Multilevel Understanding of the Impact of Individual- and School-Level Determinants on Lipid Profiles in Adolescents: The Cross-Level Interaction of Food Environment and Body Mass Index

Adolescents with comparable personal risk factors may have different lipid profiles because of the school’s context. Lipid determinants in adolescents should be considered using a multilevel perspective. This multilevel study investigated the effects of individual-level and school-level factors on lipid profiles in adolescents and evaluated the cross-level influence of lipid determinants. A representative adolescent cohort (n = 2727) was randomly selected from 36 schools in three diverse economic areas in Taiwan and assessed for their personal dietary patterns, physical parameters, and lipid profiles. For individual-level factors, both low physical activity and high body mass index (BMI) were associated with elevated triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) levels, and a sugar-sweetened beverage intake of >500 mL/day was associated with increases of 5.97 and 6.12 mg/dL in LDL-C and TC levels, respectively, compared with abstinence. Regarding school-level factors, students in schools with ≥2 health promotion programs per year had a 5.27 mg/dL lower level of LDL-C than those in schools with 0–1 program, and students in schools with ≥46 food outlets within 600 m of the school had 6.90 and 13.3 mg/dL higher levels of TG and TC, respectively, than those in schools with <46 food outlets. School context modified the individual-level positive correlation between BMI and TG level (the p-value for the random-slope effect was 0.003). In conclusion, individual-level and school-level factors exert a multilevel effect on adolescent lipid profiles. The food environment near the school has a stronger cross-level impact on individual TG levels in adolescents with a high BMI than in those with a normal BMI.     

Alterations in lipid profile of autistic boys: a case control study

We hypothesize that autism is associated with alterations in the plasma lipid profile and that some lipid fractions in autistic boys may be significantly different than those of healthy boys. A matched case control study was conducted with 29 autistic boys (mean age, 10.1 ± 1.3 years) recruited from a school for disabled children and 29 comparable healthy boys from a neighboring elementary school in South Korea. Fasting plasma total cholesterol (T-Chol), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), the LDL/HDL ratio, and 1-day food intakes were measured. Multiple regression analyses were performed to assess the association between autism and various lipid fractions. The mean TG level (102.4 ± 52.4 vs 70.6 ± 36.3; P = .01) was significantly higher, whereas the mean HDL-C level (48.8 ± 11.9 vs 60.5 ± 10.9 mg/dL; P = .003) was significantly lower in cases as compared to controls. There was no significant difference in T-Chol and LDL-C levels between cases and controls. The LDL/HDL ratio was significantly higher in cases as compared to controls. Multiple regression analyses indicated that autism was significantly associated with plasma TG (β = 31.7 ± 11.9; P = .01), HDL (β = −11.6 ± 2.1; P = .0003), and the LDL/HDL ratio (β = 0.40 ± 0.18; P = .04). There was a significant interaction between autism and TG level in relation to plasma HDL level (P = .02). Fifty-three percent of variation in the plasma HDL was explained by autism, plasma TG, LDL/HDL ratio, and the interaction between autism and plasma TG level. These results indicate the presence of dyslipidemia in boys with autism and suggest a possibility that dyslipidemia might be a marker of association between lipid metabolism and autism.     

Dietary fat intake and lipid profiles of Iranian adolescents: Isfahan Healthy Heart Program--Heart Health Promotion from Childhood

