Unscrambling the research: Eggs, serum cholesterol and coronary heart disease

The role of dietary cholesterol in raising plasma cholesterol levels has been debated over the past 25 years. Consequently, eggs, as a food high in dietary cholesterol, have been targeted as a food to limit when advising patients on a diet to lower serum cholesterol levels. The aim of the present review was to evaluate the literature to address the effects of dietary cholesterol from eggs on serum cholesterol levels and risk of coronary heart disease. An increase in dietary cholesterol from eggs by 100 mg daily, equivalent to half a medium egg or three to four eggs a week, results in an increase of approximately 0.05 mmol/L in LDL cholesterol. Adding 100 mg of cholesterol per day (equivalent to three to four eggs a week) to a high saturated fat diet caused an increase in LDL cholesterol of 0.061 ± 0.006 mmol/L, whereas adding the same quantity of cholesterol to a low saturated fat diet caused an increase in LDL cholesterol of only 0.036 ± 0.004 mmol/L (P = 0.03). Despite the small increase in LDL‐cholesterol levels with increasing egg intake, most epidemiological studies have shown little or no association between egg intake and risk of coronary heart disease. However, the impact of dietary cholesterol for people with type 2 diabetes has been poorly studied. In conclusion, in a healthy Western population, there is insufficient evidence to excessively restrict egg intake as part of a healthy diet. Eggs should be considered in a similar way as other protein‐rich foods and selected as part of a varied diet that is low in saturated fat and contains a variety of cardio‐protective foods such as fish, wholegrains, fruits, vegetables, legumes and nuts.     

Major dietary patterns and their associations with cardiovascular risk factors among women in West Bengal, India

Few studies have examined dietary patterns in relation to cardiovascular risk factors in Asian populations, particularly in India. The present study was undertaken to explore dietary patterns in a general urban Bengalee population of women in West Bengal, India, and their association with cardiovascular risk factors. We performed a cross-sectional study of 701 women (aged 35 years and above) selected by cluster sampling from twelve different wards of the Kolkata Municipal Corporation (Kolkata, India). The following three major dietary patterns were identified: the 'vegetable, fruits and pulses' pattern (characterised by higher intakes of dark-yellow and green leafy vegetables, sweets, fruits, pulses, nuts, poultry and eggs, and lower intake of mustard oil); the 'hydrogenated and saturated fat and vegetable oil' pattern (characterised by higher intakes of butter, hydrogenated oil, ghee, vegetable oil, mustard oil, condiments, sweets, fish, high-fat dairy and refined grain); the 'red meat and high-fat dairy' pattern (characterised by higher intakes of red meat, high-fat dairy products, whole grain, high-energy drinks and condiments, and lower intakes of fish, refined grain and low-fat dairy products). The vegetable, fruits and pulses pattern was inversely associated with serum total cholesterol (TC), LDL-cholesterol and non-HDL-cholesterol (HDL-C) concentrations (P < 0·05 for all). The hydrogenated and saturated fat and vegetable oil pattern was positively associated with BMI, waist circumference (WC) and HDL-C concentration (P < 0·05 for all). In this Bengalee population, these three major dietary patterns were observed, and the dietary patterns were independently associated with BMI, WC and serum TC concentrations in women.     

Impact of Diets Rich in Whole Grains and Fruits and Vegetables on Cardiovascular Risk Factors in Overweight and Obese Women: A Randomized Clinical Feeding Trial

Objective: Previous interventions have reported desirable effects of diets rich in whole grains or rich in fruits and vegetables on cardiovascular disease (CVD) risk factors and weight management. However, data are lacking regarding the effect of these fiber sources separately. The aim of this randomized clinical feeding trial was to investigate the effects of fiber-rich diets with different sources of fiber (fruits, vegetables, and whole grains) on weight loss and CVD risk factors in overweight and obese women.

Methods: Overweight and obese women (N = 75) were randomized to one of three weight loss diets that were rich in whole grains, fruits and vegetables, or both for 10 weeks. Body weight, waist circumference, and risk factors of CVD were examined at baseline and 10 weeks.

