Serum and lipoprotein sitostanol and non-cholesterol sterols after an acute dose of plant stanol ester on its long-term consumption

Purpose

Chronic inhibition of cholesterol absorption with large doses of plant stanol esters (staest) alters profoundly cholesterol metabolism, but it is unknown how an acute inhibition with a large staest dose alters the postprandial serum and lipoprotein cholesterol precursor, plant sterol, and sitostanol contents.

Methods

Hypercholesterolemic subjects, randomly and double-blind divided into control (n?=?18) and intervention groups (n?=?20), consumed experimental diet without and with staest (plant stanols 8.8?g/day) for 10?weeks. Next morning after a fasting blood sample (0 h), the subjects had a breakfast without or with staest (4.5?g of plant stanols). Blood sampling was repeated 4?h later. Lipoproteins were separated with ultracentrifugation, and sterols were measured with gas–liquid chromatography.

Results

In 0-h chylomicrons and VLDL, plant sterols were lower in staest than in controls. Postprandially, cholestenol (cholesterol synthesis marker) was reduced in chylomicrons in staest compared with controls (?0.13?±?0.04?μg/dL vs. 0.01?±?0.08?μg/dL, P?P?Conclusions Chronic cholesterol absorption inhibition with large amount of plant stanol esters decreases plant sterols in triglyceride-rich lipoproteins. Acute plant stanol ester consumption increases sitostanol content in triglyceride-rich lipoproteins but suggests to decrease the risk of plant sterol and plant stanol accumulation into vascular wall by chylomicrons.     

Serum sterol responses to increasing plant sterol intake from natural foods in the Mediterranean diet

Background

Phytosterols in natural foods are thought to inhibit cholesterol absorption. The Mediterranean diet is rich in phytosterol-containing plant foods.

Aim of the study

To assess whether increasing phytosterol intake from natural foods was associated with a cholesterol-lowering effect in a substudy of a randomized trial of nutritional intervention with Mediterranean diets for primary cardiovascular prevention (PREDIMED study).

Methods

One hundred and six high cardiovascular risk subjects assigned to two Mediterranean diets supplemented with virgin olive oil (VOO) or nuts, which are phytosterol-rich foods, or advice on a low-fat diet. Outcomes were 1-year changes in nutrient intake and serum levels of lipids and non-cholesterol sterols.

Results

Average phytosterol intake increased by 76, 158 and 15 mg/day in participants assigned VOO, nuts and low-fat diets, respectively. Compared to participants in the low-fat diet group, changes in outcome variables were observed only in those in the Mediterranean diet with nuts group, with increases in intake of fibre, polyunsaturated fatty acids and phytosterols (P < 0.020, all) and significant (P < 0.05) reductions of LDL-cholesterol (0.27 mmol/l or 8.3%) and the LDL/HDL-cholesterol ratio (0.29 mmol/l or 11.5%). Variations in saturated fat, cholesterol or fibre intake were unrelated to LDL-cholesterol changes. In the whole group, changes in serum sitosterol-to-cholesterol, which reflect those of dietary phytosterol intake and absorption, correlated inversely to LDL-cholesterol changes (r = ?0.256; P = 0.008). In multivariate analyses, baseline LDL-cholesterol, increases in serum sitosterol ratios and statin use were independently associated with LDL-cholesterol reductions.

Conclusions

Small amounts of phytosterols in natural foods appear to be bioactive in cholesterol lowering.     

Blueberry anthocyanins at doses of 0.5 and 1 % lowered plasma cholesterol by increasing fecal excretion of acidic and neutral sterols in hamsters fed a cholesterol-enriched diet

Purpose

The present study investigated the underlying mechanism associated with the hypocholesterolemic activity of blueberry anthocyanins by examining its effect on fecal sterol excretion and gene expression of major receptors, enzymes, and transporters involved in cholesterol metabolism.

