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The Effect of Resveratrol on Blood Lipid Profile: A Dose-Response Meta-Analysis of Randomized Controlled Trials.
Cao, X, Liao, W, Xia, H, Wang, S, Sun, G
Nutrients. 2022;14(18)
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It is well known that cardiovascular disease is a leading cause of death. Imbalances in the blood lipid levels, such as elevation of total cholesterol, Triglycerides and LDL cholesterol, may increase the risk of cardiovascular disease. It has been shown that resveratrol, a polyphenol found in grapes, blueberries, mulberries, raspberries, peanuts, and knotweeds, has protective effects against cardiovascular disease. In this meta-analysis, 17 randomised controlled trials were included, with varying durations of 4 to 48 weeks and intervention dosages ranging from 10 to 3000 mg/day. According to the results of this meta-analysis, Resveratrol supplementation significantly reduced total cholesterol, triglycerides, and LDL cholesterol, but not HDL cholesterol. In addition, the reduction in LDL cholesterol was more significant in type 2 diabetic patients when resveratrol was supplemented for 12 weeks or more. A crucial factor in determining the effectiveness of resveratrol supplementation is its dosage. High doses over 500 mg/day were found to have the opposite effect of increasing body mass index and body weight and suppressing the cardioprotective effect. The effects of different dosages and durations of resveratrol supplementation on cardiometabolic health require further robust research. Healthcare professionals may use the results of this study to understand the importance of careful consideration when supplementing resveratrol as a nutraceutical.
Abstract
(1) Background: The effects of resveratrol on blood lipids are controversial. Whether there is a dose-response of the lipid profile upon resveratrol supplementation is unknown. (2) Methods: This dose-response meta-analysis of randomized controlled trials (RCTs) was performed to explore the effects of resveratrol supplementation on lipid profile. A systematical and comprehensive search of several databases was conducted by 30 June 2022. (3) Results: The results indicated that the intake of resveratrol could significantly decrease the total cholesterol (TC) (mean difference = -10.28; 95%CI: -13.79, -6.76, p < 0.001), triglyceride (TG) (Mean difference = -856; 95%CI: -12.37, -4.75, p < 0.001) and low-density lipoprotein cholesterol (LDL-C) (mean difference = -5.69; 95%CI: -11.07, -0.31, p = 0.038) level, but did not alter the level of high-density lipoprotein cholesterol (HDL-C). In the non-linear dose-response analysis, we observed a significant effect of the supplementation dosage on the level of LDL-C (p-nonlinearity = 0.002). Results from the sub-group analysis showed that the reduction of LDL-C was more significant in the trials with a duration of ≥12 weeks and in subjects with type 2 diabetes mellitus. (4) Conclusion: Findings from this study suggest that resveratrol may be beneficial to reduce TC, TG, and LDL-C levels in the blood. The dosage of the resveratrol intervention is an essential factor that affects the level of LDL-C.
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Impact of Replacement of Individual Dietary SFAs on Circulating Lipids and Other Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in Humans.
Sellem, L, Flourakis, M, Jackson, KG, Joris, PJ, Lumley, J, Lohner, S, Mensink, RP, Soedamah-Muthu, SS, Lovegrove, JA
Advances in nutrition (Bethesda, Md.). 2022;13(4):1200-1225
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Cardiovascular disease is one of the leading causes of mortality worldwide, and metabolic disorders such as diabetes, hyperlipidaemia, and hypertension contribute to this risk. Cardiometabolic disease (CMD) can be reduced by reducing saturated fatty acids (SFAs) and replacing them with unsaturated fatty acids (UFAs). Dietary SFA's are classified as a whole group in general dietary guidelines. However, blood lipid levels and other biomarkers of CMD may be affected differently by individual dietary SFAs. In this systematic review and meta-analysis, 44 randomised controlled trials were included that investigated the effects of replacing SFAs with individual dietary SFAs or UFAs on markers of CMD. CMD markers like Total cholesterol (TC), LDL cholesterol, and apoB concentrations were significantly reduced by replacing 1.5%TE of palmitic acid with oleic acid or UFAs for 14 days. The research also showed associations between apoB and LDL-cholesterol and apoA-I and HDL-cholesterol concentrations. Dietary palmitic acid substituted with UFAs significantly reduced fasting LDL-cholesterol and total cholesterol. The majority of studies included in this study focused on dietary palmitic acid and not much on stearic acid, myristic acid, or lauric acid. Therefore, further robust studies are required to assess the effect of individual dietary SFAs on the markers of CMD, including markers of inflammation, hemostasis, glycemic control, or metabolic hormones. Healthcare professionals can use this study to understand the benefits of substituting SFAs with UFAs on CMD markers.
