visceral fat and age in study subjects with both the wild-type and mutant alleles of the UCP-1 gene. Doenjang supplementation significantly reduced visceral fat and increased the free fatty acid concentrations in subjects with the G allele of the UCP-1 polymorphism, which suggests that doenjang may be related to increased free fatty acid levels caused by elevated lipolysis in these subjects.     

A beverage of Asiatic plantain extracts alleviated postprandial oxidative stress in overweight hyperlipidemic subjects challenged with a high-fat meal: a preliminary study

There is emerging interest in the potential of the phenolic compounds of Asiatic plantain (Plantago asiatica L.) to attenuate in vitro and in vivo oxidative stress. We hypothesized that a single administration of Asiatic plantain beverage may exert protective effects against postprandial oxidative stress. This preliminary study was designed to compare the ability of different doses of Asiatic plantain beverage to mitigate the postprandial effects of a high-fat meal on the oxidation of lipids and DNA in overweight hyperlipidemic subjects. In a randomized, double-blind, placebo-controlled parallel design (n = 10/group), 40 subjects were administered a single high-fat meal with either a placebo or 1 of 3 Asiatic plantain extract beverages (low, intermediate, or high dose). Blood samples were obtained at fasting and 60, 120, 240, and 360 minutes (total of 5 samples) after intervention. The data showed a tendency for plasma free fatty acid levels to decrease in response to high-dose Asiatic plantain at all time points. Plasma oxidized low-density lipoprotein levels were significantly reduced with high-dose Asiatic plantain at 120 minutes (P = .0251 vs placebo). A comet assay revealed that DNA damage in lymphocytes was significantly decreased by Asiatic plantain at 360 minutes (P = .0225 vs placebo). There were no treatment differences in triglyceride or malondialdehyde levels. The maximum suppression was achieved with a high dose (20 g Asiatic plantain extract/80 mL). These results suggest that by protecting low-density lipoprotein and DNA, an Asiatic plantain beverage may be useful to enhance antioxidant.     

Weight loss increased serum adiponectin but decreased lipid levels in obese subjects whose body mass index was lower than 30 kg/m

We hypothesized that weight loss in obese subjects may affect adipokine levels, such as adiponectin and tumor necrosis factor (TNF) α. This study investigated the effects of an 8-week weight-control program on serum adiponectin, TNF-α, and blood lipid level profiles in obese subjects. Twenty obese subjects with a body mass index (BMI) higher than 25 kg/m² were recruited for this weight loss program that used dietetic control and aerobic exercise training. A total of 3 obese men and 11 obese women (mean age, 40.3 ± 10.8 years; BMI, 30.0 ± 3.4 kg/m²) finished the program. Anthropometric and biochemical characteristics in subjects before and after the program were determined. The results showed that subjects' body weight, BMI, waist circumference, hip circumference, diastolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol levels significantly (P < .05) decreased during the program. Further analysis showed a negative correlation between delta adiponectin and delta TNF-α, triacylglycerol, and systolic blood pressure in obese subjects. Subgroup analysis showed that obese subjects whose original BMI was less than 30 kg/m² had significantly increased serum adiponectin levels, and more than 3% weight reduction markedly improved blood lipids and body fat profiles during the program. Our findings suggest that weight reduction through an 8-week weight loss program may have anti-inflammatory and antiatherogenic effects via increased serum adiponectin levels and improvements in blood lipid profiles and systolic blood pressure.     

Resveratrol supplementation improves glycemic control in type 2 diabetes mellitus

