Oats and soy in lipid-lowering diets for women with hypercholesterolemia: is there synergy?

OBJECTIVES: To study possible synergistic effects of oats and soy on reducing total and low-density lipoprotein cholesterol (LDL-C) concentrations in human beings and the efficacy and feasibility of including these adjustments to a National Cholesterol Education Program Step I diet. SUBJECT/SETTING: One hundred twenty-seven postmenopausal women with moderate hypercholesterolemia were recruited from a large Midwestern workforce and senior centers in the surrounding community. Intervention and clinical visits were conducted in these same facilities. DESIGN: After a 3-week lead-in period on the Step I diet, participants were randomly assigned to 1 of 4 dietary treatments for an additional 6 weeks: an oats/milk group, a wheat/soy group, an oats/soy group, and a wheat/milk group. Clinical measurements included blood draws, body weight and height, blood pressure, and medical history data. Three-day food records were collected at baseline and Weeks 3 and 9 of the intervention. Randomization was stratified based on the status of hormone replacement therapy and was blocked with sizes 4 or 8 for group assignment. RESULTS: After 3 weeks on the Step I diet, total cholesterol, LDL-C, and triglyceride levels; total fat and saturated fat intake, dietary cholesterol intake, Keys score, and body mass index were all reduced. Following an additional 6 weeks on the Step I diet plus intervention, total cholesterol and LDL-C were further reduced for both the oats/soy group and oats/milk group. There were no significant further changes in total cholesterol, LDL-C, or high-density lipoprotein cholesterol levels in the wheat/soy and wheat/milk groups. Body mass index remained stable in all groups from Week 3 to Week 9. APPLICATIONS: Nonpharmacologic dietary interventions like the Step I diet are feasible in a community setting and can produce rapid and significant lipid-lowering benefits. Daily consumption of 2 servings of oats can contribute to further lipid alterations in this population although soy intake at this dose may not. Palatability and convenience are important considerations in achieving dietary adherence.     

The effect of breakfast cereal on diet and serum cholesterol: a randomized trial in North Karelia, Finland.

OBJECTIVE: To test the hypothesis that a high carbohydrate breakfast with breakfast cereal leads to a meaningful reduction in dietary energy intake from fat, especially from saturated fat, and thus lower serum cholesterol levels. DESIGN: An open randomized controlled cross-over trial. The subjects were randomized into intervention breakfast cereal or usual breakfast (control) groups. SETTING: Free-living subjects aged 29-71 y in Eastern Finland SUBJECTS: 224 enrolled, 209 completed the study. The subjects were recruited from a survey of a random population sample and from other sources, and their serum cholesterol was not lower than 5.0 mmol/l. Recruited persons did not have any chronic disease or very low saturated fat intake. INTERVENTION: The cereal group consumed 80 g (men) or 60 g (women) cereal at breakfast and the control group continued their usual dietary habits for six weeks. After a wash out of six weeks, a cross-over with another six week trial period took place. Measurements (including serum samples and a 3 d food record) took place before and after the two trial periods. RESULTS: The intervention period led to 2.5 en% (energy percent units) reduction in saturated fatty acids intake. The reduction in total fat intake was 5.5 en%. This was compensated for by increased intake of carbohydrates. The reduction in saturated fatty acids intake led to modest (but in group 1 significant) 0.15 mmol/l (2.5%) reduction in total serum cholesterol level. CONCLUSIONS: The trial showed that regular cereal breakfast can lead to reduced intake of total and saturated fatty acids of the daily diet and consequently to reduction in serum cholesterol level.     

Does provision of additional dietary information affect actual or only reported compliance to a low-fat diet over 12 weeks in hyperlipidaemic individuals? Report of a pilot study