Results: During the 10-week dietary intervention phase, the reductions in weight (p = 0.03), waist circumference (p = 0.001), systolic blood pressure (p = 0.04), fasting blood sugar (p = 0.03), and triglycerides (p = 0.001) were higher in the whole grains group compared with the fruits and vegetables group or the combination diet group. Also, the whole grain group had a greater increase (p = 0.01) in high-density lipoprotein cholesterol compared to the other groups. The change in other risk factors, including diastolic blood pressure and low-density lipoprotein cholesterol, was not different among the three diet groups. Within-group comparisons revealed significant reductions in weight, waist circumference, and fasting blood sugar in all groups. Only the fruits and vegetables group and the whole grains group had significant decreases in low-density lipoprotein cholesterol over 10 weeks (p ≤ 0.03).

Conclusions: This trial suggests that in overweight and obese women, a weight loss diet rich in whole grains may have a more beneficial effect on CVD risk factors than diets rich in fruits and vegetables or a combination of whole grains and fruits and vegetables.     

Oxidative Damage,Antioxidants and Stroke

Nutritional factors may have an important role to play in incidence and treatment of stroke. Many epidemiological studies report that people who eat a relatively large quantity of fruits, vegetables and grains have a lower risk of death, particularly from cardiovascular disease. Some of these studies consistently revealed an association between increased risk of stroke and low plasma concentrations of antioxidants. There is also strong indirect evidence that free radical production appears to be an important mechanism of brain injury after exposure to ischaemia and reperfusion. The role of free radical formation in the pathogenesis of ischaemic brain damage and the neuroprotective effect of antioxidants are not definitely established and need further studies.     

Lipoproteins, nutrition, and heart disease

This article reviews the current status of our knowledge of lipoproteins, nutrition, and coronary heart disease (CHD). Special emphasis is placed on CHD risk assessment, dietary intervention studies, diet-gene interactions, and current dietary guidelines and the contributions of my laboratory to these areas. CHD remains a major cause of death and disability, and risk factors include age, sex, hypertension, smoking, diabetes, elevated serum LDL cholesterol, and low HDL cholesterol. Emerging independent risk factors include elevated serum concentrations of lipoprotein(a), remnant lipoproteins, and homocysteine. The cornerstone of CHD prevention is lifestyle modification. Dietary intervention studies support the concepts that restricting saturated fat and cholesterol and increasing the intake of essential fatty acids, especially n - 3 fatty acids, reduces CHD risk. The variability in LDL-cholesterol response to diet is large, related in part to APOE and APOA4 genotype. The use of antioxidants in intervention studies has not been shown to reduce CHD risk. Compliance with dietary recommendations remains a major problem, and directly altering the food supply may be the most effective way to ensure compliance. The available data indicate that the recommendation to use fats, oils, and sugars sparingly for CHD prevention should be modified to a recommendation to use animal, dairy, and hydrogenated fats; tropical oils; egg yolks; and sugars sparingly and to increase the use of vegetables, fruit, and whole grains.     

Increasing antioxidant intake from fruits and vegetables: practical strategies for the Scottish population

Background Increasing intakes of dietary antioxidants may help to reduce oxidative damage caused by free radicals and provide protection against the progression of a number of chronic diseases. The present study aimed to estimate the antioxidant intake from fruits and vegetables in the UK and Scottish population and to examine consumption models to identify potential strategies to optimize antioxidant intake from these foods. Methods This was a retrospective study of cross‐sectional data on fruit and vegetable intake in relation to antioxidant intake. Antioxidant capacity of individual fruits and vegetables was determined by the ferric reducing antioxidant power assay and data on quantity and frequency of consumption of fruits and vegetables determined from National Diet and Nutrition Survey 2000–2001. Results Mean antioxidant intake in UK population from fruits and vegetables varied by region. In the Scottish sample (n = 123), mean antioxidant intake was estimated at 680 ± 689 μmol day^?1 with 92% subjects consuming <400 g of fruits and vegetables per day. Consumption data showed that strawberries, apples, orange citrus fruits, purple broccoli and cauliflower were the top five sources of antioxidants from fruits and vegetables in the Scottish population. Conclusions Appropriate selection of fruits and vegetables would help to achieve a higher antioxidant intake with the potential to produce significant health benefits.     

