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Comparison of the Effects of Brazil Nut Oil and Soybean Oil on the Cardiometabolic Parameters of Patients with Metabolic Syndrome: A Randomized Trial.
Costa E Silva, LM, Pereira de Melo, ML, Faro Reis, FV, Monteiro, MC, Dos Santos, SM, Quadros Gomes, BA, Meller da Silva, LH
Nutrients. 2019;(1)
Abstract
Recent evidence suggests that replacing saturated fat with unsaturated fat is beneficial for cardiovascular health. This study compared the effects of Brazil nut oil (BNO) and soybean oil (SO) supplementation for 30 days on anthropometric, blood pressure, biochemical, and oxidative parameters in patients with metabolic syndrome (MS). Thirty-one patients with MS were randomly allocated to receive 30 sachets with 10 mL each of either BNO (n = 15) or SO (n = 16) for daily supplementation. Variables were measured at the beginning of the study and after 30 days of intervention. No change in anthropometric and blood pressure variables were observed (p > 0.05). Total (p = 0.0253) and low-density lipoprotein (p = 0.0437) cholesterol increased in the SO group. High-density lipoprotein cholesterol decreased (p = 0.0087) and triglycerides increased (p = 0.0045) in the BNO group. Malondialdehyde levels decreased in the BNO group (p = 0.0296) and total antioxidant capacity improved in the SO group (p = 0.0110). Although the addition of oils without lifestyle interventions did not affect anthropometric findings or blood pressure and promoted undesirable results in the lipid profile in both groups, daily supplementation of BNO for 30 days decreased lipid peroxidation, contributing to oxidative stress reduction.
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CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (the CORDIOPREV study): Rationale, methods, and baseline characteristics: A clinical trial comparing the efficacy of a Mediterranean diet rich in olive oil versus a low-fat diet on cardiovascular disease in coronary patients.
Delgado-Lista, J, Perez-Martinez, P, Garcia-Rios, A, Alcala-Diaz, JF, Perez-Caballero, AI, Gomez-Delgado, F, Fuentes, F, Quintana-Navarro, G, Lopez-Segura, F, Ortiz-Morales, AM, et al
American heart journal. 2016;:42-50
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Abstract
Coronary heart disease (CHD) represents a major global health burden. However, despite the well-known influence that dietary habits exert over the progression of this disease, there are no well-established and scientifically sound dietary approaches to prevent the onset of clinical outcomes in secondary prevention. The objective of the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (CORDIOPREV study, clinical trials number NCT00924937) is to compare the ability of a Mediterranean diet rich in virgin olive oil versus a low-fat diet to influence the composite incidence of cardiovascular events after 7 years in subjects with documented CHD at baseline. For this purpose, we enrolled 1,002 coronary patients from Spain. Baseline assessment (2009-2012) included detailed interviews and measurements to assess dietary, social, and biological variables. Results of baseline characteristics: The CORDIOPREV study in Spain describes a population with a high body mass index (37.2% overweight and 56.3% obesity) and with a median of low-density lipoprotein cholesterol of 88.5 mg/dL (70.6% of the patients having <100 mg/dL and 20.3% patients <70 mg/dL). A total of 9.6% of the participants were active smokers, and 64.4% were former smokers. Metabolic syndrome was present in 58% of this population. To sum up, we describe here the rationale, methods, and baseline characteristics of the CORDIOPREV study, which will test for the first time the efficacy of a Mediterranean diet rich in extra virgin olive oil as compared with a low-fat diet on the incidence of CHD recurrence in a long-term follow-up study.
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Adiposity and cardiovascular disease risk factors in renal transplant recipients: Are there differences between sexes?
