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Harrison SA, Ruane PJ, Freilich B, Neff G, Patil R, Behling C, Hu C, Shringarpure R, de Temple B, Fong E, Tillman EJ, Rolph T, Cheng A, Yale K. A randomized, double-blind, placebo-controlled phase IIa trial of efruxifermin for patients with compensated NASH cirrhosis. JHEP Rep 2022; 5:100563. [PMID: 36644237 PMCID: PMC9832280 DOI: 10.1016/j.jhepr.2022.100563] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/03/2022] [Indexed: 01/18/2023] Open
Abstract
Background & Aims Efruxifermin has shown clinical efficacy in patients with non-alcoholic steatohepatitis (NASH) and F1-F3 fibrosis. The primary objective of the BALANCED Cohort C was to assess the safety and tolerability of efruxifermin in patients with compensated NASH cirrhosis. Methods Patients with NASH and stage 4 fibrosis (n = 30) were randomized 2:1 to receive efruxifermin 50 mg (n = 20) or placebo (n = 10) once-weekly for 16 weeks. The primary endpoint was safety and tolerability of efruxifermin. Secondary and exploratory endpoints included evaluation of non-invasive markers of liver injury and fibrosis, glucose and lipid metabolism, and changes in histology in a subset of patients who consented to end-of-study liver biopsy. Results Efruxifermin was safe and well-tolerated; most adverse events (AEs) were grade 1 (n = 7, 23.3%) or grade 2 (n = 19, 63.3%). The most frequent AEs were gastrointestinal, including transient, mild to moderate diarrhea, and/or nausea. Significant improvements were noted in key markers of liver injury (alanine aminotransferase) and glucose and lipid metabolism. Sixteen-week treatment with efruxifermin was associated with significant reductions in non-invasive markers of fibrosis including Pro-C3 (least squares mean change from baseline [LSMCFB] -9 μg/L efruxifermin vs. -3.4 μg/L placebo; p = 0.0130) and ELF score (-0.4 efruxifermin vs. +0.4 placebo; p = 0.0036), with a trend towards reduced liver stiffness (LSMCFB -5.7 kPa efruxifermin vs. -1.1 kPa placebo; n.s.). Of 12 efruxifermin-treated patients with liver biopsy after 16 weeks, 4 (33%) achieved fibrosis improvement of at least one stage without worsening of NASH, while an additional 3 (25%) achieved resolution of NASH, compared to 0 of 5 placebo-treated patients. Conclusions Efruxifermin appeared safe and well-tolerated with encouraging improvements in markers of liver injury, fibrosis, and glucose and lipid metabolism following 16 weeks of treatment, warranting confirmation in larger and longer term studies. Lay summary Cirrhosis resulting from non-alcoholic steatohepatitis (NASH), the progressive form of non-alcoholic fatty liver disease, represents a major unmet medical need. Currently there are no approved drugs for the treatment of NASH. This proof-of-concept randomized, double-blind clinical trial demonstrated the potential therapeutic benefit of efruxifermin treatment compared to placebo in patients with cirrhosis due to NASH. Clinical Trial Number NCT03976401.