Health benefits of fruits and vegetables

Fruits and vegetables are universally promoted as healthy. The Dietary Guidelines for Americans 2010 recommend you make one-half of your plate fruits and vegetables. Myplate.gov also supports that one-half the plate should be fruits and vegetables. Fruits and vegetables include a diverse group of plant foods that vary greatly in content of energy and nutrients. Additionally, fruits and vegetables supply dietary fiber, and fiber intake is linked to lower incidence of cardiovascular disease and obesity. Fruits and vegetables also supply vitamins and minerals to the diet and are sources of phytochemicals that function as antioxidants, phytoestrogens, and antiinflammatory agents and through other protective mechanisms. In this review, we describe the existing dietary guidance on intake of fruits and vegetables. We also review attempts to characterize fruits and vegetables into groups based on similar chemical structures and functions. Differences among fruits and vegetables in nutrient composition are detailed. We summarize the epidemiological and clinical studies on the health benefits of fruits and vegetables. Finally, we discuss the role of fiber in fruits and vegetables in disease prevention.     

Fruit and vegetables consumption in relation to health and diet of medical students in Crete, Greece

In Greece, prevalence of cardiovascular disease has been increasing during the last few decades. From a public health point of view, it is important to identify lifestyle practices associated with cardiovascular disease risk factors. As part of the Clinical Nutrition course at the University of Crete School of Medicine, 507 medical students (292 men, 215 women) were examined during the period 1995-2001. Individual 24-hour dietary recalls were taken, lifestyle questionnaires were completed, and anthropometric and serum lipid measurements were performed. Fruits and vegetables were consumed by 90% of men (370 +/- 275 g/day) and 94% of women (354 +/- 283 g/day). Among non/ex-smokers who ate fruit and vegetables, 41% consumed > or = 400 g/day, compared to 31% of current smokers (p = 0.05). The risk for high-density lipoprotein cholesterol (HDL-C) < 35 mg/dL, low-density lipoprotein cholesterol (LDL-C) > 130 mg/dL, and total cholesterol/HDL-C ratio (TC:HDL-C) > or = 5 decreased with increasing quartile of fruit and vegetables consumption (trend p < 0.01). Fruit and vegetable intake was favorably related to intake of dietary fiber, calcium, magnesium, potassium, folate, and vitamins C, E, A, B1 and B6, and inversely related to saturated and trans fatty acids and cholesterol. Prospective studies should be performed within the general young adult population to assess the long-term effects of fruit and vegetable consumption on chronic disease risk development.     

Association of dietary fiber with temporal changes in serum cholesterol in Japanese-Brazilians

To examine dietary intakes in relation to long-term serum lipoprotein changes in a prospective cohort study with 7 y of follow-up, serum lipids were analyzed by enzymatic methods, while food intake was calculated from validated food frequency questionnaires. First- and second-generation Japanese-Brazilians (n = 316) living in Bauru, S?o Paulo/Brazil, of both genders, aged 40 to 79 y were assessed at baseline in 1993. Multiple linear regression models were used with changes in serum lipoproteins as the dependent variable and changes in dietary intakes as the independent variables, adjusted for confounding factors. In energy-adjusted analyses, changes in serum total cholesterol were inversely associated with changes in total dietary fiber, fruits/fruit juices and vegetables after adjustment for age and gender. Each increase of 10 g in the consumption of total dietary fiber was associated with a reduction of 12.5 mg/dL in the serum total cholesterol (p<0.05). Our results highlight the importance of increased intakes of total fiber, fruits and vegetables to prevent and control dyslipidemia in Japanese migrants.     

Food preference questionnaire as a screening tool for assessing dietary risk of cardiovascular disease within health risk appraisals