This randomized controlled pilot study was designed to measure the effect of additional dietary information on change in reported percentage energy from fat (% fat), total daily energy intake (TDEI), body mass index (BMI) and serum cholesterol in 13 hyperlipidaemic subjects, referred from the Cardiology Unit of St. Bartholomew's Hospital, over 12 weeks. At baseline (visit 1), % fat and TDEI were assessed using a validated food frequency questionnaire (Paisley et al ., 1996), and BMI and fasting lipids were measured. «Standard>> low-fat dietary advice was given to all patients. Subjects were randomized at 4 weeks (visit 2) to receive either further «standard>> dietary advice (control group) or further «standard>> dietary advice plus an additional information package (intervention group). At 12 weeks (visit 3), % fat, TDEI, BMI and fasting lipids were reassessed. Both groups reported a significant reduction in % fat; a 23% reduction ( P =0.00) in the intervention group, and an 11% reduction ( P =0.005) in the control group. However, there was no significant difference in the reported % fat at the end of the study between the two groups ( P =0.57). Plasma cholesterol was not significantly reduced in either the intervention or the control group (mean 7.3–6.7 mmol/l, 7.2–6.6 mmol/l, respectively). Reported energy intake was significantly reduced in both groups, but the extent of energy reduction was not reflected in the degree of weight lost. These results suggest that the provision of additional dietary information affects reported rather than actual compliance to a low-fat diet.     

血脂偏高学龄儿童膳食干预效果分析

目的　评价血脂偏高学龄儿童的膳食干预效果。方法　对 316名 7～ 11岁在校儿童进行血脂谱水平测定 ,以总胆固醇 (TC)≥ 4 .2 6mmol/L或低密度脂蛋白胆固醇 (LDL C)≥ 2 .2 3mmol/L确定膳食干预对象 ,随机分为干预组 (12 0人 )和对照组 (40人 ) ;干预组遵循低胆固醇、低饱和脂肪酸食谱方案 ,干预期 3个月 ;干预前后对两组人群进行膳食调查、问卷调查及体格检查 (身高、体重、皮褶厚度等 )。结果　膳食干预后干预组儿童TC、LDL C水平与对照组相比无明显改变 (干预前分别为4 .6 4mmol/L和 2 .6 6mmol/L ,干预后分别为 4 .6 8mmol/L和 2 .6 2mmol/L ,P >0 .0 5 ) ,载脂蛋白A1(apoA1)水平由干预前 1378.4mg/L升高为 14 4 1.3mg/L(P <0 .0 5 ) ;膳食总能量、胆固醇、饱和脂肪酸 (SFA)摄入明显减少 ,其中脂肪供能比由干预前的 4 0 .7%下降到 31.2 % ,SFA供能比已达到“膳食控制一级方案”要求 (7.7% <10 % )。此外干预组儿童健康知识水平提高 ,不良生活、饮食习惯改善 (总分由干预前 2 4 .6上升为 2 7.4 ) ;身高增长与对照组一致。结论　对血脂偏高儿童进行以家庭为基础、以膳食调整为主的高危干预策略可有效提高血脂偏高儿童的健康知识水平 ,改善其不良生活及饮食习惯 ,同时不影响儿童的正常生长发育。     

Coaching patients with coronary heart disease to achieve the target cholesterol: a method to bridge the gap between evidence-based medicine and the "real world"--randomized controlled trial

Community studies have demonstrated suboptimal achievement of lipid targets in the management of patients with coronary heart disease (CHD). An effective strategy is required for the application of evidence-based prevention therapy for CHD. The objective of this study was to test coaching as a technique to assist patients in achieving the target cholesterol level of <4.5 mmol/L. Patients with established CHD (n = 245) underwent a stratified randomization by cardiac procedure (coronary artery bypass graft surgery or percutaneous coronary intervention) to receive either the coaching intervention (n = 121) or usual medical care (n = 124). The primary outcome measure was fasting serum total cholesterol (TC), serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and calculated low-density lipoprotein cholesterol (LDL-C) level, measured at 6 months post-randomization. At 6 months, the serum TC and LDL-C levels were significantly lower in the coaching intervention group (n = 107) than the usual care group (n = 112): mean TC (95%CI) 5.00 (4.82-5.17) mmol/L versus 5.54 (5.36-5.72) mmol/L (P <.0001); mean LDL-C (95%CI) 3.11 (2.94-3.29) mmol/L versus 3.57 (3.39-3.75) mmol/L (P <.0004), respectively. Coaching had no impact on TG or on HDL-C levels. Multivariate analysis showed that being coached (P <.001) had an effect of equal magnitude to being prescribed lipid-lowering drug therapy (P <.001). The effectiveness of the coaching intervention is best explained by both adherence to drug therapy and to dietary advice given. Coaching may be an appropriate method to reduce the treatment gap in applying evidence-based medicine to the "real world."     

Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis

BACKGROUND: Plasma lipid and lipoprotein responses have been variable in dietary intervention studies. OBJECTIVE: The objective of this study was to evaluate the effects of the National Cholesterol Education Program's Step I and Step II dietary interventions on major cardiovascular disease risk factors using meta-analysis. DESIGN: MEDLINE was used to select 37 dietary intervention studies in free-living subjects published from 1981 to 1997. RESULTS: Step I and Step II dietary interventions significantly decreased plasma lipids and lipoproteins. Plasma total cholesterol (TC), LDL cholesterol, triacylglycerol, and TC:HDL cholesterol decreased by 0.63 mmol/L (10%), 0.49 mmol/L (12%), 0.17 mmol/L (8%), and 0.50 (10%), respectively, in Step I intervention studies, and by 0.81 mmol/L (13%), 0.65 mmol/L (16%), 0.19 mmol/L (8%), and 0.34 (7%), respectively, in Step II intervention studies (P < 0.01 for all). HDL cholesterol decreased by 7% (P = 0.05) in response to Step II but not to Step I dietary interventions. Positive correlations between changes in dietary total and saturated fatty acids and changes in TC and LDL and HDL cholesterol were observed (r = 0.59, 0.61, and 0.46, respectively; P < 0.001). Multiple regression analyses showed that for every 1% decrease in energy consumed as dietary saturated fatty acid, TC decreased by 0.056 mmol/L and LDL cholesterol by 0.05 mmol/L. Moreover, for every 1-kg decrease in body weight, triacylglycerol decreased by 0.011 mmol/L and HDL cholesterol increased by 0.011 mmol/L. Exercise resulted in greater decreases in TC, LDL cholesterol, and triacylglycerol and prevented the decrease in HDL cholesterol associated with low-fat diets. CONCLUSION: Step I and Step II dietary interventions have multiple beneficial effects on important cardiovascular disease risk factors.     

The Metabolic Effects of Oats Intake in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c) (MD, −0.42%; 95% CI, −0.61% to −0.23%), fasting blood glucose (FBG) (MD, −0.39 mmol/L; 95% CI, −0.58 to −0.19 mmol/L), total cholesterol (TC) (MD, −0.49 mmol/L; 95% CI, −0.86 to −0.12 mmol/L), low-density lipoprotein cholesterol (LDL-C) (MD, −0.29 mmol/L; 95% CI, −0.48 to −0.09 mmol/L). Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required.     

血清总胆固醇水平对大豆蛋白降血脂作用的影响

摘要：目的　探讨血清总胆固醇水平对大豆蛋白降血脂作用的影响。方法　招募单纯高脂血症志愿者９０人
［平均年龄（５１．６５±１０．７８）岁］,随机分为大豆分离蛋白组（狀＝４５）和酪蛋白组（狀＝４５）,在不改变饮食
及运动习惯的基础上,酪蛋白组每人每天补充２４ｇ酪蛋白,大豆分离蛋白组每人每天补充１８ｇ大豆分离蛋
白＋６ｇ酪蛋白混合物,共８周。试验前和试验结束时,测量身高、体质量、计算体质指数,测定血清脂质
水平。以研究对象干预前血清总胆固醇ＴＣ 水平的中位数６．７３ ｍｍｏｌ／Ｌ 作为分界点,分析干预前血清总胆
固醇（ＴＣ）水平低于或高于６．７３ｍｍｏｌ／Ｌ 的高脂血症者血清脂质的变化情况。结果　大豆分离蛋白组和酪
蛋白组血清ＴＣ＜６．７３ｍｍｏｌ／Ｌ 的研究对象干预前后血脂水平变化差异无统计学意义。大豆分离蛋白组血
清ＴＣ≥６．７３ｍｍｏｌ／Ｌ 的研究对象血清ＴＣ、ＬＤＬ Ｃ、ＡｐｏＢ 水平分别比干预前降低７．３％、１１．７％ 和６．４％
（犘＜０．０５）,ＴＣ∶ ＨＤＬ Ｃ,ＬＤＬ Ｃ∶ ＨＤＬ Ｃ,ＡｐｏＢ∶ ＡｐｏＡ１ 比值分别比干预前降低６．６％、９．５％ 和
１１．６％ （犘＜０．０５）。大豆分离蛋白组和酪蛋白组之间血脂水平差异无统计学意义。结论　高脂血症者血清
总胆固醇水平可影响大豆蛋白的降血脂作用,大豆蛋白对血清胆固醇水平较高的人效果较好。
关键词：血清总胆固醇水平;大豆蛋白;血脂
中图分类号：Ｒ１５１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０６ ０５９７ ０４     

