Effect of a high-protein, very-low-calorie diet on body composition and anthropometric parameters of obese middle-aged women.

Effects of a very-low-calorie (420 kcal/day), high-protein diet (70 g/day) and realimentation on weight and body composition of 15 obese, middle-aged women were examined in a 4-6 mo study. Mean weight loss was 20.5 kg (1.1 kg/wk). Fat accounted for 83% and lean body mass (LBM) for 17% of total body weight loss. Multiple regression equations estimated from anthropometric measures were developed to predict the body density of obese individuals both before and after weight loss. Best predictors of body density in obese women before and after weight loss were circumference measurements in the trunk area. Nine previously published population specific and generalized equations for predicting body fat in women were not strongly enough correlated with body fat values obtained by densitometry in this study to be of use clinically.

Effect of a high-protein, very-low-calorie diet on resting metabolism, thyroid hormones, and energy expenditure of obese middle-aged women.

A 4-6 mo study was conducted to examine effects of a very-low-calorie, high-protein diet and realimentation on energy expenditure, resting metabolic rate (RMR), and serum thyroid hormones of obese women aged 30-54 yr. Fifteen healthy women, greater than or equal to 126% ideal body weight, were placed on the diet (420 kcal/day) and lost an average of 1.1 kg/wk until a predetermined goal weight was attained. RMR, triiodothyronine (T3), and reverse T3 decreased significantly (p less than 0.05). Thyroxine remained unchanged. Upon gradual realimentation onto solid foods, all metabolic parameters increased significantly within 5 wk toward pre-diet baseline values, but RMR (kcal/h) and T3 values remained significantly below pre-study values. Estimates of mean energy expenditure, utilizing a technique based on energy intake and body composition changes, averaged 1719 kcal/day during the diet period.

Effect of diets high in butter, corn oil, or high-oleic acid sunflower oil on serum lipids and apolipoproteins in men.

This randomized blind crossover study compared serum lipid and apolipoprotein concentrations in 20 men consuming 37-43% of energy as fat from diets based on corn oil, high-oleic acid sunflower oil, and butter. Each phase of the crossover design included 2 wk of butter-based diet followed by 5 wk of designated vegetable-oil-based diet with a 7-wk washout period between phases. Compared with values for the butter-based diet, the vegetable-oil-based diets reduced serum total cholesterol by 16-21% (p less than 0.001), LDL cholesterol by 21-26% (p less than 0.001), triglycerides by 10-21% (p less than 0.01 for the higher figure), and apolipoprotein B-100 by 22-29% (p less than 0.001). When values fell, they fell further on the corn-oil-based diet. There were no significant changes in serum HDL cholesterol or apolipoprotein A-1. These data suggest that when men on diets high in saturated fatty acids reduce their saturated fatty acid intake but not their total fat intake, many can still experience a significant lowering in serum total cholesterol.

Supplementation frequency and ascorbic acid status in adult males.

This study was performed to determine if experimental subjects given ascorbic acid (AA) in a 240-mg dose every 4 days maintain blood levels of AA similar to levels of control subjects given 20 mg three times per day. All subjects ingested foods providing 6 to 7 mg AA/day but adequate in other nutrients. Mean serum AA for all subjects was 1.26 mg/dl initially indicating a habitual AA intake of over 100 mg/day. After 32 days on 66 mg AA/day, mean serum AA of control subjects remained below 0.7 mg/dl. After the first depletion period experimental subjects had significantly lower (p less than 0.05) serum AA than control subjects (0.74 versus 1.02 mg/dl). By the third depletion period experimental subjects adjusted to the less frequent dosage such that serum levels of AA were not lower. They were sometimes significantly higher (p less than 0.05) 1 day after the 240-mg dose. Experimental subjects had similar or higher mean white blood cell AA throughout the experiment. White blood cell AA was significantly (p less than 0.05) and negatively correlated with white blood cell count (r = -0.65) Results suggest that subjects adjust to receiving supplements of AA on a periodic basis at least under the conditions imposed in this study.

Estimation of energy expenditure and maintenance energy requirements of college-age men and women.

