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High-density lipoprotein-cholesterol and diet in a healthy elderly population.

This study examined how high-density lipoprotein-cholesterol (HDL-C) correlated with a 3-day food record of fat, protein, carbohydrate, and alcohol consumption in a group of 270 healthy subjects over age 60. HDL-C concentrations correlated with alcohol consumption (expressed as grams/day) (r = + .25, P less than .001), and inversely with total carbohydrate (r = - .18, P less than .01) and refined carbohydrate (r = - .17, P less than .01) ingestion (expressed as a percent of total caloric intake). Subjects consuming diets low in either total carbohydrate or refined carbohydrate had 10 to 20% higher HDL-C levels than did those consuming diets high in these food substances. The relationships between HDL-C levels and alcohol and carbohydrate ingestion were independent of other variables which correlated with HDL-C levels. Dietary fat (total fat, saturated fat, unsaturated fat, and cholesterol) did not correlate with HDL-C. LDL-cholesterol and triglyceride levels did not correlate with any dietary variable measured.

Aged↗

Is there an optimal diet for the hypertriglyceridemic patient?

Many dietary factors affect plasma triglycerides. Those which decrease the triglyceride level include n-3 fatty acids from fish oil, weight loss, alcohol restriction, and a higher fat (unsaturated fat) diet, whereas a high-carbohydrate, low-fat diet increases triglycerides. The individual responses and the associated magnitude of change in triglycerides as a result of these different dietary factors will vary. For patients with hypertriglyceridemia, fish oil supplements will usually elicit the most potent effects. However, some patients can normalize their triglyceride level with weight loss plus exercise, by avoiding or limiting their alcohol intake, and by increasing the total fat content of their diet. In addition, fish oil supplements can help further to reduce plasma triglycerides. Thus, the combined effects of multiple dietary interventions provide the most potent means of maximally lowering the plasma triglyceride level.

Coronary Disease↗

Therapeutic lifestyle changes and pharmaceutical care in the treatment of dyslipidemias in adults.

OBJECTIVE: To review each therapeutic lifestyle change (TLC) component listed in the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) cholesterol guidelines and discuss how the guidelines can be used by pharmacists in the treatment of patients with dyslipidemias. DATA SOURCES: Published guidelines and abstracts identified through PubMed (May 1987-March 2004), Medline (January 1966-March 2004), using the search terms cholesterol, hypercholesterolemia, dyslipidemia, hyperlipidemia, diet, saturated fats, unsaturated fats, trans-fatty acids, overweight, obese, exercise, physical activity, program adherence, and guidelines; as well as the NCEP ATP III guidelines, the 2004 ATP III update, National Heart, Lung, and Blood Institute Obesity Guidelines, and Dietary Guidelines for Americans 2005. STUDY SELECTION: Performed manually by author. DATA EXTRACTION: Performed manually by author. DATA SYNTHESIS: TLC components are recommended in the NCEP ATP III guidelines for treatment of patients with dyslipidemias independent of medication use. Dietary modifications are the primary focus of TLC therapy. Saturated fat intake should be limited to less than 7% of total caloric intake and trans-fatty acid intake should be low for patients with dyslipidemias. Persons who are overweight or obese with dyslipidemias should reduce body weight through a combination of physical activity, total calorie reduction, and behavior therapy modifications. CONCLUSION: Pharmacists, given the proper training, can be effective at offering preventive pharmaceutical care for decreasing high blood cholesterol and the risk for coronary heart disease through patient counseling on TLC components as well as drug therapy in patients with dyslipidemias.

Adult↗

Achievement of American Diabetes Association clinical practice recommendations among U.S. adults with diabetes, 1999-2002: the National Health and Nutrition Examination Survey.