Methods

Hamsters were divided into three groups and fed a 0.1 % cholesterol diet containing 0 % (CTL), 0.5 % (BL), and 1.0 % (BH) blueberry anthocyanins, respectively, for six weeks. Plasma total cholesterol (TC), triacylglycerols (TAG), and non-high-density lipoproteins cholesterol (non-HDL-C) were measured using the enzymatic kits, and the gene expression of transporters, enzymes, and receptors involved in cholesterol absorption and metabolism was quantified using the quantitative PCR. GC analysis was used to quantify hepatic cholesterol and fecal acidic and neutral sterols.

Results

Dietary supplementation of 0.5 and 1.0 % blueberry anthocyanins for 6 weeks decreased plasma TC concentration by 6–12 % in a dose-dependent manner. This was accompanied by increasing the excretion of fecal neutral and acidic sterols by 22–29 % and 41–74 %, respectively. Real-time PCR analyses demonstrated that incorporation of blueberry anthocyanins into diet down-regulated the genes of NPC1L1, ACAT-2, MTP, and ABCG 8. In addition, blueberry anthocyanins were also able to down-regulate the gene expression of hepatic HMG-CoA reductase.

Conclusion

The cholesterol-lowering activity of blueberry anthocyanins was most likely mediated by enhancing the excretion of sterols accompanied with down-regulation on gene expression of intestinal NPC1L1, ACAT-2, MTP, and ABCG 8.     

The influence of dietary fibre source and gender on the postprandial glucose and lipid response in healthy subjects

Background

Consumption of soluble dietary fibre is correlated with decreased postprandial glucose and insulin responses and hence has beneficial effects on the metabolic syndrome.

Aim of the study

To investigate the effects on postprandial glucose, insulin and triglyceride concentrations of meals enriched with soluble dietary fibres from oats, rye bran, sugar beet fibre or a mixture of these three fibres.

Methods

Thirteen healthy human volunteers (6 men and 7 women, aged 20–28 years) were included in the study. The subjects came to the study centre once a week after an overnight fast to ingest test meals and a control meal in random order. The meals contained either oat powder (62 g, of which 2.7 soluble fibre), rye bran (31 g, of which 1.7 g soluble fibre), sugar beet fibre (19 g, of which 5 g soluble fibre), a mixture of these three fibres (74 g, of which 1.7 g soluble fibre from each source, giving 5 g soluble fibre) or no added fibre (control) and were all adjusted to contain the same total amount of available carbohydrates. Blood samples were drawn before and every 30 min up to 180 min after the meals.

Results

Meals with rye bran gave a lower postprandial glucose peak when compared with the control meal, and this effect was more pronounced in women compared to men. Oat powder, containing a low amount of total fibre and a high amount of carbohydrates in liquid matrix, gave a higher incremental glucose peak concentration compared to rye bran and sugar beet fibre and higher insulin incremental area under curve compared to control. The oat powder also influenced the effects of the mixed meal, diminishing the glucose-lowering effects. Postprandial triglyceride levels tended to be higher after all fibre-rich meals, but only significant for oat powder and the mixed meal when compared with the control meal.

Conclusions

Postprandial glucose, insulin and triglyceride concentrations are influenced by dietary fibre-rich meals, depending on fibre source, dose of soluble and total fibre and possibly gender.     

Time of ingestion relative to meal intake determines gastrointestinal responses to a plant sterol–containing yoghurt drink

Purpose

Plant sterol (PS)-enriched food products are known to reduce plasma cholesterol concentrations by inhibiting the absorption of dietary and biliary cholesterol. The physiological responses induced by food intake in the gastrointestinal tract are all important factors in determining the overall effect of PS. The aim of this study was therefore to assess the effect of timing of consumption of a plant sterol (PS)–containing yoghurt drink relative to meal ingestion on gastric emptying (GE) of the drink and gallbladder (GB) volume.

Methods

This is a randomized, single-centre, controlled study with crossover design in 12 healthy male volunteers. Three treatments were tested; a 100 mL PS yoghurt drink (labeled with 1,000 mg acetaminophen) was consumed 45 min prior to, during and 45 min after a solid meal. Plasma samples were taken, and gallbladder volumes were measured at baseline and at regular intervals during a 6-h study period.

