Effects of Dietary Macronutrients on Plasma Lipid Levels and the Consequence for Cardiovascular Disease

Potential Modulatory Roles of Gut Microbiota and Metabolites in the Associations of Macronutrient-to-Physical Activity Ratios With Dyslipidemia

BACKGROUND

Lifestyle factors toward diet and physical activity (PA) may directly influence the pathophysiology of dyslipidemia. However, the associations of the specific macronutrient-to-PA ratio with dyslipidemia, and the underlying mechanisms regarding gut microbiota and metabolites, remain largely unexplored.

METHODS

Dietary and PA information from 273 participants with or at risk of metabolic syndrome was collected via a food frequency questionnaire and the International Physical Activity Questionnaire. Gut microbial genera and fecal metabolites were profiled through 16S rRNA sequencing and untargeted LC-MS metabolomics, respectively. Machine-learning algorithms were applied to identify gut microbiome features of macronutrient-to-PA ratios and to construct microbiome risk score.

RESULTS

Higher macronutrient-to-PA ratios, especially for high saturated fatty acid intake, were associated with increased risks of dyslipidemia, with adjusted odds ratio (95% CIs) of 2.87 (1.41-5.99) for hypercholesteremia, 2.21 (1.11-4.48) for hypertriglyceridemia, and 2.52 (1.26-5.16) for high low-density lipoprotein cholesterol. Microbiome risk scores were significantly associated with elevated levels of total cholesterol, triglycerides, and low-density lipoprotein cholesterol. Additionally, for each macronutrient-to-PA ratio, a core group of gut microbial genera were identified (eg, Phocaeicola, Lachnoclostridium, Limosilactobacillus, and Tyzzerella), exhibiting positive associations with lipid disorders and superior discrimination capacities for hypercholesterolemia, hypertriglyceridemia, and high low-density lipoprotein cholesterol. Furthermore, we identified 9 metabolites (eg, acetyl phosphate, glycerol, and pyruvic acid), predominantly enriched in dyslipidemia-related pathways and associated with both core gut microbial taxa and macronutrient-to-PA ratios.

CONCLUSIONS

This study identified varied associations between macronutrient-to-PA ratios and dyslipidemia and depicted the potential modulatory roles of gut microbiota and fecal metabolites.

Associations between dietary macronutrient composition and cardiometabolic health: data from NHANES 1999-2014

PURPOSE

Dietary macronutrients significantly impact cardiometabolic health, yet research often focuses on individual macronutrient relationships. This study aimed to explore the associations between dietary macronutrient composition and cardiometabolic health.

METHODS

This study included 33,681 US adults (49.7 ± 18.3 years; 52.5% female) from the National Health and Nutrition Examination Survey during 1999-2014. Dietary data was derived from 1 to 2 separate 24-hour recalls and cardiometabolic health included lipid profile, glycemic control, blood pressure, and adiposity collected in a mobile examination center. Associations between dietary macronutrient composition and cardiometabolic health were examined using generalized additive models adjusted for age, socio-demographics, lifestyle, and diet quality.

RESULTS

In females, triglycerides (P < 0.01) and HDL cholesterol (P < 0.01) were the least optimal in diets containing lower fat (10%) and higher carbohydrate (75%). In males, HDL cholesterol was positively associated with fat (P < 0.01) and no association with triglycerides was detected. Total-C associations were male specific (P = 0.01) and highest in diets composed of 25% protein, 30% carbohydrate, and 45% fat. In both sexes, systolic blood pressure (P ≤ 0.02) was highest in diets containing lower fat (10%) coupled with moderate protein (25%). Diastolic blood pressure associations were female specific (P < 0.01) with higher values in those consuming the upper range of fat (55%). There were no associations of macronutrient composition with glycemic control or adiposity.

CONCLUSION

This study revealed sex-specific relationships between macronutrient composition and cardiometabolic health. Future research is needed to explore these relationships across age groups.

Effects of Ethanolic and Aqueous Extracts of Garcinia gardneriana Leaves in an In Vivo Experimental Model Induced by a Hyperlipidic Diet

The study of medicinal plants, such as the genus Garcinia (Clusiaceae), in the treatment of non-communicable chronic diseases has aroused the interest of researchers. However, there are no studies in the literature that have investigated the effects of Garcinia gardneriana in experimental models of obesity for possible metabolic alterations. Swiss mice receiving a high-fat diet were supplemented with aqueous or ethanolic extract of G. gardneriana at doses of 200 or 400 mg/kg/day. It was found that there was a reduction in food consumption in experimental groups compared with the control groups, and the group supplemented with aqueous extract at a dose of 200 mg/kg/daydisplayed a reduction in weight. The results showed an increase in the values of high density lipoprotein (HDL-c), total cholesterol, triglycerides and fasting blood glucose. G. gardneriana did not protect against insulin resistance, and caused in an increase in monocyte chemoattractant protein-1 (MCP-1) concentrations and a reduction in interleukin 10 (IL-10). In addition, hepatic steatosis and microvesicular steatosis were indicated. It was revealed that, under the experimental conditions in the study, G. gardneriana did not prevent weight gain or comorbidities; that is, a different behavior was obtained from that described in the literature with regard to the medicinal potential of the Garcinia species, which is probably related to the phytochemical properties.

