Therapeutic lifestyle change and adult treatment panel III: Evidence then and now

Stone, Neil J.; Horn, Linda Van

doi:10.1007/s11883-002-0047-x

Cited by 21 publications

(10 citation statements)

References 98 publications

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“…Participants assigned to the low-carbohydrate diet were instructed to maintain an intake of digestible carbohydrate (total carbohydrate minus total fiber) of less than 40 g/d. Those assigned to the low-fat diet were instructed to maintain less than 30% of their daily energy intake from total fat (with <7% from saturated fat) and 55% from carbohydrate, based on National Cholesterol Education Program guidelines (7–9). Neither diet included a specific calorie or energy goal.…”

Section: Methodsmentioning

confidence: 99%

“…The few that have either did not assess a typical low-carbohydrate diet or included severely obese participants, most of whom had type 2 diabetes or the metabolic syndrome (4–6). Hence, we conducted a randomized, parallel-group trial to examine the effects of a 12-month low-carbohydrate diet compared with a low-fat diet (7–9) on body weight and CVD risk factors in a diverse population with a substantial proportion of black persons with no clinical comorbid conditions.…”

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confidence: 99%

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Effects of Low-Carbohydrate and Low-Fat Diets

et al. 2014

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Background Low-carbohydrate diets are popular for weight loss, but their cardiovascular effects have not been well-studied, particularly in diverse populations. Objective To examine the effects of a low-carbohydrate diet compared with a low-fat diet on body weight and cardiovascular risk factors. Design A randomized, parallel-group trial. (ClinicalTrials.gov: NCT00609271) Setting A large academic medical center. Participants 148 men and women without clinical cardiovascular disease and diabetes. Intervention A low-carbohydrate (<40 g/d) or low-fat diet (<30% fat; <7% saturated fat). Both groups received dietary counseling at regular intervals throughout the trial. Measurements Data on weight, cardiovascular risk factors, and dietary composition were collected at 0, 3, 6, and 12 months. Results Sixty participants (82%) in the low-fat group and 59 (79%) in the low-carbohydrate group completed the intervention. At 12 months, participants on the low-carbohydrate diet had greater decreases in weight (mean difference in change, −3.5 kg [95% CI, −5.6 to −1.4 kg]; P < 0.001), fat mass (mean difference in change, −1.5% [CI, −2.6% to −0.4%]; P = 0.011), ratio of total to high-density lipoprotein (HDL) cholesterol (mean difference in change, −0.44 [CI, −0.71 to −0.16]; P = 0.002), and triglyceride level (mean difference in change, −0.16 mmol/L [−14.1 mg/dL] [CI, −0.31 to −0.01 mmol/L {−27.4 to −0.8 mg/dL}]; P = 0.038) and greater increases in HDL cholesterol level (mean difference in change, 0.18 mmol/L [7.0 mg/dL] [CI, 0.08 to 0.28 mmol/L {3.0 to 11.0 mg/dL}]; P< 0.001) than those on the low-fat diet. Limitation Lack of clinical cardiovascular disease end points. Conclusion The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors. Primary Funding Source National Institutes of Health.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Effects of Low-Carbohydrate and Low-Fat Diets

et al. 2014

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“…Because of structural similarity to cholesterol, PS has a good effect on lowering cholesterol concentrations by competing with cholesterol for intestinal absorption [13]. Daily intake of 2 g PS is in the recommendations of the national cholesterol education program (NCEP) in decreasing total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) level [14]. However, plant sterol was shown to have a limited effect on lowering circulating triglyceride (TG) levels [15].…”

Section: Introductionmentioning

confidence: 99%

Plant Sterol Ester of α-Linolenic Acid Attenuates Nonalcoholic Fatty Liver Disease by Rescuing the Adaption to Endoplasmic Reticulum Stress and Enhancing Mitochondrial Biogenesis

