Incorporation of Lean Red Meat into a National Cholesterol Education Program Step I Diet: A Long-Term,Randomized Clinical Trial in Free-Living Persons with Hypercholesterolemia

Objective: Clinicians often recommend that intake of all meat, particularly red meat, be reduced in conjunction with a low-fat, low-cholesterol diet to reduce low-density lipoprotein (LDL) cholesterol. This study was designed to determine the long-term effects of lean red meat (beef, veal and pork) compared to lean white meat (poultry and fish) consumption on lipoprotein concentrations in free-living hypercholesterolemic subjects consuming a National Cholesterol Education Program (NCEP) Step I diet.

Methods: A randomized, crossover design was utilized. Hypercholesterolemic men and women (LDL cholesterol between 3.37 and 4.92 mmol/L) (triglycerides <3.96 mmol/L) (n = 145) were counseled to consume ≥80% of their 170 g/d meat intake as either lean red meat or lean white meat for two 36-week phases, separated by a four-week washout period of free meat selection. Subjects were instructed to follow an NCEP Step I diet throughout the study.

Results: There were no significant differences in lipid concentrations between the lean red meat and lean white meat phases. LDL cholesterol was 4.02 ± 0.04 (SEM) and 4.01 ± 0.04 mmol/L in the white and red phases, respectively; this represented a decrease of ～2% from baseline concentrations (p < 0.01). Total cholesterol also declined by 1% from baseline (p < 0.05), and high-density lipoprotein (HDL) cholesterol rose over the study period by ～2% to ～3% from baseline to reach concentrations of 1.37 ± 0.03 mmol/L and 1.38 ± 0.03 mmol/L in the white and red phases, respectively (p < 0.001). Triglycerides were not altered by treatment.

Conclusions: Consumption of lean red meat or lean white meat, as part of an NCEP Step I diet, is similarly effective for reducing LDL cholesterol and elevating HDL cholesterol concentrations in free-living persons with hypercholesterolemia.     

Triglyceride Recrystallized Phytosterols in Fat-Free Milk Improve Lipoprotein Profiles More Than Unmodified Free Phytosterols in Hypercholesterolemic Men and Women

Objective: Foods incorporating plant sterols (PS) consistently decrease serum low-density lipoprotein cholesterol (LDL-C), although results vary depending on the PS form and food matrix. The objective was to study the effect of a novel triglyceride-recrystallized phystosterol (TRP) incorporated into fat-free milk on markers of cardiovascular risk compared to unmodified free sterols alone in the same fat-free milk.

Methods: Hypercholesterolemic men and women (n = 13 males/7 females; 56 ±10 years; body mass index 27.3 ±5.9 kg/m²) participated in 3 sequential 4-week phases of 480 mL milk consumption. During phase 1 (control) all subjects consumed 2% milk containing no PS, followed by phase 2 with fat-free milk containing free PS (2 g/d fPS) and phase 3 with fat-free milk with TRP (2 g/d). After each phase, determinations of lipoprotein cholesterol distribution, particle concentration via nuclear magnetic resonance (NMR), apolipoproteins, inflammatory markers, and fat-soluble dietary antioxidants were made.

Results: Body mass, body composition, dietary energy and macronutrients, and physical activity were unaffected throughout the study. Compared to the control 2% milk, LDL-C was significantly (p < 0.05) decreased by fPS (?9.1%) and was further decreased by TRP (?15.4%); reductions with TRP were significantly greater. Total LDL particle concentration was decreased to a greater extent after TRP (?8.8%) than fPS (?4.8%; p < 0.05). Only TRP significantly decreased serum levels of apolipoprotein B (apoB; ?6%), interleukin-8 (IL-8; ?11%) and monocyte chemotactic protein-1 (MCP-1; ?19%). Plasma α- and γ-tocopherols and carotenoids, normalized to cholesterol, remained unchanged throughout the study with the exception that β-carotene was lowered by 18%.

Conclusion: In summary, TRP in fat-free milk may provide cardiovascular benefits beyond that of fPS by inducing more substantial decreases in LDL cholesterol and particle concentration, associated with declines in markers of vascular inflammation.     