Long-term high-fat diet disrupts lipid metabolism and causes inflammation in adult male rats: possible intervention of endoplasmic reticulum stress

This study investigated the effect of long-term high-fat diet (HFD) on plasma lipid profile and probability of inflammation in adult rats. After weaning, male offspring were divided into six groups based on diet type and medication. After 20 weeks of dietary intake, 4-PBA (endoplasmic reticulum (ER) stress inhibitor) was injected for three days. Then, blood samples were taken to measure plasma concentrations of low-density lipoprotein (LDL), triglyceride (TG), high-density lipoprotein (HDL), cholesterol, leptin and interleukin 1-β (IL 1-β). The HFD increased body weight and food intake and intra-abdominal fat and thymus weights, which were associated with elevated plasma leptin level. Moreover, HFD increased plasma concentrations of TG, LDL, cholesterol and IL 1-β and decreased HDL level. Injection of 4-PBA reversed the plasma parameters changes caused by HFD. It seems that long-term HFD feeding through inducing the ER stress, disrupted the lipid metabolism and resulted in inflammation.

Comparison of Formula-Based Methods with Diverse TGL: VLDL-C Ratio for Calculating LDL-C in a Tertiary Care Hospital

Background  The most popular Friedewald formula (FF) was tailored with a fixed factor of 5 for triglyceride-very low-density lipoprotein cholesterol (TGL:VLDL-C) ratio. Some of the subsequent studies on diverse population demonstrated modified FF with only altered TGL:VLDL-C ratio, comprising either a fixed or an adjustable factor. Hata and Nakajima as well as Puavilai et al proposed fixed factors of 4 and 6, respectively. Recently, Martin et al recommended an adjustable factor derived as N-strata-specific median TGL:VLDL-C ratio based on TGL and non-high-density lipoprotein cholesterol (non-HDL-C).

Aim  This comparative retrospective study evaluates the efficacy of LDL-C formulae, varying only in TGL-VLDL-C ratio, using direct LDL-C assay as a reference method in a tertiary care hospital.

Materials and Methods  A total of 1,747 patient records with lipid profile data were procured. Concordance analysis, absolute difference, and post hoc test were employed as analytical tools. The impact of total cholesterol (TChol), TGL, and HDL-C on formulae was also evaluated.

Results  Overall, Martin equation had relatively the highest concordance, narrowest absolute difference, and minimal influence of TChol, TGL, and HDL-C. On the contrary, the Hata method revealed comparatively the lowest concordance, widest absolute difference, and high influence of TChol, TGL, and HDL-C. The remaining formula-based approaches, that is, FF and Puavilai calculation, executed mostly inconsistent intermittent features between Martin equation and Hata method.

Conclusion  Relatively dominant and competitive analytical attributes of the Martin equation with an adjustable TGL:VLDL-C factor outweigh the remaining three formulae-based methods with fixed TGL:VLDL-C factor in Indian adults.

Effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients in the Kurdistan region of Iraq

Objective

This study was employed to assess the effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients.

Method

This cross-sectional study was conducted among a representative sample, which was selected using a census survey of hypertensive patients (both gender, aged 25-50 years, on regular antihypertensive drugs (atenolol: 50 mg orally once a day)), during Ramadan month that was falling in April to May 2020. The patients were receiving care at Halabja hospital in the Kurdistan region of Iraq. All patients were assessed in two phase's baseline (a week before Ramadan) and end stage (a week after Ramadan), using anthropometric indices, physical examination, biochemical tests, and a structured questionnaire. Statistical analysis was performed using SPSS version 21.

Results

A total of 120 hypertensive patients were included in the study (50% females and 50% males), with a mean age of 37.5 ± 6.6 years. The major finding of our study was the significant decrease in blood pressure (P < 0.001). Furthermore, the body weight, body mass index, and waist circumference of the participants decreased after Ramadan fasting in a significant approach (P < 0.001 for all). However, for the lipid profile components, the total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol change persisted not statistically significant (P > 0.05), while only triglyceride decreased drastically after Ramadan fasting (P < 0.001).

Conclusion

Ramadan fasting could contribute in the improvement of blood pressure and lowers triglyceride levels, body weight, body mass index, and waist circumference of adult hypertensive patients.