Results

When consumed before the consumption of a meal, the yoghurt drink exhibited fast GE. The solid meal intake caused a significant contraction of the gallbladder. Consumption of the PS drink before the meal had no significant effect on GB volume as compared to baseline and compared to during and after meal consumption.

Conclusions

The PS-containing drink, which empties fast from the stomach, does not sufficiently trigger gallbladder contraction without co-ingestion of a solid meal and in consequence does not induce the necessary physiological changes needed to allow PS to exhibit their effect on inhibiting cholesterol absorption.     

A high intake of dietary fiber influences C-reactive protein and fibrinogen,but not glucose and lipid metabolism,in mildly hypercholesterolemic subjects

Purpose

The aim of the study was to investigate how a diet high in dietary fiber, with several fiber sources included, modulates glucose and lipid metabolism and the inflammatory response in humans.

Methods

Subjects (n = 25) aged 58.6 (1.1) years (mean and SD) with a BMI of 26.6 (0.5) kg/m² and a total cholesterol (TC) of 5.8 (0.1) mmol/L (mean and SEM) were given a high fiber (HF) and low fiber (LF) diet, in a randomized controlled 5-week crossover intervention, separated by a 3-week washout. The HF diet consisted of oat bran, rye bran, and sugar beet fiber incorporated into test food products; one bread roll, one ready meal, and two beverages consumed daily. Equivalent food products, without added fibers, were provided in the LF diet.

Results

Total dietary fiber intake was 48.0 g and 30.2 g per day for the HF and LF diet, respectively. Significant reduction in C-reactive protein (CRP) was observed between the diets (P = 0.017) and a significant reduction in fibrinogen within the HF diet (P = 0.044). There were no significant effects in other measured circulating cytokines or in glucose, insulin, and lipid levels.

Conclusions

Our study suggests that a 5-week high dietary fiber intake of oat bran, rye bran, and sugar beet fiber might reduce the low-grade inflammatory response measured as CRP which could, together with reduced fibrinogen, help to prevent the risk of cardiovascular disease.     

The impact of severe preeclampsia on maternal quality of life

Purpose

Preeclampsia (PE) is a serious life event that can change women’s psychological profile. The aim of this study was to evaluate the physical and mental health-related quality of life (HR-QoL) in women after PE and the impact of contributing factors.

Methods

Ninety-five women who had suffered from PE answered the Short-Form-12 Health Survey on general state of health. Comparison was made with the reference values and among the study cohorts, namely mild (14.7 %), severe (74.7 %) and superimposed PE (10.5 %). Medical parameters were evaluated as additional factors, and age served as covariate.

Results

Quality of mental life was significantly worse in all patients (p < 0.01), especially in those after severe PE (p < 0.01) compared to the reference range. These women demonstrated significantly worse results than those affected by the mild form (p = 0.03). Women who had had superimposed PE were neither physically nor mentally impaired compared to the standard population values (p = 0.94 and p = 0.90, respectively). After controlling for medical parameters and age, differences remained statistically significant. Multiparous women scored significantly worse on the mental scale than primiparous (p = 0.02), and pregnant women scored significantly worse than non-pregnant women on the physical level (p = 0.04).

Conclusions

This study shows that women who have suffered from severe PE are substantially reduced in their mental quality of life. An extensive medical care including HR-QoL parameters might improve pregnancy outcome.     

Capsaicinoids lower plasma cholesterol and improve endothelial function in hamsters

Purpose

Capsaicinoids are the active compounds in chili pepper. The present study investigated the effect of capsaicinoids on plasma lipids, functionality of aorta including atherosclerotic plaque development, cholesterol absorption biomarker, fecal sterol excretion, and gene expression of major receptors, enzymes, and transporters involved in cholesterol metabolism.