Fernandes, JF, Leal, PM, Rioja, S, Bregman, R, Sanjuliani, AF, Barreto Silva, MI, Torres, MR
Nutrition (Burbank, Los Angeles County, Calif.). 2013;(10):1231-6
Abstract
OBJECTIVE The aim of this study was to evaluate high body adiposity and cardiovascular disease (CVD) risk factors prevalence, in renal transplant recipients (RTR), comparing men with women. METHODS In this retrospective cross-sectional study, 102 patients (55 men) who were 49 ± 1.2 y and 114.3 ± 9 mo post-transplant (post-tx) were evaluated. Pretransplant (pre-tx) period data and weight gain during the first year post-tx were obtained from patient charts and post-tx data were collected during a routine visit at nephrology clinic. Body mass index (BMI) ≥ 25 kg/m(2) defined overweight and BMI ≥ 30 kg/m(2) defined obesity. RESULTS Pre-tx overweight prevalence was low and similar between men and women (26%), whereas only women showed obesity (11%). Post-tx body weight increased significantly in the entire group, leading to an increase in overweight (to 38% in men and 51% in women) and obesity (to 11% in men and 23% in women) prevalence. Post-tx comparisons between men and women showed that women had higher (women versus men; P < 0.05) BMI values (26.7 ± 0.8 versus 24.7 ± 0.5 kg/m(2)), weight gain during first year post-tx (9.2 ± 1.1 versus 5.5 ± 1 kg), abdominal obesity (57% versus 23%) and diabetes (34% versus 16%) prevalence. The associations between adiposity and CVD risk factors showed that pre-tx overweight increased the risk for diabetes in post-tx; pos-tx high BMI and abdominal obesity increased the risk for metabolic syndrome; abdominal obesity increased the risk for dyslipidemia in women. CONCLUSIONS High body adiposity prevalence was high after transplantation and increased the risk for metabolic syndrome, an important CVD risk factor. Women showed higher total body adiposity values, abdominal obesity, and diabetes prevalence than men. Abdominal obesity increased the risk for dyslipidemia in women.
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Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects.
Tay, J, Brinkworth, GD, Noakes, M, Keogh, J, Clifton, PM
Journal of the American College of Cardiology. 2008;(1):59-67
Abstract
OBJECTIVES This study was designed to compare the effects of an energy-reduced, isocaloric very-low-carbohydrate, high-fat (VLCHF) diet and a high-carbohydrate, low-fat (HCLF) diet on weight loss and cardiovascular disease (CVD) risk outcomes. BACKGROUND Despite the popularity of the VLCHF diet, no studies have compared the chronic effects of weight loss and metabolic change to a conventional HCLF diet under isocaloric conditions. METHODS A total of 88 abdominally obese adults were randomly assigned to either an energy-restricted (approximately 6 to 7 MJ, 30% deficit), planned isocaloric VLCHF or HCLF diet for 24 weeks in an outpatient clinical trial. Body weight, blood pressure, fasting glucose, lipids, insulin, apolipoprotein B (apoB), and C-reactive protein (CRP) were measured at weeks 0 and 24. RESULTS Weight loss was similar in both groups (VLCHF -11.9 +/- 6.3 kg, HCLF -10.1 +/- 5.7 kg; p = 0.17). Blood pressure, CRP, fasting glucose, and insulin reduced similarly with weight loss in both diets. The VLCHF diet produced greater decreases in triacylglycerols (VLCHF -0.64 +/- 0.62 mmol/l, HCLF -0.35 +/- 0.49 mmol/l; p = 0.01) and increases in high-density lipoprotein cholesterol (HDL-C) (VLCHF 0.25 +/- 0.28 mmol/l, HCLF 0.08 +/- 0.17 mmol/l; p = 0.002). Low-density lipoprotein cholesterol (LDL-C) decreased in the HCLF diet but remained unchanged in the VLCHF diet (VLCHF 0.06 +/- 0.58 mmol/l, HCLF -0.46 +/- 0.71 mmol/l; p < 0.001). However, a high degree of individual variability for the LDL response in the VLCHF diet was observed, with 24% of individuals reporting an increase of at least 10%. The apoB levels remained unchanged in both diet groups. CONCLUSIONS Under isocaloric conditions, VLCHF and HCLF diets result in similar weight loss. Overall, although both diets had similar improvements for a number of metabolic risk markers, an HCLF diet had more favorable effects on the blood lipid profile. This suggests that the potential long-term effects of the VLCHF diet for CVD risk remain a concern and that blood lipid levels should be monitored. (Long-term health effects of high and low carbohydrate, weight loss diets in obese subjects with the metabolic syndrome; http://www.anzctr.org.au; ACTR No. 12606000203550).
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Is atorvastatin superior to other statins? Analysis of the clinical trials with atorvastatin having cardiovascular endpoints.