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Key Words
- ADA(s), anti-drug antibody(ies)
- AE, adverse event
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- ANCOVA, analysis of covariance
- AST, aspartate aminotransferase
- CFB, change from baseline
- CTX-1, C-terminal telopeptide of type 1 collagen
- C–P, Child-Pugh
- DXA, dual-energy X-ray absorptiometry
- ELF, enhanced liver fibrosis
- FGF21
- FGF21, fibroblast growth factor-21
- FGFR, fibroblast growth factor receptor
- GGT, gamma-glutamyltransferase
- HDL-C, HDL-cholesterol
- HOMA-IR, homeostatic model assessment of insulin resistance
- HPA, hypothalamic-pituitary-adrenal
- HbA1c, hemoglobin A1c
- INR, international normalized ratio
- IRT, interactive response technology
- LDL-C, LDL-cholesterol
- LS, least squares
- MELD, model for end-stage liver disease
- NAFLD, non-alcoholic fatty liver disease
- NAS, NAFLD activity score
- NASH, non-alcoholic steatohepatitis
- NAb, neutralizing antibody
- Non-HDL-C, non-HDL-cholesterol
- P1NP, procollagen type-I N-terminal propeptide
- P3NP, procollagen type III N-terminal propeptide
- PAI-1, plasminogen activator inhibitor-1
- Pro-C3, N-terminal type III collagen propeptide
- TEAE, treatment-emergent adverse event
- TIMP-1, tissue inhibitor of metalloproteinase-1
- ULN, upper limit of normal
- cirrhosis
- clinical trial
- efruxifermin
- histopathology
- hs-CRP, high-sensitivity C-reactive protein
- liver disease
- non-alcoholic steatohepatitis/NASH
- nonalcoholic fatty liver disease/NAFLD
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Affiliation(s)
| | - Peter J. Ruane
- Ruane Clinical Research Group Inc., Los Angeles, CA, United States
| | | | - Guy Neff
- Covenant Metabolic Specialists, LLC, Sarasota, FL, United States
| | - Rashmee Patil
- South Texas Research Institute, Edinburg, TX, United States
| | | | - Chen Hu
- MedPace, INC, Cincinnati, OH, United States
| | | | | | - Erica Fong
- Akero Therapeutics, South San Francisco, CA, United States
| | | | - Timothy Rolph
- Akero Therapeutics, South San Francisco, CA, United States
| | - Andrew Cheng
- Akero Therapeutics, South San Francisco, CA, United States
| | - Kitty Yale
- Akero Therapeutics, South San Francisco, CA, United States,Corresponding author. Address: 601 Gateway Blvd, Suite 350, South San Francisco, CA 94080, United States; Tel.: 415 823 7554.
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Chakraborty S, Paul K, Mallick P, Pradhan S, Das K, Chakrabarti S, Nandi DK, Bhattacharjee P. Consortia of bioactives in supercritical carbon dioxide extracts of mustard and small cardamom seeds lower serum cholesterol levels in rats: new leads for hypocholesterolaemic supplements from spices. J Nutr Sci 2019; 8:e32. [PMID: 31595188 DOI: 10.1017/jns.2019.28] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/17/2019] [Indexed: 12/14/2022] Open
Abstract
Melatonin-rich and 1,8-cineole-rich extracts have been successfully obtained from yellow mustard (YM) and small cardamom (SC) seeds, respectively, employing green technology of supercritical CO2 (SC-CO2) extraction. Chemical profiling confirmed the presence of melatonin and 1,8-cineole and co-extractants in the respective extracts. Electron paramagnetic resonance spectroscopy attested strong antioxidant activities of the extracts foregoing pan-assay interference compounds involved in spectroscopic analysis. These extracts also exhibited synergistic efficacies greater than unity confirming antioxidant synergy among the co-extracted bioactives therein. To ascertain hypocholesterolaemic efficacies, these extracts were co-administered orally with Triton X (at the pre-optimised dose of 175 mg/kg body weight (BW)) to Wistar albino rats at doses of 550, 175 and 55 mg/kg BW. Serum total cholesterol levels in the rats were monitored on days 3, 7, 15 and 21. On day 21, total cholesterol level reduced appreciably by 49·44 % in rats treated with YM seed extract and by 48·95 % in rats treated with SC seed extract, comparable with atorvastatin-administered rats (51·09 %). Either extract demonstrated inhibitory effects on hepatic 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase activity. A molecular docking exercise identified specific compounds in the extracts which possessed binding affinities comparable with therapeutically used HMG-CoA reductase inhibitors. In silico and in vivo studies concertedly concluded that the consortium of bioactive components in the extracts cannot be considered as invalid metabolic panaceas and therefore these 'green' extracts could be safely subjected to clinical studies as preventive biotherapeutics for hypercholesterolaemia. These extracts could be consumed per se as hypocholesterolaemic supplements or could be ingredients of new spice-based therapeutic foods.
