Palm and partially hydrogenated soybean oils, compared with soybean and canola oils, adversely altered the lipoprotein profile in moderately hyperlipidemic subjects without significantly affecting HDL intravascular processing markers.

Pycnogenol (PYC), an extract of French maritime pine bark (Pinus pinaster), is a potent antioxidant with potential health benefits. Its bioavailabilty has previously been shown by urinary excretion studies of constituents and metabolites of PYC. The aim of this study was to test the effect of PYC supplementation on measures of oxidative stress and the lipid profile in humans. Twenty-five healthy subjects received PYC (150 mg/d) for 6 wk. Fasting blood was collected at baseline, after 3 and 6 wk of supplementation, and again after a 4-wk washout period. After 6 wk of supplementation with PYC, a significant increase in plasma polyphenol levels was detectable, which was reversed after the 4-wk washout phase. The antioxidant effect of PYC was demonstrated by a significant increase in oxygen radical absorbance capacity (ORAC) in plasma throughout the supplementation period (P < 0.05). The ORAC value returned to baseline after the 4-wk washout period. Moreover, in addition to its antioxidant effects, PYC significantly reduced LDL-cholesterol levels and increased HDL-cholesterol levels in plasma of two-thirds of the subjects. While the LDL changes reversed during washout, the HDL increase did not. There was no significant difference in LDL oxidizability or plasma lipid peroxides following PYC supplementation. Hence, following oral supplementation in humans, PYC significantly increases antioxidant capacity of plasma, as determined by ORAC, and exerts favorable effects on the lipid profile.

OBJECTIVELatinos with type 2 diabetes (T2D) face major healthcare access and disease management disparities. We examined the impact of the Diabetes Among Latinos Best Practices Trial (DIALBEST), a community health worker (CHW)–led structured intervention for improving glycemic control among Latinos with T2D.RESEARCH DESIGN AND METHODSA total of 211 adult Latinos with poorly controlled T2D were randomly assigned to a standard of healthcare (n = 106) or CHW (n = 105) group. The CHW intervention comprised 17 individual sessions delivered at home by CHWs over a 12-month period. Sessions addressed T2D complications, healthy lifestyles, nutrition, healthy food choices and diet for diabetes, blood glucose self-monitoring, and medication adherence. Demographic, socioeconomic, lifestyle, anthropometric, and biomarker (HbA1c, fasting blood glucose, and lipid profile) data were collected at baseline and 3, 6, 12, and 18 months (6 months postintervention). Groups were equivalent at baseline.RESULTSParticipants had high HbA1c at baseline (mean 9.58% [81.2 mmol/mol]). Relative to participants in the control group, CHWs had a positive impact on net HbA1c improvements at 3 months (−0.42% [−4.62 mmol/mol]), 6 months (−0.47% [−5.10 mmol/mol]), 12 months (−0.57% [−6.18 mmol/mol]), and 18 months (−0.55% [−6.01 mmol/mol]). The overall repeated-measures group effect was statistically significant (mean difference −0.51% [−5.57 mmol/mol], 95% CI −0.83, −0.19% [−9.11, −2.03 mmol/mol], P = 0.002). CHWs had an overall significant effect on fasting glucose concentration that was more pronounced at the 12- and 18-month visits. There was no significant effect on blood lipid levels, hypertension, and weight.CONCLUSIONSDIALBEST is an effective intervention for improving blood glucose control among Latinos with T2D.

Objective-This systematic review assesses the impact of peer education/counseling on nutrition and health outcomes among Latinos, and identifies future research needs.Design-A systematic literature search was conducted by: a) searching internet databases, b) conducting backward searches from reference lists of articles of interest, c) manually reviewing the archives of the Center for Eliminating Health Disparities among Latinos (CEHDL), d) searching the Journal of Nutrition Education and Behavior, and e) directly contacting researchers in the field. We reviewed 22 articles derived from experimental or quasi-experimental studies.Outcomes-Type 2 diabetes behavioral and metabolic outcomes, breastfeeding, nutrition knowledge, attitudes and behaviors.Results-Peer nutrition education has a positive influence on diabetes self-management, breastfeeding outcomes, as well as on general nutrition knowledge and dietary intake behaviors among Latinos.Conclusions and implications-There is a need for longitudinal randomized trials testing the impact of peer nutrition education interventions grounded on goal setting and culturally appropriate behavioral change theories. Inclusion of reliable scales and the construct of acculturation is needed for further advancing the knowledge in this promising field. Operational research is also needed to identify the optimal peer educator characteristics, the type of training that they should receive, the client loads and dosage (i.e., frequency and amount of contact needed between needed peer educator and client), and the best educational approaches and delivery settings.