OBJECTIVES: To assess the serum lipid profiles of Iranian adolescents and their correlation with dietary fat intake and to evaluate the knowledge, attitude, and practice (KAP) of students, parents, and school staff. METHODS: The subjects of this cross-sectional study were 2000 students (1000 girls and 1000 boys), ages 11-18 years, selected by multistage random sampling, and one of their parents (2000 subjects), as well as 500 school staff in urban and rural areas of two provinces in Iran (one for further interventions and the other for reference). The data were obtained by questionnaires, anthropometric measurements, 3-day food record form, and a 20-item food frequency questionnaire (FFQ). All serum lipids were determined in the same laboratory. RESULTS: Although the percentage of fat intake (21.2 +/- 0.4%) among the adolescents was within the recommended daily allowance (RDA < or = 30%), in most cases, the percentiles of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were significantly higher and the percentiles of high-density lipoprotein cholesterol (HDL-C) were lower than standard values according to Lipid Research Clinics (LRC) data; for example, the mean TC values for girls in the 11- to 14- and 15- to 18-year age groups were significantly higher than LRC standard values (169 and 172 vs. 160 and 159 mg/dl, respectively, P < 0.05). This difference was also significant in boys (167 and 168 vs. 160 and 153 mg/dl, respectively) at the P < 0.05 level. A significant linear association was shown between adolescents' dyslipidemia and the frequency of intake of hydrogenated fat, fast foods, cheese puffs, and potato chips (P < 0.05). Although the protein intake was lower than the RDA (13.4 +/- 0.9% vs. 15%, P < 0.05), because of the highly prevalent consumption of fatty lamb meat, the frequency of red meat intake had a direct association with dyslipidemia (P < 0.05). CONCLUSION: The improper intake of high amounts of saturated fat and the observed serum lipid profile of Iranian adolescents are likely placing them at increased risk for cardiovascular disease (CVD) and necessitate developing guidelines and community-based interventions.     

Relationship between plasma leptin levels and lipid profiles among school children in Taiwan--the Taipei Children Heart Study

Leptin, an adipose tissue-derived of gene product, is important in energy metabolism. However, the role of leptin in the metabolism of lipids is still not clear in humans. The purpose of this study was to evaluate the association of plasma leptin concentrations and lipid profiles among school children in Taiwan. After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1264 children (617 boys and 647 girls) aged 12–16 years for this study. We measured the anthropometric variables, lifestyle factors and biochemical parameters among these children. Anthropometric measurements included body height (BH) and weight (BW) and we calculated body mass index (BMI) as the ratio of the BW to the square of the BH, expressed in kg/m². Plasma leptin levels were measured by radioimmunoassay. We also measured lipid profiles including serum total cholesterol (CHOL), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), and lipoprotein(a) (Lp(a)) levels, and calculated low density lipoprotein-cholesterol (LDL-C) levels and CHOL to HDL-C ratio (TCHR). Girls had higher leptin, CHOL, TG, HDL-C, (LDL-C), Apo-A1, Apo-B, and Lp(a) levels and lower BMI than boys did. Plasma leptin concentrations were significantly positively correlated with TG, LDL-C, and Apo-B, but negatively with HDL-C and Apo-A1 in both the genders. Children with higher plasma leptin levels (>75th percentiles) have significantly higher TG, HDL-C, LDL-C, TCHR, and Apo-B than those with relatively lower leptin levels. In multivariate regression analyses, the association between plasma leptin level and lipid profiles (such as CHOL, TG, and Apo-B) were still significant (p < 0.05) even after adjusting for BMI among boys. However, this association became attenuated and insignificant among girls. Finally, in the model that included the standard covariates, plasma leptin was the most predictive of CHOL, TG and Apo-B levels among those school children in Taiwan. Our results suggest that plasma leptin and BMI were independently associated with the lipids and lipoprotein profiles among Taiwanese Children. In both genders, children in the top 25% of the leptin distribution have more adverse lipid and lipoprotein profiles.     