Methods

Hamsters were divided into five groups and fed a high-cholesterol diet containing 0 % (CON), 0.010 % (LD), 0.015 % (MD), 0.020 % (HD), and 0.030 % (VD) capsaicinoids, respectively, for 6 weeks. Plasma lipids were measured using the enzymatic kits, and the gene expression of transporters, enzymes, and receptors involved in cholesterol absorption and metabolism was quantified using the quantitative PCR. Endothelial function was assessed by measuring the acetylcholine-induced endothelium-dependent relaxations in aorta.

Results

Capsaicinoids reduced plasma total cholesterol, non-high-density lipoprotein cholesterol, and triacylglycerols with high-density lipoprotein cholesterol being unaffected. All four experimental groups had a decrease in the atherosclerotic plaque compared with CON. Dietary capsaicinoids increased the fecal excretion of total acidic sterols possibly mediated by up-regulation of cholesterol 7α-hydroxylase and down-regulation of liver X receptor alpha. Plasma sterol analysis demonstrated that capsaicinoids decreased the ratio of plasma campesterol/cholesterol, suggesting they decreased cholesterol absorption. Capsaicinoids could improve the endothelium-dependent relaxations and reduce the endothelium-dependent contractions by inhibiting the gene expression of COX-2. However, no dose-dependent effect of capsaicinoids on these parameters was seen.

Conclusion

Capsaicinoids were beneficial in improving lipoprotein profile and aortic function in hamsters fed a high-cholesterol diet.     

Fate of dietary phytosteryl/-stanyl esters: analysis of individual intact esters in human feces

Purpose

The objective was to investigate the metabolic fate of phytosteryl/-stanyl fatty acid and ferulic acid esters upon consumption by healthy humans.

Methods

A capillary gas chromatographic methodology was employed to follow a randomized, single-blind three group crossover clinical trial and to quantify simultaneously individual intact esters, liberated phytosterols/-stanols and their metabolites in feces. Skimmed milk drinking yogurts enriched with complex mixtures of phytosteryl/-stanyl fatty acid esters and ferulates, respectively, were employed as food carriers.

Results

On average, 73 % of total plant stanyl fatty acid esters and 80 % of total plant steryl fatty acid esters were hydrolyzed. Among the individuals, the hydrolysis rates ranged from 40 to 96 %. In addition, there were subject-dependent discrepancies between the amounts of phytosterols/-stanols actually determined in the feces and the calculated hydrolysis rates. On average, 69 % of the amounts of sterols/stanols expected from the amounts of remaining intact esters were found.

Conclusions

The study revealed large interindividual variability regarding the recoveries of dietary phytosteryl/-stanyl esters upon gastrointestinal passage in healthy humans. Nevertheless, there was a significant impact of the acid moiety (oleate = linoleate = linolenate > eicosanoate > palmitate > ferulate) on the hydrolysis rates; the influence of the phytosterol/-stanol moiety was less pronounced.     

Distribution of procyanidins and their metabolites in rat plasma and tissues in relation to ingestion of procyanidin-enriched or procyanidin-rich cocoa creams

Background

Procyanidins are extensively metabolized via phase-II and microbial enzymes. However, their distribution in the body is not well characterized.

Aim

This study investigates the distribution of procyanidins (monomers and dimers) and their phase-II metabolites in plasma and tissues (thymus, heart, liver, testicle, lung, kidney, spleen and brain).

Methods

Wistar rats were fed with 1 g of cocoa cream (CC), 50 mg of procyanidin hazelnut skin extract (PE) and 50 mg PE in 1 g CC (PECC). The rats were killed at 0, 1, 1.5, 2, 3, 4 and 18 h after gavage, and the plasma and tissues were analyzed by UPLC–MS/MS.