OBJECTIVE: Nutrition components of health risk appraisals (HRAs) aim to rapidly and accurately assess dietary behaviors that increase disease risk. Because cognitive research suggests that recalling food likes/dislikes may be simpler and more accurate than recalling intake, we tested whether a preference measure was predictive of cardiovascular disease risk factors within an HRA. METHODS: HRA participants (422 primarily non-Hispanic white men, mean age 46+/-10 years) from a manufacturing company completed surveys to assess fat and sweet food/beverage preference; frequency of consuming fat and sweet foods/beverages, alcoholic beverages, fiber-rich foods (whole grains, fruits, and vegetables); and physical activity. Per measured risk factors, 34% had central obesity (waist circumference>or=102 cm), 32% had hypertension (>or=140 and/or>or=90 mm Hg), 52% had prehypertension (>or=120 to 139 and/or>or=80 to 89 mm Hg), and 52% had an elevated total cholesterol level (>or=200 mg/dL [5.2 mmol/L]). STATISTICAL ANALYSES: Multiple linear regression models explaining variability in waist circumference, blood pressure, and serum lipids were tested. RESULTS: Although preference and intake pairs for fat and sweets were significantly correlated, intake of fat and sweets failed to associate significantly with any risk factor. Significant variance in waist circumference was explained by age, fat preference, fiber intake, and physical activity. Those with greater circumferences liked fat more, consumed less fiber, and exercised less. Waist circumference in turn contributed significantly to models predicting serum lipid levels and blood pressure. Alcohol intake explained variability in serum lipid levels-higher intakes were associated with higher high-density lipoprotein cholesterol levels. The models predicting risk were generally more explanatory in younger (<50 years) than in older men. CONCLUSIONS: Including a preference measure within an HRA appears to enhance cardiovascular disease risk factor assessment. Fat preference, intake of fiber-rich foods, and alcohol proved the best dietary determinants of cardiovascular disease risk factors.     

Cardiovascular Disease Risk Factors are Lower in African-American Vegans Compared to Lacto-Ovo-vegetarians

Objective: This study was undertaken to determine if African-American strict vegetarians (vegans) exhibit lower blood pressure (BP) and a more favorable serum lipid profile than their lacto-ovo vegetarian (LOV) counterparts, and if plasma ascorbic acid (AA) concentrations could explain any group differences in these cardiovascular disease (CVD) risk factors.

Methods: Habitual dietary intake, anthropometric characteristics, blood pressure, and blood lipids and ascorbic acid concentrations were determined in African-American study participants (male vegans, n=14, age=45.6 years; male LOV, n=49, age=49.8; female vegans, n=31, age=51.1, female LOV, n=94, age=52.1) recruited from Seventh-Day Adventist Churches in several cities in the northeastern United States.

Results: Body mass index (BMI) was significantly lower in the vegans (24.7±1.9 kg/m²) compared to LOV (26.4±0.45 kg/m²). There were no diet or gender differences in BP. Serum total cholesterol (3.75±0.12 vs. 4.51±0.10 mmol/L), LDL-cholesterol (2.06±0.13 vs. 2.65±0.09 mmol/l), and triglycerides (0.94±0.07 vs. 1.17±0.04 mmol/L) were significantly (p<0.05) lower in vegans compared to LOV, but there were no dietary group differences in HDL-C. The ratio of total to HDL-cholesterol was significantly lower in vegans than in LOV (3.0±0.13 vs. 3.7±0.13). There were no dietary group differences in plasma AA concentrations. However, in the entire sample, plasma AA was inversely associated with BP (SBP: r=?0.46, p<0.001, DBP: r=?0.32, p<0.001), but unrelated to the serum lipid concentrations.

Conclusion: African-American vegans exhibit a more favorable serum lipid profile than lacto-ovovegetarians and plasma AA is inversely related to BP in African-American vegetarians but does not explain any of the differences in CVD risk factors between vegans and lacto-ovo vegetarians.     

Long-term consumption of a raw food diet is associated with favorable serum LDL cholesterol and triglycerides but also with elevated plasma homocysteine and low serum HDL cholesterol in humans

High consumption of vegetables and fruits is associated with reduced risk for cardiovascular disease. However, little information is available about diets based predominantly on consumption of fruits and their health consequences. We investigated the effects of an extremely high dietary intake of raw vegetables and fruits (70-100% raw food) on serum lipids and plasma vitamin B-12, folate, and total homocysteine (tHcy). In a cross-sectional study, the lipid, folate, vitamin B-12, and tHcy status of 201 adherents to a raw food diet (94 men and 107 women) were examined. The participants consumed approximately 1500-1800 g raw food of plant origin/d mainly as vegetables or fruits. Of the participants, 14% had high serum LDL cholesterol concentrations, 46% had low serum HDL cholesterol, and none had high triglycerides. Of raw food consumers, 38% were vitamin B-12 deficient, whereas 12% had an increased mean corpuscular volume (MCV). Plasma tHcy concentrations were correlated with plasma vitamin B-12 concentrations (r = -0.450, P < 0.001), but not with plasma folate. Plasma tHcy and MCV concentrations were higher in those in the lowest quintile of consumption of food of animal origin (P(trend) < 0.001). This study indicates that consumption of a strict raw food diet lowers plasma total cholesterol and triglyceride concentrations, but also lowers serum HDL cholesterol and increases tHcy concentrations due to vitamin B-12 deficiency.     