Resveratrol is a naturally occurring polyphenolic compound. Numerous animal studies have been reported on its wide-ranging beneficial effects in the biological system including diabetes mellitus (DM). We hypothesized, therefore, that oral supplementation of resveratrol would improve the glycemic control and the associated risk factors in patients with type 2 diabetes mellitus (T2DM). The present clinical study was therefore carried out to test the hypothesis. Sixty-two patients with T2DM were enrolled from Government Headquarters Hospital, Ootacamund, India, in a prospective, open-label, randomized, controlled trial. Patients were randomized into control and intervention groups. The control group received only oral hypoglycemic agents, whereas the intervention group received resveratrol (250 mg/d) along with their oral hypoglycemic agents for a period of 3 months. Hemoglobin A_1c, lipid profile, urea nitrogen, creatinine, and protein were measured at the baseline and at the end of 3 months. The results reveal that supplementation of resveratrol for 3 months significantly improves the mean hemoglobin A_1c (means ± SD, 9.99 ± 1.50 vs 9.65 ± 1.54; P < .05), systolic blood pressure (mean ± SD, 139.71 ± 16.10 vs 127.92 ± 15.37; P < .05), total cholesterol (mean ± SD, 4.70 ± 0.90 vs 4.33 ± 0.76; P < .05), and total protein (mean ± SD, 75.6 ± 4.6 vs 72.3 ± 6.2; P < .05) in T2DM. No significant changes in body weight and high-density lipoprotein and low-density lipoprotein cholesterols were observed. Oral supplementation of resveratrol is thus found to be effective in improving glycemic control and may possibly provide a potential adjuvant for the treatment and management of diabetes.     

Short-term consumption of sucralose, a nonnutritive sweetener, is similar to water with regard to select markers of hunger signaling and short-term glucose homeostasis in women

Nonnutritive sweeteners have been used to lower the energy density of foods with the intention of affecting weight loss or weight maintenance. However, some epidemiological and animal evidence indicates an association between weight gain or insulin resistance and artificial sweetener consumption. In the present study, we hypothesized that the nonnutritive sweetener sucralose, a trichlorinated sucrose molecule, would elicit responses similar to water but different from sucrose and sucrose combined with sucralose on subjective and hormonal indications of hunger and short-term glucose homeostasis. Eight female volunteers (body mass index, 22.16 ± 1.71 kg/m²; age, 21.75 ± 2.25 years) consumed sucrose and/or sucralose in water in a factorial design. Blood samples were taken at fasting and 30 and 60 minutes after treatment followed by a standardized breakfast across treatments, and blood samples were taken 30, 60, 90, and 120 minutes after breakfast. Plasma was analyzed for glucose, insulin, glucagon, triacylglycerols (TAG), and acylated ghrelin. Perceptions of hunger and other subjective measurements were assessed before each blood sample. No differences were detected in subjective responses, circulating triacylglycerol, or glucagon concentrations among treatments over time. Significant differences were observed in insulin, glucose, and acylated ghrelin concentrations over time only between sucrose-containing treatments and non–sucrose-containing treatments regardless of sucralose consumption. Therefore, sucralose may be a relatively inert nonnutritive sweetener with regard to hunger signaling and short-term glucose homeostasis.     

Dietary factors are associated with coronary heart disease risk factors in college students

It is hypothesized that healthy dietary and physical activity choices will be inversely associated with coronary heart disease (CHD) risk factors. Results from a cross-sectional study of 294 first-year University of Rhode Island students were used for the analyses. The presence of CHD risk factors was defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines. Diet was assessed by three 24-hour food recalls, and physical activity was assessed by the International Physical Activity Questionnaire. Logistic regression models adjusted for sex estimated the odds of having CHD risk factors. A higher percent of kilocalories from alcohol was associated with a 9.9% increased risk for elevated triacylglycerol (odds ratio [OR], 1.099; 95% confidence interval [CI], 1.000-1.207). Sugar intake (OR, 1.015; 95% CI, 1.004-1.026), saccharin intake (OR, 1.047; 95% CI, 1.015-1.080), and body mass index (BMI; OR, 1.139; 95% CI, 1.037-1.252) were associated with an increased risk of low high-density lipoprotein cholesterol; dietary fiber intake (OR, 0.934; 95% CI, 0.873-1.000) was associated with a decreased risk of low high-density lipoprotein cholesterol. Participants with a higher BMI were 9.4% more likely to have elevated fasting glucose (OR, 1.094; 95% CI, 1.004-1.192) and 193.6% more likely to have a larger waist circumference (OR, 2.936; 95% CI, 1.543-5.586). Dietary factors and BMI are better indicators of CHD risk than physical activity is in this population.     

