No abstract

Thirty-five women with metabolic syndrome and high plasma low-density lipoprotein (LDL) cholesterol (≥100 mg/dl) participated in a dietary intervention consisting of a Mediterranean-style low-glycemic-load diet for 12 weeks. Participants were randomly allocated to consume diet only (n=15) or diet plus a medical food containing soy protein and plant sterols (n=20). Plasma concentrations of carotenoids, lipoprotein subfractions and oxidized LDL (OxLDL) were measured. Independent of treatment, women had a significant increase in plasma lutein (P<.0001) and β-carotene (P<.0001), while plasma lycopene was reduced (P<.05) after 12 weeks. Low-density lipoprotein cholesterol was reduced from 138±35 to 114±33 mg/dl (P<.0001). In addition, decreases were observed in the atherogenic subfractions: large very low-density lipoprotein (P<.05), small LDL (P<.00001) and medium high-density lipoprotein (P<.05). Oxidized LDL was significantly reduced by 12% in both groups (P<.01). Changes in OxLDL were inversely correlated with plasma lutein (r=−.478, P<.0001). The data indicate that women complied with the dietary regimen by increasing fruits and vegetable intake. Decreased consumption of high-glycemic foods frequently co-consumed with lycopene-rich tomato sauce such as pasta and pizza may be responsible for the lowering of this carotenoid in plasma after 12 weeks. These results also suggest that plasma lutein concentrations may protect against oxidative stress by reducing the concentrations of OxLDL.

Both metabolic syndrome (MetS) and elevated LDL cholesterol (LDL-C) increase the risk for cardiovascular disease (CVD). We hypothesized that low HDL cholesterol (HDL-C) would further increase CVD risk in women having both conditions. To assess this, we recruited 89 women with MetS (25-72 y) and LDL-C ≥ 2.6 mmol/L. To determine whether plasma HDL-C concentrations were associated with dietary components, circulating atherogenic particles, and other risk factors for CVD, we divided the subjects into two groups: high HDL-C (H-HDL) (≥ 1.3 mmol/L, n = 32) and low HDL-C (L-HDL) (< 1.3 mmol/L, n = 57). Plasma lipids, insulin, adiponectin, apolipoproteins, oxidized LDL, Lipoprotein(a), and lipoprotein size and subfractions were measured, and 3-d dietary records were used to assess macronutrient intake. Women with L-HDL had higher sugar intake and glycemic load (P < 0.05), higher plasma insulin (P < 0.01), lower adiponectin (P < 0.05), and higher numbers of atherogenic lipoproteins such as large VLDL (P < 0.01) and small LDL (P < 0.001) than the H-HDL group. Women with L-HDL also had larger VLDL and both smaller LDL and HDL particle diameters (P < 0.001). HDL-C was positively correlated with LDL size (r = 0.691, P < 0.0001) and HDL size (r = 0.606, P < 0.001), and inversely correlated with VLDL size (r = -0.327, P < 0.01). We concluded that L-HDL could be used as a marker for increased numbers of circulating atherogenic lipoproteins as well as increased insulin resistance in women who are already at risk for CVD.

We analyzed the dietary records of 18 women (25‐61y) classified with the metabolic syndrome (MetS) with a mean body mass index of 31.8 ± 4.0 kg/m2 to establish potential relationships between dietary intake, anthropometrics and plasma lipids in this population. The mean waist circumference was 101.4 ± 8.8 cm and mean plasma triglycerides were 193.5 ± 45.0 mg/dL. Plasma HDL cholesterol ranged from 23 to 76 mg/dL, blood pressure ranged from 100/70 to 150/90 mm Hg and plasma glucose from 66 to 129 mg/dL. We evaluated diet intake by using 3 day dietary records. Fiber intake was only 56% of the dietary recommendations and subjects were also consuming inappropriate levels of Vitamin D (‐40%), tocopherol (‐45%), ascorbic acid (‐12%), calcium (‐29%) magnesium (‐25%) and iron (‐29%). Waist circumference was positively correlated with energy intake (r = 0.647, P < 0.01), sugar intake (r= 0.547, P < 0.025) and added sugar (r = 0.654, P < 0.005). Intake of omega 3 fatty acids was inversely correlated with systolic blood pressure (r =‐0.475. P< 0.05) while dietary fiber intake was negatively associated with plasma LDL cholesterol (r=‐0.513, P < 0.05). The data suggest that in these women, sugar intake may contribute to the high waist circumference, a key parameter for MetS classification. In addition, it is clear that aside from the obesity problem, this population has poor dietary habits with major deficiencies in important micronutrients [Supported by Metagenics, Inc, Gig Harbor, WA].

We investigated effects of a Mediterranean‐style low glycemic load diet, with or without a soy protein, plant sterol‐(SPS) supplement, on cardiometabolic risk factors in 8 women with metabolic syndrome (MetS). Subjects had high plasma triglycerides (TG) (163.5 ± 59.1 mg/dL), elevated body mass index (31.0 ± 3.5 kg/m2), total body fat of 39 ± 4.9 kg, total trunk fat of 20.7 ± 2.9 kg, and plasma LDL of 107.1 ± 31.8 mg/dL. The 8‐week intervention diet provided an average energy distribution of 30:45:25 fat:carbohydrate:protein. Five subjects were randomly allocated to the SPS supplement. Compared to baseline, dietary protein intake increased (P<0.005), while added sugar and saturated fat decreased at 8 wks. Glycemic index decreased from 62.1 ± 5.4 to 48.8 ± 8.9 (P < 0.01) and glycemic load from 111.3 ± 34.2 to 50.1 ± 27.8 (P < 0.005). All subjects experienced significant reductions in body weight (5%; P < 0.001), total body fat (9%; P < 0.005), trunk fat (12%; P < 0.005), and in both systolic (P < 0.01) and diastolic (P < 0.05) blood pressure. Waist circumference decreased from 93.5 ± 3.9 to 88.3 ± 3.6 cm (P < 0.01). Plasma TG were reduced by 33% (P < 0.002) and total cholesterol from 203.6 ± 33.6 to 171.0 ± 44.5 mg/dL (P < 0.05). The intervention resulted in significant health benefits on all MetS parameters, mainly by reducing trunk fat and alleviating dyslipidemias. [Supported by Metagenics Inc., Gig Harbor, WA]