Lipoprotein profiles,not anthropometric measures,correlate with serum lipoprotein(a) values in children: the Taipei children heart study

Objectives: Plasma lipoprotein(a) [Lp(a)] is a risk factor for cardiovascular disease. The purpose of this study is to evaluate the correlation of anthropometric measures, lipids and lipoprotein profiles and serum Lp(a) values among children in Taiwan. We will attempt to find parameters that will be able to predict Lp(a) levels in children. Design and methods: After a probability-proportional-to size, multi-stages sampling procedure, we randomly sampled 1500 schoolchildren from 10 schools in Taipei city. Anthropometric measures including body weight, body height, waist and hip circumference and skinfolds were measured. We used standard methods to measure serum total cholesterol (CHOL), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 and B (ApoA1 and ApoB) and Lp(a) levels. We also calculated low density lipoprotein-cholesterol (LDL-C) and CHOL/HDL-C ratio (TCHR) by formula. Results: We sampled 1283 children (635 boys and 648 girls) with a mean age of 13.3 years (from 12 to 16 years) in this study. The mean and medium serum Lp(a) levels were 16.8 and 8.8 mg/dl among boys and 20.8 and 11.9 mg/dl among girls. Children in the highest quintile of Lp(a) (mean = 49.6 and 58.6 mg/dl for boys and girls, respectively) had higher CHOL, LDL-C, ApoB levels and TCHR than children in the lowest quintile (mean = 3.1 and 3.7 mg/dl for boys and girls, respectively). Lipids and lipoprotein profiles, such as CHOL, LDL-C, Apo-B and TCHR were positively correlated with Lp(a) levels in both genders. Furthermore, the children with Lp(a) levels greater than or equal to 30 mg/dl had higher CHOL, LDL-C and Apo-B levels when compared to children with Lp(a) levels less than 30 mg/dl. After adjusting for age, cigarette smoking, alcohol drinking, puberty development and heart rates, LDL-C and ApoB levels were significantly positively associated with Lp(a) levels while ApoA1 was negatively associated among boys. Among girls, only Apo-B was significantly positively associated with Lp(a) and TG was negatively associated with Lp(a) levels. Most importantly, none of the anthropometric measures were significantly correlated with Lp(a) levels. Conclusions: From this study, we found that lipids and lipoproteins profiles, rather than degree of adiposity as reflected by anthropometric measures, are significantly associated with serum Lp(a) levels among school children.     

Risk factors for chronic disease in Thai schoolchildren

One thousand and ninety students from five Bangkok schools participated in the Thai “Know Your Body” program. Mean total cholesterol for all students was 167.0 mg/dl (171.5 for girls and 162.5 for boys). Twenty-nine and two-tenths percent of the children had cholesterol values equal to or greater than 180 mg/dl; 5.7% were overweight (greater than 120% of their ideal weight); 0.2% had blood pressure equal to or greater than 140/90 mm Hg; and only 2.6% reported being smokers.     

High temperature- and high pressure-processed garlic improves lipid profiles in rats fed high cholesterol diets

Garlic protects against degenerative diseases such as hyperlipidemia and cardiovascular diseases. However, raw garlic has a strong pungency, which is unpleasant. In this study, we examined the effect of high temperature/high pressure-processed garlic on plasma lipid profiles in rats. Sprague-Dawley rats were fed a normal control diet, a high cholesterol (0.5% cholesterol) diet (HCD) only, or a high cholesterol diet supplemented with 0.5% high temperature/high pressure-processed garlic (HCP) or raw garlic (HCR) for 10 weeks. The body weights of the rats fed the garlic-supplemented diets decreased, mostly because of reduced fat pad weights. Plasma levels of total cholesterol (TC), low-density lipoprotein cholesterol, and triglyceride (TG) in the HCP and HCR groups decreased significantly compared with those in the HCD group. Additionally, fecal TC and TG increased significantly in the HCP and HCR groups. It is notable that no significant differences in plasma or fecal lipid profiles were observed between the HCP and HCR groups. High temperature/high pressure-processed garlic contained a higher amount of S-allyl cysteine than raw garlic (P<.05). The results suggest that high temperature/high pressure-processed garlic may be useful as a functional food to improve lipid profiles.     

