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Jenkins DJA, Jones PJ, Frohlich J, Lamarche B, Ireland C, Nishi SK, Srichaikul K, Galange P, Pellini C, Faulkner D, de Souza RJ, Sievenpiper JL, Mirrahimi A, Jayalath VH, Augustin LS, Bashyam B, Leiter LA, Josse R, Couture P, Ramprasath V, Kendall CWC. The effect of a dietary portfolio compared to a DASH-type diet on blood pressure. Nutr Metab Cardiovasc Dis 2015; 25:1132-1139. [PMID: 26552742 DOI: 10.1016/j.numecd.2015.08.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/07/2015] [Accepted: 08/12/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Compared to a DASH-type diet, an intensively applied dietary portfolio reduced diastolic blood pressure at 24 weeks as a secondary outcome in a previous study. Due to the importance of strategies to reduce blood pressure, we performed an exploratory analysis pooling data from intensively and routinely applied portfolio treatments from the same study to assess the effect over time on systolic, diastolic and mean arterial pressure (MAP), and the relation to sodium (Na(+)), potassium (K(+)), and portfolio components. METHODS AND RESULTS 241 participants with hyperlipidemia, from four academic centers across Canada were randomized and completed either a DASH-type diet (control n = 82) or a dietary portfolio that included, soy protein, viscous fibers and nuts (n = 159) for 24 weeks. Fasting measures and 7-day food records were obtained at weeks 0, 12 and 24, with 24-h urines at weeks 0 and 24. The dietary portfolio reduced systolic, diastolic and mean arterial blood pressure compared to the control by 2.1 mm Hg (95% CI, 4.2 to -0.1 mm Hg) (p = 0.056), 1.8 mm Hg (CI, 3.2 to 0.4 mm Hg) (p = 0.013) and 1.9 mm Hg (CI, 3.4 to 0.4 mm Hg) (p = 0.015), respectively. Blood pressure reductions were small at 12 weeks and only reached significance at 24 weeks. Nuts, soy and viscous fiber all related negatively to change in mean arterial pressure (ρ = -0.15 to -0.17, p ≤ 0.016) as did urinary potassium (ρ = -0.25, p = 0.001), while the Na(+)/K(+) ratio was positively associated (ρ = 0.20, p = 0.010). CONCLUSIONS Consumption of a cholesterol-lowering dietary portfolio also decreased blood pressure by comparison with a healthy DASH-type diet. CLINICAL TRIAL REG. NO.: NCT00438425, clinicaltrials.gov.
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Affiliation(s)
- D J A Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
| | - P J Jones
- Richardson Center for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, MB, Canada
| | - J Frohlich
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - B Lamarche
- School of Nutrition, Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada
| | - C Ireland
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - S K Nishi
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - K Srichaikul
- Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - P Galange
- Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - C Pellini
- Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - D Faulkner
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - R J de Souza
- Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - J L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
| | - A Mirrahimi
- Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - V H Jayalath
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - L S Augustin
- Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - B Bashyam
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - L A Leiter
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - R Josse
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - P Couture
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada
| | - V Ramprasath
- Richardson Center for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, MB, Canada
| | - C W C Kendall
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada; College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
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Nishi SK, Kendall CWC, Bazinet RP, Bashyam B, Ireland CA, Augustin LSA, Blanco Mejia S, Sievenpiper JL, Jenkins DJA. Nut consumption, serum fatty acid profile and estimated coronary heart disease risk in type 2 diabetes. Nutr Metab Cardiovasc Dis 2014; 24:845-852. [PMID: 24925120 DOI: 10.1016/j.numecd.2014.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 03/31/2014] [Accepted: 04/03/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Nut consumption has been associated with decreased risk of coronary heart disease (CHD) and type 2 diabetes which has been largely attributed to their healthy fatty acid profile, yet this has not been ascertained. Therefore, we investigated the effect of nut consumption on serum fatty acid concentrations and how these relate to changes in markers of glycemic control and calculated CHD risk score in type 2 diabetes. METHODS AND RESULTS 117 subjects with type 2 diabetes consumed one of three iso-energetic (mean 475 kcal/d) supplements for 12 weeks: 1. full-dose nuts (50-100 g/d); 2. half-dose nuts with half-dose muffins; and 3. full-dose muffins. In this secondary analysis, fatty acid concentrations in the phospholipid, triacylglycerol, free fatty acid, and cholesteryl ester fractions from fasting blood samples obtained at baseline and week 12 were analyzed using thin layer and gas chromatography. Full-dose nut supplementation significantly increased serum oleic acid (OA) and MUFAs compared to the control in the phospholipid fraction (OA: P = 0.036; MUFAs: P = 0.024). Inverse associations were found with changes in CHD risk versus changes in OA and MUFAs in the triacylglycerol (r = -0.256, P = 0.011; r = -0.228, P = 0.024, respectively) and phospholipid (r = -0.278, P = 0.006; r = -0.260, P = 0.010, respectively) fractions. In the cholesteryl ester fraction, change in MUFAs was inversely associated with markers of glycemic control (HbA1c: r = -0.250, P = 0.013; fasting blood glucose: r = -0.395, P < 0.0001). CONCLUSION Nut consumption increased OA and MUFA content of the serum phospholipid fraction, which was inversely associated with CHD risk factors and 10-year CHD risk. CLINICAL TRIAL REG NO NCT00410722, clinicaltrials.gov.
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Affiliation(s)
- S K Nishi
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - C W C Kendall
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; College of Pharmacy and Nutrition, Division of Nutrition and Dietetics, University of Saskatchewan, Saskatoon, SK, Canada.
| | - R P Bazinet
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - B Bashyam
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - C A Ireland
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - L S A Augustin
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - S Blanco Mejia
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - J L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - D J A Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada
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