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Role of a prudent breakfast in improving cardiometabolic risk factors in subjects with hypercholesterolemia: a randomized controlled trial
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Lantmännen.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
(English)Article in journal (Other academic) Submitted
Abstract [en]

Background & Aims: It is unclear whether advising a prudent breakfast alone is sufficient to improve blood lipids and cardiometabolic risk factors in overweight hypercholesterolemic subjects.

Methods: The aim of the present study was to investigate whether a prudent low-fat breakfast (PB) rich in dietary fiber lowers low-density lipoprotein cholesterol (LDL-C) and other cardiometabolic risk factors in subjects with elevated LDL-cholesterol levels. In a parallel, controlled, 12-week study, 79 healthy overweight subjects (all regular breakfast eaters) were randomly allocated to a group that received a PB based on Nordic foods provided ad libitum or a control group that consumed their usual breakfast. The PB was in accordance with national and Nordic nutrition recommendations and included oat bran porridge with low-fat milk or yogurt, bilberry or lingonberry jam, whole grain bread, low-fat spread, poultry or fatty fish, and fruit.

Results: No differences were found in LDL-C, blood lipids, body weight, or glucose metabolism, but SAD, plasma CRP, and TNF-R2 were lower during PB compared with controls (p<0.05). In the overall diet, PB increased dietary fiber and b-glucan compared with controls (p<0.05).

Conclusions: Advising a prudent breakfast for 3 months did not influence blood lipids, body weight, or glucose metabolism but reduced markers of visceral fat and inflammation.

 

Keyword [en]
Prudent breakfast, LDL-cholesterol, cardiometabolic risk factors, Nordic diet, inflammation, visceral fat
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Nutrition
Identifiers
URN: urn:nbn:se:uu:diva-211870OAI: oai:DiVA.org:uu-211870DiVA: diva2:669056
Available from: 2013-12-02 Created: 2013-12-02 Last updated: 2014-01-24Bibliographically approved
In thesis
1. A Healthy Nordic Diet and Cardiometabolic Risk Factors: Intervention Studies with Special Emphasis on Plasma Lipoproteins
Open this publication in new window or tab >>A Healthy Nordic Diet and Cardiometabolic Risk Factors: Intervention Studies with Special Emphasis on Plasma Lipoproteins
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A healthy diet is important in the prevention of cardiovascular disease (CVD). Several risk factors, modifiable by diet, are involved in the development of CVD, e.g. hyperlipidaemia, hyperglycaemia, insulin resistance, obesity and hypertension. Little data however exist on diets composed of foods originating from the Nordic countries, and their potential to reduce CVD risk.

This thesis aimed to investigate whether an ad libitum healthy Nordic diet (ND), either provided as a whole diet, or as a prudent breakfast (PB) alone, could influence CVD risk factors in healthy, mildly hypercholesterolemic men and women. Another aim was to describe the nutrient and food composition of the ND, both by using self-reported data and serum biomarkers of dietary fat quality.

The primary clinical outcome measure was LDL-cholesterol, and other cardiometabolic risk factors were secondary outcomes.

Two parallel, randomised, controlled intervention studies were conducted in free-living subjects. Clinical and dietary assessments were performed at baseline and at the end of dietary interventions. All foods were provided to subjects randomised to ND, whereas only breakfast items were supplied to subjects randomised to PB. Control groups followed their habitual diet/breakfast.

Compared with controls, ND reduced body weight and improved several CVD risk factors including LDL-cholesterol, insulin sensitivity and blood pressure. Several, but not all effects were probably partly mediated by diet-induced weight loss. ND accorded with Nordic nutrition recommendations and was defined as “a plant-based diet, where animal products are used sparingly as side dishes”. Compared with average Swedish diet, ND was high in dietary fibre, but low in sodium, meat, high-fat dairy products, sweets and alcohol. A decreased intake of saturated fat and increased intake of n-3 PUFA during ND was partly reflected in serum lipids. Eating a PB without other dietary changes did not improve lipid or glucose metabolism, but decreased markers of visceral fat and inflammation, without influencing body weight.

This thesis suggests that a whole ND, but not PB alone, promotes weight loss and improves multiple CVD risk factors in healthy subjects after 6 weeks. These results suggest that ND could have a potential role in the prevention of cardiometabolic diseases.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. x+85 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 956
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-211874 (URN)978-91-554-8820-8 (ISBN)
Public defence
2014-01-24, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2013-12-20 Created: 2013-12-02 Last updated: 2014-01-24

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