1.
Diets high in carbohydrate may not be appropriate for rs328 G carriers with the metabolic syndrome.
Zhang, S, Ma, Y, Guo, H, Wan, W, Xue, K
Asia Pacific journal of clinical nutrition. 2015;(3):546-54
Abstract
The objective of this study was to test how the genetic polymorphisms located within the lipoprotein lipase (LPL) locus would modulate the relationship between a diet high in carbohydrate and insulin resistance related traits in metabolic syndrome adults. A one year nutritional intervention study focusing on education to increase dietary intake of whole grain, vegetable and fruit, and to reduce the intake of sodium, simple sugar and dietary fat (especially cooking oil and pork lard) was conducted. Two districts in Shanghai, China were randomly selected to be the intervention and control group, and patients (n=235) with metabolic syndrome within these two districts were selected based on a multistage sampling method. Fasting glucose was reduced in rs328 CC homozygotes (p=0.028) but not G carriers (p=0.686) within the intervention group. Also an ancillary study with greater statistical power by combining the baseline measurements across both the intervention and control groups was conducted to test the cross-sectional statistical interactions between carbohydrate/fat and lipoprotein lipase genotypes for homeostasis model assessment of insulin resistance/insulin/fasting glucose. Increased carbohydrate intakes were positively associated with homeostasis model assessment of insulin resistance and insulin in rs328 G carriers but not CC homozygotes (p for interaction was 0.025). These results indicate that diet high in carbohydrate may not be suitable for metabolic syndrome rs328 G carriers, calling for the development of personalized dietary intervention for metabolic syndrome subjects.
2.
Association between carbohydrate intake and serum lipids.
Ma, Y, Li, Y, Chiriboga, DE, Olendzki, BC, Hebert, JR, Li, W, Leung, K, Hafner, AR, Ockene, IS
Journal of the American College of Nutrition. 2006;(2):155-63
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Abstract
BACKGROUND The effect of dietary carbohydrate on blood lipids has received considerable attention in light of the current trend in lowering carbohydrate intake for weight loss. OBJECTIVES To evaluate the association between carbohydrate intake and serum lipids. METHODS Blood samples and 24-hour dietary and physical activity recall interviews were obtained from each subject at quarterly intervals for five consecutive quarters between 1994 and 1998 from 574 healthy adults in Central Massachusetts. Relationships between serum lipids and dietary carbohydrate factors were assessed using linear mixed models and adjusting for other risk factors known to be related to blood lipids. Both cross-sectional and longitudinal results were reported. RESULTS Cross-sectional analysis results from this study suggest that higher total carbohydrate intake, percentage of calories from carbohydrate, glycemic index (GI) and/or glycemic load (GL) are related to lower high-density lipoprotein cholesterol (HDL-C) and higher serum triacylglycerol levels, while higher total carbohydrate intake and/or GL are related to lower total and low-density lipoprotein cholesterol (LDL-C) levels. In a one-year longitudinal analysis, GL was positively associated with total and LDL-C levels, and there was an inverse association between percentage of calories from carbohydrate and HDL-C levels. CONCLUSIONS Results suggest that there is a complex and predominantly unfavorable effect of increased intake of highly processed carbohydrate on lipid profile, which may have implications for metabolic syndrome, diabetes, and coronary heart disease. Further studies in the form of randomized controlled trials are required to investigate these associations and determine the implications for lipid management.
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Change in women's diet and body mass following intensive intervention for early-stage breast cancer.
Hebert, JR, Ebbeling, CB, Olendzki, BC, Hurley, TG, Ma, Y, Saal, N, Ockene, JK, Clemow, L
Journal of the American Dietetic Association. 2001;(4):421-31
Abstract
OBJECTIVE To determine the effectiveness of an intensive dietary intervention on diet and body mass in women with breast cancer. DESIGN Randomized clinical trial. SUBJECTS 172 women aged 20 to 65 years with stage I or II breast cancer. INTERVENTION A 15-session, mainly group-based and dietitian-led nutrition education program (NEP) was compared to a mindfulness-based stress reduction clinic program (SRC); or usual supportive care (UC). MAIN OUTCOME MEASURES Dietary fat, complex carbohydrates, fiber, and body mass were measured. STATISTICAL ANALYSIS In addition to descriptive statistics, analysis of variance was conducted to test for differences according to intervention group. RESULTS Of the 157 women with complete dietary data at baseline, 149 had complete data immediately postintervention (at 4 months) and 146 had complete data at 1 year. Women randomized to NEP (n = 50) experienced a large reduction in fat consumption (5.8% of energy as fat) at 4 months and much of this reduction was preserved at 1 year (4.1% of energy) (both P < .0002) vs no change in either SRC (n = 51) or UC (n = 56). A 1.3-kg reduction in body mass was evident at 4 months in the NEP group (P = .003) vs no change in the SRC and UC groups. Women who had higher-than-average expectations of a beneficial effect of the intervention experienced larger changes. APPLICATIONS Dietitians' use of group nutrition interventions appear to be warranted. Increasing their effectiveness and maintaining high levels of adherence may require additional support, including the involvement of significant others, periodic individual meetings, or group booster sessions.