Data from two nationwide dietary surveys have led to the suggestion that human energy requirements have been overestimated. A 5-wk energy balance study was conducted to estimate the energy expenditure and maintenance energy requirements of 12 college-age men and women, 20 to 29 yr of age, by the factorial method and by measurement of energy intake and changes in body energy content (intake/balance technique). Mean daily energy expenditure estimated by the intake/balance technique and the factorial method, respectively, was 3081 and 3040 kcal (r = 0.90) for the male subjects and 2183 and 2283 kcal (r = 0.53) for the female subjects. Although differences between the intake/balance and factorial estimations of energy expenditure tended to be greater for individuals than groups and for females than males, the factorial method as performed in this study provided accurate estimations of energy expenditure. In addition, the estimated energy requirements of the college-age subjects in this study provide evidence to support the Recommended Dietary Allowances for energy for this age group.

Serum lipid and apolipoprotein concentrations in healthy men on diets enriched in either canola oil or safflower oil.

This randomized, blind study measured changes in serum lipid and apolipoprotein concentrations in 16 men consuming 39 +/- 1% of energy (en%) as fat either from safflower- or canola-oil-based diets for 8 wk. Initially, the men were stabilized for 3 wk on a typical American (baseline) diet. Compared with baseline, the vegetable-oil-based diets reduced serum total cholesterol 9-15% (P less than 0.002), low-density-lipoprotein (LDL)-cholesterol 12-20% (P less than 0.002), and apolipoprotein B-100 21-24% (P less than 0.001). There were no significant changes from baseline to the end of the study in serum triglycerides, total high-density-lipoprotein (HDL) cholesterol, HDL3 cholesterol, HDL2 cholesterol, or apolipoprotein A-I. These data suggest that even if total fat intake remains at 39-40 en%, many men show lowered LDL cholesterol if saturated fatty acid intake is minimized and that diets high in polyunsaturated fatty acids do not necessarily lower HDL-cholesterol concentrations.

Effects of diets high in saturated fatty acids, canola oil, or safflower oil on platelet function, thromboxane B2 formation, and fatty acid composition of platelet phospholipids.

Platelet function and fatty acid composition were investigated in 30 healthy male subjects who ate a controlled-saturated-fatty-acid (baseline) diet for 3 wk and then consumed either safflower oil or canola oil as a major fat source for 8 wk. Fatty acid composition of platelet phospholipids reflected changes in dietary fatty acid composition. Compared with baseline a 35% decrease (P less than 0.05) in arachidonic acid was observed in platelet phospholipids of the canola-oil diet group while long chain n-3 fatty acids rose 7-26% (P greater than 0.05). Compared with baseline both unsaturated-fatty-acid diets reduced platelet aggregation at 3 wk of oil-based diet feeding (P less than 0.01) whereas only canola oil influenced platelet function (lowered ATP secretion) at 8 wk (P less than 0.01). No significant difference was observed in thromboxane B2 concentrations between oil-treatment groups at 8 wk. Both oil-based diets had short-term beneficial effects on platelet function but the effect of canola oil persisted longer.

Selenium status of a rural (predominantly Amish) community living in a low-selenium area.

Selenium intake and blood selenium and selenium-dependent glutathione peroxidase concentrations were assessed in a rural, 71% Amish, sample of residents in a region with low availability of soil selenium and in urban (Columbus, OH) residents. Subjects were interviewed (24-h dietary recalls) on three separate occasions over an 18-month period, and blood and food samples were taken for analysis (maximum subject observations = 452). Mean selenium intake of the entire population was 82.8 +/- 4.4 micrograms/day. Rural and urban residents at 82.0 +/- 4.9 and 83.6 +/- 4.4 micrograms/day, respectively, did not differ significantly in intake. A breakdown by gender within location demonstrated that rural males consumed the most selenium (104.7 +/- 6.1 micrograms/day) and rural females the least (59.3 +/- 6.3 micrograms/day). Rural subject groups had significantly lower mean whole blood, plasma, and erythrocyte selenium levels (12.5 to 14.5%) as well as blood selenium-dependent glutathione peroxidase concentrations (5.6 to 10.8%) than urban groups. Subjects in both cohorts were in adequate selenium status as judged by blood parameters, even though about one-fourth of the dietary observations were below the safe and adequate range of selenium intake established by the Food and Nutrition Board. The rural diet was 18.3% lower in selenium density than the urban diet. High selenium grain products (greater than 0.2 micrograms/g) were the most important dietary selenium source in both groups, providing 29.3 to 41.6% of total intake.