Changes in cardiovascular risk factors with participation in a 12-week weight loss trial using a commercial format

ObjectiveThis study assessed changes in cardiovascular disease risk factors among participants in a 12-week behavioral weight loss intervention featuring a commercial format.Method132 participants were enrolled in a randomized controlled trial of a 12-week group-based lifestyle intervention that involved two structured food plan conditions. Of them, 112 (100 women and 12 men, mean BMI = 31.44 ± 2.18 kg/m²) completed the program with post-treatment assessments. Weight and changes in risk factors (cholesterol, triglycerides, fasting blood glucose, and blood pressure) were assessed at pre- and posttreatment. Additionally, changes for each risk factor were examined among participants with baseline values of risk factors beyond recommended cut points.ResultsWith no weight loss differences between conditions, analyses used the combined sample. Participants lost 3.74 ± 3.16 kg (4.37 ± 3.71% of baseline weight), and exhibited significant decreases in triglyceride, total cholesterol and LDL-cholesterol levels. There were trends toward reductions in fasting glucose, systolic blood pressure, and HDL cholesterol. Among participants with elevated baseline values, significant reductions were seen on all risk factors, with the exception of HDL cholesterol.DiscussionModest weight loss achieved via a relatively brief, non-intensive intervention using a commercial format can yield significant improvements in cardiovascular disease risk factors, particularly among individuals with initially higher-risk values.     

Lipoprotein profile in elderly persons from northwestern Spain consuming the Atlantic diet, a variant of the Mediterranean diet

To screen some cardiovascular risk factors in institutionalized elderly persons of the Spanish Northwest who consume the Atlantic variant of the Mediterranean diet, rich in vegetables, fruit, meat, fish, olive oil and dairy products, anthropometric and dietary measurements were carried out and serum glucose and lipoprotein values were determined in 94 subjects. Men consumed significantly more legumes, fruit, meat, alcohol and precooked foods but fewer vegetables than women. Significant positive correlations were found between total fat and MUFA consumption and HDL-cholesterol. Fish intake correlated negatively with total cholesterol (TC) and LDL-cholesterol. The prevalence of high TC, LDL-cholesterol, triglyceride and TC/HDL-cholesterol levels was 29%, 37%, 21%, 25% respectively, and that of low HDL-cholesterol was 15%. Women displayed a higher prevalence of dyslipemia, with significantly higher TC and higher LDL-cholesterol levels than men. Fifty percent of the women aged 75-80 presented concurrent hyperglycemia, excess weight and hypertriglyceridemia, predisposing them to the metabolic syndrome. Nonetheless, as regards the lipoprotein profile, the Atlantic diet appears appropriate for most institutionalized elderly persons.     

Citrus juice modulates antioxidant enzymes and lipid profiles in orchidectomized rats

Oxidative stress and hypogonadism are two factors linked to the increased incidence of cardiovascular disease in males. Eating fruits and vegetables is known to reduce the incidences of oxidative stress. The objective of this research was to delineate whether drinking daily squeezed orange juice (OJ) or grapefruit juice (GJ) modulates oxidative stress and antioxidant enzymes while impacting cardiovascular risk factors in hypogonad male rats. In the present study, 36 1-year-old male rats were equally divided among the following four treatments: sham (control), orchidectomized (ORX), ORX + OJ, and ORX + GJ. After 60 days of drinking OJ or GJ, antioxidant capacity, cholesterol, and triglycerides in serum and superoxide dismutase (SOD), catalase (CAT), cholesterol, and triglycerides in liver were evaluated. Serum antioxidant capacity and SOD and CAT activities decreased (P < .05), while serum cholesterol and liver triglycerides increased (P < .05) in the ORX group compared with the sham group. In contrast to the ORX group, drinking OJ was ineffective while drinking GJ decreased (P < .05) cholesterol concentration in liver and in serum. Nevertheless, OJ and GJ decreased (P < .05) triglyceride concentration in liver and increased (P < .05) serum antioxidant capacity and SOD and CAT activities compared with the ORX group. In conclusion, drinking OJ or GJ prevented oxidative stress by enhancing total antioxidant capacity and elevating liver antioxidant enzymes while modulating cardiovascular risk factors.     