Lipid-altering effects of a dietary supplement tablet containing free plant sterols and stanols in men and women with primary hypercholesterolaemia: a randomized,placebo-controlled crossover trial

This randomized, placebo-controlled, crossover trial assessed the lipid-altering efficacy of a dietary supplement (tablet form) providing 1.8 g/day free (non-esterified) plant sterols and stanols versus placebo for 6 weeks as part of a therapeutic lifestyle changes (TLC) diet in 32 men and women with primary hypercholesterolaemia. Mean ± SE baseline (end of a 5-week TLC diet lead-in) lipid concentrations (mmol/l) were total cholesterol (TC), 5.88 ± 0.08; non-high-density lipoprotein cholesterol (non-HDL-C), 4.71 ± 0.09; low-density lipoprotein cholesterol (LDL-C), 4.02 ± 0.08; HDL-C, 1.17 ± 0.06 and triglycerides (TGs), 1.51 ± 0.12. Differences from control in responses (plant sterol/stanol ? control) were significant (p < 0.05) for LDL-C ( ? 4.9%), non-HDL-C ( ? 3.6%) and TC ( ? 2.8%). HDL-C and TG responses were not significantly different between treatment conditions. These results indicate that 1.8 g/day free plant sterols/stanols administered in a tablet produced favourable lipoprotein lipid changes in men and women with hypercholesterolaemia.     

Pistachio Nuts Reduce Triglycerides and Body Weight by Comparison to Refined Carbohydrate Snack in Obese Subjects on a 12-Week Weight Loss Program

Objective: There is a widely held view that, due to high fat content, snacking on nuts will lead to weight gain, ultimately causing unhealthy changes in lipid profiles. This study is designed to study the effects of pistachio snack consumption on body weight and lipid levels in obese participants under real-world conditions.

Methods: Participants were randomly assigned to consume 1 of 2 isocaloric weight reduction diets for 12 weeks, with each providing 500 cal per day less than resting metabolic rate. Each diet included an afternoon snack of either 53 g (240 cal) of salted pistachios (n = 31) or 56 g of salted pretzels (220 cal; n = 28).

Results: Both groups lost weight during the 12-week study (time trend, p < 0.001), but there were significant differences in the changes in body mass index between the pretzel and pistachio groups (pistachio, 30.1 ± 0.4 to 28.8 ± 0.4 vs. pretzel, 30.9 ± 0.4 to 30.3 ± 0.5). At 6 and 12 weeks, triglycerides were significantly lower in the pistachio group compared with the pretzel group (88.04 ± 9.80 mg/dL vs. 144.56 ± 18.86 mg/dL, p = 0.01 at 6 weeks and 88.10 ± 6.78 mg/dL vs. 132.15 ± 16.76 mg/dL, p = 0.02 at 12 weeks), and there was a time trend difference between the 2 groups over the 12 weeks (p < 0.01). There were no significant differences in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, insulin, or glucose between the 2 groups.

Conclusion: Pistachios can be consumed as a portion-controlled snack for individuals restricting calories to lose weight without concern that pistachios will cause weight gain. By comparison to refined carbohydrate snacks such as pretzels, pistachios may have beneficial effects on triglycerides as well.     

Acute effects of the very low carbohydrate diet on sleep indices

Abstract

Objective: We compared the effect of short-term consumption of a very low carbohydrate (VLC) diet over 48 h to a control mixed diet on sleep indices in healthy, non-obese men.

Design: This study employed a repeated-measure design where subjects were given isocaloric (2400 kcal) diets and matching evening test meals (4 h before usual bed-time), which were either mixed low-fat, high carbohydrate (15.5%, 12.5% and 72% of energy from protein, fat and carbohydrate, respectively) or VLC (38%, 61% and < 1% of energy from protein, fat and carbohydrate, respectively). Polysomnographic testing was performed on the familiarization and control night, 4 h after the first VLC test meal (acute phase) and 48 h (ketosis phase) following commencement of the VLC diet.

Subjects: Fourteen healthy, non-obese men (aged 18–35 years; body mass index 23.4 ± 1.9 kg/m²) who were good sleepers took part in the study.

Measurement: Objective sleep was recorded using a computerized sleep system. Urine ketone level was monitored with reagent strips before the evening test meals and at bed-time on the control night, during the VLC acute and ketosis phases. Blood glucose level was measured with a glucometer before the evening test meal until 120 min following the meal. Hunger and fullness were assessed immediately after the meal until bed-time with Likert scales.

