Dietary fats and prevention of type 2 diabetes.

Consumption of flavanol-rich dark chocolate (DC) has been shown to decrease blood pressure (BP) and insulin resistance in healthy subjects, suggesting similar benefits in patients with essential hypertension (EH) Therefore, we tested the effect of DC on 24-hour ambulatory BP, flow-mediated dilation (FMD), and oral glucose tolerance tests (OGTTs) in patients with EH After a 7-day chocolate-free run-in phase, 20 never-treated, grade I patients with EH (10 males; 43778 years) were randomized to receive either 100 g per day DC (containing 88 mg flavanols) or 90 g per day flavanol-free white chocolate (WC) in an isocaloric manner for 15 days After a second 7-day chocolate-free period, patients were crossed over to the other treatment Noninvasive 24-hour ambulatory BP, FMD, OGTT, serum cholesterol, and markers of vascular inflammation were evaluated at the end of each treatment The homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and insulin sensitivity index (ISI) were calculated from OGTT values Ambulatory BP decreased after DC (24-hour systolic BP 11977 mm Hg, P00001; 24-hour diastolic BP 8550 mm Hg, P00001) but not WC DC but not WC decreased HOMA-IR (P00001), but it improved QUICKI, ISI, and FMD DC also decreased serum LDL cholesterol (from 3405 to 3006 mmol/L; P005) In summary, DC decreased BP and serum LDL cholesterol, improved FMD, and ameliorated insulin sensitivity in hypertensives These results suggest that, while balancing total calorie intake, flavanols from cocoa products may provide some cardiovascular benefit if included as part of a healthy diet for patients with EH (Hypertension 2005;46:398-405)

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Cocoa Reduces Blood Pressure and Insulin Resistance and Improves Endothelium-Dependent Vasodilation in Hypertensives

Caffeine stimulates central nervous system on a short term. However, the long-term impact of caffeine on cognition remains unclear. We aimed to study the association between coffee and/or tea consumption at midlife and dementia/Alzheimer's disease (AD) risk in late-life. Participants of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study were randomly selected from the survivors of a population-based cohorts previously surveyed within the North Karelia Project and the FINMONICA study in 1972, 1977, 1982 or 1987 (midlife visit). After an average follow-up of 21 years, 1409 individuals (71%) aged 65 to 79 completed the re-examination in 1998. A total of 61 cases were identified as demented (48 with AD). Coffee drinkers at midlife had lower risk of dementia and AD later in life compared with those drinking no or only little coffee adjusted for demographic, lifestyle and vascular factors, apolipoprotein E e4 allele and depressive symptoms. The lowest risk (65% decreased) was found in people who drank 3-5 cups per day. Tea drinking was relatively uncommon and was not associated with dementia/AD. Coffee drinking at midlife is associated with a decreased risk of dementia/AD later in life. This finding might open possibilities for prevention of dementia/AD.

Midlife coffee and tea drinking and the risk of late-life dementia: a population-based CAIDE study

Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study

Effects of coffee consumption on subclinical inflammation and other risk factors for type 2 diabetes: a clinical trial

The effects of boiled coffee, filtered coffee, and tea on serum lipoprotein lipids and apoproteins were compared in 42 middle-aged hypercholesterolemic subjects (21 men and 21 women) The subjects consumed the beverages, eight cups a day, in random order during successive 4-week periods with 2-week run-in intervals in a crossover design The diet was kept unchanged Statistically significant differences were found between the periods in serum total cholesterol (P less than 0001 ANOVA), LDL cholesterol (P less than 01), and apoprotein B (P less than 01) levels All differences were due to significantly higher levels during boiled coffee as compared with filtered coffee and tea No statistically significant differences were found between the filtered coffee and tea periods There were no differences in serum VLDL cholesterol or triglyceride, HDL cholesterol, and apoprotein A-I concentrations between the periods Consumption of boiled coffee thus increased the concentration of low density lipoprotein in the serum without affecting its lipid-protein composition The effect seemed to be determined by the method of brewing

Boiled coffee increases serum low density lipoprotein concentration.