OBJECTIVE: To estimate the proportion of U.S. adults with diabetes who meet American Diabetes Association (ADA) clinical practice recommendations. RESEARCH DESIGN AND METHODS: Using data from the 1999-2002 National Health and Nutrition Examination Survey, 998 adults aged >/=18 years with self-reported diabetes were identified. The proportion of adults with diabetes meeting ADA recommendations for HbA(1c) (A1C), HDL cholesterol, LDL cholesterol, triglycerides, blood pressure, renal function, nutrient intake, smoking, pneumococcal vaccination, and physical activity was estimated. RESULTS: Among U.S. adults with diabetes in 1999-2002, 49.8% had A1C <7%; 27.4, 36.0, and 65.0% were classified as low risk for HDL cholesterol, LDL cholesterol, and triglycerides, respectively. Nearly 40% met blood pressure recommendations, 66% had normal renal function, and daily nutrient recommendations for protein, saturated fat, unsaturated fat, and fiber were met by 64.0, 48.3, 28.3, and 18.3%, respectively. Although >81% of the sample reported not smoking at the time of the exam, only 38.2% reported ever having had a pneumococcal immunization, and 28.2% reported getting the recommended level of physical activity. Race, age, duration of diabetes, and education affected achievement of ADA recommendations. CONCLUSIONS: Achievement of ADA clinical practice recommendations is far from adequate in U.S. adults with diabetes.

Adult↗

Effects of troglitazone and insulin on glucose production in cultured hepatocytes isolated from rats on high fat diet.

Increased dietary fat intake in general, and saturated fat specifically, will lead to the impairment of insulin action. The aim of this study was to find out the changes in hepatic glucose output in dependence of fat diet and a possible direct action of insulin and trogitazone in hepatocytes. Hepatocytes were isolated by a collagenase perfusion technique and cultured for 24 h in M 199 serum-free medium. The glucose production in hepatocytes isolated from rats on high fat diet (unsaturated fat) was 79% higher compared to control and even 139% higher than in rats on high-fat diet (saturated fat). Troglitazone significantly decreased the glucose production in hepatocytes obtained from rats on unsaturated fat diet. The troglitazone in presence of insulin totally normalized glucose production but also only in hepatocytes obtained from rats on unsaturated-fat diet. The troglitazone showed an insulinomimetic as well as insulin-sensitizing effect but only in rats on unsaturated-fat diet.

Animals↗

Effects of saturated and unsaturated dietary fat on aflatoxin B1 metabolism.

Male Fisher 344 rats were fed diets containing either 20% corn oil, 20% coconut oil or 18% coconut oil plus 2% corn oil for 3 wk. A single dose of [3H]aflatoxin B1 [(3H]AFB1) was administered ip and the biliary excretion of aflatoxin metabolites and the binding of 3H to nucleic acids were studied. In other experiments the in vitro metabolism of AFB1 by liver postmitochondrial supernatants prepared from rats fed the different sources of dietary fat was determined. The major nonextractable aqueous metabolite of AFB1 was the aflatoxin B1-glutathione conjugate (AFB1-GSH). Variation in the source of dietary fat did not affect production of the conjugate, nor was in vivo binding of AFB1 to nucleic acids affected. Aflatoxin P1 ( AFP1 )--mostly conjugated--and aflatoxin M1 (AFM1) were also identified in the bile, and the quantities of these metabolites produced were unaffected by the dietary treatments. The metabolites recovered in the in vitro study included aflatoxins Q1, P1 and M1. The corn oil diet produced a higher microsomal cytochrome P-450 level than the coconut oil diet. Associated with the higher level of cytochrome P-450 was increased in vitro conversion of AFB1 to AFQ1 and AFM1, but not to AFP1 . The in vitro production of aqueous metabolites and the covalent binding of metabolites to protein was unaffected by the dietary treatments. The results of the in vivo and in vitro studies suggest that the formation of the putative carcinogenic metabolite, AFB1-epoxide, which undergoes detoxification through glutathione conjugation, is not affected by the type of dietary fat. These observations further suggest that dietary fat, in particular unsaturated fat, affects AFB1 carcinogenesis through a mechanism other than by alteration of the metabolic activation of AFB1.

