Effects of a Dietary Portfolio of Cholesterol-Lowering Foods vs Lovastatin on Serum Lipids and C-Reactive Protein

Jenkins, David; Kendall, Cyril W.C.; Marchie, Augustine; Faulkner, Dorothea; Wong, Julia M W; Souza, Russell J. de; Emam, Azadeh; Parker, Tina; Vidgen, Edward; Lapsley, Karen G.; Trautwein, Elke A.; Josse, Robert G.; Leiter, Lawrence A.; Connelly, Philip W.

doi:10.1001/jama.290.4.502

Cited by 532 publications

(359 citation statements)

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“…Dietary modification remains the preferred initial treatment option for improving major lipid risk factors rather than instigating drug therapy (NCEP, 2001;Anderson, 2003). Jenkins and coworkers recently proposed the 'Portfolio diet' as a new approach to lipid management: the diet utilizes a combination of hypocholesterolaemic agents such as psyllium, oats, nuts, plant sterols and soy protein to provide an additive effect in reducing total and low-density lipoprotein cholesterol (LDL-C), equivalent to first-line drug therapy (Jenkins et al, 2002a(Jenkins et al, , 2003. Dietary intervention studies have shown that numerous legumes (eg, soy beans, navy beans, field beans, lentils, chickpeas and pinto beans) beneficially modify serum lipids (Jenkins et al, 1983;Anderson et al, 1984Anderson et al, , 1990Anderson et al, , 1995Duane, 1997;Fruhbeck et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

et al. 2004

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Objective: To examine the effect of a diet containing a novel legume food ingredient, Australian sweet lupin (Lupinus angustifolius) kernel fibre (LKFibre), compared to a control diet without the addition of LKFibre, on serum lipids in men. Design: Randomized crossover dietary intervention study. Setting: Melbourne, Australia -Free-living men. Subjects: A total of 38 healthy males between the ages of 24 and 64 y completed the intervention. Intervention: Subjects consumed an LKFibre and a control diet for 1 month each. Both diets had the same background menus with seven additional experimental foods that either contained LKFibre or did not. Depending on energy intake, the LKFibre diet was designed to contain an additional 17 to 30 g/day fibre beyond that of the control diet. Results: Compared to the control diet, the LKFibre diet reduced total cholesterol (TC) (mean7s.e.m.; 4.571.7%; P ¼ 0.001), low-density lipoprotein cholesterol (LDL-C) (5.472.2%; P ¼ 0.001), TC: high-density lipoprotein cholesterol (HDL-C) (3.072.0%; P ¼ 0.006) and LDL-C:HDL-C (3.872.6%; P ¼ 0.003). No effects on HDL-C, triacylglycerols, glucose or insulin were observed. Conclusions: Addition of LKFibre to the diet provided favourable changes to some serum lipid measures in men, which, combined with its high palatability, suggest this novel ingredient may be useful in the dietary reduction of coronary heart disease risk.

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Section: Introductionmentioning

confidence: 99%

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

et al. 2004

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“…0% total energy and <50 mg dietary cholesterol/4 . 2 MJ (1000 kcal) was present (32)(33)(34) . Furthermore, the diet provided 30 .…”

Section: The Dietary Portfoliomentioning

confidence: 99%

“…05). These two approaches were shown to be more effective in modifying the risk factors of CHD than the NCEP-derived control (33) .…”

Section: The Dietary Portfolio: Metabolic Trialsmentioning

confidence: 99%

“…The metabolic studies indicate that the dietary portfolio is efficacious in reducing serum cholesterol concentrations (32)(33)(34)(35) . However, as discussed previously, the aim was to develop a dietary approach that in addition to being effective was also easy to comply with.…”

Section: The Dietary Portfolio: Long-term Sustainabilitymentioning

confidence: 99%

“…3) %, P = 0 . 002 respectively) (33) and significant in another when subjects with C-reactive protein levels above the 75th percentile were excluded (-23 . 8 (SE 6 .…”

Section: Other Benefits and Future Directionmentioning

confidence: 99%

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Session 4: CVD, diabetes and cancer A dietary portfolio for management and prevention of heart disease

2009

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CHD is the leading cause of worldwide mortality. The prevalence of heart disease has been linked to the adoption of a sedentary lifestyle and the increased dietary dependence on saturated fats from animal sources and the intake of refined foods. Elevated blood cholesterol level is one of the major risk factors for CHD. While cholesterol-lowering drug therapy (statins) has been effective in reducing the risk of heart disease, there are those individuals who are unwilling or because of muscle pains or raised levels of liver or muscle enzymes are unable to take cholesterol-lowering medication. Fortunately, there is evidence linking a number of dietary components to CHD risk reduction. The strength of this evidence has prompted various regulatory bodies to advocate diet as the first line of defence for primary prevention of heart disease. It was therefore decided to combine four dietary components that have been shown to lower blood cholesterol concentrations (nuts, plant sterols, viscous fibre and vegetable protein) in a dietary portfolio in order to determine whether the combined effect is additive. In a metabolically-controlled setting this dietary portfolio has proved to be as effective as a starting dose of a first-generation statin cholesterol-lowering medication in reducing the risk of CHD. The dietary portfolio has also been shown to be effective in sustaining a clinically-significant effect in the long term under a 'real-world' scenario. However, success of the diet depends on compliance and despite the accessibility of the foods adherence has been found to vary greatly. Overall, the evidence supports the beneficial role of the dietary portfolio in reducing blood cholesterol levels and CHD risk.

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The Effect of Weight Loss on C-Reactive Protein

2007

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Background: Several studies suggest that weight loss reduces C-reactive protein (CRP) level; however, the consistency and magnitude of this effect has not been well characterized. Our objective was to test the hypothesis that weight loss is directly related to a decline in CRP level. Data Sources:We searched the Cochrane Controlled Trials Register and MEDLINE databases and conducted hand searches and reviews of bibliographies to identify relevant weight loss intervention studies. Study Selection:We included all weight loss intervention studies that had at least 1 arm that was a surgical, lifestyle, dietary, and/or exercise intervention. Abstracts were independently selected by 2 reviewers. Data Extraction: Two reviewers independently abstracted data on the characteristics of each study population, weight loss intervention, and change in weight and CRP level from each arm of all included studies. Data Synthesis:We analyzed the mean change in CRP level (milligrams per liter) and the mean weight change (kilograms), comparing the preintervention and postintervention values from each arm of 33 included studies using graphical displays of these data and weighted regression analyses to quantify the association.Results: Weight loss was associated with a decline in CRP level. Across all studies (lifestyle and surgical interventions), we found that for each 1 kg of weight loss, the mean change in CRP level was −0.13 mg/L (weighted Pearson correlation, r =0.85). The weighted correlation for weight and change in CRP level in the lifestyle interventions alone was 0.30 (slope, 0.06). The association appeared roughly linear. Conclusion:Our results suggest that weight loss may be an effective nonpharmacologic strategy for lowering CRP level.

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Effects of a Dietary Portfolio of Cholesterol-Lowering Foods vs Lovastatin on Serum Lipids and C-Reactive Protein

Cited by 532 publications

References 43 publications

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

Session 4: CVD, diabetes and cancer A dietary portfolio for management and prevention of heart disease

The Effect of Weight Loss on C-Reactive Protein

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