Han

Guo

et al. 2019

Oxidative Medicine and Cellular Longevity

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Nonalcoholic fatty liver disease (NAFLD) is becoming more common in the world and is presenting a great challenge concerning prevention and treatment. Plant sterol ester of α-linolenic acid (PS-ALA) has a potential benefit to NAFLD. To examine the effect of PS-ALA on NAFLD, C57BL/6J mice were given a control diet, high fat and high cholesterol diet (HFD), and HFD plus 2% PS, 1.3% ALA, or 3.3% PS-ALA for 16 weeks. Our results showed that PS-ALA treatment suppressed hepatic steatosis, ameliorated lipid disorder, attenuated inflammatory response, and inhibited oxidative stress. In the molecular level, PS-ALA downregulated high transcriptional and translational levels of endoplasmic reticulum (ER) stress markers (Grp78 and Chop) leading to decreased protein expression of transcription factor and key enzymes involved in de novo lipogenesis (Srebp-1c and Fas) and cholesterol synthesis (Srebp-2 and Hmgcr). In parallel, PS-ALA blocked Nlrp3 activation and reduced release of IL-1β and IL-18 via inhibiting ER stress-induced sensitization of unfolded protein response sensors (Ire1α and Xbp1s). Finally, PS-ALA improved HFD-induced mitochondrial damage and fatty acid accumulation as exhibited by higher protein and mRNA expression of key genes administering mitochondrial biogenesis (Pgc-1α, Nrf1, and Tfam) and fatty acid β-oxidation (Pparα and Cpt1a). In conclusion, our study originally demonstrated that PS-ALA rescued ER stress, enhanced mitochondrial biogenesis, and thus ameliorated NAFLD.

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“…In patients who do not respond to dietary changes by a significant decrease in cholesterolemia, an alternative approach to pharmaceutical intervention is supplementation with plant sterols. Recently, the National Cholesterol Education Program included the consumption of 2 g of plant sterols/stanols in its recommendations to lower elevated LDL cholesterol levels (2). Indeed, the lowering effect of plant sterols on plasma total and LDL cholesterol in humans is well documented (3).…”

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confidence: 99%

Fish oil fatty acid esters of phytosterols alter plasma lipids but not red blood cell fragility in hamsters

Demonty

Ebine

Xiao-ming

et al. 2005

Lipids

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In an attempt to combine the hypocholesterolemic properties of plant sterols with the hypotriglyceridemic action of fish oil FA, plant sterols have recently been esterified to fish oil n-3 PUFA. The objective of this study was to determine the effects of plant sterols esterified to n-3 PUFA on plasma lipid levels and erythrocyte fragility. For 5 wk, male Golden Syrian hamsters were fed diets varying in cholesterol and plant sterol content: (i) Non-cholesterol (semipurified diet with no added cholesterol or plant sterols) (ii), Cholesterol (0.25% cholesterol) (iii), Sterols (0.25% cholesterol plus 1% nonesterified plant sterols), or (iv) Fish oil esters of plant sterols (0.25% cholesterol plus 1.76% EPA and DHA sterol esters, providing 1% plant sterols). The addition of fish oil esters of plant sterols to the cholesterol diet decreased (P = 0.001) plasma total cholesterol levels by 20%, but nonesterified plant sterols did not have such a beneficial impact. In addition, non-HDL cholesterol concentrations were 29% lower in hamsters fed fish oil esters of plant sterols than in hamsters fed nonesterified plant sterols (P < 0.0001). Despite higher (P < 0.0001) plant sterol levels in whole erythrocytes of hamsters fed nonesterified plant sterols and fish oil esters of plant sterols compared with hamsters fed no plant sterols, no difference was observed in erythrocyte fragility. The present results show that EPA and DHA esters of plant sterols have a hypocholesterolemic effect in hamsters, and that these new esters of plant sterols exert no detrimental effect on erythrocyte fragility.

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Therapeutic lifestyle change and adult treatment panel III: Evidence then and now

Cited by 21 publications

References 98 publications

Effects of Low-Carbohydrate and Low-Fat Diets

Effects of Low-Carbohydrate and Low-Fat Diets

Plant Sterol Ester of α-Linolenic Acid Attenuates Nonalcoholic Fatty Liver Disease by Rescuing the Adaption to Endoplasmic Reticulum Stress and Enhancing Mitochondrial Biogenesis

Fish oil fatty acid esters of phytosterols alter plasma lipids but not red blood cell fragility in hamsters

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