Results

Epicatechin–glucuronide was the main metabolite in the plasma after the CC intake, with C _max at 423 nM and t _max at 2 h, and methyl catechin–glucuronide (301 nM, 2 h) was the main metabolite in the plasma after the PE intake. As a result of the PECC enrichment, epicatechin–glucuronide (452 nM, 1.5 h) and catechin–glucuronide (297 nM, 2 h) were the main metabolites in the plasma. Methyl catechin–glucuronide was found in the liver after PE (8 nmol/g tissue, 4 h) and PECC (8 nmol/g, 1.5 h). The kidney was found to contain a high concentration of phase-II metabolites of procyanidins and is therefore thought to be the main site of metabolism of the compounds. Methyl catechin–sulfate (6.4 nmol/g, 4 h) was only quantified in the brain and after PE intake. Catechin metabolites were not found in the spleen or heart. Phenolic acids were detected in all tissues.

Conclusions

The formulation of a product enriched or fortified with procyanidins is a way to increase their bioavailability, with clear effects on the plasmatic pharmacokinetics, and a greater accumulation of phenolic metabolites in such tissues as the liver, kidney, lung and brain.     

Is the cardiovascular risk profile of people living in Roma settlements worse in comparison with the majority population in Slovakia?

Objectives

Roma constitute a large minority in several Central European countries, with a mostly disadvantaged societal and health position. The aim of this study was to assess biological and other cardiovascular diseases (CVD) risk factors in people living in Roma settlements and to compare them with non-Roma.

Methods

We used data from the cross-sectional Hepa-Meta study conducted in Slovakia. The sample consisted of 452 Roma (mean age = 34.7, 35.2 % men) and 403 non-Roma (mean age = 33.5, 45.9 % men). The effect of ethnicity was analysed using logistic regression adjusted for age and stratified by gender.

Results

Roma were more likely to have obesity, low HDL cholesterol, normal total cholesterol, and to smoke than non-Roma. Moreover, Roma women were more likely to have abdominal obesity and Roma men to have normal LDL cholesterol than non-Roma. No significant differences by ethnicity were found regarding hypertriglyceridaemia, hyperglycaemia and hypertension.

Conclusions

Our study confirmed higher rates of some CVD risk factors in Roma compared with non-Roma. Our findings call for interventions aiming at decreasing CVD risks and improving health literacy among Roma, to reduce CVD morbidity and premature mortality.     

Disturbed eating at high altitude: influence of food preferences, acute mountain sickness and satiation hormones

Purpose

Hypoxia has been shown to reduce energy intake and lead to weight loss, but the underlying mechanisms are unclear. The aim was therefore to assess changes in eating after rapid ascent to 4,559 m and to investigate to what extent hypoxia, acute mountain sickness (AMS), food preferences and satiation hormones influence eating behavior.

Methods

Participants (n = 23) were studied at near sea level (Zurich (ZH), 446 m) and on two days after rapid ascent to Capanna Margherita (MG) at 4,559 m (MG2 and MG4). Changes in appetite, food preferences and energy intake in an ad libitum meal were assessed. Plasma concentrations of cholecystokinin, peptide tyrosine–tyrosine, gastrin, glucagon and amylin were measured. Peripheral oxygen saturation (SpO₂) was monitored, and AMS assessed using the Lake Louis score.

Results

Energy intake from the ad libitum meal was reduced on MG2 compared to ZH (643 ± 308 vs. 952 ± 458 kcal, p = 0.001), but was similar to ZH on MG4 (890 ± 298 kcal). Energy intake on all test days was correlated with hunger/satiety scores prior to the meal and AMS scores on MG2 but not with SpO₂ on any of the 3 days. Liking for high-fat foods before a meal predicted subsequent energy intake on all days. None of the satiation hormones showed significant differences between the 3 days.

Conclusion

Reduced energy intake after rapid ascent to high altitude is associated with AMS severity. This effect was not directly associated with hypoxia or changes in gastrointestinal hormones. Other peripheral and central factors appear to reduce food intake at high altitude.     

Calcium co-ingestion augments postprandial glucose-dependent insulinotropic peptide1–42, glucagon-like peptide-1 and insulin concentrations in humans

Purpose

This study determined whether calcium co-ingestion potentiates postprandial GIP_1–42 and GLP-1 concentrations in humans and the concomitant impact on insulin, appetite sensations and substrate metabolism.