Despite initial enthusiasm, the relationship between glycemic index (GI) and glycemic response (GR) and disease prevention remains unclear. This review examines evidence from randomized, controlled trials and observational studies in humans for short-term (e.g., satiety) and long-term (e.g., weight, cardiovascular disease, and type 2 diabetes) health effects associated with different types of GI diets. A systematic PubMed search was conducted of studies published between 2006 and 2018 with key words glycemic index, glycemic load, diabetes, cardiovascular disease, body weight, satiety, and obesity. Criteria for inclusion for observational studies and randomized intervention studies were set. The search yielded 445 articles, of which 73 met inclusion criteria. Results suggest an equivocal relationship between GI/GR and disease outcome. The strongest intervention studies typically find little relationship among GI/GR and physiological measures of disease risk. Even for observational studies, the relationship between GI/GR and disease outcomes is limited. Thus, it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes. Other measures of dietary quality, such as fiber or whole grains may be more likely to predict health outcomes. Interest in food patterns as predictors of health benefits may be more fruitful for research to inform dietary guidance.

These data revealed that excess dietary cholesterol does not increase the risk of developing an atherogenic lipoprotein profile in pre-menopausal women, regardless of their response classification. Although the addition of 640 mg of cholesterol to the diet did result in an increase in plasma cholesterol in hyperresponders, the LDL/HDL ratio was maintained. This result, accompanied by increases in CETP activity, leads to the speculation that hyper-responders may process the excess cholesterol in the plasma compartment through an enhancement of the reverse cholesterol transport pathway. With this mechanism identified, further measurement of additional parameters is needed to verify this conclusion.

The purpose of this study was to evaluate the differences that occur within the plasma compartment of normolipidemic men, classified on the basis of their response to prolonged consumption of additional dietary cholesterol. Using a crossover design, 40 men aged 18-57 y were randomly allocated to an egg (640 mg/d additional dietary cholesterol) or placebo group (0 mg/d additional dietary cholesterol), for two 30-d periods, which were separated by a 3-wk washout period. Subjects were classified as hypo- [increase in plasma total cholesterol (TC) of <0.05 mmol/L for each additional 100 mg of dietary cholesterol consumed] or hyperresponders (increase in TC of > or =0.06 mmol/L for each additional 100 mg of dietary cholesterol consumed) on the basis of their plasma reaction to the additional dietary cholesterol provided. Male hyporesponders did not experience an increase in LDL cholesterol (LDL-C) or HDL cholesterol (HDL-C) during the egg period, whereas both lipoproteins were significantly (P < 0.0001 and P < 0.05, respectively) elevated in hyperresponders. Although the LDL/HDL ratio was increased in male hyperresponders after the high cholesterol period, the mean increase experienced by this population was still within National Cholesterol Education Program guidelines. Furthermore, male hyperresponders had higher lecithin cholesterol acyltransferase (P < 0.05) and cholesteryl ester transfer protein (P < 0.05) activities during the egg period, which suggests an increase in reverse cholesterol transport. These data suggest that additional dietary cholesterol does not increase the risk of developing an atherogenic lipoprotein profile in healthy men, regardless of their response classification.

OBJECTIVE -We sought to assess the intra-and interindividual variability of glycemic index value determinations for white bread using glucose as the reference food.RESEARCH DESIGN AND METHODS -A total of 23 healthy adults (aged 20 -70 years) completed up to three sets of two visits per set. Each pair of visits assessed the glycemic response to 50 g available carbohydrates from commercial white bread and glucose, administered in random order. Glycemic index values were calculated by dividing the 2-h incremental area under the serum glucose response curve after each commercial white bread challenge by the mean area under the curve (AUC) for glucose.RESULTS -The mean Ϯ SE ratio of the AUC after white bread intake by the AUC after glucose intake for the first set of determinations was 78 Ϯ 15 (n ϭ 23; coefficient of variation [CV] 94%). When using glycemic index values calculated with the subset of participants who completed three sets of tests (n ϭ 14), glycemic index values for each of the three sets of determinations were 78 Ϯ 10, 60 Ϯ 5, and 75 Ϯ 10, respectively. CVs were 50, 28, and 50%, respectively. The mean glycemic index value of these three sets was 71 Ϯ 6, with a CV of 30%. When an ANOVA approach was applied to these data, the interindividual CV was 17.8%, and the intra-individual variation was 42.8%.CONCLUSIONS -These data suggest that in response to a challenge of white bread relative to glucose, within-individual variability is a greater contributor to overall variability than amongindividual variability. Further understanding of all the sources of variability would be helpful in better defining the utility of glycemic index values.