Aflatoxin B1↗

Beta-adrenergic receptor-mediated functions in porcine adipose tissue are not affected differently by saturated vs. unsaturated dietary fats.

Young postweaning pigs were fed a high fat diet containing beef tallow (saturated fat) or corn oil (unsaturated fat). Adipose tissue was used to measure adipocyte size and number of cells per gram of tissue, ligand binding by beta-adrenergic receptors and lipolytic and palmitate esterification rates. Pigs fed the saturated fat diet had more saturated and monounsaturated fatty acids and less polyunsaturated fatty acid in the crude membrane fraction. Adipocytes were larger in pigs fed the saturated fat diet. There was no difference in the binding affinities of the receptors; more binding sites were expressed on a protein or cell basis and fewer sites were expressed per unit surface area in adipocyte ghosts isolated from pigs fed the saturated fat diet. Fatty acid esterification was greater in pigs fed saturated fat diets. Isoproterenol inhibition was marginal in both groups but tended to be greater in pigs fed saturated fat diets. The beta-adrenergic receptor-mediated lipolytic rates were not different; only the theophylline-stimulated rates tended to be greater in the saturated fat-fed group. Thus, a large increase in saturated fatty acid concentration of porcine adipose tissue membranes caused an increase in beta-adrenergic receptor number without any change in receptor affinity. These receptor changes were at best only marginally reflected in beta-adrenergic agonist-mediated functions.

Adipose Tissue↗

Dietary fat intake and the risk of coronary heart disease in women.

BACKGROUND: The relation between dietary intake of specific types of fat, particularly trans unsaturated fat and the risk of coronary disease remains unclear. We therefore studied this relation in women enrolled in the Nurses' Health Study. METHODS: We prospectively studied 80,082 women who were 34 to 59 years of age and had no known coronary disease, stroke, cancer, hypercholesterolemia, or diabetes in 1980. Information on diet was obtained at base line and updated during follow-up by means of validated questionnaires. During 14 years of follow-up, we documented 939 cases of nonfatal myocardial infarction or death from coronary heart disease. Mutivariate analyses included age, smoking status, total energy intake, dietary cholesterol intake, percentages of energy obtained from protein and specific types of fat, and other risk factors. RESULTS: Each increase of 5 percent of energy intake from saturated fat, as compared with equivalent energy intake from carbohydrates, was associated with a 17 percent increase in the risk of coronary disease (relative risk, 1.17; 95 percent confidence interval, 0.97 to 1.41; P=0.10). As compared with equivalent energy from carbohydrates, the relative risk for a 2 percent increment in energy intake from trans unsaturated fat was 1.93 (95 percent confidence interval, 1.43 to 2.61; P<0.001); that for a 5 percent increment in energy from monounsaturated fat was 0.81 (95 percent confidence interval, 0.65 to 1.00; P=0.05); and that for a 5 percent increment in energy from polyunsaturated fat was 0.62 (95 percent confidence interval, 0.46 to 0.85; P= 0.003). Total fat intake was not signficantly related to the risk of coronary disease (for a 5 percent increase in energy from fat, the relative risk was 1.02; 95 percent confidence interval, 0.97 to 1.07; P=0.55). We estimated that the replacement of 5 percent of energy from saturated fat with energy from unsaturated fats would reduce risk by 42 percent (95 percent confidence interval, 23 to 56; P<0.001) and that the replacement of 2 percent of energy from trans fat with energy from unhydrogenated, unsaturated fats would reduce risk by 53 percent (95 percent confidence interval, 34 to 67; P<.001). CONCLUSIONS: Our findings suggest that replacing saturated and trans unsaturated fats with unhydrogenated monounsaturated and polyunsaturated fats is more effective in preventing coronary heart disease in women than reducing overall fat intake.

Adult↗

The effects of unsaturated dietary fats on absorption, excretion, synthesis, and distribution of cholesterol in man.