Soy proteins and isoflavones reduce interleukin-6 but not serum lipids in older women: a randomized controlled trial

Soy foods contain several components, notably, isoflavones and amino acids, that may improve cardiovascular health. We evaluated the long-term effect of soy protein and/or soy isoflavones supplementation on serum lipids and inflammatory markers using a 1-year randomized, double-blind, placebo-control, clinical trial in 131 healthy ambulatory women older than 60 years. We hypothesized that soy protein, in combination with isoflavones, would have the largest positive effect on coronary heart disease risk factors (serum lipids and inflammatory markers) compared with either intervention alone and that, within groups receiving isoflavones, equol producers would have more positive effects on coronary heart disease risk factors than nonequol producers. After a 1-month baseline period, participants were randomized into 1 of 4 intervention groups: soy protein (18 g/d) and isoflavone tablets (105 mg/d isoflavone aglycone equivalents), soy protein and placebo tablets, control protein and isoflavone tablets, or control protein and placebo tablets. T Tests were used to assess differences between equol and nonequol producers. Ninety-seven women completed the trial. Consumption of protein powder and isoflavone tablets did not differ among groups, and compliance with study powder and tablets was 79% and 90%, respectively. After 1 year, in the entire population, there were either no or little effects on serum lipids and inflammatory markers, regardless of treatment group. Equol producers, when analyzed separately, had significant improvements in total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios (−5.9%, P = .02; −7.2%, P = .04 respectively). Soy protein and isoflavone (either alone or together) did not impact serum lipids or inflammatory markers. Therefore, they should not be considered an effective intervention to prevent cardiovascular disease because of lipid modification in healthy late postmenopausal women lacking the ability to produce equol.     

Inclusion of Atlantic salmon in the Chinese diet reduces cardiovascular disease risk markers in dyslipidemic adult men

Although the beneficial effects of n-3 fatty acids on several physiologic functions have been widely reported, information about the effects of oily fish in the Asian diet on cardiovascular disease (CVD) risk is diminutive. We hypothesize that daily inclusion of oily fish for 8 weeks in the Chinese diet will elevate serum eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels and reduce CVD risk markers in dyslipidemic adult men, comparable with the effects generally observed by inclusion of oily fish in the Western diet. In this 8-week randomized, parallel-arm, food-based intervention study, lunches were prepared with 500 g pork/chicken/beef, typically consumed fish (hairtail and freshwater carp), or oily fish (salmon). Male subjects aged between 35 and 70 years with hyperlipidemia were randomly assigned to eat lunches with pork/chicken/beef (n = 30 subjects at 8 weeks), freshwater fish (n = 30), or oily fish (n = 32). Circulating markers were measured at baseline and at 8 weeks. In the oily fish diet, dietary EPA and DHA levels were significantly increased as compared with other diets; and the n-6:n-3 polyunsaturated fatty acid ratio was decreased (P < .05). Thus, the oily fish diet significantly elevated serum EPA and DHA concentrations (P < .01) and lowered serum n-6:n-3 ratio at 8 weeks (P < .05). Furthermore, oily fish intake significantly reduced serum levels of triglycerides (P < .05) and interleukin-6 (P < .01) and increased levels of high-density lipoprotein cholesterol (P < .01). In conclusion, daily inclusion of oily fish as part of the Chinese diet for 8 weeks is sufficient to significantly increase the serum content of long-chain n-3 polyunsaturated fatty acids and reduce levels of CVD risk markers in dyslipidemic adult men.     