Abstract
Little is known of the impact of individual SFAs and their isoenergetic substitution with other SFAs or unsaturated fatty acids (UFAs) on the prevention of cardiometabolic disease (CMD). This systematic literature review assessed the impact of such dietary substitutions on a range of fasting CMD risk markers, including lipid profile, markers of glycemic control and inflammation, and metabolic hormone concentrations. Eligible randomized controlled trials (RCTs) investigated the effect of isoenergetic replacements of individual dietary SFAs for ≥14 d on ≥1 CMD risk markers in humans. Searches of the PubMed, Embase, Scopus, and Cochrane CENTRAL databases on 14 February, 2021 identified 44 RCTs conducted in participants with a mean ± SD age of 39.9 ± 15.2 y. Studies' risk of bias was assessed using the Cochrane Risk of Bias tool 2.0 for RCTs. Random-effect meta-analyses assessed the effect of ≥3 similar dietary substitutions on the same CMD risk marker. Other dietary interventions were described in qualitative syntheses. We observed reductions in LDL-cholesterol concentrations after the replacement of palmitic acid (16:0) with UFAs (-0.36 mmol/L; 95% CI: -0.50, -0.21 mmol/L; I2 = 96.0%, n = 18 RCTs) or oleic acid (18:1n-9) (-0.16 mmol/L; 95% CI: -0.28, -0.03 mmol/L; I2 = 89.6%, n = 9 RCTs), with a similar impact on total cholesterol and apoB concentrations. No effects on other CMD risk markers, including HDL-cholesterol, triacylglycerol, glucose, insulin, or C-reactive protein concentrations, were evident. Similarly, we found no evidence of a benefit from replacing dietary stearic acid (18:0) with UFAs on CMD risk markers (n = 4 RCTs). In conclusion, the impact of replacing dietary palmitic acid with UFAs on lipid biomarkers is aligned with current public health recommendations. However, owing to the high heterogeneity and limited studies, relations between all individual SFAs and biomarkers of cardiometabolic health need further confirmation from RCTs. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020084241.
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Buckwheat and Cardiometabolic Health: A Systematic Review and Meta-Analysis.
Llanaj, E, Ahanchi, NS, Dizdari, H, Taneri, PE, Niehot, CD, Wehrli, F, Khatami, F, Raeisi-Dehkordi, H, Kastrati, L, Bano, A, et al
Journal of personalized medicine. 2022;12(12)
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Buckwheat is a gluten-free, pseudo-grain rich in bioactive compounds that are cardiometabolic health protective. Bioactive cardioprotective compounds include proteins, fibre, and polyphenols such as rutin and quercetin-3-glucoside. This systematic review and meta-analysis investigated the supplementation and consumption of buckwheat and its effects on cardiovascular risk markers. Sixteen studies were included in the systematic review, and ten were included in the meta-analysis. This systematic review and meta-analysis showed a modest, non-significant improvement in total cholesterol and glucose levels. Further robust studies are required to investigate the beneficial effects of bioactive compounds found in buckwheat due to the high heterogeneity of the included studies and the poor quality of the included studies. However, healthcare professionals can use the results of this research to understand the potential of buckwheat in improving or maintaining cardiometabolic health.