Effects of fish oil on serum lipids in men during a controlled feeding trial.

Effects of fish-oil (FO) feeding on serum lipids were investigated in a 42-d controlled diet study. Fifteen healthy male college students were assigned to one of three groups: control (0 g FO); 5 g FO, supplying 2 g n - 3 (omega-3) fatty acids (FAs); or 20 g FO, supplying 8 g n - 3 FAs. In an initial 7-d period subjects consumed a basal diet with no FO. Then FO replaced an equivalent amount of margarine for 5 wk. FO feeding significantly (p less than 0.05) decreased the serum n - 6 FAs, linoleic acid, eicosatrienoic acid, and arachidonic acid. A significant increase in the n - 3 FAs, eicosapentaenoic acid and docosahexaenoic acid, was noted in serum, platelet, and neutrophil phospholipids. The 20-g-FO group showed a 30% decrease (p less than 0.01) in triglycerides after 2 wk FO with no further decrease observed. Thus, 20 g FO produced changes in both FA patterns and triglyceride concentrations whereas 5 g FO produced changes in FA patterns only. Neither FO amount resulted in significant changes in total or HDL cholesterol, apolipoprotein A-I, or apolipoprotein B-100.

Dietary carbohydrate and intensity of interval swim training.

We tested the effects of 9 d of a high-carbohydrate diet (80% of calories as CHO, 80% CHO diet) vs. a moderate-CHO diet (43% of calories as CHO, 43% CHO diet) on the abilities of collegiate swimmers to maintain a high intensity of interval swim training. Interval swim times and other physiological indices were recorded the last 5 d of each diet. Swim-interval distances ranged from 50-m interval sets to continuous 3000-m swims. There were no diet effects on mean swim velocities for any interval distance, and mean (+/- SEM) velocities for all swims were identical for both diets. There were no diet effects on the physiological indices; however, postswim blood lactate concentrations were higher after the 80% CHO diet. When mean +/- SEM daily caloric intake is 19.56 +/- 2.16 MJ (4675 +/- 516 kcal) for swimmers undertaking swim training to develop aerobic capacity, an 80% CHO diet provides no advantage over a 43% CHO diet for maintaining interval-swim-training intensity.

Relative effects on serum lipids and apolipoproteins of a caprenin-rich diet compared with diets rich in palm oil/palm-kernel oil or butter.

Two randomized, blind studies measured changes in serum cholesterol, other serum lipids, and apolipoprotein (apo) concentrations in hypercholesterolemic men consuming caprenin (Cap)-rich diets after either baseline diets enriched in palm oil/palm-kernel oil (PO/PKO) or butter. The triglyceride Cap contains 45% 22:0 and 50% 8:0-10:0. Compared with baseline values established at 3 wk on the PO/PKO diet, the 17 subjects on the Cap diet showed significant reductions after 6 wk in HDL cholesterol (HDL-C), HDL2-C, and HDL3-C and a significant increase in the ratio of total cholesterol, LDL-C, triglycerides, apo B-100, or apo A-I were seen. Compared with baseline values established at 3 wk on the butter diet, after 6 wk the seven subjects receiving the Cap diet showed no significant changes in the lipid and apolipoprotein indexes analyzed. These data show that one or more of 8:0, 10:0, and 22:0 fatty acids can contribute to hypercholesterolemia in men.

Relative effects of high saturated fatty acid levels in meat, dairy products, and tropical oils on serum lipoprotein and low-density lipoprotein degradation by mononuclear cells in healthy males.

