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。     

妊娠期糖尿病孕妇膳食脂肪摄入与血脂及糖尿病发病相关性分析

目的分析妊娠期糖尿病(GDM)孕妇膳食脂肪摄入情况与血脂及GDM发病的相关性,为孕妇膳食的合理搭配和GDM的预防提供参考依据。方法选取2015年3月-2017年3月在该院就诊的224例GDM孕妇为研究组,另选取同时期在该院产检的224例正常孕妇为对照组。采取24 h膳食回顾调查法和食物频度法分别比较两组孕妇孕期增重及三大营养素摄入情况;比较两组孕妇膳食脂肪中各类脂肪酸摄入情况及血脂相关指标。结果研究组孕期增重、脂肪摄入量、饱和脂肪酸(SFA)摄入量均显著高于对照组(均P0.05);研究组单不饱和脂肪酸(MUFA)供能比、多不饱和脂肪酸(PUFA)供能比与对照组相比显著降低(P0.05);研究组血清总胆固醇(5.94±1.53)mmol/L、三酰甘油(2.36±1.01)mmol/L、游离脂肪酸(1.14±0.57)mmol/L、低密度脂蛋白胆固醇(LDL-C)为(3.29±0.86)mmol/L,对照组同类指标分别为(5.02±0.96)mmol/L、(1.71±0.65)mmol/L、(0.83±0.39)mmol/L、(2.52±0.54)mmol/L,两组各指标相比,研究组显著高于对照组(均P0.05);研究组总胆固醇、游离脂肪酸、LDL-C水平与SFA摄入量及供能比、MUFA摄入量呈正相关;GDM发病率与SFA摄入量呈正相关,与不饱和脂肪酸供能比呈负相关。结论 SFA高摄入是GDM发病的危险因素,较高的不饱和脂肪酸供能比有利于GDM的改善。     

高胆固醇血症患者膳食脂肪摄入与血脂变化的相关性研究

目的 研究高胆固醇血症患者膳食脂肪摄入与血脂变化之间的关系.方法 筛查739名志愿者后,纳入297例血清总胆固醇(TC)5.13 mmol/L的广州市民,随访6个月,采用连续3 d的24 h膳食回顾法及食用油种类及用量记录表调查研究对象膳食摄入情况,并测定研究对象在研究起始和结束时的血脂水平,分析不同膳食脂肪供能比及脂肪酸供能比与血脂变化的关系.结果 纳入研究对象297例,其中281例(男88例,女193例)完成6个月的研究,研究起始时对象的TC为(6.09±0.68)mmot/L.将研究对象按照总脂供能比,分为<25%(90例),25%～30%(97例),30%(94例)3组,总脂供能比≤30%的Ⅰ组及Ⅱ组TC、低密度脂蛋白胆固醇(LDL-C)降低率大于总脂供能比30%的Ⅲ组.将研究对象按照饱和脂肪酸(SFA)供能比分为<7%(81例),7%～10%(129例),10%(71例)3组,SFA供能比≤10%的Ⅰ组和Ⅱ组TC、LDL-C降低率大于SFA供能比10%的Ⅲ组.将研究对象按照单不饱和脂肪酸(MUFA)供能比分为<10%(93例),10%～13%(106例),13%(82例)3组,MUFA供能比为10%～13%的Ⅱ组,代和LDL-C降低率大于另外两组.将研究对象按照多不饱和脂肪酸(PUFA)供能比分为<7%(88例),7%～9%(94例),9%(99例)3组,未发现3组间血脂降低率差异有统计学意义.结论 对于血脂异常患者,总脂供能比≤30%,SFA供能比≤10%,MUFA供能比在10%～13%的范围有利于改善其血脂水平.     