Identification of risk factors of hypercholesterolemia in children--9-year follow-up

According to the hypothesis that atherosclerosis originates in childhood, it would be important for preventive purpose to identify and correct its risk factors among children, particularly hypercholesterolemia; 116 children belonging to a cohort of 556 children were found with total cholesterol level of greater than or equal to 200 mg/dl at least once during the first three years of life. These children at risk for hypercholesterolemia were followed up after nine years and compared with a control group of children having total cholesterol level of below 200 mg/dl and matched by sex and age. Both groups were submitted to a clinical examination, blood lipid determination, anthropometric measurements and were tested for food consumption. The average levels of total cholesterol (CT), triglycerides (TG), LDL-cholesterol, Apo B and CT/HDL-cholesterol (IA), Apo A/Apo B ratios were significantly higher among the children at risk, but HDL-cholesterol was lower. Forty per cent of children at risk had the CT level greater than or equal to 190 mg/dl in comparison with 15% of controls. The proportion of IA greater than or equal to 4.5 was 30% for the group at risk versus 8% for controls. The supra-iliac skinfold thickness was higher among the children at risk. Likewise the mothers of children at risk had higher weight and Quetelet index than the controls. The energy intake provided by the saturated fatty acids was higher for the group at risk, having a CT greater than or equal to 200 mg/dl. The intake of proteins, carbohydrates and fibres was significantly different in the two groups. Amino-acids were consumed less among the children at risk. Only 10% of children follow the recommendation for the proportion of calories supplied by fats. These results suggest that the intervention should be undertaken on dietary habits of the child as well as of its family in order to lower the risk of hypercholesterolemia.     

Plasma tocopherol and tocopherol to lipid ratios in a normal population of infants and children

The plasma tocopherol concentrations were measured by HPLC in 73 apparently healthy West German children aged from 1 to 14 years and in 7 cord blood samples and 5 infants below 1 year of age. Total tocopherols ranged from 584 to 2024 micrograms/dl in the children above 1 year of age (mean 1046 +/- 283 micrograms/dl) and from 511 to 1155 micrograms/dl in the infants below 1 year of age (mean 879 +/- 270 micrograms/dl). The total tocopherol/total lipid ratio-representing the reliable index for vitamin E status-was far above 0.6 mg/g lipid, a level which is regarded as the lower limit of normal (range 1.23 to 4.09 mg/g total lipid in the older children and 1.52 to 2.05 in the infants below 1 year). A positive correlation was found between plasma lipids and total tocopherol (r = 0.71). Our investigation demonstrated an excellent vitamin E status in the children investigated which is considered to reflect the high supply of West German food with PUFA and vitamin E.     

Serum lipid levels in elementary and junior high school children and their relationship to relative weight

Serum lipid levels were measured in 2,626 schoolchildren ages 7 to 15 years in three elementary schools and one junior high school in a suburban area of Osaka during 1984-1985. The mean cholesterol levels increased with age in boys ages 7 to 10 years (from 156 to 177 mg/dl) and then decreased at age 13, after which the levels again increased slightly until age 15. Girls showed a similar tendency with a peak at age 10 and a minimum at age 12. Cholesterol levels were significantly lower in junior high school boys (a mean of 154-161 mg/dl for ages 13-15 years) than in girls of the same age or in boys and girls ages 10 to 12 years in the upper grades of elementary school. Cholesterol and triglyceride levels tended to be lower or the high-density lipoprotein cholesterol levels higher in elementary schools where boys and girls engaged in physical exercise than in schools where the children were not strongly encouraged to exercise. About 50% of the hypertriglyceridemic children were obese.     

Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis

Cocoa products, which are rich sources of flavonoids, have been shown to reduce blood pressure and the risk of cardiovascular disease. Dark chocolate contains saturated fat and is a source of dietary calories; consequently, it is important to determine whether consumption of dark chocolate adversely affects the blood lipid profile. The objective was to examine the effects of dark chocolate/cocoa product consumption on the lipid profile using published trials. A detailed literature search was conducted via MEDLINE (from 1966 to May 2010), CENTRAL and ClinicalTrials.gov for randomized controlled clinical trials assessing the effects of flavanol-rich cocoa products or dark chocolate on lipid profile. The primary effect measure was the difference in means of the final measurements between the intervention and control groups. In all, 10 clinical trials consisting of 320 participants were included in the analysis. Treatment duration ranged from 2 to 12 weeks. Intervention with dark chocolate/cocoa products significantly reduced serum low-density lipoprotein (LDL) and total cholesterol (TC) levels (differences in means (95% CI) were -5.90 mg/dl (-10.47, -1.32 mg/dl) and -6.23 mg/dl (-11.60, -0.85 mg/dl), respectively). No statistically significant effects were observed for high-density lipoprotein (HDL) (difference in means (95% CI): -0.76 mg/dl (-3.02 to 1.51?mg/dl)) and triglyceride (TG) (-5.06 mg/dl (-13.45 to 3.32 mg/dl)). These data are consistent with beneficial effects of dark chocolate/cocoa products on total and LDL cholesterol and no major effects on HDL and TG in short-term intervention trials.     

Distributions of total cholesterol, triglycerides, and high-density lipoprotein cholesterol in Israeli Jewish children of different geographic-ethnic origins, ages 9-17 years

To determine age and ethnic patterns of blood lipid levels in childhood and adolescence and to extend previous adult and late adolescent Israeli data to prepubertal ages, the levels of plasma total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were determined among 1,153 schoolchildren in the area of Petah-Tikva. Half of the children were born to immigrants from Yemen. Among boys, TC levels progressively decreased as age increased from 10-11 to 14-15 years (159 to 142 mg/dl). The age-specific TC and HDL-C means among boys are compatible with an initial swift fall with age, followed by a rise restricted to TC during puberty. Among girls, progressively lower means through ages 12-13 and increasingly higher ones for older age groups are also compatible with puberty-determined changes, previously observed in American cohorts. The differences in TC were only partly accounted for by lower HDL-C means at higher ages (52 mg/dl in the youngest and 45 mg/dl in the oldest age group, respectively, among boys, compared with 53 mg/dl for girls at both ages 9 and 16-17). TG levels in boys, but not in girls, showed age differences paralleling those found for HDL-C, but in an inverse direction. TC means were lower as age increased only among female offspring of European-born Jews (159 to 148 mg/dl, ages 9-12 compared with ages 13-17), a phenomenon that requires further study. Overall, TC and HDL-C were clearly higher among girls than boys beginning at ages 12-13, with little or no sex differences in TG. The sex differences in TC, contrary to previous studies, were not fully accounted for by HDL-C sex differences. The ethnic variability paralleled previous findings in Israeli adults and adolescents, showing low TC levels among male offspring of Yemenite and other Asian-born fathers. The ethnic differences among girls were small. No specific pattern of age-related lipid changes was found in the group of Yemenite origin, who represented offspring of parents with notoriously low levels of coronary heart disease incidence.     

Bifidobacteria supplementation: Effects on plasma lipid profiles in dyslipidemic children

ObjectivePreclinical investigations support the use of probiotics in the treatment of hypercholesterolemia, but clinical evidence is often contrasting. The aim of this study was to evaluate the effects of a probiotic formulation containing three Bifidobacterium strains on lipid profiles in children affected by primary dyslipidemia.MethodsThirty-eight children with dyslipidemia, ages 10.8 ± 2.1 y, were enrolled in a randomized, double-blind, placebo-controlled cross-over study. After a 4-wk diet run-in period, the children received probiotics (B. animalis subspecies lactis MB 2409, B. bifidum MB 109B, and B. longum subspecies longum BL04) or placebo for 3 mo. After 1 mo, wash-out treatments were switched. A strict dietary evaluation concerning satured fatty acids and cholesterol content, STEP I diet accordingly, was performed by a dietitian who examined the weekly dietary diary at each visit.ResultsBaseline lipid profile was (mean ± SD): total cholesterol (TC) 222.8 ± 23.2 mg/dL, high-density lipoprotein cholesterol (HDL-C) 55.8 ± 12.2 mg/dL, triglycerides (TG) 99.0 ± 61.7 mg/dL, and low-density lipoprotein cholesterol (LDL-C) 147.2 ± 21.9 mg/dL. After 3 mo of probiotic treatment, the lipid profile was: TC 211.9 ± 27.3 mg/dL, HDL-C 60.7 ± 14.2 mg/dL, TG 79.5 ± 34.5 mg/dL, and LDL-C 135.3 ± 24.2 mg/dL. Compared with placebo, probiotics reduced TC by 3.4% (P = 0.02) and LDL-C by 3.8% (P = 0.001). No significant dietary change occurred through the study and no relevant adverse effects were observed.ConclusionsTreatment with a Bifidobacterium probiotic formulation was well tolerated and useful in combination with to diet therapy. Children with dyslipidemia benefited from this approach, although the results need to be confirmed by larger controlled studies.     

