Effects of 3-month Mediterranean-type diet on postprandial TAG and apolipoprotein B48 in the Medi-RIVAGE cohort

Abstract

Objective: To determine the postprandial lipaemia response before and after intervention with healthy diets in the Medi-RIVAGE cohort of subjects with moderate risk factors of CVD. Design: One hundred and thirty-five adults (fifty-two men and eighty-three women) followed either a Mediterranean-type (MED) diet or a low-fat American Heart Association-type diet in a parallel design for 3 months. At entry and after 3 months, lipids, glucose and insulin were measured in the fasting samples; TAG and apolipoprotein B48 (ApoB48; a marker of intestinally derived chylomicrons) levels were measured in the fasting and postprandial samples after a standard test meal. Results: The MED diet only lowered (P , 0?028) fasting TAG and both diets reduced TAG and ApoB48 levels 5 h after the test meal. The overall 5 h postprandial ApoB48 response (area under curve (AUC)/incremental AUC) was lowered after both diets but this effect was more marked after the MED-diet intervention. Whatever the TAG level at entry, normo-and hyper TAG subjects showed a reduction in the postprandial ApoB48 levels after 3-month diets. BMI at entry did not impact the effect of diets given subjects with BMI , or .25 kg/m 2 showed reduced postprandial ApoB48. Men and women displayed comparable postprandial changes after dietary challenges. Conclusions:A MED diet appears efficient to improve postprandial lipaemia, a recently acknowledged CVD risk, in men and women at moderate cardiovascular risk.Postprandial lipaemia has received increasing attention during the past two decades (1,2) . Indeed, following a typical fat-containing meal (30-60 g fat), circulating TAG shows a marked elevation within 1-2 h and can remain elevated for 5-8 h in healthy subjects and longer in dyslipidaemic patients (3,4) . On the basis of dietary habits, it is clear that the dominant state of TAG metabolism for most humans is postprandial (1,(5)(6)(7) .The specificity of the postprandial period is a physiological transient accumulation of TAG-rich lipoprotein (TRL) particles in the circulation as provided by both the liver (very LDL) and the small intestine (chylomicrons secreted after lipid digestion and absorption) (1,8) . The capacity of individuals to regulate circulating TAG levels, that is, to secrete and clear TRL postprandially, is obviously an important reflection of their metabolic homeostasis as challenged by dietary intakes (9) .It is now well recognised that elevated postprandial lipaemia and TRL is a characteristic metabolic abnormality of a number of lifestyle-related diseases and conditions that are associated with increased cardiovascular morbidity and mortality (10)(11)(12) . Exacerbated postprandial lipaemia has been repeatedly associated with cardiovascular risk during clinical studies (13) . Moreover, recent and large epidemiological surveys have clearly evidenced the strong association between the extent of non-fasting TAG and the relative risk for cardiovascular events in men and women (14,15) .Thus, the habitual high-saturated fat, high-carbohydrate/ sug...

Physiology in Medicine: update on lifestyle determinants of postprandial triacylglycerolemia with emphasis on the Mediterranean lifestyle

“…Both normal and overweight subjects experienced similar reduction in PPL after a MUFA-rich Mediterranean-type diet (21). The same was true for subjects with normal or high fasting TAG levels; i.e., a MUFA-rich Mediterranean-type diet is an effective strategy to reduce an important CVD risk factor independently of body mass index or fasting TAG levels.…”

“…Collectively, data from these studies suggest that a HF-MUFA diet leads to significantly higher earlier (1-3 h) (24,34,68,69) but lower later (Ͼ4 h) postprandial total TAG and TRL-TAG responses (21,24,33,34,68,69). A reduced number of TRL (21,46,68,76), increased production of TRL containing apoE (90) and increased size of TRL (68) (mainly chylomicrons) postprandially (note: larger chylomicrons have greater affinity to LPL and thereby cleared more efficiently) results in increased TRL catabolic rate (90) and, most importantly, increased percentage of TRL that are cleared rather than being converted to the atherogenic particles LDL (90).…”

“…Several studies have compared the effects on PPL of a diet high in total fat and MUFA (HFMUFA) (olive oil) vs. low in fat and high in carbohydrates (LFHC) and/or vs. a diet high in fat and SFA (HFSFA) (butter). Many (21,24,33,34,39,46,68,69,76,79,90), but not all (4,14,20,26,65,70,71,85), found that the HFMUFA diet was superior to the other two diets in several aspects of postprandial TAG metabolism in both healthy and nonhealthy volunteers (Tables 1 and 2).…”

“…A reduced number of TRL (21,46,68,76), increased production of TRL containing apoE (90) and increased size of TRL (68) (mainly chylomicrons) postprandially (note: larger chylomicrons have greater affinity to LPL and thereby cleared more efficiently) results in increased TRL catabolic rate (90) and, most importantly, increased percentage of TRL that are cleared rather than being converted to the atherogenic particles LDL (90).…”

Mécanisme d’absorption intestinale des acides gras à longue chaîne : rôle émergent du CD36

“…Par cons equent, l'augmentation du rapport ApoCII/ApoCIII et de la taille des chylomicrons expliqueraient la plus faible hypertriglyc erid emie postprandiale observ ee paradoxalement apr es ce type de r egime hyperlipidique chez le rongueur (Petit et al, 2007) et retrouv ee chez l'homme (Defoort et al, 2011). Cette adaptation intestinale est donc un facteur emergent de la r egulation de la triglyc erid emie postprandiale.…”