非肥胖型妊娠期糖尿病孕妇膳食脂肪摄入分析及其影响

目的:分析非肥胖型妊娠期糖尿病(GDM)孕妇膳食脂肪摄入情况,了解其对血脂和糖尿病发病的影响。方法:以2010年1月~2013年1月在该院产科门诊确诊的GDM患者133例为病例组;以年龄、孕周作为频数匹配因素,选取同一时期产检的正常孕妇110例作为对照组,采用24 h回顾性膳食调查(3天),分析两组孕妇膳食结构,比较两组的孕期增重和血脂水平。结果:病例组在孕24~28周较孕前平均增重(9.38±4.02)kg,高于对照组〔(6.48±3.84)kg〕,两组比较,差异有统计学意义(t=-4.26,P<0.001);病例组平均每日总能量、蛋白质、脂肪和碳水化合物的摄入量明显升高;病例组孕妇平均每日饱和脂肪酸摄入量为(15.73±7.75)g,明显高于对照组〔(12.53±4.44)g〕,两组比较,差异有统计学意义(t=-4.02,P<0.001);病例组单不饱和脂肪酸供能比为(12.65±3.23)%、多不饱和脂肪酸供能比为(10.47±2.90)%,均低于对照组〔(13.47±3.23)%,(11.95±3.21)%〕,两组比较,差异有统计学意义(t=1.98,3.77,P均<0.05);病例组血清胆固醇〔(6.89±1.42)mmol/L〕、甘油三酯〔(3.21±1.14)mmol/L〕、低密度脂蛋白胆固醇〔(3.08±0.83)mmol/L〕、游离脂肪酸〔(1.02±0.46)mmol/L〕均高于对照组孕妇〔(6.00±0.92)mmol/L、(2.30±0.68)mmol/L、(2.67±0.61)mmol/L、(0.88±0.35)mmol/L〕,两组比较,差异有统计学意义(P<0.001);病例组平均每天饱和脂肪酸摄入量对血清游离脂肪酸、胆固醇、低密度脂蛋白胆固醇水平影响最大,呈正相关;随着饱和脂肪酸摄入量增加,患GDM的可能性增加(β=1.14,OR=3.14,95%CI=1.80~5.47,P<0.001),而随着单不饱和脂肪酸供能比和多不饱和脂肪酸供能比的增加,患GDM的可能性减小(β=-0.67,OR=0.51,95%CI=0.29~0.85,P=0.016;β=-0.55,OR=0.58,95%CI=0.35~0.95,P=0.031)。结论:非肥胖型GDM孕妇孕期膳食中脂肪摄入的不合理性表现为脂肪的摄入量、脂肪供能比、饱和脂肪酸摄入量增多,单不饱和脂肪酸供能比和多不饱和脂肪酸供能比减少,直接导致了孕期体重增加过多和血脂水平升高,从而导致了GDM的发生。饱和脂肪酸摄入量是GDM的危险因素,而单不饱和脂肪酸供能比和多不饱和脂肪酸供能比则是GDM的保护因素。     

北京市区儿童血脂谱水平及其影响因素研究

目的:为从儿童期开始进行心脑血管病的早期预防提供基础资料.方法:对北京市城区315名7～11岁儿童进行血脂谱水平测定及其影响因素调查.结果:TC、TG、LDL-C、HDL-C、apoB、apoAI、Lp(a)水平(-x±s)依次为4.17±0.70、0.87±0.37、2.19±0.59、1.46±0.29(单位均为mmol/L)和1 377.2±142.6、692.2±150.4、193.3±205.6(单位均为mg/L);TC、LDL-C的正常参考值范围分别为(3.11～5.35)mmol/L和(1.34～3.21)mmol/L.超重、血压偏高、心血管病家庭史等因素均对儿童血脂谱水平有较大影响;多因素分析表明,TC、LDL-C、apoB水平与皮褶厚度、超重度、血压、膳食中脂肪供能比、胆固醇及饱和脂肪酸摄入量均呈正相关;而HDL-C、apoAI水平与体脂指标呈负相关.结论:体重和收缩压是影响血脂谱水平的两个显著因素.     

北京市8个社区高脂血症膳食干预效果分析

为探讨以社区为基础的高脂血症膳食干预效果 ,在高脂血症筛查的基础上 ,从北京市新街口等 8个社区随机抽取 180名高脂血症患者和血脂偏高者 ,按所在社区分为试验组和对照组。试验组进行膳食干预 ,随访 6个月 ,于干预前后分别进行膳食调查 (72小时回顾法 )、体格检查和血脂指标检测。经过干预 ,试验组能量摄入减少 13 2 % ,脂肪摄入减少 2 4 75 % ,胆固醇减少 2 4 4% ,烹调用油减少 2 2 43% ,降低幅度明显大于对照组 (P <0 0 5 ) ;三大营养素供能比例趋向合理 ;试验组体重降低 0 17% ,体质指数降低 0 6 7% ,腰臀比降低 3 37% ,其中体重和体质指数的变化相比对照组差异具有显著性 (P <0 0 5 )。试验组血清总胆固醇、低密度脂蛋白胆固醇分别降低 0 2 9mmol L(5 6 1% ,P <0 0 5 )和 0 2 5mmol L(7 0 6 % ,P <0 0 5 ) ,而对照组无明显变化。结果提示 ,以社区为基础的膳食干预可以有效地改善高脂血症患者的膳食结构 ,控制体重 ,降低血清总胆固醇和低密度脂蛋白胆固醇水平     

