Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins

Abstract

Background: A Step I diet with lean beef compared with lean white meat both decrease LDL cholesterol. To our knowledge, no studies have evaluated a low–saturated fatty acid (SFA) (<7% calories) diet that contains lean beef.Objective: We studied the effect on LDL cholesterol of cholesterol-lowering diets with varying amounts of lean beef [ie, Dietary Approaches to Stop Hypertension (DASH): 28 g beef/d; Beef in an Optimal Lean Diet (BOLD): 113 g beef/d; and Beef in an Optimal Lean Diet plus additional protein (BOLD+): 153 g beef/d] compared with that of a healthy American diet (HAD).Design: Thirty-six hypercholesterolemic participants (with LDL-cholesterol concentrations >2.8 mmol/L) were randomly assigned to consume each of the 4 diets (HAD: 33% total fat, 12% SFA, 17% protein, and 20 g beef/d), DASH (27% total fat, 6% SFA, 18% protein, and 28 g beef/d), BOLD (28% total fat, 6% SFA, 19% protein, and 113 g beef/d), and BOLD+ (28% total fat, 6% SFA, 27% protein, and 153 g beef/d) for 5 wk.Results: There was a decrease in total cholesterol (TC) and LDL-cholesterol concentrations (P < 0.05) after consumption of the DASH (−0.49 ± 0.11 and −0.37 ± 0.09 mmol/L, respectively), BOLD (−0.48 ± 0.10 and −0.35 ± 0.9 mmol/L, respectively), and BOLD+ (−0.50 ± 0.10 and −0.345 ± 0.09 mmol/L, respectively) diets compared with after consumption of the HAD (−0.22 ± 0.10 and −0.14 ± 0.10 mmol/L, respectively). Apolipoprotein A-I, C-III, and C-III bound to apolipoprotein A1 particles decreased after BOLD and BOLD+ diets compared with after the HAD, and there was a greater decrease in apolipoprotein B after consumption of the BOLD+ diet than after consumption of the HAD (P < 0.05 for both). LDL cholesterol and TC decreased after consumption of the DASH, BOLD, and BOLD+ diets when the baseline C-reactive protein (CRP) concentration was <1 mg/L; LDL cholesterol and TC decreased when baseline CRP concentration was >1 mg/L with the BOLD and BOLD+ diets.Conclusions: Low-SFA, heart-healthy dietary patterns that contain lean beef elicit favorable effects on cardiovascular disease (CVD) lipid and lipoprotein risk factors that are comparable to those elicited by a DASH dietary pattern. These results, in conjunction with the beneficial effects on apolipoprotein CVD risk factors after consumption of the BOLD and BOLD+ diets, which were greater with the BOLD+ diet, provide support for including lean beef in a heart-healthy dietary pattern. This trial was registered at clinicaltrials.gov as NCT00937898.

Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

“…Although the prospective associations of DASH score with long‐term outcomes were independent of baseline blood pressure, we do not know if subjects with higher DASH scores continued to have better‐controlled blood pressure over time, which leaves the possibility that the beneficial effects of the DASH diet are mediated by blood pressure. Previous studies showed that the DASH diet improves the lipid profile by lowering triglyceride levels, total cholesterol, and LDL‐cholesterol concentration 44, 45, 46. In the baseline characteristics of this study, we observe lower triglyceride levels and higher HDL concentrations in the highest tertile of the DASH score compared to the lowest tertile.…”

Red meat in global nutrition

“…Dietary Approaches to Stop Hypertension), which traditionally limits beef to 28.3 g/day as a strategy to reduce saturated fat, was modified to include up to 141 g of lean beef per day. The beef-rich diet was equally effective for lipoprotein reduction and was more effective for apolipoprotein B reduction (Roussell et al, 2012) than the traditional red meat-limiting DASH diet. Dietary intervention studies investigating the individual contribution of red meats, other than beef, to blood lipid outcomes are lacking indicating a need to fill this research gap.…”

“…These data suggest that inclusion of lean red meat may improve longterm adherence with dietary recommendations for lipid management. In keeping with these observations, Roussell et al (2012) recently reported results from a rigorously designed RCT where a DASH-style diet (i.e. Dietary Approaches to Stop Hypertension), which traditionally limits beef to 28.3 g/day as a strategy to reduce saturated fat, was modified to include up to 141 g of lean beef per day.…”

Research gaps in evaluating the relationship of meat and health

“…The American beef industry has produced many products that meet the USDA definition of "lean" which is defined as containing no more than 10 g total fat and 4.5 g of saturated fat in a serving of approximately 100 g. In fact, controlled feeding intervention studies have clearly shown reductions in risk factors for heart disease, such as total cholesterol, LDL-cholesterol, apolipoproteins A-I and C-III, and systolic blood pressure, as well as the augmentation index -a measure of vascular reactivity (Roussell et al, 2012(Roussell et al, , 2014. A meta-analysis of 124 RCTs on lipid and lipoprotein changes comparing beef against poultry or fish consumption found no significant differences (Maki et al, 2012).…”