Methods

Ten healthy males consumed two energy- and macronutrient-matched meals in a double-blind, randomized, crossover design. The calcium content of the control meal was 3 mg/kg body mass, which was increased to 15 mg/kg body mass with calcium co-ingestion. Circulating concentrations of GIP_1–42, GLP-1 and insulin were determined over a 180-min postprandial period, followed by 60 min of exercise. Visual analogue scales were used to determine subjective appetite sensations. Rates of energy expenditure and substrate (lipid and carbohydrate) oxidation were estimated using indirect calorimetry.

Results

Calcium co-ingestion resulted in a 47 % increase in GIP_1–42, a 22 % increase in GLP-1 and a 19 % increase in insulin areas under the curve for the 120 min following consumption (all P < 0.05). Furthermore, appetite sensations were suppressed by calcium co-ingestion by 12 % (P = 0.034). No differences, however, were observed in substrate metabolism (P > 0.05).

Conclusion

Ingestion of a high-calcium meal potentiates postprandial GIP_1–42, GLP-1 and insulin concentrations in humans. Subjective appetite is also temporarily suppressed, although substrate metabolism is unaffected.     

Antioxidant and inflammatory response following high-fat meal consumption in overweight subjects

Purpose

Postprandial metabolic stress as a consequence of ingestion of high-energy meals is recognized as an important risk factor for cardiovascular disease. The objective of this study was to evaluate the inflammatory and antioxidant response of the body to the acute ingestion of a high-fat meal (HFM).

Methods

Fifteen healthy overweight subjects were recruited for the study. After HFM consumption, plasma glucose, insulin, uric acid (UA), triglycerides (TG), total cholesterol (TC), thiols (SH), inflammatory cytokines (IL-6 and TNF-α) and dietary antioxidants were measured at 0, 0, 5, 1, 2, 4, 6 and 8 h points from ingestion.

Results

The ingestion of HFM induced significant increases in both TG and TC, with peaks at 4 h (p < 0.001) and 8 h (p < 0.01), respectively. IL-6 and TNF-α significantly increased postprandially, reaching maximum concentrations 8 h after meal consumption (p < 0.001). Whereas plasma concentrations of vitamins and carotenoids were not changed by HFM, SH and UA increased, peaking 2–4 h postingestion (p < 0.001 and 0.01, respectively). Increments of SH and UA were positively correlated with AUC for TG (Pearson coefficient 0.888, p < 0.001 and 0.923, p < 0.001, respectively).

Conclusions

Present results indicate that as a consequence of an excess of dietary fat, the body responds through an inflammatory reaction, which is accompanied by an increment of endogenous antioxidant defenses, mediated by UA and SH, but not by vitamins C and E and carotenoids. Although further studies are needed, results of the current investigation represent novel findings on endogenous strategies of redox defense from fat overloads.     

Milk phospholipid and plant sterol-dependent modulation of plasma lipids in healthy volunteers

Purpose

Hypolipidemic and/or hypocholesterolemic effects are presumed for dietary milk phospholipid (PL) as well as plant sterol (PSt) supplementation. The aim was to induce changes in plasma lipid profile by giving different doses of milk PL and a combination of milk PL with PSt to healthy volunteers.

Methods

In an open-label intervention study, 14 women received dairy products enriched with moderate (3 g PL/day) or high (6 g PL/day) dose of milk PL or a high dose of milk PL combined with PSt (6 g PL/day + 2 g PSt/day) during 3 periods each lasting 10 days.

Results

Total cholesterol concentration and HDL cholesterol concentration were reduced following supplementation with 3 g PL/day. No significant change in LDL cholesterol concentration was found compared with baseline. High PL dose resulted in an increase of LDL cholesterol and unchanged HDL cholesterol compared with moderate PL dose. The LDL/HDL ratio and triglyceride concentration remained constant within the study. Except for increased phosphatidyl ethanolamine concentrations, plasma PL concentrations were not altered during exclusive PL supplementations. A combined high-dose PL and PSt supplementation led to decreased plasma LDL cholesterol concentration, decreased PL excretion, increased plasma sphingomyelin/phosphatidyl choline ratio, and significant changes in plasma fatty acid distribution compared with exclusive high-dose PL supplementation.