Serum lipid levels in an Iranian population of children and adolescents: Tehran lipid and glucose study

Data from 3148 participants aged 3–19years (1447 males and 1701 females) in the cross-sectional phase of Tehran lipid and glucose study (February 1999–May 2000) were used to determine serum lipid levels [total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after 12–14 hours overnight fast. The values were analyzed by sex and age. Mean serum TC concentration was 170 mg/dl. TC was significantly greater in females than males (173 vs. 167 mg/dl, p < 0.05). The 90th and 95th percentiles for serum TC were 211 and 227 mg/dl, respectively. There was a significant decrease in mean TC in males during puberty. Thirty-one percent of population had TC values between 170 and 199 mg/dl and 16% had values of 200 mg/dl or greater. The mean TGs values were 103 for males and 108 mg/dl for females [non-significant (NS)]. The prevalence of high-risk values of TGs increased with age in males, reaching a peak at 17–19years. The mean HDL-C level was 45 mg/dl. Mean HDL-C was highest at 7–10years of age and decreased thereafter. The mean LDL-C was 102 in males and 107 mg/dl in females (NS). Twenty-two percent had LDL-C values between 110 and 129 mg/dl and 17% had values 130 mg/dl or greater. The results showed higher levels of TC, LDL-C and TGs and lower HDL-C in Tehranian children and adolescents than other studies. To design comprehensive public health programs to reduce serum lipid levels among Iranian children and adolescents, underlying factors for the high prevalence of dyslipoproteinemia should be sought.     

Serum cholesterol levels in a multiracial sample of 7,439 preschool children from Arizona.

BACKGROUND. The distribution and correlates of serum levels of total cholesterol were studied in cross-sectional analyses of 7,439 1 to 4 year olds examined through the Arizona Department of Health Services. RESULTS. Mean cholesterol levels increased with age, and levels among 2 year olds approached those seen in adolescents. Racial and ethnic differences in cholesterol levels were observed: mean (age-adjusted) levels were 147 mg/dl among American Indians (n = 622), 153 mg/dl among Hispanics (n = 3165), 154 mg/dl among non-Hispanic whites (n = 3448), and 163 mg/dl among blacks (n = 204). Cholesterol levels were not associated either with obesity, as assessed by relative weight or the Quetelet index, or with breast-feeding during infancy. Very overweight (greater than or equal to 20 kg/m2) 3 and 4 year olds, however, tended to have higher mean levels of cholesterol than did other children. The proportion of children with borderline (170 to 199 mg/dl) or high (greater than or equal to 200 mg/dl) levels of cholesterol varied by race/ethnicity: borderline (high) levels were seen among 14% (3%) of American Indians and 29% (11%) of blacks. The proportions of white and Hispanic children having cholesterol levels between 170 and 199 mg/dl or greater than or equal to 200 mg/dl were midway between those seen among American Indians and blacks. CONCLUSION. Additional information on the interrelationships of lipids and lipoproteins may aid in the identification of children who will be at increased risk for cardiovascular disease in adulthood.     