Abstract
Buckwheat (BW) is suggested to have beneficial effects, but evidence on how it affects cardiometabolic health (CMH) is not yet established. We aimed to assess the effects of BW and/or its related bioactive compounds on cardiovascular disease (CVD) risk markers in adults. Five databases were searched for eligible studies. Observational prospective studies, nonrandomized or randomized trials were considered if they assessed BW, rutin or quercetin-3-glucoside intake and CVD risk markers. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting. We selected 16 human studies based on 831 subjects with mild metabolic disturbances, such as hypercholesterolemia, diabetes and/or overweight. Eight studies, investigating primarily grain components, were included in the meta-analyses (n = 464). High study heterogeneity was present across most of our analyses. Weighted mean difference (WMD) for subjects receiving BW supplementation, compared to controls, were - 0.14 mmol/L (95% CI: -0.30; 0.02) for total cholesterol (TC), -0.03 mmol/L (95% CI: -0.22; 0.16) for LDL cholesterol, -0.14 kg (95% CI: -1.50; 1.22) for body weight, -0.04 mmol/L (95% CI: - 0.09;0.02) for HDL cholesterol, -0.02 mmol/L (95% CI: -0.15; 0.11) for triglycerides and -0.18 mmol/L (95% CI: -0.36; 0.003) for glucose. Most of the studies (66.7%) had concerns of risk of bias. Studies investigating other CVD markers were scarce and with inconsistent findings, where available. Evidence on how BW affects CMH is limited. However, the available literature indicates that BW supplementation in mild dyslipidaemia and type 2 diabetes may provide some benefit in lowering TC and glucose, albeit non-significant. Our work highlights the need for more rigorous trials, with better methodological rigor to clarify remaining uncertainties on potential effects of BW on CMH and its utility in clinical nutrition practice.
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Effects of Mediterranean Diet and Physical Activity on Pulmonary Function: A Cross-Sectional Analysis in the ILERVAS Project.
Gutiérrez-Carrasquilla, L, Sánchez, E, Hernández, M, Polanco, D, Salas-Salvadó, J, Betriu, À, Gaeta, AM, Carmona, P, Purroy, F, Pamplona, R, et al
Nutrients. 2019;11(2)
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The Mediterranean diet is characterised by an abundant consumption of extra-virgin olive oil, fruits, vegetables, nuts, and legumes, a moderate consumption of fish and seafood, poultry, fermented dairy products, and red wine with meals, and low intakes of sweetened beverages, red meat and ready meals. The aim of the study was to evaluate the association between adherence to a Mediterranean diet and physical activity on pulmonary function in a large middle-aged population at low-to-moderate cardiovascular risk. The study is an ongoing study that between 2015 and 2017 enrolled a total of 3020 subjects – women aged between 50 to 70 years and men aged between 45 to 65 years – with the presence of at least one cardiovascular risk factor. Results indicate that a low adherence to the Mediterranean diet was linked with impaired breathing patterns and higher prevalence of abnormal lung function when compared to participants with a higher adherence to this dietary pattern. Additionally, vigorous physical activity was accompanied by better results in lung function than that observed in inactive subjects. The study provides initial clinical evidence about the independent and deleterious effect of both low adherence to the Mediterranean diet and low physical activity practice on lung function in participants without known pulmonary disease.