Results: The proportion of rapid-eye movement (REM) sleep to total sleep time was significantly reduced at the VLC acute and VLC ketosis when compared to the control night (P = 0.006; n = 11 and P = 0.05; n = 14, respectively). The percentage of slow wave sleep (SWS) significantly increased for both the VLC acute (17.7 ± 6.7) and ketosis (17.8 ± 6.1) phases compared to control (13.9 ± 6.3), P = 0.02 for both phases.

Conclusions: In healthy, good sleepers, the VLC diet over the short-term promotes increases in the percentage of SWS (deep sleep stage 4) and a reduction in the percentage of REM sleep ('dreaming' sleep) compared to the control mixed diet. The sleep changes may be linked to the metabolism of the fat content of the VLC diet.     

山西省农村地区居民血清总胆固醇水平追踪分析

目的 分析山西省733名农村居民血清TC水平的纵向变化状况。方法 以曾经参加过2002年中国居民营养与健康调查的山西省5个农村地区居民为基础,于2015年进行追踪调查,采集调查对象空腹静脉血,采用胆固醇氧化酶法测定血清TC浓度。结果 733名研究对象中,男性332名,女性401名。2002年基线调查时年龄为（42.6±9.5）岁,76.2%的男性和83.8%的女性文化程度在初中及以下。男性与女性吸烟的比例分别为65.7%和1.2%,饮酒比例分别为26.8%和4.0%,肥胖比例分别为6.3%和12.0%,中心性肥胖比例分别为27.1%和31.9%。2015年追踪调查时年龄为（55.8±9.5）岁,男性与女性吸烟比例分别为48.2%和1.5%,饮酒比例分别为49.7%和3.0%,肥胖比例分别上升至11.8%和18.2%,中心性肥胖比例分别上升至41.6%和53.6%。2002－2015年,追踪人群血清TC水平由（3.82±0.89）mmol/L上升至（4.72±0.97）mmol/L,平均上升幅度为27.2%。男性血清TC水平由（3.84±0.94）mmol/L上升至（4.54±0.93）mmol/L,女性血清TC水平由（3.81±0.84）mmol/L上升至（4.86±0.98）mmol/L,增幅分别为22.7%和30.9%。18～、30～、40～、50～59岁组的血清TC水平由（3.42±0.83）、（3.72±0.77）、（3.90±0.83）、（4.00±1.03）mmol/L上升至（4.38±1.01）、（4.79±0.92）、（4.73±0.99）、（4.76±0.96）mmol/L。各年龄组增加幅度分别为31.4%、32.1%、25.2%和22.6%。经配对t检验和方差分析,不同性别、年龄、文化程度、婚姻状况、心血管疾病家族史、吸烟、饮酒、BMI和腰围组的血清TC水平在不同年度的差异均有统计学意义（P<0.01）。结论 山西省农村居民血清TC水平纵向上升速度较快。     

China: transformations of its cuisine,a prelude to understanding its people.

Objective:Familial hypercholesterolemia (FH) is a predominantly inherited disorder, which contributes to a defect of the LDL-cholesterol receptor. For adults with familial hypercholesterolemia (FH), it is known that a supplementary diet of monounsaturated fatty acids reduces elevated levels of total cholesterol and LDL-cholesterol and may further increase HDL-cholesterol. In particular the reduced intake of dietary fat reduces total serum cholesterol and LDL-cholesterol in the range of 10% to 15% and inhibits LDL-oxidation. Once the diagnosis of familial hypercholesterolemia is made in early childhood a supplementary diet with rapeseed oil should be started as early as possible to prevent development of atherosclerosis and subsequent complications. So far there are no reports of a lipid lowering diet enriched with rapeseed oil in children and adolescents.

Methods:Seventeen children and young adolescents (male = 6, female = 11, ages 4 to 19 years) diagnosed with FH were enrolled in this study. They received dietary training and a classical low fat/low cholesterol diet enriched with rapeseed oil over five months. In the first two months they received orally mean 15 g/day (8–23 g/day), for the remaining three months mean 22 g/day (15–30 g/day) rapeseed oil. The calculation of the three-days dietary protocols showed the following characteristics: 29.5% calories from fat, 14.3% calories from protein and 54.6% calories from carbohydrates. The subjects had six sessions of dietary counseling, and serum lipids levels and lipoprotein(a) were estimated; each month’s diet adherence was controlled by a dietitian and discussed with the patients and their families during this five-month study.