北京市儿童血脂谱水平及其影响因素研究

目的为从儿童期开始进行心脑血管病的早期预防提供基础资料.方法对北京市城区315名7～11岁儿童进行血脂谱水平测定及其影响因素调查.结果TC、TG、LDL-C、HDL-C、apoB、apoAI、Lp(a)水平(-x±s)依次为4.17±0.70、0.87±0.37、2.19±0.59、1.46±0.29(单位均为mmol/L)和1 377.2±142.6、692.2±150.4、193.3±205.6(单位均为mg/L);TC、LDL-C的正常参考值范围分别为(3.11～5.35)mmol/L和(1.34～3.21)mmol/L.超重、血压偏高、心血管病家庭史等因素均对儿童血脂谱水平有较大影响;多因素分析表明,TC、LDL-C、apoB水平与皮褶厚度、超重度、血压、膳食中脂肪供能比、胆固醇及饱和脂肪酸摄入量均呈正相关;而HDL-C、apoAI水平与体脂指标呈负相关.结论体重和收缩压是影响血脂谱水平的两个显著因素.     

广州市区2～6岁健康儿童及心血管病家族史儿童血脂水平分析

目的①调查广州市区2～6岁健康散居儿童血脂的正常参考值、临界值、危险值;②调查2 -6岁健康散居儿童高血脂症发生率;③心血管病家族史对儿童血脂的影响。方法对1541例广州市区2—6 岁健康散居儿童空腹12小时以上抽取静脉血,检测其血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。结果 2～6岁健康散居儿童的TC、TG、LDL—C正常值(百分位法)分别为<4．56 mmol／L、<1．00 mmol／L、<2．74 mmol／L,危险值分别为>5．36 mmol／L、>1．43 mmol／L、 >3．30mmol／L;血脂异常的总检出率为7．75％;心血管家族史阳性的儿童的血脂TC、HDL-C、LDL—C与正常儿童比较有显著差别(P<0．01)。结论冠心病、动脉粥样硬化的危险因素——血脂异常早在2—6岁健康儿童中已存在一定比例,应早期进行血脂筛查和饮食干预,小儿高脂血症应早期预防。     

广州40～65岁居民膳食脂肪酸构成与血脂关系的研究

目的:分析广州中老年人膳食脂肪和脂肪酸构成(饱和脂肪酸:单不饱和脂肪酸:多不饱和脂肪酸,SFA:MUFA:PUFA,S:M:P)与血脂的关系。方法:招募40~65岁广州市民,用食物模具量化的食物频数问卷和三日膳食回顾调查对象每日摄入食物种类和数量,计算能量和营养素摄入量。结果:(1)188名男性,367名女性进入本研究。男女能量摄入分别为9.7±2.24和8.48±2.04MJ/d,脂肪供能比分别为28.3%±7.2%和30.4%±6.1%,S:M:P分别为1:1.5:0.9和1:1.5:1.1。(2)脂肪供能比≤30%(n=333)者总胆固醇(TC)、低密度脂蛋白(LDL)、甘油三酯(TG)水平均显著低于脂肪供能比>30%(n=222)者。(3)脂肪供能20%~30%时,不同S:M:P三组间的血脂水平无差异。(4)脂肪供能比30%~45%时,S:M:P为1:1.5:1的Ⅱ组TC、LDL水平均显著低于S:M:P为1:1.2:0.7的Ⅰ组和1:1.8:1.4的Ⅲ组。结论:与脂肪供能比>30%的膳食相比,脂肪供能比≤30%的膳食更有利于维持血脂正常;脂肪供能比≤30%时,不同S:M:P可能对血脂没有显著影响;而脂肪供能比为30%~45%,S:M:P为1:1.5:1的膳食比1:1.2:0.7和1:1.8:1.4的膳食更有利于维持血脂正常。     