Cholesterol balance studies were carried out in 11 patients with various types of hyperlipoproteinemia to determine the mechanism by which unsaturated fats lower plasma cholesterol. Unsaturated fats produced no increase in fecal endogenous neutral steroids in 10 of 11 patients and no decrease in absorption of exogenous cholesterol in 5 patients who received cholesterol in the diet. In 8 of 11 patients no changes occurred in excretion of bile acids during the period on unsaturated fat when plasma cholesterol was declining. However, in 3 of 11 patients small but significant increases in bile acid excretion were found during this transitional period; in 2 others increases also occurred after plasma cholesterol had become constant at lower levels on unsaturated fat.Since the majority of patients showed no change in cholesterol or bile acid excretions during the transitional period, we propose that when excretion changes did occur they were probably not the cause of the plasma cholesterol change. Furthermore, turnover data and specific activity curves suggested that cholesterol synthesis was not influenced by exchange of dietary fats. Thus, excluding changes in excretion and synthesis, we conclude that it is most likely that unsaturated fats cause plasma cholesterol to be redistributed into tissue pools. We have also examined the possibility that cholesterol which is redistributed into tissues could be secondarily excreted as neutral steroids or bile acids. In at least 5 of 11 patients excretion patterns were consistent with this explanation. However, we cannot rule out that excretion changes may have been due to alterations in transit time, to changes in bacterial flora, or to transitory changes in absorption or synthesis of cholesterol or bile acids. Our conclusion that unsaturated fats cause a redistribution of cholesterol between plasma and tissue pools points to the necessity in future to explore where cholesterol is stored, to what extent stored cholesterol can be mobilized, and to define the factors governing these fluxes.

Adolescent↗

Composition and flavor of milk and butter from cows fed unsaturated dietary fat and receiving bovine somatotropin.

Composition and flavor of milk and butter were evaluated from cows divided into four treatments including a control, control with bST, added dietary fat from sunflower seeds with bST, or added dietary fat from safflower seeds with bST. Feeding added unsaturated dietary fat resulted in lower concentrations of short-and medium-chain and higher concentrations of long-chain fatty acids in milk fat and butter. Milk fat unsaturated fatty acid concentrations were 25.0, 28.4, 39.6, and 37.9%, and butter unsaturated fatty acid concentrations were 23.0, 26.9, 37.8, and 36.2% for control, control with bST, sunflower seeds with bST, and safflower seeds with bST, respectively. Sensory evaluations indicated that butters from the bST with sunflower seed and bST with safflower seed treatments were equal or superior in flavor to the control butter. Milk from cows receiving bST or fed added unsaturated dietary fat and receiving bST was no more susceptible to oxidized off-flavors than control milk. Butters from sunflower seed and safflower seed treatments with bST contained higher concentrations of unsaturated fatty acids, were softer at 4 and 20 degrees C, and possessed acceptable flavor and processing characteristics compared with butters from control and control with bST.

Animals↗

Lactational responses of dairy cows fed unsaturated dietary fat and receiving bovine somatotropin.

Feeding unsaturated dietary fat to lactating dairy cows receiving bST may effectively alter the fatty acid composition of milk fat. This was tested using 16 Holstein cows assigned to one of four treatments during midlactation. Treatments were control, control diet with 15.5 mg of bST/d per cow, dietary fat from sunflower seeds and bST, or dietary fat from safflower seeds and bST. Diets were formulated to contain 19% CP and contained 25% corn silage, 25% alfalfa hay, and 50% concentrate mix on a DM basis. Milk yield was not significantly higher when bST was administered and increased with added fat diets (29.5, 32.7, 40.0, and 34.1 kg/d for the control, control with bST, sunflower seed with bST, and safflower seed with bST treatments, respectively). Percentage of milk fat was similar for all treatments. Concentrations of long-chain and unsaturated fatty acids in milk were increased slightly by bST and substantially with added fat. Milk protein percentages were not influenced by bST but were reduced by approximately .2 unit with added fat. Added unsaturated dietary fat coupled with bST increased milk yield and produced a greater concentration of unsaturated fatty acids in milk.

Animal Feed↗