Plasma lipid response and nutritional adequacy in hypercholesterolemic subjects on the American Heart Association Step-One Diet

Bae, Chul Young; Keenan, Joseph M.; Fontaine, Patricia; Wenz, Joyce B.; Ripsin, Cynthia M.; McCaffrey, D.

doi:10.1001/archfami.2.7.765

Cited by 15 publications

(4 citation statements)

References 2 publications

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“…12 However, few carefully controlled studies have been carried out to demonstrate the efficacy of the Step 1 diet. In studies with large numbers of subjects by Bae et al, 6,7 Denke, 10 and Denke and Grundy, 11 subjects were instructed in the diets but were "free-living." In better-controlled studies, 8,9,[13][14][15] the groups were small.…”

Section: Discussionmentioning

confidence: 99%

Effects of Reducing Dietary Saturated Fatty Acids on Plasma Lipids and Lipoproteins in Healthy Subjects

Ginsberg

Kris‐Etherton²,

Dennis

et al. 1998

ATVB

261

143

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Few well-controlled diet studies have investigated the effects of reducing dietary saturated fatty acid (SFA) intake in premenopausal and postmenopausal women or in blacks. We conducted a multicenter, randomized, crossover-design trial of the effects of reducing dietary SFA on plasma lipids and lipoproteins in 103 healthy adults 22 to 67 years old. There were 46 men and 57 women, of whom 26 were black, 18 were postmenopausal women, and 16 were men > or =40 years old. All meals and snacks, except Saturday dinner, were prepared and served by the research centers. The study was designed to compare three diets: an average American diet (AAD), a Step 1 diet, and a low-SFA (Low-Sat) diet. Dietary cholesterol was constant. Diet composition was validated and monitored by a central laboratory. Each diet was consumed for 8 weeks, and blood samples were obtained during weeks 5 through 8. The compositions of the three diets were as follows: AAD, 34.3% kcal fat and 15.0% kcal SFA; Step 1, 28.6% kcal fat and 9.0% kcal SFA; and Low-Sat, 25.3% kcal fat and 6.1% kcal SFA. Each diet provided approximately 275 mg cholesterol/d. Compared with AAD, plasma total cholesterol in the whole group fell 5% on Step 1 and 9% on Low-Sat. LDL cholesterol was 7% lower on Step 1 and 11% lower on Low-Sat than on the AAD (both P<.01). Similar responses were seen in each subgroup. HDL cholesterol fell 7% on Step 1 and 11% on Low-Sat (both P<.01). Reductions in HDL cholesterol were seen in all subgroups except blacks and older men. Plasma triglyceride levels increased approximately 9% between AAD and Step 1 but did not increase further from Step 1 to Low-Sat. Changes in triglyceride levels were not significant in most subgroups. Surprisingly, plasma Lp(a) concentrations increased in a stepwise fashion as SFA was reduced. In a well-controlled feeding study, stepwise reductions in SFA resulted in parallel reductions in plasma total and LDL cholesterol levels. Diet effects were remarkably similar in several subgroups of men and women and in blacks. The reductions in total and LDL cholesterol achieved in these different subgroups indicate that diet can have a significant impact on risk for atherosclerotic cardiovascular disease in the total population.

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Section: Discussionmentioning

confidence: 99%

Effects of Reducing Dietary Saturated Fatty Acids on Plasma Lipids and Lipoproteins in Healthy Subjects

Ginsberg

Kris‐Etherton²,

Dennis

et al. 1998

ATVB

261

143

View full text Add to dashboard Cite

show abstract

“…The AHA Step 1 diet, primarily intended as the starting point for treating hypercholesterolemia, restricts total fat to no more than 30 percent of total calories, saturated fat to no more than 10 percent of total calories, and cholesterol to less than 300 mg/day [37]. It has been found to lower both serum total cholesterol and LDL cholesterol [38] but has also been associated with lowering serum HDL cholesterol [39] as well as with nutritional inadequacies [40] and has since been replaced by new, more comprehensive AHA dietary recommendations as part of Therapeutic Lifestyle Changes [41]. More comprehensive diets, such as those which reduce glycemic load and increase fiber, may be required in combination with supplemental phytonutrients such as RIAA : PAC in order to achieve more substantial reductions in established risk markers for cardiovascular disease and type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Hop and Acacia Phytochemicals Decreased Lipotoxicity in 3T3-L1 Adipocytes,db/dbMice, and Individuals with Metabolic Syndrome

Minich

Lerman

Darland

et al. 2010

Journal of Nutrition and Metabolism

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The plant-based compounds rho-iso-alpha acids (RIAA) from Humulus lupulus (hops) and proanthocyanidins (PAC) from Acacia nilotica have been shown to modulate insulin signaling in vitro. We investigated their effects on triglyceride (TG) deposition in 3T3-L1 adipocytes, glucose and insulin in obese mouse models, and metabolic syndrome markers in adults with metabolic syndrome. The combination of RIAA and PAC synergistically increased TG content and adiponectin secretion in 3T3-L1 adipocytes under hyperinsulinemic conditions and reduced glucose or insulin in obese mice. In a clinical trial, tablets containing 100 mg RIAA and 500 mg PAC or placebo were administered to metabolic syndrome subjects (3 tablets/day, n = 35; 6 tablets/day, n = 34; or placebo, n = 35) for 12 weeks. Compared to placebo, subjects taking 3 tablets daily showed greater reductions in TG, TG : HDL, fasting insulin, and HOMA scores. The combination of RIAA : PAC at 1 : 5 (wt : wt) favorably modulates dysregulated lipids in insulin resistance and metabolic syndrome.

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“…A limitation of looking solely at the nutrient:energy ratio of the diet is that it is still possible for the target nutrient not to meet the RDA. The data shown in T 11, 12, and 13 reveal nutrients that are low, as well as those that increase in free‐living subjects following Step‐One and Step‐Two diets 15–18 . These data are reported on the basis of the percent of the RDA achieved, the percent of the subjects consuming less than two‐thirds of the RDA for key nutrients, as well as the percent increase in certain nutrients in the fat‐modified diets.…”

Section: Nutrient Adequacy Of Fat‐modified Dietsmentioning

confidence: 99%

Impact of Macronutrient Substitutes on the Composition of the Diet and the U.S. Food Supply

Sigman‐Grant

Taylor

Moriarty

et al. 1997

Annals of the New York Academy of Sciences

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Plasma lipid response and nutritional adequacy in hypercholesterolemic subjects on the American Heart Association Step-One Diet

Cited by 15 publications

References 2 publications

Effects of Reducing Dietary Saturated Fatty Acids on Plasma Lipids and Lipoproteins in Healthy Subjects

Effects of Reducing Dietary Saturated Fatty Acids on Plasma Lipids and Lipoproteins in Healthy Subjects

Hop and Acacia Phytochemicals Decreased Lipotoxicity in 3T3-L1 Adipocytes,db/dbMice, and Individuals with Metabolic Syndrome

Impact of Macronutrient Substitutes on the Composition of the Diet and the U.S. Food Supply

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