北京市区儿童营养状况与血脂谱水平相关性分析

目的 :　了解儿童营养状况与血脂谱水平的相关性。方法 :　对北京市朝阳区 3 1 6名7～ 1 1岁儿童进行血脂谱水平检测、膳食调查及体格检测。结果 :　儿童脂肪供能比为 3 6.2 1 % ,超出标准上限 (2 5 %～ 3 0 % ) ,60 .1 %儿童每日胆固醇摄入量≥ 3 0 0 mg;儿童每日胆固醇摄入量与TC、apo B水平呈正相关 ,糖类供能比与 HDL-C水平正相关 ;高胆固醇摄入组儿童 TC、LDL-C、apoAI水平大于低胆固醇组 ;超重 /肥胖儿童 TC、TG、LDL-C、apo B、Lp(a)水平高于体重正常组及体重不足组 ,并随肥胖程度的增加而增加 ;男童腰臀围比与 TC、TG、LDL-C、apo B水平正相关 ,与HDL-C负相关。结论 :　超重 /肥胖 (尤其向心性肥胖 )、不合理膳食与儿童血脂异常关系密切 ,可以作为早期诊断血脂异常高危儿童的指标     

Development and validation of an instrument to assess child dietary fat intake

BACKGROUND: brief dietary assessment instrument to assess dietary intakes of total fat, saturated fatty acids (SFA), and cholesterol in young children was developed and validated. METHODS: Young children and their parent or primary caretaker were recruited from a general primary care health center and local Head Start programs. Dietary records, entered and analyzed using the Minnesota Nutrition Data System, were used to calculate children's mean dietary intakes. Stepwise linear regression analysis was used to select questionnaire items that best predicted total fat, SFA, and dietary cholesterol intakes. RESULTS: This yielded a 17-item Child Dietary Fat Questionnaire (CDFQ); 9 questions correlated with total fat intake (r = 0.68, P < 0.0001); 15 questions correlated with SFA intake (r = 0.75, P < 0.0001); and 4 questions correlated with dietary cholesterol intake (r = 0.57, P < 0.0001). The test-retest reliabilities of the CDFQ in predicting children's dietary intakes of total fat, SFA, and cholesterol were 0.41, 0.66, and 0.64, respectively. The criterion-based validity of the CDFQ, evaluated against 4 days of dietary records, yielded correlations of 0.54 (P < 0.0001) for total fat, 0.36 (P < 0.01) for SFA, and 0.55 (P < 0. 0001) for dietary cholesterol intake. CONCLUSIONS: The 17-item CDFQ is a brief, easy-to-use dietary assessment instrument that could be used to identify children with high, as well as low, dietary intakes of total fat, SFA, and/or cholesterol.     

Nutrient intakes and cholesterol values of the parents in a prospective randomized child-targeted coronary heart disease risk factor intervention trial--the STRIP project.

OBJECTIVE: To analyze food consumption, nutrient intakes and serum cholesterol concentrations of the parents in a child-targeted CHD intervention trial, during which the age of children increased from 7 months to 5 y. DESIGN AND SUBJECTS: The children were randomized to an intervention group (n = 540) or a control group (n = 522) at six months of age. The intervention families were counseled at 3-6 month intervals to reduce their child's intake of saturated fat and cholesterol. Dietary issues were discussed with the control families only briefly. The parents' food consumption was analyzed by 24 h dietary recall at the child's age of 7 and 13 months and at 2, 3, 4, and 5 y. Nutrient intakes were calculated using the Micro-Nutrica program. RESULTS: The mothers and fathers of the intervention children used less butter, more margarine and more skim milk than those of the control children (P < 0.001 for all measurements). After the onset of counseling, the intervention mothers consumed continuously less fat (1.4 E% less at the child's age of 5 y), less saturated fat (1.5 E% less at the child's age of 5 y) and more polyunsaturated fat (0.5 E% more at the child's age of 5 y) than the control mothers (P = 0.008, P < 0.001 and P < 0.001 for trend, respectively). After the child's age of 13 months the intervention fathers also had a continuously lower fat intake (2.4 E% less at the child's age of 5 y) and consumed less saturated fat (1.5 E% less at the child's age of 5 y) than the control fathers (P < 0.001 for trend for both measurements). The serum cholesterol concentration of the intervention mothers was consistently lower than that of the control mothers during the intervention (at child's age of 5 y 4.86 and 5.09 mmol/L, respectively; P for trend = 0.03), while the values of the intervention and control fathers showed no differences. CONCLUSIONS: Continuous dietary intervention begun in infancy and focused on modification of the child's diet according to the current principles of preventive cardiology, was accompanied by a moderate decrease in the intake of total and saturated fat in the parents, but serum cholesterol concentration diminished consistently only in the mothers of the intervention children.     