Conclusion

Milk PL supplementations influence plasma cholesterol concentrations, but without changes of LDL/HDL ratio. A combined high-dose milk PL and PSt supplementation decreases plasma LDL cholesterol concentration, but it probably enforces absorption of fatty acids or fatty acid-containing hydrolysis products that originated during lipid digestion.     

The effect of submicron fat droplets in a drink on satiety,food intake,and cholecystokinin in healthy volunteers

Purpose

Small fat droplets infused into the gut reduce food intake and hunger more than bigger ones, at levels as low as 6 g, and these effects are hypothesized to occur via satiety hormones such as cholecystokinin. It is, however, unknown whether the effect of droplet size would persist after oral consumption. It is also unknown whether an even smaller droplet size can affect hunger and food intake and at what minimum amount of fat. Therefore, the aim of the study was to test the effect of very fine fat droplets on satiety and food intake in two different quantities.

Methods

In a balanced-order 4-way crossover design, 24 volunteers consumed a fat-free meal replacement drink with either 5 or 9 g oil (rapeseed) and either 3 or 0.1 μm droplet size. Appetite scores and plasma cholecystokinin levels (in n = 12 subset) were measured for 180 min, when food intake was assessed during an ad libitum meal. Data were analyzed by ANCOVA, followed by Dunnett’s test and paired t test. The behavior of the emulsions was also characterized in a simulated gastrointestinal model.

Results

Despite faster in vitro lipolysis of the smallest droplets, neither droplet size nor fat amount affected satiety or food intake. From t = 45–150 min, cholecystokinin response was 50 % higher (P < 0.05) after the 0.1 versus 3 μm, but only with 9 g fat.

Conclusion

When this particular fat at these amounts is delivered in a meal replacement drink, droplet size does not influence appetite or food intake. This effect is independent of the amount of fat or plasma cholecystokinin changes.     

Plasma phospholipids indicate impaired fatty acid homeostasis in preterm infants

Background

During fetal development, docosahexaenoic (DHA) and arachidonic acid (ARA) are particularly enriched in brain phospholipids. After preterm delivery, fetal enrichment of DHA and ARA via placental transfer is replaced by enteral and parenteral nutrition, which is rich in linoleic acid (LA) instead. Specific DHA and ARA enrichment of lipoproteins is reflected by plasma phosphatidylcholine (PC) species, whereas plasma phosphatidylethanolamine (PE) composition reflects hepatic stores.

Objective

We profiled PC and PE species in preterm infant plasma, compared with cord and maternal blood, to assess whether current feeding practice meets fetal conditions in these patients.

Design

Preterm infant plasma (N = 171, 23–35 w postmenstrual age (PMA), postnatal day 1–103), cord plasma (N = 194) and maternal serum (N = 121) (both 24–41 w PMA) were collected. After lipid extraction, PC and PE molecular species were analyzed using tandem mass spectrometry.

Results

Phospholipid concentrations were higher in preterm infant than in cord plasma after correction for PMA. This was mainly due to postnatal increases in LA-containing PC and PE, resulting in decreased fractions of their DHA- and ARA-containing counterparts. These changes in preterm infant plasma phospholipids occurred during the time of transition to full enteral feeds (day 0–10 after delivery). Thereafter, the fraction of ARA-containing phospholipids further decreased, whereas that of DHA slowly reincreased but remained at a level 50 % of that of PMA-matched cord blood.

Conclusions

The postnatal increase in LA–PC in preterm infant plasma results in decreased fractions of DHA–PC and ARA–PC. These changes are also reflected by PE molecular composition as an indicator of altered hepatic fatty acid homeostasis. They are presumably caused by inadequately high LA, and low ARA and DHA supply, at a stage of development when ARA–PC and DHA–PC should be high, probably reducing the availability of DHA and ARA to the developing brain and contributing to impaired neurodevelopment of preterm infants.     