To determine the effects of three saturated fatty acid combinations on lipoprotein metabolism, we fed 18 21- to 32-year-old men three diets in a crossover design for 28-day periods separated by washout periods of 4 to 6 weeks. The men self-selected a prescribed diet at home emphasizing saturated fat as the visible fat for 1 week. Then, they ate experimental diets providing 40%, 15%, 17%, and 7% of food energy, respectively, as total, saturated, monounsaturated, and polyunsaturated fatty acids, levels representing amounts available in the US diet. Different test fatty acid combinations, given at 4 to 6 energy% (en%) each, were incorporated into food products: 12:0 + 14:0, 14:0 + 16:0, and 16:0 + 18:0. Test fatty acids were equalized by giving free myristic acid (14:0) with palm kernel oil or butter and sheanut butter (high in 18:0) with lard. The diet highest in 12:0 + 14:0 also provided 4.2 en% 16:0, the most common saturated fatty acid in the US diet. Mean apparent absorption of all fatty acids was at least 90%. The three diets produced similar concentrations of serum total and low-density lipoprotein (LDL) cholesterol and apolipoprotein (apo) B-100 regardless of the apo E phenotype of the subjects. Compared with baseline, the experimental diets affected serum high-density lipoprotein (HDL) concentrations (P < .06), with the highest values occurring on diet 12:0 + 14:0. When the change from baseline in receptor-mediated degradation of 125I-LDL in freshly isolated mononuclear cells (MNC) was stratified by apo E phenotype, diet 16:0 + 18:0 produced a 30% increase, compared with a 9% decrease on diet 12:0 + 14:0 and a 6% increase on diet 14:0 + 16:0 in subjects with the apo E3/3 phenotype. These results suggested that different saturated fatty acid combinations, consumed at levels typical of availability in the United States and with diets providing ample unsaturated fat, had similar cholesterolemic properties in healthy males despite some subtly different effects on lipoprotein metabolism.

Sandwich enzyme-linked immunosorbent assay for plasma cholesteryl ester transfer protein concentration.

OBJECTIVES: Cholesteryl ester transfer protein (CETP) mediates the transfer of HDL cholesterol to apoB-containing lipoproteins. Its mass and activity are increased in several pro-atherogenic conditions. The objective of this study is to develop a cost- and time-effective sandwich ELISA for plasma CETP concentration. DESIGN AND METHODS: Monoclonal anti-CETP, TP20, was used as the capture antibody, while the other biotinylated monoclonal anti-CETP, TP2, was used for detection. The results were expressed in an arbitrary unit, ng biotin-TP2 bound per microl plasma. Plasma CETP concentrations, activities and their relationship were assessed in 35 IDDM children. RESULTS: The assay had an intra-assay CV of 8.75% and an inter-assay CV under 10%. Plasma CETP concentration of these subjects ranged from 0.36-1.89 ng biotin-TP2/microL. CETP concentration was significantly correlated with CETP activity (r = 0.51, p < 0.01). CONCLUSION: The sandwich ELISA we have developed carried sufficient sensitivity for assaying plasma CETP concentration in human.

Risk factors for coronary heart disease in type 1 diabetic children: the influence of apoE phenotype and glycemic regulation.

The effects of apolipoprotein E (apoE) phenotype and glycemic regulation on plasma levels of lipids and lipoproteins, low density lipoprotein (LDL) composition, LDL particle size, and LDL oxidation were examined in 35 type 1 diabetic children aged 5-12 years. All subjects were classified according to glycemic regulation (HbA(1c)<8% vs. HbA(1c)>8%). ApoE phenotypes were identified by isoelectric focusing (IEF) followed by immunoblotting. Results from two-way analysis of variance (ANOVA) showed that subjects with apoE 4/3 and HbA(1c)>8% had higher concentrations of total cholesterol (TC), LDL-cholesterol (LDL-C), and LDL-cholesterol ester (LDL-CE) than subjects with the same apoE phenotype and HbA(1c)<8%. LDL particles in all subjects were classified as the subclass pattern A. Both LDL particle size and susceptibility of LDL to oxidation were not different among subjects stratified by apoE phenotype. In conclusion, children with type 1 diabetes mellitus included in this study did not have high-risk lipoprotein profiles at this early stage of life. However, there was some indication that those with the apoE 4/3 phenotype were more likely to have more favorable lipid profiles when HbA(1c) levels were <8%.

Selenium content of foods purchased or produced in Ohio.