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?     

Effect of an increased intake of alpha-linolenic acid and group nutritional education on cardiovascular risk factors: the Mediterranean Alpha-linolenic Enriched Groningen Dietary Intervention (MARGARIN) study

BACKGROUND: The effect of long-term increased intakes of alpha-linolenic acid (ALA; 18:3n-3) on cardiovascular risk factors is unknown. OBJECTIVES: Our objectives were to assess the effect of increased ALA intakes on cardiovascular risk factors and the estimated risk of ischemic heart disease (IHD) at 2 y and the effect of nutritional education on dietary habits. DESIGN: Subjects with multiple cardiovascular risk factors (124 men and 158 women) were randomly assigned in a double-blind fashion to consume a margarine rich in either ALA [46% linoleic acid (LA; 18:2n-6) and 15% ALA; n = 114] or LA (58% LA and 0.3% ALA; n = 168). An intervention group (n = 110; 50% ALA) obtained group nutritional education, and a control group (n = 172; 34% ALA) received a posted leaflet containing the standard Dutch dietary guidelines. RESULTS: Average ALA intakes were 6.3 and 1.0 g/d in the ALA and LA groups, respectively. After 2 y, the ALA group had a higher ratio of total to HDL cholesterol (+0.34; 95% CI: 0.12, 0.56), lower HDL cholesterol (-0.05 mmol/L; -0.10, 0), higher serum triacylglycerol (+0.24 mmol/L; 0.02, 0.46), and lower plasma fibrinogen (-0.18 g/L; -0.31, -0.04; after 1 y) than did the LA group (adjusted for baseline values, sex, and lipid-lowering drugs). No significant difference existed in 10-y estimated IHD risk. After 2 y, the intervention group had lower saturated fat intakes and higher fish intakes than did the control group. CONCLUSIONS: Increased ALA intakes decrease the estimated IHD risk to an extent similar to that found with increased LA intakes. Group nutritional education can effectively increase fish intake.     

Effect of low-saturated fat, low-cholesterol dietary intervention on fatty acid compositions in serum lipid fractions in 5-year-old children. The STRIP project

OBJECTIVE: To evaluate the effect of dietary low-saturated fat, low-cholesterol intervention on fat intake and fatty acid compositions in serum cholesterol ester (CE), phospholipid (PL) and triglyceride (TG) fractions in five-year-old children. DESIGN AND SUBJECTS: The STRIP project is a prospective, randomised intervention project in which 1062 seven-month-old infants were recruited from the well-baby clinics. 764 children participated in the 5-year follow-up; 202 of them were randomly selected for this study. Diet was assessed with 4-d dietary records. Serum CE, PL and TG fatty acid compositions were analysed with gas-liquid chromatography. RESULTS: Saturated fat intake of intervention children (mean (confidence interval)) (girls 11.9 (11.2-12.6) % of energy intake (E%); boys 12.5 (11.9-13.1)) was lower than that of the control children (girls 14.4 (13.7-15.2) E%; boys 15.0 (14.3-15. 8) E%) (P=0.0001 for the difference between intervention and control groups). The intake of unsaturated fat differed only slightly. Dietary ratios of polyunsaturated to saturated fatty acids (PS ratios) of the intervention and control diets were 0.44 and 0.33, respectively (P=0.0001). Furthermore, serum cholesterol concentrations of the intervention and control children differed (4. 28 (4.13-4.43) mmol/L vs 4.49 (4.35-4.63) mmol/L; P=0.04). Relative proportion of saturated fatty acids in serum TG was lower (34.9% vs 36.3%; P=0.04) and that of n-6 polyunsaturated fatty acids higher (13.9% vs 12.4%; P=0.0004) in the intervention than in the control children, whereas serum CE and PL fatty acid compositions of intervention and control groups were closely similar. However, intake of linoleic acid correlated better with serum linoleic acid relative content in the CE fraction (r=0.36; P=0.0001) than in the PL (r=0.27; P=0.0002) or in the TG (r=0.23; P=0.0016) fraction. CONCLUSIONS: Intervention resulted in decreased intake of saturated fatty acids and lowered serum total and LDL cholesterol concentrations. Of serum lipid fractions, TG fatty acid composition was the most sensitive and parallelled the findings in dietary food records.     