Status of cardiovascular health in a transition European country: findings from a population-based cross-sectional study

Objectives

Our aim was to assess the prevalence of ideal cardiovascular health (CVH) in the adult population of Republic of Srpska (RS), Bosnia and Herzegovina, and its relationship with socio-demographic characteristics of participants.

Methods

We included 4,170 adults (mean age 50.2 years; 54 % women) from the National Health Survey performed from September to November 2010 in RS. Population prevalence of CVH health metrics (smoking, body mass index, physical activity, diet, cholesterol, blood pressure, and glucose) were estimated according to the American Heart Association criteria for “ideal”, “intermediate”, and “poor” levels.

Results

Only 0.02 % participants had ideal (all 7 health metrics at ideal levels), 7.6 % intermediate, and 92.4 % poor (at least one metric at poor level) CVH. The fasting glucose was the most prevalent (75.9 %), whereas the healthy diet was the least prevalent (4.4 %) ideal CVH metric.

Conclusions

Our study indicates extremely low prevalence of ideal and high prevalence of poor CVH in the adult RS population. Such alarming results require urgent action. Comprehensive public health strategies and interventions must be developed to assist individuals and population in improving their CVH.     

Effect of dietary fatty acid composition on substrate utilization and body weight maintenance in humans

Background/purpose

Dietary fat content is a primary factor associated with the increase in global obesity rates. There is a delay in achieving fat balance following exposure to a high-fat (HF) diet (≥ 40 % of total energy from fat) and fat balance is closely linked to energy balance. Exercise has been shown to improve this rate of adaptation to a HF diet. Recently, however, the role of dietary fatty acid composition on energy and macronutrient balance has come into question.

Methods

We chose studies that compared monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and saturated fatty acids (SFA). We have reviewed studies that measured diet-induced thermogenesis (DIT), energy expenditure (EE), or fat oxidation (FOx) in response to a HF meal challenge, or long-term dietary intervention comparing these fatty acids.

Results

While single-meal studies show that SFA induce lower DIT and FOx compared to unsaturated fats, the effect of the degree of unsaturation (MUFA vs. PUFA) appears to yet be determined. Long-term dietary interventions also support the notion that unsaturated fats induce greater EE, DIT, and/or FOx versus SFA and that a high MUFA diet induces more weight loss compared to a high SFA diet. Sex and BMI status also affect the metabolic responses to different fatty acids; however, more research in these areas is warranted.

Conclusion

SFA are likely more obesigenic than MUFA, and PUFA. The unsaturated fats appear to be more metabolically beneficial, specifically MUFA ≥ PUFA > SFA, as evidenced by the higher DIT and FOx following HF meals or diets.     

The impact of common mental disorders on work ability in mentally and physically demanding construction work

Purpose

To gain insight into (1) the prevalence and incidence of common mental disorders (CMD) and low work ability among bricklayers and construction supervisors; (2) the impact of CMD on current work ability and work ability 1 year later and (3) the added value of job-specific questions about work ability for detecting signs of low work ability.

Methods

We randomly selected 750 bricklayers and 750 supervisors. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire 1 year later. Work ability was measured with the first three questions of the Work Ability Index and job-specific questions. Self-reported CMD were measured with instruments designed to detect a high need for recovery after work, distress and depression. We used univariate logistic regression to analyse the presence or absence of CMD as independent variable.

Results

The prevalence and incidence of CMD among 199 bricklayers and 224 supervisors was 22 %/10 % and 32 %/15 %, respectively. The prevalence of low general work ability was comparable for both occupations (5 %). CMD were associated with low current work ability and low work ability at follow-up (ORs 4.3–22.4), but not with a reduction in work ability 1 year later. Questions on job-specific work ability resulted in more indications of low work ability among both occupations than did questions on general work ability.

Conclusions

Regardless of occupation, workers who report CMD at baseline have a high likelihood of current low work ability and low work ability 1 year later.