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Key Words
- AI, atherogenic index
- BW, body weight
- EDX, energy dispersive X-rays
- EPR, electron paramagnetic resonance
- FT-IR, Fourier transformed IR spectroscopy
- GOLD, Genetic Optimization for Ligand Docking
- HDL-C, HDL-cholesterol
- HED, human equivalent dose
- HMG-CoA reductase
- HMG-CoA, 3-hydroxy-3-methyl-glutaryl-CoA
- Hypocholesterolaemic activity
- LC-ESI-MS, liquid chromatography-electrospray ionisation MS
- LDL-C, LDL-cholesterol
- OECD, Organization of Economic Co-operation and Development
- PDB, protein data bank
- SC, small cardamom
- SC-CO2, supercritical CO2
- SCbest, small cardamom seed extract obtained at the optimum conditions of SC-CO2
- Small cardamom seeds
- Supercritical carbon dioxide extraction
- TC, total cholesterol
- YM, yellow mustard
- YMbest, yellow mustard seed extract obtained at the optimum conditions of SC-CO2
- Yellow mustard seeds
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Liu Y, Poon S, Seeman E, Hare DL, Bui M, Iuliano S. Fat from dairy foods and 'meat' consumed within recommended levels is associated with favourable serum cholesterol levels in institutionalised older adults. J Nutr Sci 2019; 8:e10. [PMID: 30918631 DOI: 10.1017/jns.2019.5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 01/17/2023] Open
Abstract
CVD is common in older adults. Consumption of ‘meat’ (beef, pork, lamb, game, poultry, seafood, eggs) and dairy foods (milk, cheese, yoghurt) is encouraged in older adults as these foods provide protein and nutrients such as essential fatty acids, Ca, Fe, Zn and vitamins A, D and B12 required for healthy ageing. However, these foods also contain saturated fats considered detrimental to cardiovascular health. To determine the effect of their consumption on CVD risk we assessed associations between fat intake from ‘meat’ and dairy foods and serum cholesterol levels in 226 aged-care residents (mean age 85·5 years, 70 % female). Dietary intake was determined over 2 d using visual estimation of plate waste. Fat content of foods was determined using nutrition analysis software (Xyris, Australia). Fasting serum total cholesterol (TC), LDL-cholesterol and HDL-cholesterol were measured, and the TC:HDL-cholesterol ratio calculated. Associations were determined using random-effect models adjusted for CVD risk factors using STATA/IC 13.0. Total fat and saturated fat from ‘meat’ and dairy foods were associated with higher serum HDL-cholesterol levels, and dairy fat intake and number of servings were associated with a lower TC:HDL-cholesterol ratio. Every 10 g higher intake of fat and saturated fat from dairy products, and each additional serving was associated with a −0·375 (95 % CI −0·574, −0·175; P = 0·0002), a −0·525 (95 % CI −0·834, −0·213; P = 0·001) and a −0·245 (95 % CI −0·458, −0·033; P = 0·024) lower TC:HDL-cholesterol ratio, respectively. Provision of dairy foods and ‘meat’ in recommended amounts to institutionalised older adults potentially improves intakes of key nutrients with limited detriment to cardiovascular health.
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Matsumoto S, Beeson WL, Shavlik DJ, Siapco G, Jaceldo-Siegl K, Fraser G, Knutsen SF. Association between vegetarian diets and cardiovascular risk factors in non-Hispanic white participants of the Adventist Health Study-2. J Nutr Sci 2019; 8:e6. [PMID: 30828449 DOI: 10.1017/jns.2019.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/11/2018] [Accepted: 01/03/2019] [Indexed: 12/14/2022] Open
Abstract
The association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Data from 650 non-Hispanic white adults who participated in one of two clinical sub-studies (about 2 years after the baseline) of the Adventist Health Study-2 (AHS-2) were analysed. Four dietary patters were identified using a validated 204-item semi-quantitative FFQ completed at enrolment into AHS-2: vegans (8·3 %), lacto-ovo-vegetarians (44·3 %), pesco-vegetarians (10·6 %) and non-vegetarians (NV) (37·3 %). Dietary pattern-specific prevalence ratios (PR) of CVD risk factors were assessed adjusting for confounders with or without BMI as an additional covariable. The adjusted PR for hypertension, high total cholesterol and high LDL-cholesterol were lower in all three vegetarian groups. Among the lacto-ovo-vegetarians the PR were 0·57 (95 % CI 0·45, 0·73), 0·72 (95 % CI 0·59, 0·88) and 0·72 (95 % CI 0·58, 0·89), respectively, which remained significant after additionally adjusting for BMI. The vegans and the pesco-vegetarians had similar PR for hypertension at 0·46 (95 % CI 0·25, 0·83) and 0·62 (95 % CI 0·42, 0·91), respectively, but estimates were attenuated and marginally significant after adjustment for BMI. Compared with NV, the PR of obesity and abdominal adiposity, as well as other CVD risk factors, were significantly lower among the vegetarian groups. Similar results were found when limiting analyses to participants not being treated for CVD risk factors, with the vegans having the lowest mean BMI and waist circumference. Thus, compared with the diet of NV, vegetarian diets were associated with significantly lower levels of CVD risk factors among the non-Hispanic whites.