Hypoxanthine levels in human urine serve as a screening indicator for the plasma total cholesterol and low-density lipoprotein modulation activities of fermented red pepper paste

Fermented red pepper paste (FRPP) is one of the most well-known traditional foods in Korea. The effects of FRPP in experimental animals and adipocytes have been previously reported. However, the biochemical effects have not yet been validated in humans with various genetic backgrounds and environmental factors. In this study, 28 female volunteers (body mass index, more than 23 kg/m²) aged 19 to 60 years were treated with either FRPP or a placebo for 12 weeks. Marked cholesterol modulation was observed in the FRPP-treated group compared with the placebo group. Although the baseline (pretreatment) total cholesterol and low-density lipoprotein levels and body mass index of the volunteers did not differ significantly between the placebo- and FRPP-treated groups, FRPP caused a modulation of cholesterol levels not seen in the placebo group, causing either no variation or a decrease in low-density lipoprotein and total cholesterol levels. Thus, urinary metabolomic profiling of pretreatment samples was carried out in these 2 FRPP-treated groups using ¹H-nuclear magnetic resonance–based metabolomic techniques. These 2 groups, with their opposing cholesterol-modulation tendencies, could be clearly differentiated by orthogonal projections to latent structures–discriminant analysis-derived score plots. In addition, their levels of hypoxanthine differed markedly. We propose that urinary hypoxanthine levels can be used as a screening biomarker to predict the efficacy of the cholesterol-modulating activity of FRPP in human subjects.     

Cardiovascular risk factors in young,overweight, and obese European adults and associations with physical activity and omega-3 index

Excess body fat is associated with increased cardiovascular disease (CVD) risk. The hypothesis of the study was that physical activity and omega-3 index, a marker of past long chain n-3 polyunsaturated fatty acids consumption, counteract the negative associations between fatness and CVD risk factors in young overweight and obese adults. A total of 324 subjects (20-40 years, body mass index [BMI], 27.5-32.5 kg/m², from Iceland, Spain, and Ireland) were investigated cross-sectionally. Dietary intake, anthropometric measurements, blood pressure, CVD risk factors, and fatty acids in erythrocyte membrane were analyzed. Information on physical activity was collected. Linear models were constructed to find out the associations of BMI, physical activity (quartiles), and omega-3 index with CVD risk factors. The most frequently increased risk factors were blood lipids (41.4%) and blood pressure (32.1%); fewer participants experienced disturbed glucose metabolism (11.8%). Body mass index was significantly associated with increased CVD risk factors (P = .001-.029), with the exception of total cholesterol, low-density lipoprotein, and high-density lipoprotein. The highest physical activity quartile had a lower fat mass (P = .005, at a given BMI), leptin (P = .008, in male participants only), and interleukin 6 (P = .021) but higher high-density lipoprotein (P = .020) than other quartiles; however, an approximate dose-response relationship could only be observed for leptin. The omega-3 index was not associated with lower low-density lipoprotein (P = .056), but docosahexaenoic acid in erythrocyte membrane was associated to it (P = .016). It is concluded that physical activity and docosahexaenoic acid diminish some of the negative health effects associated with overweight and obesity; however, body fatness remains the most important variable associated with increased CVD risk factors in young overweight and obese adults.     

Green tea extract reduces blood pressure,inflammatory biomarkers,and oxidative stress and improves parameters associated with insulin resistance in obese,hypertensive patients

Green tea (GT) consumption is known to be associated with enhanced cardiovascular and metabolic health. The purpose of this study is to examine the hypothesis that supplementation with GT alters insulin resistance and associated cardiovascular risk factors in obese, hypertensive patients. In a double-blind, placebo-controlled trial, 56 obese, hypertensive subjects were randomized to receive a daily supplement of 1 capsule that contained either 379 mg of GT extract (GTE) or a matching placebo, for 3 months. At baseline and after 3 months of treatment, the anthropometric parameters, blood pressure, plasma lipid levels, glucose levels, creatinine levels, tumor necrosis factor α levels, C-reactive protein levels, total antioxidant status, and insulin levels were assessed. Insulin resistance was evaluated according to the homeostasis model assessment–insulin resistance protocol. After 3 months of supplementation, both systolic and diastolic blood pressures had significantly decreased in the GTE group as compared with the placebo group (P < .01). Considerable (P < .01) reductions in fasting serum glucose and insulin levels and insulin resistance were observed in the GTE group when compared with the placebo group. Serum tumor necrosis factor α and C-reactive protein were significantly lower, whereas total antioxidant status increased in the GTE group compared with the placebo (P < .05). Supplementation also contributed to significant (P < .05) decreases in the total and low-density lipoprotein cholesterol and triglycerides, but an increase in high-density lipoprotein cholesterol. In conclusion, daily supplementation with 379 mg of GTE favorably influences blood pressure, insulin resistance, inflammation and oxidative stress, and lipid profile in patients with obesity-related hypertension.     

