Design of the Women's Health Initiative clinical trial and observational study

Cholesterol-lowering effects of dietary fiber: a meta-analysis

OBJECTIVE Overweight and obese individuals are encouraged to lose 5–10% of their body weight to improve cardiovascular disease (CVD) risk, but data supporting this recommendation are limited, particularly for individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted an observational analysis of participants in the Look AHEAD (Action For Health in Diabetes) study ( n = 5,145, 40.5% male, 37% from ethnic/racial minorities) and examined the association between the magnitude of weight loss and changes in CVD risk factors at 1 year and the odds of meeting predefined criteria for clinically significant improvements in risk factors in individuals with type 2 diabetes. RESULTS The magnitude of weight loss at 1 year was strongly ( P P = 0.79). Compared with weight-stable participants, those who lost 5 to 1c (odds ratio 3.52 [95% CI 2.81–4.40]), a 5-mmHg decrease in diastolic blood pressure (1.48 [1.20–1.82]), a 5-mmHg decrease in systolic blood pressure (1.56 [1.27–1.91]), a 5 mg/dL increase in HDL cholesterol (1.69 [1.37–2.07]), and a 40 mg/dL decrease in triglycerides (2.20 [1.71–2.83]). The odds of clinically significant improvements in most risk factors were even greater in those who lost 10–15% of their body weight. CONCLUSIONS Modest weight losses of 5 to

https://care.diabetesjournals.org/content/diacare/34/7/1481.full.pdf

Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals With Type 2 Diabetes

Background Guidelines established by the National Cholesterol Education Program (NCEP) promote exercise and weight loss for the treatment of abnormal lipoprotein levels. Little is known, however, about the effects of exercise or the NCEP diet, which is moderately low in fat and cholesterol, in persons with lipoprotein levels that place them at high risk for coronary heart disease. Methods We studied plasma lipoprotein levels in 180 postmenopausal women, 45 through 64 years of age, and 197 men, 30 through 64 years of age, who had low high-density lipoprotein (HDL) cholesterol levels (≤59 mg per deciliter in women and ≤44 mg per deciliter in men) and moderately elevated levels of low-density lipoprotein (LDL) cholesterol (>125 mg per deciliter but 125 mg per deciliter but <190 mg per deciliter in men). The subjects were randomly assigned to aerobic exercise, the NCEP Step 2 diet, or diet plus exercise, or to a control group, which received no intervention. Results Dietary...

https://www.nejm.org/doi/pdf/10.1056/NEJM199807023390103

Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol.

Polyunsaturated fatty acids (PUFA) are vulnerable to peroxidative attack. Protecting PUFA from peroxidation is essential to utilize their beneficial effects in health and in preventing disease. The antioxidants vitamin E, t-butylhydroxy toluene (BHT) and t-butylhydroxy anisole (BHA) inhibited ascorbate/Fe(2+)-induced lipid peroxidation in rat liver microsomes. In addition, a number of spice principles, for example, curcumin (5-50 microM) from turmeric, eugenol (25-150 microM) from cloves and capsaicin (25-150 microM) from red chillies inhibited lipid peroxidation in a dose-dependent manner. Zingerone from ginger inhibited lipid peroxidation at high concentrations (greater than 150 microM) whereas linalool (coriander), piperine (black pepper) and cuminaldehyde (cumin) had only marginal inhibitory effects even at high concentrations (600 microM). The inhibition of lipid peroxidation by curcumin and eugenol was reversed by adding high concentrations of Fe2+.

Studies on spice principles as antioxidants in the inhibition of lipid peroxidation of rat liver microsomes

The role that diet plays in the management of plasma lipid levels is discussed in this review It has long been recognized that saturated fatty acids and cholesterol raise the plasma cholesterol level whereas polyunsaturated fatty acids lower it Recently, the effects of other dietary constituents in the management of plasma lipid levels have been established In particular, monounsaturated fatty acids, soluble fiber, and vegetarian diets favorably affect plasma lipid levels Overweight and obesity adversely affect plasma lipid levels Omega-3 fatty acids are hypotriglyceridemic, and high carbohydrate diets low in saturated fatty acids are hypocholesterolemic Further work is required to establish the long-term consequences of alcohol and coffee consumption on the plasma lipid response A variety of alternative dietary strategies can be employed in conjunction with traditional dietary recommendations (ie, reduce total fat, especially saturated fatty acids and dietary cholesterol) for the management of plasma lipid levels The expected plasma total cholesterol (specifically low-density-lipoprotein cholesterol) reduction is approximately 10% to 20% when dietary saturated fatty acids and cholesterol are decreased to less than or equal to 7% of calories and less than or equal to 200 mg of cholesterol per day Further dietary modifications, such as increasing soluble fiber, may lead to additional reductions of 1% to 10% in plasma total cholesterol

P D Wood

Papers

The effect of diet on plasma lipids, lipoproteins, and coronary heart disease.