Nutrition protocols for the prevention of cardiovascular disease

Cardiovascular disease is the number one cause of death in the United States, and prevention of cardiovascular disease is at the top of the public health agenda. Evidence shows that reducing the incidence of coronary heart disease with diet is possible. More than a half century of evidence from epidemiologic, experimental, and clinical trials pinpoints a positive correlation between lifestyle and dietary factors as they relate to blood lipids, blood pressure, and coronary heart disease risk, and a number of evidence-based nutrition guidelines have emerged. The National Cholesterol Education Program's Therapeutic Lifestyle Changes diet includes unsaturated fats, fiber, and plant sterols/stanols. The whole foods approach incorporates increased consumption of fruits, vegetables, whole grains, and fish; and the American Heart Association guidelines emphasize functional foods like soy protein, nuts, and alcohol. These guidelines display the rationale for nutrition intervention as a primary prevention for cardiovascular disease. In addition, body weight, body mass index, waist circumference, and waist-to-hip ratio are examined as risk factors for cardiovascular disease. This article highlights key nutrients and lifestyle factors in preventing cardiovascular disease and identifies practical applications for clinicians.     

Potential Cardioprotective Effects of Sumac Capsule in Patients With Hyperlipidemia: A Triple-Blind Randomized,Placebo-Controlled Crossover Trial

Objective: Alternative medicine and herbal drugs have been taken into account for managing cardiovascular risk factors. Sumac (Rhus coriaria L.) is rich in biologically active ingredients known to improve cardiovascular health. We investigated the effect of sumac on systolic (SBP) and diastolic (DBP) blood pressure, flow-mediated dilation (FMD), body mass index (BMI), and serum concentrations of lipids and fasting blood sugar (FBS) in participants with hyperlipidemia in a triple-blind randomized placebo- controlled crossover trial.

Methods: Thirty adults with dyslipidemia (mild to moderate elevation of plasma total cholesterol and/or triglycerides [TG; total cholesterol ≥ 6.0 mmol/L or TG ≥ 1.7 mmol/L and TG ≤ 5.0 mmol/L]) were assigned randomly to a sumac or a placebo group. Participants in the sumac group received sumac capsules (500 mg/twice daily) for the first 4 weeks, followed by 2 weeks’ washout period; the patients were then switched to a 4-week interval and received placebo for 4 weeks in the second period. The placebo group received these treatments in reverse order. FMD, BMI, SBP, DBP, lipids, and FBS were measured at baseline and after each period.

Results: Differences between placebo group and sumac group (placebo-sumac) were significantly decreased for BMI (0.21 ± 0.075 kg/m²), SBP (1.87 ± 0.83 mm Hg), DBP (1.32 ± 0.46 mm Hg), and total cholesterol (14.42 ± 4.95 mmol/L) and significantly increased for FMD (?0.23% ± 0.065%). Plasma level of TG did not change significantly across the treatment.

Conclusion: Sumac consumption may decrease cardiovascular risk factors in persons with mild to moderate hyperlipidemia.     

Effects of grape antioxidant dietary fiber in cardiovascular disease risk factors