Abstract
A few studies showed that both adherence to Mediterranean diet (MedDiet) and physical activity practice have a positive impact on pulmonary function in subjects with lung disease. These associations are not well studied in subjects free from lung disease. In a cross-sectional study conducted in 3020 middle-aged subjects free of lung disease, adherence to the MedDiet using the Mediterranean Diet Adherence Screener, and physical activity practice using the International Physical Activity Questionnaire short form were recorded. Respiratory function was assessed using forced spirometry and the results were evaluated according to the Global initiative for Chronic Obstructive Lung Disease. Logistic regression models were used to analyze the associations between adherence to the MedDiet and physical activity practice with the presence of ventilatory defects. Participants with a high adherence to MedDiet, in comparison to those with low adherence, had both higher forced vital capacity (FVC; 100 (87⁻109) vs. 94 (82⁻105) % of predicted, p = 0.003) and forced expired volume in the first second (FEV1; 100 (89⁻112) vs. 93 (80⁻107) % of predicted, p < 0.001). According to their degree of physical activity, those subjects with a high adherence also had both higher FVC (100 (88⁻107) vs. 94 (83⁻105) % of predicted, p = 0.027) and FEV1 (100 (89⁻110) vs. 95 (84⁻108) % of predicted, p = 0.047) in comparison with those with low adherence. The multivariable logistic regression models showed a significant and independent association between both low adherence to MedDiet and low physical activity practice, and the presence of altered pulmonary patterns, with differences between men and women. However, no joint effect between adherence to MedDiet and physical activity practice on respiratory function values was observed. Low adherence to MedDiet and low physical activity practice were independently associated with pulmonary impairment. Therefore, the lung mechanics seem to benefit from heart-healthy lifestyle behaviors.
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Time and Intervention Effects of Daily Almond Intake on the Changes of Lipid Profile and Body Composition Among Free-Living Healthy Adults.
Liu, Y, Hwang, HJ, Kim, HS, Park, H
Journal of medicinal food. 2018;21(4):340-347
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Existing evidence shows that tree nut intake may reduce risk factors associated cardiovascular diseases. While studies have demonstrated this with almond consumption, the mechanism remains uncertain. The aim of this randomised controlled trial was to evaluate the effects of daily almond consumption on changes in body composition and lipid profiles at four different measurement points to provide further mechanistic insight. Eighty-five participants were randomised to either almond or control group and those in the almond group consumed 56g of almonds per day for 20 weeks. Anthropometric and bioimpedance measures were taken, as well as blood lipid profiles, at weeks 0, 8, 16 and 20. This study revealed patterns in blood lipid profiles fluctuations throughout the 20 weeks by utilising four time points. Continuous almond consumption led to significantly greater reductions in blood lipid levels compared to the control group, demonstrating the cardioprotective effects of almonds.
Abstract
Favorable health benefits of almond have been shown in several previous studies. However, repeated measures, randomized, controlled trials to investigate the changes due to almond intake based on the time effects have not yet been reported. The current study was conducted to evaluate the effects of daily almond intake on changes in body composition and lipid profiles for 20 weeks with four measurements among healthy adults. Participants in the almond group showed favorable changes on blood lipid profiles, including levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein (non-HDL-C) after consuming 56 g of almond per day for 20 weeks compared with those at baseline. At week 20, subjects in the almond group showed significantly decreased TC, LDL-C, non-HDL-C, TG, body fat mass, and waist-hip ratio compared with those of the control group who consumed isocaloric control food. The mixed model also confirmed that there were significant time effects in several bioimpedance indicators (i.e., total body protein, fat-free mass, etc.) and all of the lipid profile parameters in the almond group. These results confirm the effects of lipid-lowering and modifying body composition of almond consumption. In addition, our results suggest that the measuring time points would be critical to capture the effects of dietary intervention.
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The Effect of a 12-Week Health Training Program on Selected Anthropometric and Biochemical Variables in Middle-Aged Women.