Dietary fat saturation affects apolipoprotein AII levels and HDL composition in postmenopausal women.

Increased HDL-cholesterol levels have been associated with lower coronary heart disease (CHD) risk. However, HDL are heterogeneous lipoproteins, and particles enriched in apolipoprotein (Apo) AII have been associated with increased CHD risk. We examined the effect of dietary intervention on HDL composition in 14 postmenopausal women subjected to two consecutive diet periods, i.e., an oleic acid sunflower oil diet followed by a palmolein diet, each lasting 4 wk. The linoleic acid was kept at 4% total energy and the cholesterol intake at 400 mg/d. The palmolein diet increased serum total cholesterol (TC) (P < 0.001), phospholipids (P < 0.001), Apo AII (P < 0.001), HDL cholesterol (P < 0.05), HDL lipids (P < 0.05), HDL proteins (P < 0.01) and the HDL total mass (P < 0.05). The HDL cholesterol/Apo AI ratio was increased 22.0% (P < 0.05), whereas the HDL cholesterol/Apo AII and the Apo AI/Apo AII ratios were decreased 19.4% (P < 0.01) and 30.4%, (P < 0.001), respectively. When the effects of the dietary intervention were examined according to the cholesterolemia status (< or >6.2 mmol/L), the most significant changes (P < 0.001) were related to Apo AII levels. Moreover, a significant dietary oil by cholesterol level interaction was found for Apo AII and the HDL cholesterol/Apo AII ratio. In summary, a palmolein diet increased TC and HDL cholesterol compared with oleic acid sunflower oil diet; however, the increase in Apo AII but not in Apo AI suggests the impairment of reverse cholesterol transport and potentially an increase in CHD risk. This effect was more marked in women with serum TC > 6.2 mmol/L.     

膳食脂肪对高血压人群血脂水平的影响

目的 探讨改善膳食脂肪摄入情况对血脂的影响。方法 对营养健康教育前后高血压患者的膳食脂肪摄入情况及血脂水平进行测定分析。结果 基线调查表明人群膳食脂肪及胆固醇摄入量过高,脂肪供能比占总热能的30％以上;血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL－L）水平偏高。相关分析表明,体质指数（BMI）和饱和脂肪酸（SFA）与血清TC、TG、LDL－C呈正相关;高密度脂蛋白（HDL－C）／TC与BMI、SFA呈负相关,而与单不饱和脂肪酸（MUFA）呈正相关。进行社区营养干预后,干预组脂肪供能比小于总热能的30％,与对照组相比及自身干预前后比较差异均有显著性,胆固醇摄入量有下降趋势;干预组人群血脂TC、LDL－C水平显著降低。结论 研究结果提示减少膳食脂肪和胆固醇摄入量,适当增加单不饱和脂肪酸摄入对高血压人群降低血脂水平,控制血压是有效的。     

Trends in serum total cholesterol and dietary fat intakes in New Zealand between 1989 and 2009

Objective : To describe trends in serum cholesterol and dietary fat intakes for New Zealand adults between 1989 and 2008/09. Methods : Serum total cholesterol concentrations and dietary fat intakes were analysed for 9,346 New Zealanders aged 15–98 years (52% women) who participated in three national surveys in 1989, 1997 and 2008/09. Results : Population mean serum cholesterol decreased from 6.15 mmol/L in 1989 to 5.39 mmol/L in 2008/09. Mean saturated fat intake decreased from 15.9% of energy intake in 1989 to 13.1% in 2008/09. Between 1997 and 2008/09, unsaturated fat intake increased and fat from butter and milk decreased. Older adults had the largest decrease in serum cholesterol (1.35 mmol/L). Conclusions : The decrease in serum cholesterol is substantially larger than reported for many other high‐income countries, and occurred in parallel with changes in dietary fat intakes and, for older adults, increased use of cholesterol‐lowering medications. Implication : Given the demonstrated role of reduced saturated fat intake on lowering serum cholesterol, and as population average serum cholesterol levels and saturated fat intakes exceed recommended levels, initiatives to further encourage reductions in saturated fat are imperative.     