OBJECTIVE: The objective of the study was to evaluate the effects of a grape product rich in dietary fiber and natural antioxidants on cardiovascular disease risk factors. METHODS: A randomized, controlled parallel-group trial was carried out. Thirty-four non-smoking (21 normocholesterolemic and 13 hypercholesterolemic) adults were supplemented for 16 wk with 7.5 g/d of grape antioxidant dietary fiber, a natural product containing 5.25 g of dietary fiber and 1400 mg of polyphenols. Nine non-supplemented non-smokers were followed as a control group. Fasting blood samples, blood pressure, and anthropometric readings were obtained at baseline and at week 16. Subjects were allowed to consume their regular diet, which was monitored weekly. RESULTS: Grape antioxidant dietary fiber (7.5 g/d) reduced significantly (P < 0.05) total cholesterol (9%), low-density lipoprotein cholesterol (9%), and systolic and diastolic blood pressures (6% and 5% respectively). Greater reductions in total cholesterol (14.2%) and low-density lipoprotein cholesterol (11.6%, P < 0.05) were observed in hypercholesterolemic subjects. No changes were observed in the control group. There was a reduction of 2.5 points in the Framingham Global Risk Score in the supplemented group. A significant reduction in triacylglycerol concentration took place in the supplemented hypercholesterolemic subjects (18.6%, P < 0.05). CONCLUSION: Grape antioxidant dietary fiber showed significant reducing effects in lipid profile and blood pressure. The effects appear to be higher than the ones caused by other dietary fibers, such as oat fiber or psyllium, probably due to the combined effect of dietary fiber and antioxidants.     

Dietary cholesterol, eggs and coronary heart disease risk in perspective

Summary  The idea that dietary cholesterol increases risk of coronary heart disease (CHD) by turning into blood cholesterol is compelling in much the same way that fish oil improves arthritis by lubricating our joints! Dietary cholesterol, chiefly in the form of eggs, has long been outlawed as a causative agent in CHD through its association with serum cholesterol. However, the scientific evidence to support a role for dietary cholesterol in CHD is relatively insubstantial in comparison with the incontrovertible link between its circulating blood relative in low density lipoprotein (LDL) cholesterol and CHD. Interpretation of the relationship between dietary cholesterol and CHD has been repeatedly confounded by an often inseparable relationship between dietary cholesterol and saturated fat. It has also been exaggerated by the feeding of unphysiologically high intakes of eggs. Nonetheless, numerous studies have shown that dietary cholesterol can increase serum LDL-cholesterol, but the size of this effect is highly variable between individuals and, according to over 30 years of prospective epidemiology, has no clinically significant impact on CHD risk. Variation in response to dietary cholesterol is a real phenomenon and we can now identify nutrient–gene interactions that give rise to this variation through differences in cholesterol homeostasis. More importantly, to view eggs solely in terms of the effects of their dietary cholesterol on serum cholesterol is to ignore the potential benefits of egg consumption on coronary risk factors, including obesity, diabetes and metabolic syndrome. Cardiovascular risk in these conditions is largely independent of LDL-cholesterol. These conditions are also relatively unresponsive to any LDL-cholesterol raising effects of dietary cholesterol. Treatment is focused primarily on weight loss, and it is in this respect that eggs may have a new and emerging role in facilitating weight loss through increased satiety.     

Fruit, vegetable, and antioxidant intake and all-cause, cancer, and cardiovascular disease mortality in a community-dwelling population in Washington County, Maryland

Higher intake of fruits, vegetables, and antioxidants may help protect against oxidative damage, thus lowering cancer and cardiovascular disease risk. This Washington County, Maryland, prospective study examined the association of fruit, vegetable, and antioxidant intake with all-cause, cancer, and cardiovascular disease death. CLUE participants who donated a blood sample in 1974 and 1989 and completed a food frequency questionnaire in 1989 (N = 6,151) were included in the analysis. Participants were followed to date of death or January 1, 2002. Compared with those in the bottom fifth, participants in the highest fifth of fruit and vegetable intake had a lower risk of all-cause (cases = 910; hazard ratio (HR) = 0.63, 95% confidence interval (CI): 0.51, 0.78; p-trend = 0.0004), cancer (cases = 307; HR = 0.65, 95% CI: 0.45, 0.93; p-trend = 0.08), and cardiovascular disease (cases = 225; HR = 0.76, 95% CI: 0.54, 1.06; p-trend = 0.15) mortality. Higher intake of cruciferous vegetables was associated with lower risk of all-cause mortality (HR = 0.74, 95% CI: 0.60, 0.91; p-trend = 0.04). No statistically significant associations were observed between dietary vitamin C, vitamin E, and beta-carotene intake and mortality. Overall, greater intake of fruits and vegetables was associated with lower risk of all-cause, cancer, and cardiovascular disease death. These findings support the general health recommendation to consume multiple servings of fruits and vegetables (5-9/day).