Intake of milk,but not total dairy,yogurt, or cheese,is negatively associated with the clustering of cardiometabolic risk factors in adolescents

Epidemiologic studies have reported an inverse association between dairy product consumption and cardiometabolic risk factors in adults, but this relation is relatively unexplored in adolescents. We hypothesized that a higher dairy product intake is associated with lower cardiometabolic risk factor clustering in adolescents. To test this hypothesis, a cross-sectional study was conducted with 494 adolescents aged 15 to 18 years from the Azorean Archipelago, Portugal. We measured fasting glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, systolic blood pressure, body fat, and cardiorespiratory fitness. We also calculated homeostatic model assessment and total cholesterol/high-density lipoprotein cholesterol ratio. For each one of these variables, a z score was computed using age and sex. A cardiometabolic risk score (CMRS) was constructed by summing up the z scores of all individual risk factors. High risk was considered to exist when an individual had at least 1 SD from this score. Diet was evaluated using a food frequency questionnaire, and the intake of total dairy (included milk, yogurt, and cheese), milk, yogurt, and cheese was categorized as low (equal to or below the median of the total sample) or “appropriate” (above the median of the total sample).The association between dairy product intake and CMRS was evaluated using separate logistic regression, and the results were adjusted for confounders. Adolescents with high milk intake had lower CMRS, compared with those with low intake (10.6% vs 18.1%, P = .018). Adolescents with appropriate milk intake were less likely to have high CMRS than those with low milk intake (odds ratio, 0.531; 95% confidence interval, 0.302-0.931). No association was found between CMRS and total dairy, yogurt, and cheese intake. Only milk intake seems to be inversely related to CMRS in adolescents.     

Daily flaxseed consumption improves glycemic control in obese men and women with pre-diabetes: a randomized study

The study hypothesis was that fasting glucose, insulin, fructosamine, C-reactive protein, and interleukin-6 decrease and adiponectin increases with daily flaxseed consumption in overweight or obese individuals with pre-diabetes. In this randomized, cross-over study overweight or obese men and postmenopausal women (n = 25) with pre-diabetes consumed 0, 13, or 26 g ground flaxseed for 12 weeks. Glucose, insulin, homeostatic model assessment (HOMA-IR), and normalized percent of α-linolenic fatty acid (ALA) were significantly different by treatment (multiple analysis of variance, P = .036, P = .013, P = .008, P = .024 respectively). Paired t tests showed glucose decreased on the 13 g intervention compared to the 0 g period [13g = −2.10 ± 1.66 mg/L (mean ± SEM), 0 g = 9.22 ± 4.44 mg/L, P = .036]. Insulin decreased on the 13 g intervention but not the 26 g (P = .021) and 0 g (P = .013) periods (13 g = −2.12 ± 1.00 mU/L, 26 g = 0.67 ± 0.84 mU/L, 0g = 1.20 ± 1.16 mU/L). HOMA-IR decreased on the 13 g period but not on the 26 g (P = .012) and 0 g (P = .008) periods (13g = −0.71 ± 0.31, 26g = 0.27 ± 0.24, 0g = 0.51 ± 0.35). The α-linolenic fatty acid decrease for the 0 g period was different than the 13 g (P = .024) and 26 g (P = .000) periods (13 g = 0.20 ± 0.04, 26g = 0.35 ± 0.07, 0g = −0.01 ± 0.07). Fructosamine, high sensitivity C-reactive protein, adiponectin, and high-sensitivity interleukin-6 had no significant differences. Flaxseed intake decreased glucose and insulin and improved insulin sensitivity as part of a habitual diet in overweight or obese individuals with pre-diabetes.