A spread enriched with plant sterol-esters lowers blood cholesterol and lipoproteins without affecting vitamins A and E in normal and hypercholesterolemic Japanese men and women

The objective of the study was to investigate whether different initial baseline cholesterol levels modulate the efficacy of a spread enriched with plant sterol-esters (PS) in lowering blood cholesterol in a Japanese population consuming their usual diet. Healthy adults with a mean age of 45 y and mean plasma total cholesterol (TC) level of 6.5 mmol/L were recruited to participate in a double-blind trial comprised of a run-in period of 1 wk, followed by two intervention periods of 3 wks in a 2 x 2 crossover design and a post-trial follow-up of 3 wk. Volunteers consumed two spreads, one enriched with PS (12 g/100 g plant sterols) and a control spread not fortified with PS. Recommended spread intake was 15 g/d. Effects on plasma lipids, lipoproteins, beta-carotene and vitamins A and E were assessed. Plasma TC and LDL cholesterol (LDL-C) concentrations were 5.8 and 9.1% lower, respectively, when subjects consumed the PS spread than when they consumed the control spread (P < 0.001). Subjects were divided into two groups [normal and mildly cholesterolemic (TC <5.7 mmol/L) and hypercholesterolemic (TC >/= 5.7 mmol/L)]. Reductions (P < 0.001) in TC and LDL-C due to treatment in the former group were 4.9 and 7.9%, respectively. In the hypercholesterolemic group, the reductions (P < 0.001) were 7.1 and 10.6%, respectively. The decreases did not differ between normal/mildly cholesterolemic and hypercholesterolemic subjects. Plasma apolipoprotein B (apoB) and remnant-like particle (RLP) cholesterol (RLP-C) concentrations were lower when subjects consumed the PS spread (44.3 g/L) than the control spread (49.7 g/L). Plasma beta-carotene concentration was lower (P < 0.001) in subjects consuming the PS spread than in the control. Changes in plasma vitamins A and E levels did not differ after intake of the PS and control spreads. In conclusion, consumption of a PS-enriched spread effectively lowered plasma TC, LDL-C, apoB and RLP-C regardless of baseline plasma TC at an intake of 1.8 g/d of plant sterols.     

Relations of lipoprotein lipase gene polymorphism at Pvu II locus and dietary intervention predisposition in hyperlipidemia population]

In order to investigate the relation of lipoprotein lipase (LPL) gene polymorphism at Pvu II locus and dietary intervention predisposition in hyperlipidemia population, 436 hyperlipidemia patients were screened selected from some communities in western urban districts in Beijing, and then separated into two groups, intervention (248) and control group(188). The serum lipids profile, dietary intakes data were collected and physical examination was conducted in all subjects. Also, the LPL-Pvu II polymorphisms were analyzed by PCR-RFLP. The results showed that the total energy intake, cholesterol level and percentage of energy from dietary fat, and the serum levels of TC, LDL-C and HDL-C were significantly decreased (P < 0.05) after 6-month dietary intervention in intervention group compared with the control group. The decrease range of TC and LDL-C in carriers with LPL-Pvu II (+/+) genotype was much more than others(+/- and -/- genotypes). The results from multiple linear regression analysis showed that the susceptible factors of dietary intervention included LPL-Pvu II (+) allele, the high baseline levels of TC and LDL-C and overweight. The conclusions could be primarily drawn that the variants of LPL-Pvu II locus were important determinants of variation in serum cholesterol response to dietary change in hyperlipidemia population.     

