Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial

Abstract

The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD. However, the extent of food changes needed to achieve these effects is less explored. The aim of the present study was to investigate the effects of exchanging a few commercially available, regularly consumed key food items (e.g. spread on bread, fat for cooking, cheese, bread and cereals) with improved fat quality on total cholesterol, LDL-cholesterol and inflammatory markers in a double-blind randomised, controlled trial. In total, 115 moderately hypercholesterolaemic, non-statin-treated adults (25-70 years) were randomly assigned to an experimental diet group (Ex-diet group) or control diet group (C-diet group) for 8 weeks with commercially available food items with different fatty acid composition (replacing SFA with mostly n-6 PUFA). In the Ex-diet group, serum total cholesterol (P < 0·001) and LDL-cholesterol (P < 0·001) were reduced after 8 weeks, compared with the C-diet group. The difference in change between the two groups at the end of the study was −9 and −11 % in total cholesterol and LDL-cholesterol, respectively. No difference in change in plasma levels of inflammatory markers (high-sensitive C-reactive protein, IL-6, soluble TNF receptor 1 and interferon-γ) was observed between the groups. In conclusion, exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol, with no negative effect on levels of inflammatory markers. This shows that an exchange of a few commercially available food items was easy and manageable and led to clinically relevant cholesterol reduction, potentially affecting future CVD risk.

An Isocaloric Nordic Diet Modulates RELA and TNFRSF1A Gene Expression in Peripheral Blood Mononuclear Cells in Individuals with Metabolic Syndrome—A SYSDIET Sub-Study

“…None of the gene transcripts encoding proteins related to lipid metabolism were changed by the ND compared to the CD. We have previously shown that exchanging SFA with PUFA reduced total cholesterol and LDL-C by 9% and 11%, respectively, among subjects with slightly elevated cholesterol [29], and changed the PBMC expression levels of several lipid metabolism-related genes [30]. The reason why we did not observe any changes in lipid metabolism-related genes in the present study, may be due to the smaller effect of the ND on the lipid profile as previously shown [16].…”

Serum Omega‐6 Fatty Acids and Immunology‐Related Gene Expression in Peripheral Blood Mononuclear Cells: A Cross‐Sectional Analysis in Healthy Children

“…However, serum total omega‐6 PUFA level may be used as a biomarker of dietary total omega‐6 PUFA intake, since LA, the main contributor of serum total omega‐6 PUFA variability, cannot be synthesized in humans, and the conversion of LA into long‐chain PUFAs is limited . Moreover, the systemic environment may prime leukocytes in circulation; therefore, data obtained from isolated peripheral blood mononuclear cells (PBMCs) could well reflect the in vivo situation, and immunology‐related mRNA expression in could provide a more comprehensive characterization of inflammation, and at a higher resolution, compared to standard measurements of circulating markers.…”

Anbefalt nordisk kosthold og risikomarkører for hjerte- og karsykdom

“…A recent Norwegian study in which a few commercially available food items were replaced by equivalent products that had a better composition of fatty acids (a higher proportion of polyunsaturated fats) for eight weeks found clinically relevant changes in the total cholesterol and LDL cholesterol levels resulting from minor changes to the daily diet (52). The change in LDL cholesterol level was identical to the change found in the Improve-it study, which tested the effect of ezemitibe as add-on therapy to statin treatment (53).…”