Approximately 450 samples of about 100 types of foods consumed by rural and urban Ohioans were analyzed for selenium. Meat, dairy products, eggs, and grain products produced in Ohio have considerably lower selenium content than corresponding products produced in high selenium areas, such as South Dakota. Retail Ohio foods with interregional distribution tended to be higher in selenium content than corresponding foods produced in Ohio. Best sources of selenium in Ohio foods commonly consumed were meat and pasta products. Poor sources of selenium were fruits, most vegetables, candies, sweeteners, and alcoholic and nonalcoholic beverages. Establishment of an accurate data base for selenium depends on knowledge of the interregional distribution of foods, the selenium content of foods at their production site, and the selenium content of foods with wide local distribution.

Effect of synthetic triglycerides of myristic, palmitic, and stearic acid on serum lipoprotein metabolism.

OBJECTIVES: To determine relative effects of diets high in synthetic sources of myristic (14:0), palmitic (16:0) or stearic (18:0) acid on concentrations and metabolism of serum lipoproteins. DESIGN: Eighteen healthy women participated in a three-way cross-over study for five week periods separated by seven week washout periods, diets were assigned in random order. SUBJECTS: Premenopausal women, not on medication, were from three races (Caucasian, African-American, Asian) and four apolipoprotein E phenotype groups (3/3, 3/2, 4/3, and 4/2). INTERVENTION: During the first week the subjects consumed a baseline diet providing 11 energy (en)% saturated fat, 10en% polyunsaturated fat and 14en% monounsaturated fat. Followed by test diets with 19en% saturated fat (including 14en% test saturated fatty acid), 3en% polyunsaturated fat, and 14en% monounsaturated fat for four weeks. Synthetic fats (trimyristin, tripalmitin, and tristearin) were used in blends with natural fats and oils. RESULTS: Mean concentrations of serum total, esterified and LDL cholesterol were significantly lower after 18:0 than after 16:0 (n = 16-18, P < 0.01 for treatment effect). Myristic acid (14:0) had an intermediate effect. Receptor-mediated degradation of 125I-LDL in mononuclear cells obtained from the subjects was lower after 16:0 than after 14:0 and 18:0 (n = 16-18, P=0.05 for treatment effect). Differences in the digestibilities of the fats were not a major factor in the results. Strong cholesterolemic responses to the 16:0 diet were partly explained by apoE phenotype. CONCLUSIONS: As noted previously, stearic acid was neutral compared to 14:0 and 16:0. In contrast to studies involving natural fats, 14:0, fed as a synthetic triglyceride, was less cholesterolemic than 16:0 in a majority of subjects. ApoE phenotype influenced the cholesterolemic response particularly when diets high in 16:0 were eaten.

Differential effects of three enteral dietary regimens on selected outcome variables in burn patients.

A modular tube feeding recipe (MTF) was designed to meet the unique nutritional needs of burn patients, applying principles previously documented in our burned guinea pig model. MTF, a high-protein, low-fat, linoleic acid-restricted formulation is enriched with omega-3 fatty acids, arginine, cysteine, histidine, vitamin A, zinc, and ascorbic acid. Fifty patients, 3 to 76 years of age with burns ranging from 10 to 89% total body surface area were prospectively randomized into three groups which blindly compared MTF to two enteral regimens widely utilized in the nutritional support of burns. Age, percent total and third-degree burn, resting energy expenditure, and calorie and protein intake were similar in all groups. Data analysis demonstrated significant superiority of MTF in the reduction of wound infection (p less than 0.03) and length of stay/percent burn (p less than 0.02). MTF was also associated with a decreased incidence of diarrhea, improved glucose tolerance, lower serum triglycerides, reduced total number of infectious episodes and trends toward improved preservation of muscle mass, although statistical significance was not achieved. Seventy percent of deaths occurred in the group supported with an inherently large dose of fat and linoleic acid. Combining these observations, it is believed that MTF is effective in modulating an improved response to burn injury.

Cholesteryl ester transfer and cholesterol esterification in type 1 diabetes: relationships with plasma glucose.