Blood cholesterol and lipid-lowering effects of carrageenan on human volunteers

Algal polysaccharides such as carrageenan are good sources of dietary fibre. Previous studies have shown that carrageenan has hypoglycemic effects, but its cholesterol and lipid-lowering effects have yet to be demonstrated. In this study, carrageenan was incorporated into 4 food items, then fed to 20 human volunteers to determine its effects on blood cholesterol and lipid levels. The study followed a randomized crossover design. Each phase of the study--control and experimental--lasted for 8 weeks separated by a 2-week washout. At control, the subjects consumed their usual food intake; at experimental, they were given test foods with carrageenan partly substituting similar items in their usual diet. Fasting venous blood samples were collected immediately before and after each phase to assay serum cholesterol and triglyceride. The mean serum cholesterol was significantly lower (P<0.0014) after the experimental phase at 3.64 mmol/L compared with the mean level after the control phase, 5.44 mmol/L. The mean triglyceride level after the experimental phase, 0.87 mmol/L, was significantly lower (P<0.0006) in comparison to the level after the control phase, 1.28 mmol/L. The mean HDL cholesterol level significantly increased (P<0.0071) after the experimental phase at 1.65 mmol/L compared to the mean value after the control phase, 1.25 mmol/L. No significant differences were observed between the LDL cholesterol levels after the experimental and the control phases. This study indicates that regular inclusion of carrageenan in the diet may result in reduced blood cholesterol and lipid levels in human subjects.     

The effects of zinc supplementation on serum zinc and cholesterol concentrations in hemodialysis patients.

OBJECTIVE: To examine the effect of zinc sulfate supplementation on the concentrations of serum zinc and serum cholesterol in hemodialysis (HD) patients. SETTING: Outpatient dialysis center in a large metropolitan city. DESIGN: Randomized, double-blind, before-after trial. PATIENTS: Twenty-eight maintenance HD patients were selected. Twenty (15 women and 5 men) completed the study. Subjects were identified for inclusion in the study by the following criteria: HD treatment for a minimum of 6 months, no signs of gastrointestinal disorders, and no record of hospitalizations for reasons other than vascular access complications within the last 3 months. INTERVENTIONS: Patients were given a daily supplement of 7.7 micromol zinc sulfate (50 mg elemental zinc) or a cornstarch placebo capsule for 90 days. Patients completed 2-day food records, at day 0 and day 90 of the study, which included 1 dialysis day and 1 nondialysis day. MAIN OUTCOME MEASURE: Fasting, predialysis serum samples were collected on days 0, 40, and 90 to determine serum zinc and total cholesterol (TCHOL) concentrations. Dietary parameters, including zinc, protein, and energy intake, were also analyzed on days 0 and 90. RESULTS: Initial concentrations of serum zinc indicated subjects were below the normal range for serum zinc standards (12 micromol/L [80 microg/dL]). After supplementation, subjects in the zinc-supplemented group showed significant increases in serum zinc concentrations from 0.79 microg/mL at day 0 to 0.96 microg/mL at day 90. Serum TCHOL concentrations were initially low among subjects in the control (2.914 +/- 0.158 mmol/L [112.7 +/- 6.1 mg/dL]) and zinc-supplemented (3.155 +/- 0.354 mmol/L [122.0 +/- 13.7 mg/dL]) groups. Serum TCHOL concentrations in the control group increased slightly throughout the study period but did not reach statistical significance. A progressive increase in serum TCHOL concentration was observed in the zinc-supplemented group from the beginning (3.155 +/- 0.354 mmol/L [122.0 +/- 13.7 mg/dL]) to the end (4.445 +/- 0.478 mmol/L [171.9 +/- 18.5 mg/dL]) of the study (r =.63, P <.05). Mean serum high-density lipoprotein (HDL) cholesterol concentrations for the zinc-supplemented group were 0.959 mmol/L +/- 0.11 (37.1 mg/dL +/- 4.3), 0.825 mmol/L +/- 0.08 (31.9 mg/dL +/- 3.2), and 0.908 mmol/L +/- 0.10 (35.1 mg/dL +/- 3.9) from the beginning to the end of the experimental period. The mean serum HDL cholesterol concentrations for the control group were 0.760 mmol/L +/- 0.075 (29.4 mg/dL +/- 2.9), 0.760 +/- 0.08 (29.4 mg/dL +/- 3.0), and 0.799 mmol/L +/- 0.13 (30.9 mg/dL +/- 4.9) from the beginning to the end of the experimental period. A progressive increase in low-density lipoprotein (LDL) cholesterol concentration was observed for the zinc-supplemented group throughout the study. Mean LDL cholesterol concentrations for the zinc-supplemented group were 2.19 mmol/L +/- 0.39 (85 mg/dL +/- 15.0), 3.30 mmol/L +/- 0.36 (127.8 mg/dL +/- 14.1), and 3.53 mmol/L +/- 0.53 (136.7 mg/dL +/- 20.6) from the beginning to the end of the study period. When serum zinc concentration was correlated with serum LDL cholesterol concentration, a significant correlation was found (r =.62, P <.03) for the zinc-supplemented group and no significant difference was found for the control group. No significant differences in LDL cholesterol concentrations were found within the control group from the beginning to the end of the study. Dietary intake of zinc, cholesterol, total fat, and saturated fat remained constant and did not statistically influence serum values. Reported energy intake increased significantly in the zinc-supplemented group from 5,799 kJ/24 h (1,385 kcal/d) at day 0 to 7,042 kJ/24 h (1,682 kcal/d) at day 90. CONCLUSION: Zinc supplementation is an effective means of improving serum levels of zinc and cholesterol in the HD patient.     