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Key Words
- AHS-2, Adventist Health Study-2
- Adventist Health Study-2
- BP, blood pressure
- Bio-MRS, Biologic Manifestations of Religion Study
- Cardiovascular risk factors
- DBP, diastolic blood pressure
- DM, diabetes mellitus
- Diets
- Disease prevalence
- EPIC, European Prospective Investigation into Cancer and Nutrition
- FBG, fasting blood glucose
- HDL-C, HDL-cholesterol
- HR, hazard ratio
- LDL-C, LDL-cholesterol
- LOV, lacto-ovo-vegetarian
- Lipids
- MDS, Mediterranean Diet Score
- NV, non-vegetarian
- PR, prevalence ratio
- PV, pesco-vegetarian
- SBP, systolic blood pressure
- TC, total cholesterol
- VG, vegan
- Vegetarian dietary patterns
- WC, waist circumference
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Musa-Veloso K, Paulionis L, Poon T, Lee HY. The effects of almond consumption on fasting blood lipid levels: a systematic review and meta-analysis of randomised controlled trials. J Nutr Sci 2016; 5:e34. [PMID: 27752301 DOI: 10.1017/jns.2016.19] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/29/2016] [Accepted: 05/09/2016] [Indexed: 12/17/2022] Open
Abstract
A systematic review and meta-analysis of randomised controlled trials was undertaken to determine the effects of almond consumption on blood lipid levels, namely total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), TAG and the ratios of TC:HDL-C and LDL-C:HDL-C. Following a comprehensive search of the scientific literature, a total of eighteen relevant publications and twenty-seven almond-control datasets were identified. Across the studies, the mean differences in the effect for each blood lipid parameter (i.e. the control-adjusted values) were pooled in a meta-analysis using a random-effects model. It was determined that TC, LDL-C and TAG were significantly reduced by −0·153 mmol/l (P < 0·001), −0·124 mmol/l (P = 0·001) and −0·067 mmol/l (P = 0·042), respectively, and that HDL-C was not affected (−0·017 mmol/l; P = 0·207). These results are aligned with data from prospective observational studies and a recent large-scale intervention study in which it was demonstrated that the consumption of nuts reduces the risk of heart disease. The consumption of nuts as part of a healthy diet should be encouraged to help in the maintenance of healthy blood lipid levels and to reduce the risk of heart disease.