The activities of two crucial enzymes of reverse cholesterol transport, cholesterol ester transfer protein (CETP) and lecithin:cholesterol acyltransferase (LCAT), and their relationships with lipid profile and fasting plasma glucose were examined in 35 type 1 diabetic children. The CETP and LCAT activities were significantly lower (p<0.05) in the 4 subjects with normal fasting plasma glucose levels (<6.39 mmol/l) than in the 28 with high plasma glucose levels (CEPT activity, 10.63+/-3.81 vs. 32.18+/-13.94 nmol/ml h; LCAT activity, 25.52+/-4.53 vs. 39.52+/-12.52 nmol/ml h; both p<0.05). The subjects with high plasma glucose levels also had higher total and LDL-cholesterol than those with normal glucose levels. CETP activity was positively correlated with fasting plasma glucose, CETP concentration, LCAT activity, total cholesterol, free cholesterol, LDL-C, and LDL-cholesteryl ester, while negatively correlated with cholesteryl ester to free cholesterol ratio, LDL triglyceride to protein ratio, and LDL triglyceride to cholesteryl ester ratio. LCAT activity was found to positively correlate with CETP activity, total cholesterol, free cholesterol, LDL-C, CETP concentration, and LDL-cholesteryl ester, while it negatively correlated with cholesteryl ester to free cholesterol ratio. The results observed in type 1 diabetic subjects suggest that (1) accelerated LCAT and CETP activities may result in the accumulation of LDL-cholesteryl ester; and (2) fasting plasma glucose may be a major determinant of CETP activity.

Mechanisms mediating lipoprotein responses to diets with medium-chain triglyceride and lauric acid.

Medium-chain triglycerides (MCT) are often used in specialized formula diets or designer fats because of their special properties. Yet their influence on lipid metabolism is not completely understood. In this two-period cross-over study, the effects of MCT (8:0 + 10:0) in contrast to a similar saturated fatty acid (12:0) were compared. Eighteen healthy women ate a baseline diet [polyunsaturated (PUFA)/saturated fat = 0.9] for 1 wk. Then, they consumed test diets (PUFA/saturated fat = 0.2) for 4 wk. Monounsaturated fat and cholesterol were constant in baseline and treatment diets. MCT and 12:0, substituted for part of the PUFA, provided 14 energy (en)% of the test diets. In comparison to the PUFA baseline diet, a 16% increase in mean serum low density lipoprotein (LDL)-cholesterol (C) on the 12:0 diet was accompanied by a 21% decrease in mean receptor-mediated degradation of LDL by freshly isolated mononuclear cells (MNC) in vitro. The MNC assay theoretically gives an indication of receptor-mediated degradation of LDL. In contrast, the MCT diet raised mean receptor-mediated degradation of LDL by 42%, a finding out of line with the mean 11% increase in serum LDL-C. Perhaps MCT, by increasing the rate of LDL-C production, overcame the rate of LDL-C clearance. The 12:0 diet enhanced some factors involved in reverse cholesterol transport (e.g., high density lipoprotein fractions) while MCT had a different or less pronounced effect. The overall effects of MCT on cholesterol metabolism may or may not be desirable, whereas those of 12:0 appear largely undesirable as previously reported.

Effect of moderate to very low fat defined formula diets on serum lipids in healthy subjects.

Serum total cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride levels were studied in healthy male and female subjects consuming for one-week periods a diet of conventional food (CF) providing 42% of energy as fat, principally butter fat, and then in random order nutritionally complete, defined formula diets of moderate (32%) to very low (1%) fat content. Compared to CF, the formula with 32% of energy as corn oil lowered serum cholesterol by 25% and the ratio of total to HDL-cholesterol by 13%. Low (9%) and very low (1-3%) fat formulas reduced HDL-cholesterol by as much as 40%, raised the total:HDL-cholesterol ratio by about 20% and raised serum triglyceride levels by as much as 100%. When low and very low fat formulas were ingested for three weeks, these effects persisted although maximal responses occurred during the first week. These results demonstrated that a moderate fat formula diet with a high P/S ratio had a more favorable effect on serum lipid levels than various low fat formulas. Low fat conventional food diets should be studied in long-term controlled metabolic experiments before such diets are recommended to the general population for coronary heart disease or cancer prevention.