Meta-analysis of the effects of soy protein containing isoflavones on the lipid profile

BACKGROUND: Convincing evidence shows that soy protein intake has beneficial effects on lipid changes, but it is unclear which components of soy protein are responsible. OBJECTIVE: We conducted a meta-analysis to identify and quantify the effects of soy protein containing isoflavones on the lipid profile. DESIGN: Twenty-three eligible randomized controlled trials published from 1995 to 2002 were identified from the PUBMED database (National Library of Medicine, Bethesda, MD). Weighted mean effect sizes were calculated for net changes in serum lipid concentrations by using fixed-effect or random-effect models. Pre-specified subgroup analyses were performed to explore the influence of covariates on net lipid change. RESULTS: Soy protein with isoflavones intact was associated with significant decreases in serum total cholesterol (by 0.22 mmol/L, or 3.77%), LDL cholesterol (by 0.21 mmol/L, or 5.25%), and triacylglycerols (by 0.10 mmol/L, or 7.27%) and significant increases in serum HDL cholesterol (by 0.04 mmol/L, or 3.03%). The reductions in total and LDL cholesterol were larger in men than in women. Initial total cholesterol concentrations had a powerful effect on changes in total and HDL cholesterol, especially in subjects with hypercholesterolemia. Studies with intakes >80 mg showed better effects on the lipid profile. The strongest lowering effects of soy protein containing isoflavones on total cholesterol, LDL cholesterol, and triacylglycerol occurred within the short initial period of intervention, whereas improvements in HDL cholesterol were only observed in studies of >12 wk duration. Tablets containing extracted soy isoflavones did not have a significant effect on total cholesterol reduction. CONCLUSIONS: Soy protein containing isoflavones significantly reduced serum total cholesterol, LDL cholesterol, and triacylglycerol and significantly increased HDL cholesterol, but the changes were related to the level and duration of intake and the sex and initial serum lipid concentrations of the subjects.     