Result:During five months of rapeseed oil diet serum triglycerides decreased by 29% (119.2 ± 62.8 mg/dL vs. 84.9 mean ± 39.7 mg/dL), VLDL-cholesterol by 27% (23 ± 12 mg/dL vs. 17 ± 8 mg/dL), total cholesterol by 10% (233 ± 35 mg/dL vs. 213 ± 36 mg/dL), LDL-cholesterol by 7% (151 ± 31 mg/dL vs. 142 ± 31 mg/dL). HDL-cholesterol (59 ± 15 mg/dL vs. 57 ± 11 mg/dL) and Lp(a) (29.8 ± 36.3 mg/dL vs. 32.6 ± 40.7 mg/dL) were not changed significantly. The diet was well accepted; in most families a sustained change was reported.

Conclusions:Our results indicate that in children and adolescents with FH a lipid-lowering diet with rapeseed oil has a similar effect on total serum cholesterol and LDL-cholesterol compared to classical cholesterol reduction diets (step I). However, an additional pronounced effect on lowering of triglycerides and VLDL-cholesterol can be observed.     

2013年中国人群高胆固醇对期望寿命的影响

目的 探讨中国人群高胆固醇对期望寿命的影响。方法 用2013年中国慢性病及其危险因素监测获得人群血清TC水平,计算分城乡、东中西部的高胆固醇人群归因分值,进而利用死因登记资料和人口统计数据,估算高胆固醇的归因死亡及其对期望寿命的影响。结果 2013年,中国≥ 25岁人群血清TC水平为（4.8±1.0）mmol/L,城市人群TC水平[（4.8±1.0）mmol/L]高于农村[（4.7±1.0）mmol/L],东部地区人群TC最高[（4.9±1.0）mmol/L],中部最低[（4.6±1.0）mmol/L],男性和女性TC均为（4.8±1.0）mmol/L。全部死亡中,2.9%归因于高胆固醇（264 998人）,其中89.3%死于缺血性心脏病（236 540人）,女性全死因人群归因分值（3.7%）高于男性（2.3%）,城市（3.4%）高于农村（2.4%）,东部最高（3.7%）,西部最低（2.1%）。中国人群高胆固醇归因死亡率为19.6/10万,女性（21.2/10万）高于男性（18.0/10万）,城市（20.8/10万）高于农村（18.2/10万）,东部归因死亡率最高（23.2/10万）,西部最低（15.6/10万）。2013年中国人群高胆固醇导致期望寿命损失为0.30岁,女性（0.35岁）高于男性（0.26岁）;城市人群期望寿命损失（0.34岁）高于农村（0.28岁）;东部人群期望寿命损失最高（0.36岁）,西部最低（0.23岁）。结论 高胆固醇对中国人群期望寿命的影响存在性别、城乡和地区差异。女性、城市和东部受影响较大。     

Low intestinal cholesterol absorption is associated with a reduced efficacy of phytosterol esters as hypolipemic agents in patients with metabolic syndrome

Background & aims

Phytosterols (PS) lower LDLc, but their effect on metabolic syndrome (MetS) remains unknown. We evaluated whether low-fat milk enriched with PS improves cardiovascular risk factors in these patients.

Methods

A randomised parallel trial employing 24 moderate-hypercholesterolaemic MetS patients and consisting of two 3-month intervention phases. After a 3-month healthy diet, patients were divided into two intervention groups: diet (n = 10) and diet + PS (n = 14) (2 g/day). A control group of 24 moderate-hypercholesterolaemic patients without MetS (matched in age and BMI) underwent the same procedure.

Results

Neither dietary intervention nor enrichment of PS induced any improvement in the serum lipoprotein profile of MetS patients. By contrast, in the non-MetS population, a healthy diet effectively reduced TC, LDLc, non-HDLc and Apo B-100, with further decreases in TC (6.9%), LDLc (10.5%), non-HDLc (10.3%), Apo B-100 (6.2%) and Apo B-100/ApoA-I ratio (11.6%) being observed when PS were administered. No differences in LDL diameter, hsCRP or homocysteine were detected in any of the groups after consuming PS. This supplementation produced a significant increase in PS levels only in the non-MetS population.

Conclusions

PS therapy appears to be of little value to MetS patients, likely due to its reduced intestinal cholesterol absorption. The efficacy of PS as hypocholesterolaemic agents is thus limited.     