Plant- and animal-based diet quality and mortality among US adults: a cohort study

Not all plant-based and animal foods exert the same health effects due to their various nutrient compositions. We aimed to assess the quality of plant-based v. animal foods in relation to mortality in a prospective cohort study. Using data collected from a nationally representative sample of 36 825 adults in the National Health and Nutrition Examination Survey 1999-2014, we developed a de novo Comprehensive Diet Quality Index (cDQI) that assesses the quality of seventeen foods based on the healthfulness and separately scored the quality of eleven plant-based foods in a plant-based Diet Quality Index (pDQI) and six animal foods in an animal-based Diet Quality Index (aDQI). Mortality from all causes, heart disease and cancer were obtained from linkage to the National Death Index up to 31 December 2015. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % CI after multivariable adjustments. During a median follow-up of 8·3 years, 4669 all-cause deaths occurred, including 798 deaths due to heart disease and 1021 due to cancer. Compared with individuals in the lowest quartile, those in the highest quartile of cDQI had a lower risk of all-cause mortality (HR 0·75, 95 % CI 0·65, 0·86; Ptrend < 0·001), which largely reflected the inverse relationship between quality of plant-based foods (pDQI) and all-cause mortality (HR 0·66, 95 % CI 0·58, 0·74; Ptrend < 0·001). No independent association was found for the quality of animal foods (aDQI) and mortality. Our results suggest that consuming healthy plant-based foods is associated with lower all-cause mortality among US adults.

The responses of different dosages of egg consumption on blood lipid profile: An updated systematic review and meta-analysis of randomized clinical trials

Diverse notions exist regarding egg intake, which is one of the main sources of dietary cholesterol, and its effect on blood lipids. We conducted this study to update the previous meta-analysis for their flaw in calculated effect size. PubMed, Scopus, ISI, and Cochrane were searched up to April 2019, for relevant randomized controlled clinical trials. Mean changes in total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglyceride (TG), very low-density lipoprotein cholesterol (VLDL-C), LDL-C/HDL-C, TC/HDL-C, apolipoprotein (apo)A1, and apoB100 were assessed. Meta-analysis of 66 RCTs with 3,185 participants revealed that egg consumption can significantly increase TC, LDL-C, HDL-C, TC/HDL-C, apoA1/and B100, but there was no significant effect on other serum lipids. Dose-response analysis showed a linear effect for TC, HDL-C, ApoA1, ApoB100, and nonlinear for LDL-C, and TC/HDL-C. In conclusion, intake of more than one egg daily in less than 12 weeks may increase some blood lipids without any changes in the ratio of LDL-C/HDL-C. PRACTICAL APPLICATIONS: There are controversies reports for egg intake, which is one of the main sources of dietary cholesterol. This study provides comprehensive information about the effect of the number of eggs consumed per day (dietary cholesterol) on blood lipids for nutritionists, physicians, researchers, and the general population. In this regard, our results indicated that there is a linear correlation between consumption of greater than one egg per day in a short time (no long time) and increasing lipid profiles which may increase the risk of cardiovascular diseases. However, consumption of one egg daily can be safe and this can be a useful recommendation for prevention of cardiovascular disease and promotion of healthy life which indeed are the potential or actual uses of this research.

Mangosteen (Garcinia mangostana) flesh supplementation attenuates biochemical and morphological changes in the liver and kidney of high fat diet-induced obese rats

Background

Mangosteen is a native fruit from Southeast Asia. It is rich in phenolic compounds such as xanthones, anthocyanins and phenolic acids. Mangosteen pericarp extract showed inhibitory activity towards pancreatic lipase and may have potential use for obesity treatment. However, there is limited study on the beneficial effects of mangosteen flesh against obesity. This study aimed to investigate the effects of Garcinia mangostana flesh (GMF) on biochemical and morphological changes in the liver and kidney of high-fat diet-induced obese rats.

Methods

Forty healthy Sprague-Dawley rats were randomised into five groups (n = 8) with four groups were fed with high-fat diet (HFD) for 10 weeks and a control group was fed with rat chow diet. Supplementation with GMF in obese rats was continued for 7 weeks starting from week 10th after the initiation of HFD at different doses (200 mg/kg, 400 mg/kg and 600 mg/kg). The positive and negative control rats were given distilled water via oral gavage. Plasma lipid profile, antioxidant enzymes and pro-inflammatory markers were determined using commercial kits. Liver and kidney structure were defined by histology.

Results

The rats fed with HFD for 10 weeks increased plasma LDL-cholesterol, reduced plasma glutathione peroxidase level and had significantly higher body weight compared to normal control rats (p < 0.05). Obese rats also showed elevated level of TNF-α and IL-6 after 17 weeks of HFD. Supplementation with GMF for 7 weeks in obese rats reduced their body weight, improved lipid profile, increased total antioxidant capacity and glutathione peroxidase level and lowered plasma pro-inflammatory markers (TNF-α and IL-6) (p < 0.05). In addition, GMF supplementation attenuated the abnormalities of the liver and kidney tissue caused by high fat diet.

Conclusion

Taken together, the findings suggest that supplementation of Garcinia mangostana flesh may help in reducing body weight and has the potential to ameliorate the biochemical changes of the high fat diet-induced obesity in rats. Further studies on pharmacodynamic and pharmacokinetic are required before the results are translated to human.