以健康食堂为载体的营养健康促进模式的干预效果评价

目的 评价以健康食堂为载体的营养健康促进模式的干预效果,为向其他单位食堂推广应用提供科学依据.方法 于2012年选择江苏省常州市1所创建健康食堂大学的429名教职工为干预组,另1所未采取任何干预措施的947名大学教职工为对照组,此外,干预组进一步按是否经常在食堂就餐分为经常食堂就餐组（≥2次/周）和偶尔食堂就餐组（＜2次/周）;分别在干预前、后（1年）测定血压、体质指数（BMI）,检查脂肪肝发生情况,测定血清中的葡萄糖、总胆固醇、三酰甘油、尿酸、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇;分别进行干预组和对照组间干预前后的对比,并进一步进行干预后干预组中经常食堂就餐组和偶尔食堂就餐组间的对比分析以评价其干预效果.结果干预组干预后的血糖（5.06±0.62） mmol/L、血尿酸（310.57±71.79） μmol/L、血总胆固醇（4.88 ±0.86） mmol/L、血三酰甘油（1.39±0.67）mmol/L及血低密度脂蛋白胆固醇（2.51 ±0.62） mmol/L均显著低于干预前,血高密度脂蛋白胆固醇（1.43 ±0.34） mmol/L显著高于干预前,差异均有统计学意义（t=7.513、2.126、2.062、3.731、8.891、-2.309,P＜0.05）;而对照组干预后的血糖和血尿酸均显著高于干预前,差异有统计学意义（t=-3.491、-7.703,P＜0.01）,血总胆固醇、血三酰甘油、血高密度脂蛋白胆固醇及血低密度脂蛋白胆固醇干预前后差异均无统计学意义（P＞0.05）.干预组干预后的血糖、血尿酸、血总胆固醇、血三酰甘油、血低密度脂蛋白胆固醇、BMI的异常率及高血压发生率均显著低于干预前,差异均有统计学意义（x2=4.202、3.940、4.031、7.305、59.422、4.273、7.385,P＜0.05）;而对照组除干预后血尿酸异常率和脂肪肝发生率均显著高于干预前,差异有统计学意义（x2=23.740、7.408,P＜0.05）外,干预后的血糖、血总胆固醇、血三酰甘油、血低密?     

男性青年饮用牛奶和豆浆后血脂血糖变化的研究

目的研究饮用牛奶或豆浆后健康男性青年血脂血糖的变化情况。方法 30名男性健康大学生随机分入牛奶组、豆浆组和纯净水组,每天饮用相应饮品1L,连续饮用4周。测定干预前后血浆中甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、葡萄糖(GLU)水平的变化。结果干预后牛奶组的LDL-C水平从(2.28±0.33)mmol/L下降至(1.95±0.41)mmol/L(P﹤0.05),豆浆组从(2.23±0.27)mmol/L下降至(1.94±0.37)mmol/L(P﹤0.05)。与纯净水对照组比较,牛奶组和豆浆组降LDL-C作用更为明显(P﹤0.01)。另外豆浆组的TG水平也明显降低(P﹤0.05)。各组的TC、GLU水平未见明显变化。结论饮用牛奶或豆浆对血糖没有明显影响但有一定降血脂作用,可以预防动脉粥样硬化等心血管疾病。     

膳食脂质对中老年高胆固醇血症患者血清胆固醇的影响

对１６７名中老年高胆固醇血症患者的膳食脂质摄入情况及血清总胆固醇（ＴＣ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）和低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）水平进行分析测定,结果表明：膳食脂质摄入及身体质量指数（ＢＭＩ）对血清胆固醇水平有重要影响;ＢＭＩ、膳食胆固醇和饱和脂肪酸与ＴＣ和ＬＤＬ－Ｃ水平呈正关联,ＨＤＬ－Ｃ及其与ＴＣ的比值与单不饱和脂肪酸呈正关联,而与ＢＭＩ呈负关联,提示减少膳食胆固醇和饱和脂肪摄入、     

脂蛋白脂酶基因PvuⅡ位点多态性与高脂血症人群膳食干预易感性的关系

为了解脂蛋白脂酶 (LPL)基因PvuⅡ位点多态性与高脂血症人群膳食干预效果的关系 ,从北京市西城区 8个社区居民中筛出 43 6名高脂血症患者 ,分为干预组 (2 48人 )和对照组 (188人 ) ;对两组人群进行血脂谱水平检测、膳食调查、体格检查及LPL基因PvuⅡ位点多态性检测 (PCR RFLP方法 ) ,并对干预组进行为期 6个月的膳食干预。结果表明与对照组相比 ,干预组膳食总能量、脂肪供能比及胆固醇摄入量明显降低 ,血清TC、LDL C和HDL C水平明显下降 (P <0 0 5 ) ,且LPL PvuⅡ位点 (+ +)基因型携带者TC和LDL C水平降低幅度大于 (+ - )及 (- - )基因型 ;多元线性回归分析显示膳食干预易感的因素包括LPL(+)等位基因、基限TC、LDL C水平较高以及超重等。本研究可初步得出LPL基因PvuⅡ位点 (+)等位基因与高脂血症人群膳食干预易感性密切相关 ,但限于研究对象的代表性该结论还需要进一步研究支持