Dose-response relation between serum total cholesterol levels and overall cancer risk: evidence from 12 prospective studies involving 1,926,275 participants

This study aimed to clarify the association between serum total cholesterol (TC) levels and overall cancer risk. Study-specific relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects model, and dose–response relation was also evaluated. Twelve prospective studies were identified with a total of 1,926,275 participants and 13,1676 cases. High levels of serum TC showed an inverse association with overall cancer risk (RR for the highest versus the lowest category: 0.87, 95% CI: 0.83?～?0.90; I²?=?52.5%). A linear dose-response relation between serum TC levels and overall cancer risk was found (p?=?.004 for Wald test; I²?=?49.6%), and the pooled RR was 0.92 (95% CI: 0.89?～?0.94) for 3?mmol/L, 0.86 (95% CI: 0.81?～?0.90) for 5?mmol/L, 0.80 (95% CI: 0.74?～?0.87) for 7?mmol/L. Our dose-response meta-analysis of 12 prospective studies indicated that higher serum TC levels were significantly associated with reduced cancer risk.     

Iron absorption from brown rice/brown rice-based meal and milled rice/milled rice-based meal

Background Milled rice is the staple food among Filipinos and is mostly consumed three times a day. Rice as a source of iron could therefore have an important role in the existing 37% prevalence of iron-deficiency anemia in the country. Previous iron absorption studies in Filipinos from rice and rice-based meals were carried out on milled rice but no research was done on brown rice of the same variety. This leads to the hypothesis that brown rice may be better than milled rice in terms of iron content.

Objective To determine iron absorption from brown rice and brown rice-based meal, and from milled rice and milled rice-based meal of the same variety.

Methods The rice variety used in the study was F₂ seeds of PSB Rc72H. Iron absorption from brown/milled rice and brown/milled rice-based meals was determined in 12 healthy human subjects from the incorporation of radioisotopes of iron into erythrocytes 14 days after administration of the labeled rice/rice-based meals. The above samples were also analyzed for nutrient content, including dietary fiber, and iron.

Results The iron content of brown rice was significantly higher (1.1 ± 0.1 mg/100 g) than that of milled rice (0.6 ± 0.1 mg/100 g). Brown rice has significantly greater amounts of total dietary fiber (5.4 ± 0.4%) than milled rice (1.7 ± 0.2%; P < 0.05). Both tannic acid and phytic acid contents in brown rice (56.9 ± 3.2 mg/100 g and 290.1 ± 18.0 mg/100 g, respectively) were significantly higher than those of milled rice (21.3 ± 2.3 mg/100 g and 84.0 ± 12.4 mg/100 g, respectively; P<0.05). The amount of iron absorbed from brown rice (0.13 ± 0.02 mg) did not differ significantly from that from milled rice (0.14 ± 0.02 mg). However, the amount from brown rice-based meal (0.36 ± 0.04 mg) differed significantly from that from brown rice (P<0.05) as well as that from milled rice-based meal (0.35 ± 0.03 mg) from that from milled rice (P<0.05). Moreover, brown rice-based meal did not differ significantly from milled rice-based meal (P<0.05).

Conclusion Iron absorbed from milled rice and brown rice did not differ significantly, as well as that from brown rice-based meal and milled rice-based meal. Differences in iron absorbed from brown/milled rice and brown/milled rice-based meals may be due to the iron content of the test foods and the presence of iron enhancers in the meal (e.g. fish, vegetables and citrus fruit).     

LDL cholesterol-lowering effects of grape extract used as a dietary supplement on healthy volunteers

The aim of this study was to evaluate the effects of Eminol®, the polyphenol-rich grape extract supplement (700 mg), on cardiovascular risk and oxidant stress indicators in a sample of volunteers. A randomized, double-blind, placebo-controlled clinical trial was performed over 56 days and included 60 volunteers. Thirty volunteers took 700 mg of the grape extract, Eminol® (E), and 30 took the placebo (P). On comparison of the results, a decrease in total cholesterol (E: 213.77 ± 4.1 mg/dl and P: 245.57 ± 4.1 mg/dl; p = 0.01) and LDL cholesterol (E: 142.17 ± 3.1 mg/dl and P: 165.13 ± 3.1 mg/dl; p = 0.02) levels as well as an increase in antioxidant capacity (E: 65.63 ± 5.8 μmol TE/mg and P: 57.80 ± 7.7 μmol TE/mg; p < 0.01) and vitamin E (E: 11.46 ± 0.5 μg/ml and P: 9.06 ± 0.5 μg/ml; p = 0.018) was observed. This result indicates that the grape extract Eminol® modulated the lipid profile in terms of cardiovascular risk indicators, lowering total blood cholesterol and LDL cholesterol levels.     