Pilch, W, Tota, Ł, Sadowska-Krępa, E, Piotrowska, A, Kępińska, M, Pałka, T, Maszczyk, A
BioMed research international. 2017;2017:9569513
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Regular physical activity is an important factor for health. This study evaluated physiological and biochemical changes induced by a 12 week regular exercise programme in healthy middle-aged women. 15 healthy women aged 42-47 participated in this programme which consisted of three 45 minutes high and low impact aerobics classes for 12 weeks. Body composition and biochemical markers were determined at baseline and after 12 weeks. The investigators observed a significant increase in lean body mass, and a decrease in total weight and fat mass. Biochemical markers showed decreased inflammation, increased antioxidant status and an improvement in lipid profiles (these had been within normal range at baseline). The authors also determined vitamin D status of the participants. Vitamin D levels were within normal range at baseline and did not change during the duration of the study. Higher vitamin D levels were correlated with better antioxidant status. The authors conclude that regular aerobic exercise had beneficial effects on body composition, antioxidant status, inflammatory markers and lipid profiles. The main limitation of this study was a lack of control group.
Abstract
Regular moderate physical activity positively affects health, fitness, and body composition; it regulates the pro- and anti-inflammatory cytokines levels. Vitamin D plays an important regulatory role; its adequate levels correlate with low values of inflammation markers and an increase in muscle strength and fitness in exercising people. The study's aim was to evaluate changes in somatic variables, oxidative stress, and inflammation markers, as well as blood calcidiol concentration in middle-aged healthy women after 12 weeks of aerobics classes-endurance exercises, including choreographic sequences, aiming to improve fitness and motor coordination. The training led to a significant reduction of body mass and fat tissue; it induced an increase in lean body mass. After the 12-week training program, plasma antioxidant status increased (0.65 ± 0.21, p < 0.01) and the concentration of lipid peroxidation products decreased (0.07 ± 0.02, p < 0.001). A significant increase in plasma antioxidant status associated with training could have reduced the level of proinflammatory interleukin as indicated by a positive correlation between these variables (rs = 0.64, p < 0.05). The study proved that a 12-week health training program in physically inactive middle-aged women might provide improvements in their anthropometric parameters and selected biochemical indicators.
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Low-glycaemic index diets in the management of blood lipids: a systematic review and meta-analysis.
Fleming, P, Godwin, M
Family practice. 2013;30(5):485-91
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Dietary glycaemic index (GI) is a measure of the body’s response to digesting carbohydrates. Foods with a high GI score result in a rapid spike in blood glucose and insulin levels, and increased plasma-free fatty acids. These spikes may have a direct impact on cardiovascular health. The aim of this review was to examine the effectiveness of low-GI diets in the management of blood lipids. Proposed mechanisms of high-GI diets impacting cardiovascular health include increasing reactive oxygen species, potentiating endothelial dysfunction and promoting vascular inflammation. The meta-analysis showed that low-GI diets have a significant effect on lowering total cholesterol and low-density lipoprotein (LDL) cholesterol in 5-12 weeks. Based on this study, the authors’ conclusions suggest that a low-GI diet may positively impact the lipid profile, however, a large randomised controlled trial is needed on the effects of low-GI diets on blood lipids.
Abstract
BACKGROUND Dietary glycaemic index (GI) is a measure of the postprandial glycaemic response to carbohydrates. Observational studies have found increased triglycerides and decreased high-density lipoprotein levels in patients consuming higher GI foods. OBJECTIVE Our aim was to review and synthesize the evidence on the effect of low-glucose index diets on serum lipid levels. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials on the effect of low-GI diets on serum lipid levels. We searched PubMed, Embase and Cochrane Library for published, English-language, randomized controlled trials comparing low-GI and high-GI diets for the management of blood lipids in the general population with at least 4 weeks of follow-up. We conducted a meta-analysis assuming a random effects model. RESULTS Four studies met the criteria for inclusion in the systematic review and meta-analysis. The individual studies did not always show a significant effect of a low-GI diet on serum lipids; however, when combined in a meta-analysis, low-GI diets were shown to have a significant effect on decreasing total cholesterol and low-density lipoprotein (LDL) cholesterol over a short time span (5-12 weeks). There was no significant effect on high-density lipoprotein or triglyceride levels. The forest plots for total cholesterol and LDL cholesterol did not show significant statistical heterogeneity (I (2) = 0%). CONCLUSION This meta-analysis suggests that a low-GI diet may help lower total and LDL cholesterol. The generalizability of these findings is likely limited by heterogeneity in individual study definitions of low- or high-GI diets.