The fatty acid composition of serum cholesterol esters was investigated in 325 subjects with normal glucose tolerance, 97 subjects with impaired glucose tolerance (IGT), and 98 subjects with non-insulin-dependent diabetes mellitus (NIDDM) identified by population-based screening. The proportions of palmitic acid (16:0) and palmitoleic acid (16:1) in serum cholesterol esters increased from the normal glucose tolerance group to the IGT and diabetic groups. On the other hand, the proportion of linoleic acid (18:2) was lower in diabetic subjects than in the subjects with IGT or normal glucose tolerance. The proportions of γ-linolenic (18:3), dihomo-γ-linolenic (20:3), and arachidonic (20:4) acids were highest in diabetic subjects and lowest in subjects with normal glucose tolerance. Our findings suggest that subjects with NIDDM or IGT have had higher dietary intake of saturated fatty acids. Both serum insulin and blood glucose concentrations probably have an effect on the elongation and desaturation of fatty acids, but the metabolism of linoleic acid to prostaglandin precursors seems to be different in different types of diabetes, NIDDM patients showing no abnormalities. The possibility that the fatty acid composition of plasma and membrane lipids has a role in insulin resistance and blood glucose regulation deserves further investigation.

Fatty acid composition of serum cholesterol esters in different degrees of glucose intolerance: A population-based study

The association between coffee consumption and serum cholesterol concentration was studied in a cross-sectional epidemiological study among 5704 men and women in Finland. The mean serum cholesterol values of those consuming boiled coffee (24% of the subjects) was significantly higher than that of drinkers of filtered coffee (69% of the subjects) in both sexes after adjusting for age, body mass index, smoking, serum gamma-glutamyltransferase, index of saturated fat intake, and physical activity: in men 6.37 versus 6.02 mmol/l, in women 6.22 versus 5.84 mmol/l, both significant at p less than 0.001. A significant dose-dependent effect was observed between the consumption of boiled coffee both in men and in women. For filter coffee drinkers a weak coffee dose-cholesterol association was found only for women. The magnitude of the effect of boiled coffee, 0.3-0.4 mmol/l in serum cholesterol values, is in accordance with the results from controlled trials carried out among both hyper- and normocholesterolaemic subjects.

Consumption of Boiled Coffee is Correlated with Serum Cholesterol in Finland

Effects of coffee and tea on lipoproteins and prostanoids.

The association between the consumption of coffee and tea and serum cholesterol concentration was studied in a population sample of 653 men and 695 women from east and south-west Finland. Cholesterol and high density lipoprotein (HDL) cholesterol were determined from fresh serum samples. Smoking and the intake of coffee, tea and alcohol were assessed by a questionnaire, and nutrient intake was determined from 3-day food records. Serum cholesterol and non-HDL cholesterol showed a positive and linear association with coffee consumption in men. In women, no such significant linear association was evident, although the highest mean serum cholesterol levels were found in subjects consuming seven to nine cups of coffee daily. Both in men and in women coffee consumption was positively associated with smoking and the intake of saturated and monounsaturated fatty acids and cholesterol. Serum cholesterol values, adjusted for age, body mass index, smoking, dietary cholesterol, fatty acids, alcohol and physical activity, showed a significant linear association with coffee consumption in men but not in women. Although coffee consumption and high intake of saturated fatty acids and cholesterol were related both in men and in women, adjustment for dietary and other confounding factors did not remove the association between coffee consumption and serum cholesterol concentration in men.

Antti Aro

Papers

Boiled coffee increases serum low density lipoprotein concentration.

Fatty acid composition of serum cholesterol esters in different degrees of glucose intolerance: A population-based study

Consumption of Boiled Coffee is Correlated with Serum Cholesterol in Finland

Effects of coffee and tea on lipoproteins and prostanoids.

Coffee and tea consumption, dietary fat intake and serum cholesterol concentration of Finnish men and women.