慢性三氯化镧暴露对大鼠血糖和血脂水平的影响

目的探讨稀土元素镧的慢性暴露对大鼠血糖、血脂的影响。方法分别以0.1、2和40 mg/kg剂量的三氯化镧(LaC l3)给大鼠经口灌胃,每天1次,90 d后处死;取全血测定糖化血红蛋白(HbA1 c),分离血清测定血糖(G lu)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平。结果与对照组相比,3个LaC l3暴露剂量组大鼠HbA1C、血清G lu、TG和LDL-C水平无统计学意义;0.1和2 mg/kg剂量LaC l3暴露组大鼠血清TC水平分别为(1.38±0.14)mmol/L和(1.37±0.26)mmol/L,与对照组大鼠(1.57±0.14)mmol/L相比有明显降低;0.1 mg/kg剂量LaC l3暴露组大鼠血清HDL-C为(0.79±0.12)mmol/L,比对照组大鼠(0.93±0.10)mmol/L有明显降低。结论0.1~40 mg/kg LaC l3慢性暴露对大鼠血清G lu、TG和LDL-C水平无显著影响;低、中剂量LaC l3慢性暴露可使大鼠血清TC和HDL-C降低。     

Reduction of Postprandial Glycemia by the Novel Viscous Polysaccharide PGX,in a Dose-Dependent Manner,Independent of Food Form

Objective: Health benefits of viscous fiber intake are well established; nevertheless few effective and palatable preparations are available. The objective of the study therefore was to determine palatability and effectiveness of escalating doses of PGX, a novel viscous polysaccharide (NVP), in reducing postprandial glycemia when added to a liquid and a solid meal.

Design: Two open-label, randomized, controlled trials were undertaken.

Setting: Glycemic Index Laboratories, Inc, Toronto, Ontario, Canada.

Subjects: Two groups of 10 healthy subjects each (group 1: 5 M, 5 F; 35.6 ± 13.2 y; 24.6 ± 2.1 kg/m²; and group 2: 3 M, 7 F; 33.5 ± 11.1 y; 26.3 ± 5.2 kg/m²) were studied.

Interventions: Zero, 2.5, 5, and 7.5 g of NVP were added to a glucose drink (group 1) or to white bread and margarine (WB + Marg) (group 2). Subjects repeated glucose control (group 1) or WB control (group 2) 3 times to allow calculation of the glycemic index (GI).

Measures of Outcomes: Palatability of foods and capillary blood glucose concentrations were measured fasting and at 15, 30, 45, 60, 90, and 120 minutes after the start of the meal.

Results: Addition of NVP to the meal reduced blood glucose incremental areas under the curve irrespective of dose, reaching significance at the 7.5 g dose when added to glucose (p < 0.01), and at the 5 and 7.5 g doses when added to WB + Marg (p < 0.001). The GI values of glucose with 0, 2.5, 5, or 7.5 g of NVP were (mean ± standard error of the mean [SEM]) 100.0 ± 0.0, 83.7 ± 9.0, 77.7 ± 8.2, and 72.5 ± 5.9, respectively; the GI of the WB alone, or of WB + Marg, with 0, 2.5, 5, or 7.5 g of NVP was 71.0 ± 0.0, 66.8 ± 3.0, 47.5 ± 5.9, 37.3 ± 5.9, and 33.9 ± 3.6, respectively.

Conclusion: Addition of NVP to different food matrices is highly effective in lowering the glycemic index of a food in a dose-responsive manner.     

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

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

Ensayo clínico aleatorio: papel de la dieta y ejercicios físicos en mujeres con síndrome metabólico