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Long-chain n-3 PUFAs reduce adipose tissue and systemic inflammation in severely obese nondiabetic patients: a randomized controlled trial.
Itariu, BK, Zeyda, M, Hochbrugger, EE, Neuhofer, A, Prager, G, Schindler, K, Bohdjalian, A, Mascher, D, Vangala, S, Schranz, M, et al
The American journal of clinical nutrition. 2012;96(5):1137-49
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Adipose tissue inflammation is the basis of obesity-related systemic inflammation, which predisposes patients to the development of metabolic and cardiovascular disease. Previous studies show that long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs) reduce cardiovascular events and exert anti-inflammatory effects but their effects on human adipose tissue inflammation have so far been unknown. This randomized open-label controlled clinical trial evaluated the effect of an 8-week treatment with n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on adipose tissue and systemic inflammation and on metabolic control. Fifty-five severely obese non-diabetic patients, scheduled for bariatric surgery, were allocated to receive either n-3 PUFAs (n=27) or an equivalent amount of butterfat as control (n=28). Systemic inflammatory markers and metabolic variables were measured at baseline and at the end of the intervention before the participants underwent bariatric surgery. Adipose tissue samples were collected during surgery for the assessment of inflammatory gene expression and lipid mediator production. Treatment with n-3 PUFAs for 8 weeks favourably affected adipose tissue and systemic inflammation. In adipose tissue, the expression of most inflammatory genes was reduced and the concentrations of lipid mediators, responsible for the resolution of inflammation (resolving lipid mediators), were increased. Systemically, the results showed a shift to a more anti-inflammatory plasma fatty acid profile and a decrease in circulating triglyceride levels. The authors concluded that the observed beneficial effects of n-3 PUFAs may be useful in the long-term treatment of obesity.
Abstract
BACKGROUND Chronic adipose tissue inflammation is a hallmark of obesity, triggering the development of associated pathologies, particularly type 2 diabetes. Long-chain n-3 PUFAs reduce cardiovascular events and exert well-established antiinflammatory effects, but their effects on human adipose tissue inflammation are unknown. OBJECTIVE We investigated whether n-3 PUFAs reduce adipose tissue inflammation in severely obese nondiabetic patients. DESIGN We treated 55 severely obese nondiabetic patients, scheduled to undergo elective bariatric surgery, with 3.36 g long-chain n-3 PUFAs/d (EPA, DHA) or an equivalent amount of butterfat as control, for 8 wk, in a randomized open-label controlled clinical trial. The primary efficacy measure was inflammatory gene expression in visceral and subcutaneous adipose tissue samples (subcutaneous adipose tissue and visceral adipose tissue), collected during surgery after the intervention. Secondary efficacy variables were adipose tissue production of antiinflammatory n-3 PUFA-derived eicosanoids, plasma concentrations of inflammatory markers, metabolic control, and the effect of the Pro12Ala PPARG polymorphism on the treatment response. RESULTS Treatment with n-3 PUFAs, which was well tolerated, decreased the gene expression of most analyzed inflammatory genes in subcutaneous adipose tissue (P < 0.05) and increased production of antiinflammatory eicosanoids in visceral adipose tissue and subcutaneous adipose tissue (P < 0.05). In comparison with control subjects who received butterfat, circulating interleukin-6 and triglyceride concentrations decreased significantly in the n-3 PUFA group (P = 0.04 and P = 0.03, respectively). The Pro12Ala polymorphism affected the serum cholesterol response to n-3 PUFA treatment. CONCLUSIONS Treatment with long-chain n-3 PUFAs favorably modulated adipose tissue and systemic inflammation in severely obese nondiabetic patients and improved lipid metabolism. These effects may be beneficial in the long-term treatment of obesity. This trial was registered at clinicaltrials.gov as NCT00760760.