Differences between black and white men in correlates of high density lipoprotein cholesterol

Although socioeconomic status has been positively related to levels of high density lipoprotein (HDL) cholesterol in white Americans, limited evidence suggests that an inverse association may exist among blacks. These associations were further examined using data collected in 1985-1986 from 3,562 white and 500 black men who ranged in age from 31 to 45 years. Overall, mean levels of HDL cholesterol were 8 mg/dl higher among blacks than among whites and, in each group, levels were related positively to alcohol consumption and negatively to Quetelet index and cigarette smoking. A statistically significant interaction, however, was observed between race and educational achievement: no association was seen between educational achievement and levels of HDL cholesterol among white men, but there was an inverse association among blacks. For example, a 13 mg/dl (55 vs. 42 mg/dl) difference in levels of HDL cholesterol was observed between black and white men who did not complete high school, but only a 3 mg/dl black excess (47 vs. 44 mg/dl) was seen among college graduates. About 40 percent of this reduction could be attributed to the effects of cigarette smoking, alcohol consumption, and relative weight. These results indicate that the higher levels of HDL cholesterol frequently found among black men in the United States may not apply to all social strata. Other characteristics, such as physical activity and diet, may account for the differing race-specific associations with educational achievement.     

Snack bars with high soy protein and isoflavone content for use in diets to control dyslipidaemia

The objective was to develop a cereal bar product rich in isoflavones and soy protein to be used in diets for controlling dyslipidaemia. A soy snack bar with 39.88 g/100 g dietary fibre, 34.25 g/100 g protein, 100.39 mg/100 g isoflavones and 245.47 kcal/100 g was produced. The shelf life of the product was tested over a period of 6 months. The hardness, water activity and darkness of the snack bars increased with storage time. Clinical trial was carried out to evaluate the effectiveness of the soy snack bar on the lipid profiles of 22 dyslipidaemic subjects for a period of 45 days. There was a decrease in levels of triglycerides (TGs) (- 20%) and an increase in high-density lipoprotein cholesterol (HDL-c) (+8%) comparing with baseline values. Therefore, relatively high intakes of soy protein and isoflavones in moderately hypercholesterolaemic subjects (>200 mg/dl) may have a moderately beneficial effect on plasma lipid profiles, as TG and HDL-c levels, without additional diet restrictions.     

Serum lipid response to a fat-modified, oatmeal-enhanced diet

The purpose of this study was to confirm and extend previous findings that serum cholesterol response to a fat-modified diet is enhanced by oat fiber. Participants (n = 236) were recruited from the Continental Illinois National Bank in Chicago. Data including weight, serum lipid level, lipoproteins, and 3-day food records were collected at baseline and every 4 weeks for 12 weeks. All participants were instructed to follow the fat-modified (Phase II) diet recommended by the American Heart Association (AHA). After 4 weeks, participants were randomly assigned to one of two groups. While both groups continued to follow the AHA diet, Group 1 was instructed to include 2 oz (56 g, dry wt) of oatmeal, isocalorically substituted for other carbohydrate foods. Group 2 served as the control and consumed no oat products throughout the study. Serum cholesterol values at baseline and after 4 weeks of the AHA diet were similar for both groups (203.9 and 193.0 mg/dl for Group 1 and 205.3 and 194.5 mg/dl for Group 2). After 4 weeks of oatmeal intervention, mean group differences were -6.8 and -2.1 mg/dl (P = 0.008 one-tailed t test) for Groups 1 and 2, respectively. Following an additional 4 weeks of oatmeal intervention, the Group 1 mean cholesterol increased slightly (0.9 mg/dl), while the Group 2 level decreased slightly (-0.7 mg/dl). Overall serum cholesterol responses for the two groups from Visit 2 to Visit 4 were -6.0 and -2.8 mg/dl for Groups 1 and 2, respectively (P = 0.074, one tail). Changes in weight were small and nonsignificant. Subgroup analyses revealed greater reductions in serum cholesterol among participants with the highest baseline serum cholesterol (-8.0 mg/dl vs -1.7 mg/dl for Subgroups 1 and 2, respectively). These data support previous findings that inclusion of oatmeal in a fat-modified diet is helpful in lowering serum cholesterol, particularly for individuals with elevated serum cholesterol levels.     