A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women

Epidemiologic studies and clinical trials have demonstrated that the unique fatty acid profile of nuts beneficially affects serum lipids/lipoproteins, reducing cardiovascular disease (CVD) risk. Nuts are low in SFA and high in PUFA and monounsaturated fatty acids (MUFA). Macadamia nuts are a rich source of MUFA. A randomized, crossover, controlled feeding study (5-wk diet periods) compared a Macadamia nut-rich diet [42.5 g (1.5 ounces)/8.79 MJ (2100 kcal)] [MAC; 33% total fat (7% SFA, 18% MUFA, 5% PUFA)] vs. an average American diet [AAD; 33% total fat (13% SFA, 11% MUFA, 5% PUFA)] on the lipid/lipoprotein profile of mildly hypercholesterolemic (n = 25; 15 female, 10 male) subjects. Serum concentrations of total cholesterol (TC) and LDL cholesterol (LDL-C) following the MAC (4.94 +/- 0.17 mmol/L, 3.14 +/- 0.14 mmol/L) were lower than the AAD (5.45 +/- 0.17 mmol/L, 3.44 +/- 0.14 mmol/L; P < 0.05). The serum non-HDL cholesterol (HDL-C) concentration and the ratios of TC:HDL-C and LDL-C:HDL-C were reduced following consumption of the MAC diet (3.83 +/- 0.17, 4.60 +/- 0.24, and 2.91 +/- 0.17, respectively) compared with the AAD (4.26 +/- 0.17, 4.89 +/- 0.24, and 3.09 +/- 0.18, respectively; P < 0.05). There was no change in serum triglyceride concentration. Thus, macadamia nuts can be included in a heart-healthy dietary pattern that reduces lipid/lipoprotein CVD risk factors. Nuts as an isocaloric substitute for high SFA foods increase the proportion of unsaturated fatty acids and decrease SFA, thereby lowering CVD risk.     

Effects on serum lipids of adding instant oats to usual American diets.

This study was designed as a test of the serum lipid response and dietary adaptation to recommended daily inclusion of instant oats in an otherwise regular diet. Hypercholesterolemic adults were randomly assigned to a control or intervention group. Participants in the intervention group were given packages of instant oats and requested to eat two servings per day (approximately two ounces dry weight), substituting the oats for other carbohydrate foods in order to maintain baseline calorie intake and keep weight stable. Serum lipids were measured in blood collected by venipuncture at baseline, four weeks, and eight weeks. Baseline mean total cholesterol (TC) levels were 6.56 mmol/L and 6.39 mmol/L for intervention and control groups, respectively. After eight weeks, mean serum total cholesterol of the intervention group was lower by -0.40 mmol/L, and mean net difference in TC between the two groups was 0.32 mmol/L (95% CI: 0.09, 0.54). Low-density lipoprotein-cholesterol was similarly reduced with mean net difference of 0.25 mmol/L (95% CI: 0.02, 0.48) between the two groups. Mean soluble fiber intake increased along with slight self-imposed reductions in mean total fat, saturated fat, and dietary cholesterol intake in the intervention group. Neither group changed mean body weight. Daily inclusion of two ounces of oats appeared to facilitate reduction of serum total cholesterol and LDL-C in these hyperlipidemic individuals.     

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.     

Can dietary interventions change diet and cardiovascular risk factors? A meta-analysis of randomized controlled trials.

OBJECTIVES: This study evaluated the effectiveness of dietary advice in primary prevention of chronic disease. METHODS: A meta-analysis was conducted of 17 randomized controlled trials of dietary behavior interventions of at least 3 months' duration. Results were analyzed as changes in reported dietary fat intakes and biomedical measures (serum cholesterol, urinary sodium, systolic and diastolic blood pressure) in the intervention group minus changes in the control group at 3 to 6 months and 9 to 18 months of follow-up. RESULTS: After 3 to 6 months, mean net changes in each of the five outcomes favored intervention. For dietary fat as a percentage of food energy, the change was -2.5% (95% confidence interval [CI] = -3.9%, -1.1%). Mean net changes over 9 to 18 months were as follows: serum cholesterol, -0.22 (95% CI = -0.39, -0.05) mmol/L; urinary sodium, -45.0 (95% CI = -57.1, -32.8) mmol/24 hours; systolic blood pressure, -1.9 (95% CI = -3.0, 0.8) mm Hg; and diastolic blood pressure, -1.2 (95% CI = -2.6, 0.2) mm Hg. CONCLUSIONS: Individual dietary interventions in primary prevention can achieve modest improvements in diet and cardiovascular disease risk status that are maintained for 9 to 18 months.     

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.