ObjectiveTo evaluate a program of nutritional recommendations and exercise in women with metabolic syndrome.DesignMulticentre randomised controlled trial.LocationPrimary Health Care, Holguin, Cuba.ParticipantsA cluster sample of 150 obese women with metabolic syndrome without glucose disturbances, were randomly assigned to a control (n = 70) or experimental (n = 80) group. A total of 62 women in the control group and 60 in the intervention group completed the study (June 2008-July 2009).InterventionsLow calorie diets and a program of exercises in the experimental group. Usual care in the control group.MeasurementsBody weight, body mass index, waist circumference, blood pressure, blood glucose and lipid profile.ResultsCompared to the control group, after one year, the experimental group had a lower, diastolic blood pressure (78 ± 0.9 vs 91 ± 1.1 mm Hg), total cholesterol (4.7 ± 0.1 vs 6.0 ±0.1 mmol/L), triglycerides (1.9 ± 0.0 vs 2.9 ± 0.1 mmol/L) and LDL cholesterol (2.5 ± 0.0 vs 3.5 ± 0.1 mmol/L), and a higher HDL-cholesterol (1.2 ± 0.0 vs 1.1 ± 0.0 mmol/L). There were no appreciable changes in weight, body mass index, waist circumference, systolic blood pressure and blood glucose.ConclusionsWe demonstrated the effectiveness of the intervention program on blood pressure and blood lipid profile.     

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

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

Meta-analysis of the effect of β-glucan intake on blood cholesterol and glucose levels

Objective

A meta-analysis was performed on epidemiologic studies to assess the relation between β-glucan consumption from oats and from barley on blood cholesterol level, triglyceride/triacylglycerol (TGL/TAG) level, and blood glucose level (BGL) in humans. In addition, the effect of β-glucan on total cholesterol (TC) and BGL was translated into an empirical dose–response model.

Methods

Thirty research articles that evaluated the effect of different exposure levels of β-glucan on blood cholesterol and BGL were analyzed, yielding 126 clinical studies.

Results

There was a significant inverse relation in TC (−0.60 mmol/L, 95% confidence interval [CI] −0.85 to −0.34), low-density lipoprotein (−0.66 mmol/L, 95% CI −0.96 to −0.36), and TGL/TAG (−0.04 mmol/L, 95% CI −0.15 to 0.07) after consumption of β-glucan. In contrast, an increase in high-density lipoprotein cholesterol was noted (0.03 mmol/L, 95% CI −0.06 to 0.13) with the random-effect model. The analysis showed a significant change in BGL (−2.58 mmol/L, 95% CI −3.22 to −1.84) with high heterogeneity between (I² = 97%) and across (τ² = 5.88) the studies. The fixed-effect model showed a significant change in TC, low-density lipoprotein, and BGL, whereas it showed no significant changes in high-density lipoprotein and TGL/TAG. The dose–response model showed that a 3-g/d dose of oat or barley β-glucan was sufficient to decrease TC.

Conclusion

Consumption of 3 g/d of oat or barley β-glucan is sufficient to decrease blood cholesterol, whereas the effect on BGL is still inconclusive, with high heterogeneity, and requires further clinical research studies with longer intervention periods.     

Effects of Baked Products Enriched with n-3 Fatty Acids,Folates, β-glucans,and Tocopherol in Patients with Mild Mixed Hyperlipidemia

Objective: To assess whether a diet containing foods enriched with β-glucans (3.6 g/d), folic acid (1600 μg/d), long-chain (800 mg/d) and short-chain (400 mg/d) n-3 fatty acids, and tocopherols (120 mg/d) is able to modulate positively the cardiovascular risk profile in people at slightly increased cardiovascular risk.

Methods: Sixteen subjects with mild plasma lipid abnormalities were studied according to a randomized crossover design. After a 2-week run-in period, they followed a diet containing baked products enriched with active nutrients (active diet) or a diet containing the same products but without active nutrients (control diet) for 1 month and then crossed over to the other diet. At the end of each period, a test meal of the same composition as the corresponding diet was administered, and plasma samples were obtained before and for 6 hours after the meal. Hunger and satiety were evaluated by the visual analog scale at fasting and after the meal.

Results: Fasting plasma triglycerides were significantly lower after the active versus the control diet (1.56 ± 0.18 vs 1.74 ± 0.16 mmol/l, p < 0.05), as was the postprandial level of chylomicron triglycerides and the insulin peak (p < 0.05). The active diet also reduced fasting homocysteine (8 ± 0.6 vs 10 ± 0.8 μmol/l, p < 0.05) and the feeling of hunger at the fifth and sixth hour (p < 0.05).

Conclusions: Baked functional products enriched with n-3 fatty acids, folates, β-glucans, and tocopherols within the context of a balanced diet lower fasting and postprandial plasma triglycerides, fasting homocysteinemia, and the postprandial insulin peak. They induce a greater feeling of satiety with possible beneficial implications on energy intake.     

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

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

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

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

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