Relationships of dietary fat consumption to serum total and low-density lipoprotein cholesterol in hispanic preschool children

BACKGROUND. Studies of the relationship between dietary fat intake and serum lipids in young children have yielded inconclusive results. We studied this relationship in 108 Hispanic children ages 4-5 years. METHODS. Four 24-hr recalls approximately 3 months apart and two Willett semiquantitative food frequency questionnaires approximately 6 months apart were obtained by interviewing the children's mothers. Diet measures were averaged for the multiple administrations of each of these instruments. RESULTS. Based on the 24-hr recalls, children in the highest tertile of total fat consumption (36.2% of total calories) compared with the lowest tertile (30.2% of total calories) had mean total serum cholesterol of 4.32 mmol/liter (167 mg/dl) vs 3.91 mmol/liter (151 mg/d) (test for linear trend across tertiles, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.74 mmol/liter (106 mg/dl) vs 2.29 mmol/liter (89 mg/dl) (test for linear trend, P less than 0.01). Children in the highest tertile of saturated fat consumption (14.6% of total calories) compared with the lowest tertile (11.2% of total calories) had mean total serum cholesterol of 4.39 mmol/liter (170 mg/dl) vs 3.97 mmol/liter (154 mg/dl) (test for linear trend, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.80 mmol/liter (108 mg/dl) vs 2.35 mmol/liter (91 mg/dl) (test for linear trend, P less than 0.01). These relationships remained significant when calorie-adjusted nutrient intakes were examined and after adjustment in multiple linear regression models for age, sex, and body mass index, with the exception of the association of calorie-adjusted total fat with total serum cholesterol level (P = 0.07). Similar results were obtained using the Willett questionnaires. CONCLUSIONS. These findings indicate that dietary fat, particularly saturated fat consumption, is an important correlate of blood lipid levels in preschool children. These are also the first reported data indicating that the Willett questionnaire, as a method for measuring the atherogenic components of diet, has criterion-related validity in young children.     

Effects of dietary triglycerides on serum and liver lipids and sterol excretion of rats

The effects of several highly purified simple and mixed dietary triglycerides (TGs) on serum and liver cholesterol and on sterol excretion were studied in rats. The TGs contained 4- to 18-carbon fatty acids with melting points of -75 to 63.5 degrees C. Ratios of polyunsaturated to saturated fatty acids ranged from 0.1 to 105. Ratios of total unsaturated to saturated fatty acids ranged from 0.1 to 115. All diets contained 8% TG plus 0.82% safflower oil. Sterols were quantified directly by a new and improved high resolution gas chromatographic method and were identified by mass spectrometry. TG digestibilities correlated negatively with melting points above 30 degrees C (R = -0.9). Serum cholesterol was lower in rats fed tributyrin, tricaproin, tricaprylin, tricaprin, trielaidin, trilinolein or partially hydrogenated soybean oil (43-49 mg/dl) than in those fed trilaurin, trimyristin, tripalmitin, tristearin, triolein or corn oil (54-59 mg/dl). Liver lipid levels correlated (R = 0.65) with the degree of unsaturation of dietary TGs. Liver cholesterol levels correlated negatively with fecal excretion of coprostanol plus cholesterol (R = -0.4). Coprostanol plus cholesterol excreted in feces correlated weakly (R = 0.3) with intake of total sterol and of polyunsaturated TGs (R greater than or equal to 0.4 are at least 80% significant). The results demonstrate that consumption of polyunsaturated TGs was associated with higher hepatic lipid levels. Also, greater fecal excretion of coprostanol plus cholesterol was associated with lower hepatic cholesterol levels.