Doggrell, SA
Reviews on recent clinical trials. 2006;(2):143-53
Abstract
Placebo-controlled clinical trials have shown that atorvastatin is beneficial in patients with myocardial ischemia, established coronary artery disease, hypertension and 3 other cardiovascular risk factors (e.g. left-ventricular hypertrophy, type 2 diabetes, smoking), and in diabetes, but not in patients with calcific aortic stenosis. Recently, intensive low density lipoprotein (LDL)-cholesterol lowering with atorvastatin 80 mg/day has been shown to have a greater clinical benefit than atorvastatin 10 mg/day in patients with coronary heart disease and one other high-risk factor (previous myocardial infarction, coronary revascularization or angina), and to be superior to moderate lipid lowering with pravastatin (40 mg/day) in patients with an acute coronary syndrome. However, a smaller study comparing lovastatin 5 mg/day with atorvastatin 80 mg/day was unable to detect any difference in outcomes in patients with stable coronary disease, despite the greater LDL-cholesterol lowering with the atorvastatin, possibly because it was not powered to do so. In a retrospective cohort study, atorvastatin 10 mg/day, pravastatin 20 mg/day, simvastatin 20 mg/day, lovastatin 20 mg/day and fluvastatin 20 mg/day had similar efficacy as secondary prevention after acute myocardial infarction. At present, the evidence from clinical trials is favouring the intensity of the effect on LDL-cholesterol and/or C-reactive protein (CRP) with atorvastatin 80 mg, rather than the use of atorvastatin per se, when greater benefits are observed with the 80 mg dose of atorvastatin compared to other statins. Thus, at present, it is not clear whether atorvastatin is superior to other statins in some indications (coronary heart disease, acute coronary syndromes) or whether it is the intensive lipid lowering that is responsible for the superiority. Atorvastatin has little or no ability to increase high density lipoprotein (HDL)-cholesterol, and this may be a disadvantage in patients with metabolic syndrome or diabetes, where low HDL-cholesterol is a key feature. Thus, other statins should probably be preferred to atorvastatin in patients with diabetes/metabolic syndrome. Alternatively, atorvastatin can be used in combination with a fibrate to increase HDL-cholesterol in patients with diabetes/metabolic syndrome.
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The metabolic syndrome and its cardiovascular manifestations.
Sánchez-Torres, RJ, Delgado-Osorio, H
Boletin de la Asociacion Medica de Puerto Rico. 2005;(4):271-80
Abstract
The metabolic syndrome is one of the most discussed topics in the past 15 years. It is a collection of risk factors that includes insulin resistance, central obesity, arterial hypertension, and atherogenic dyslipidemia. The presence of these risk factors increases the probability of developing diabetes mellitus and cardiovascular disease, increasing coronary and cardiovascular mortality. The prevalence of the metabolic syndrome in the US has increased in the past years due to an increased incidence of obesity and physical inactivity. Diagnosis of the metabolic syndrome can be done with the use of established criteria by the NCEP-ATP III and the WHO. The principal treatment for this condition is to modify life styles, most importantly, diet and exercise. In many cases, this intervention alone is not sufficient to control these risk factors and a more aggressive intervention is required, including drugs directed to each risk factor independently to avoid complications due to the development of cardiovascular disease associated to the syndrome.
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Dose Response to Exercise in Women aged 45-75 yr (DREW): design and rationale.
Morss, GM, Jordan, AN, Skinner, JS, Dunn, AL, Church, TS, Earnest, CP, Kampert, JB, Jurca, R, Blair, SN
Medicine and science in sports and exercise. 2004;(2):336-44
Abstract
INTRODUCTION AND PURPOSE Physical inactivity in postmenopausal women contributes to a rise in atherogenic risk factors associated with the metabolic syndrome. Although regular physical activity positively contributes to health, inactivity progressively increases with age. The Dose Response to Exercise in Women aged 45-75 yr (DREW) study is designed to investigate the effect of different amounts of exercise training on cardiorespiratory fitness and risk factors for cardiovascular disease (CVD) in postmenopausal women at moderately increased risk of CVD. METHODS DREW will recruit 450 sedentary, healthy, postmenopausal women with a body mass index of 25-40 kg.m-2, resting systolic blood pressure (BP) of 120-159 mm Hg, and a resting diastolic BP of < or = 99 mm Hg. Laboratory and self-report measures completed at baseline and 6 months include maximal oxygen consumption (.VO2max), resting BP, anthropometry, dietary habits, physical activity history, medication use, menstrual history, personal and family medical history, and fasting HDL cholesterol, LDL cholesterol, triglycerides, and glucose. Eligible participants are randomly assigned to a nonexercise group or one of three exercise groups. Participants exercise 3 to 4x wk-1 at a heart rate equivalent to 50% of .VO2max expending 4, 8, or 12 kcal.kg-1.wk-1, depending on group assignment. This study will allow quantification of possible dose-response relations (50%, 100%, and 150% of the consensus physical activity recommendation) between exercise training and study outcomes. CONCLUSION DREW can make important contributions to our understanding of the effects of physical activity in postmenopausal women and help refine public health and clinical recommendations for this group.