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Penny Kris-Etherton

Publications and source records attributed to Penny Kris-Etherton.

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Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee.

Improving diet and lifestyle is a critical component of the American Heart Association's strategy for cardiovascular disease risk reduction in the general population. This document presents recommendations designed to meet this objective. Specific goals are to consume an overall healthy diet; aim for a healthy body weight; aim for recommended levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides; aim for normal blood pressure; aim for a normal blood glucose level; be physically active; and avoid use of and exposure to tobacco products. The recommendations are to balance caloric intake and physical activity to achieve and maintain a healthy body weight; consume a diet rich in vegetables and fruits; choose whole-grain, high-fiber foods; consume fish, especially oily fish, at least twice a week; limit intake of saturated fat to <7% of energy, trans fat to <1% of energy, and cholesterol to <300 mg/day by choosing lean meats and vegetable alternatives, fat-free (skim) or low-fat (1% fat) dairy products and minimize intake of partially hydrogenated fats; minimize intake of beverages and foods with added sugars; choose and prepare foods with little or no salt; if you consume alcohol, do so in moderation; and when you eat food prepared outside of the home, follow these Diet and Lifestyle Recommendations. By adhering to these diet and lifestyle recommendations, Americans can substantially reduce their risk of developing cardiovascular disease, which remains the leading cause of morbidity and mortality in the United States.

Cardiovascular Diseases↗

Dietary omega-3 fatty acid intake and cardiovascular risk.

Dietary omega-3 fatty acids decrease the risk of cardiovascular disease (CVD). Both epidemiologic and interventional studies have demonstrated beneficial effects of omega-3 fatty acids on many CVD end points, including all CVD (defined as all coronary artery disease [CAD], fatal and nonfatal myocardial infarction [MI], and stroke combined), all CAD, fatal and nonfatal MI, stroke, sudden cardiac death, and all-cause mortality. Much of the evidence comes from studies with fish oil and fish; to a lesser extent, data relate to plant-derived omega-3 fatty acids. Cardioprotective benefits have been observed with daily consumption of as little as 25 to 57 g (approximately 1 to 2 oz) of fish high in omega-3 fatty acids, an intake equivalent to >or=1 fish meal weekly or even monthly, with greater intakes decreasing risk further in a dose-dependent manner, up to about 5 servings per week. Fish, including farm-raised fish and their wild counterparts, are the major dietary sources of the longer-chain omega-3 fatty acids. Sources of plant-derived omega-3 fatty acids include flaxseed, flaxseed oil, walnuts, canola oil, and soybean oil. Because of the remarkable cardioprotective effects of omega-3 fatty acids, consumption of food sources that provide omega-3 fatty acids--especially the longer-chain fatty acids (>or=20 carbons) from marine sources--should be increased in the diet to decrease CVD risk significantly.

Cardiovascular Diseases↗

Soy protein, isoflavones, and cardiovascular health: an American Heart Association Science Advisory for professionals from the Nutrition Committee.

Soy protein and isoflavones (phytoestrogens) have gained considerable attention for their potential role in improving risk factors for cardiovascular disease. This scientific advisory assesses the more recent work published on soy protein and its component isoflavones. In the majority of 22 randomized trials, isolated soy protein with isoflavones, as compared with milk or other proteins, decreased LDL cholesterol concentrations; the average effect was approximately 3%. This reduction is very small relative to the large amount of soy protein tested in these studies, averaging 50 g, about half the usual total daily protein intake. No significant effects on HDL cholesterol, triglycerides, lipoprotein(a), or blood pressure were evident. Among 19 studies of soy isoflavones, the average effect on LDL cholesterol and other lipid risk factors was nil. Soy protein and isoflavones have not been shown to lessen vasomotor symptoms of menopause, and results are mixed with regard to soy's ability to slow postmenopausal bone loss. The efficacy and safety of soy isoflavones for preventing or treating cancer of the breast, endometrium, and prostate are not established; evidence from clinical trials is meager and cautionary with regard to a possible adverse effect. For this reason, use of isoflavone supplements in food or pills is not recommended. Thus, earlier research indicating that soy protein has clinically important favorable effects as compared with other proteins has not been confirmed. In contrast, many soy products should be beneficial to cardiovascular and overall health because of their high content of polyunsaturated fats, fiber, vitamins, and minerals and low content of saturated fat.

American Heart Association↗

Managing abnormal blood lipids: a collaborative approach.

Current data and guidelines recommend treating abnormal blood lipids (ABL) to goal. This is a complex process and requires involvement from various healthcare professionals with a wide range of expertise. The model of a multidisciplinary case management approach for patients with ABL is well documented and described. This collaborative approach encompasses primary and secondary prevention across the lifespan, incorporates nutritional and exercise management as a significant component, defines the importance and indications for pharmacological therapy, and emphasizes the importance of adherence. Use of this collaborative approach for the treatment of ABL ultimately will improve cardiovascular and cerebrovascular morbidity and mortality.

Adolescent↗

Dietary cis and trans monounsaturated and saturated FA and plasma lipids and lipoproteins in men.

Trans monounsaturated fatty acids (TFA) are hypercholesterolemic compared to oleic acid to a degree approaching or equivalent to saturated FA. However, it is unknown to what extent these effects may be due to cholesterol lowering by oleic acid rather than elevation by saturated FA and TFA. In order to better understand the impact of replacing TFA in foods, it is first necessary to know the relative lipid-modifying effects of the major FA that change as TFA are lowered or removed. For 5 wk, 50 normocholesterolemic men were fed controlled diets providing approximately 15% of energy from protein, 39% from fat, and 46% from carbohydrate in a randomized, 6 x 6, crossover design. Eight percent of energy was replaced across diets with the following: carbohydrate (CHO) (1:1 simple to complex); oleic acid (OL); TFA; stearic acid (STE); TFA/STE (4% of energy from each); carbon 12:0-16:0 saturated FA (LMP). LDL cholesterol concentrations (mmol/L) were as follows (different superscripts indicate significance at P < or = 0.01): OL 2.95a; CHO 3.05a,b; STE 3.10b,c; LMP 3.21c,d; TFA + STE 3.32d,e; and TFA 3.36e. HDL cholesterol concentrations (mmol/L) were as allows: STE 1.16a; TFA 1.16a,b; TFA/STE 1.17a,b; CHO 1.19b; OL 1.24c; and LMP 1.30d. Triacylglycerides were highest after STE (1.13) and lowest after OL (0.88) (P < 0.001). Thus, compared to the carbohydrate control diet, TFA raised LDL cholesterol at least equivalent to LMP but had no effect on HDL cholesterol; STE had no effect on LDL cholesterol but lowered HDL cholesterol; LMP raised both LDL cholesterol and HDL cholesterol; and oleic acid raised HDL cholesterol but had no effect on LDL cholesterol.

Cross-Over Studies↗

Attaining successful weight loss with an ideal macronutrient balance.

A dramatic increase in the number of people who are overweight or obese in this country presents a growing public health problem. Successful weight loss requires diet, physical activity, and behavior modification interventions. Weight loss diets with distinctively different macronutrient profiles have resulted in short-term weight loss. There is great interest in identifying the most effective strategies to achieve long-term weight loss. Individualizing weight loss interventions, including diet, will be important to facilitate significant weight loss on a population basis. Nurses and nurse practitioners can play an integral role in supporting their patient's weight loss efforts.

Activities of Daily Living↗