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Birru RL, Ahuja V, Vishnu A, Evans RW, Miyamoto Y, Miura K, Usui T, Sekikawa A. The impact of equol-producing status in modifying the effect of soya isoflavones on risk factors for CHD: a systematic review of randomised controlled trials. J Nutr Sci 2016; 5:e30. [PMID: 27547393 PMCID: PMC4976117 DOI: 10.1017/jns.2016.18] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 11/30/2022] Open
Abstract
Recent studies suggest that the ability to produce equol, a metabolite of the soya isoflavone daidzein, is beneficial to coronary health. Equol, generated by bacterial action on isoflavones in the human gut, is biologically more potent than dietary sources of isoflavones. Not all humans are equol producers. We investigated whether equol-producing status is favourably associated with risk factors for CHD following an intervention by dietary soya isoflavones. We systematically reviewed randomised controlled trials (RCT) that evaluated the effect of soya isoflavones on risk factors for CHD and that reported equol-producing status. We searched PubMed, EMBASE, Ovid Medline and the Cochrane Central Register for Controlled Trials published up to April 2015 and hand-searched bibliographies to identify the RCT. Characteristics of participants and outcomes measurements were extracted and qualitatively analysed. From a total of 1671 studies, we identified forty-two articles that satisfied our search criteria. The effects of equol on risk factors for CHD were mainly based on secondary analyses in these studies, thus with inadequate statistical power. Although fourteen out of the forty-two studies found that equol production after a soya isoflavone intervention significantly improved a range of risk factors including cholesterol and other lipids, inflammation and blood pressure variables, these results need further verification by sufficiently powered studies. The other twenty-eight studies primarily reported null results. RCT of equol, which has recently become available as a dietary supplement, on CHD and its risk factors are awaited.
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Affiliation(s)
- Rahel L. Birru
- Department of Environmental and Occupational Health and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vasudha Ahuja
- Department of Environmental and Occupational Health and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Abhishek Vishnu
- Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Rhobert W. Evans
- Department of Environmental and Occupational Health and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu, Shiga 520-2192, Japan
| | - Takeshi Usui
- Clinical Research Institute, National Hospital Organization, Kyoto Medical Center, Kyoto, Kyoto 612-8555, Japan
| | - Akira Sekikawa
- Department of Environmental and Occupational Health and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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Weiland A, Bub A, Barth SW, Schrezenmeir J, Pfeuffer M. Effects of dietary milk- and soya-phospholipids on lipid-parameters and other risk indicators for cardiovascular diseases in overweight or obese men - two double-blind, randomised, controlled, clinical trials. J Nutr Sci 2016; 5:e21. [PMID: 27293558 DOI: 10.1017/jns.2016.9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/22/2016] [Accepted: 03/03/2016] [Indexed: 02/07/2023] Open
Abstract
The present study examined the effect of milk phospholipids (milk-PL) on lipid metabolism and on other risk factors for CVD, in comparison with milk fat (control) or soya phospholipids (soya-PL), respectively. Two double-blind parallel-group intervention trials were conducted in overweight or obese male subjects. In the first trial (trial 1), sixty-two men consumed milk enriched with either 2 g milk-PL or 2 g milk fat (control) for 8 weeks. In trial 2, fifty-seven men consumed milk enriched with either 3 g milk-PL or 2·8 g soya-PL for 7 weeks. In trial 1, milk-PL as compared with control reduced waist circumference but did not affect plasma lipids (total, HDL- and LDL-cholesterol, total cholesterol:HDL-cholesterol ratio, TAG, phospholipids), apoB, apoA1, glucose, insulin, insulin sensitivity index, C-reactive protein, IL-6, soluble intracellular adhesion molecule and total homocysteine (tHcy). Serum activities of alanine transaminase and aspartate transaminase were not changed. Activity of γ-glutamyl transferase (GGT), a marker of fatty liver, increased in the control but not in the milk-PL group, with a significant intervention effect. In trial 2, milk-PL as compared with soya-PL did not affect the above-mentioned parameters, but decreased GGT. Subjects with the methylenetetrahydrofolate reductase mutations CT and TT had 11 % (P < 0·05) higher baseline tHcy concentrations than those with the wild-type CC. However, genotype did not modulate the phospholipid intervention effect on tHcy. In conclusion, supplementation with milk-PL as compared with control fat reduced waist circumference and, as compared with both control fat and soya-PL, GGT activity.
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Key Words
- ALT, alanine transaminase
- AST, aspartate transaminase
- CRP, C-reactive protein
- CVD
- GGT, γ-glutamyl transferase
- HDL-C, HDL-cholesterol
- HOMA-IR, homeostasis model assessment of insulin resistance
- Human nutrition
- LDL-C, LDL-cholesterol
- MFGM, milk fat globule membrane
- MTHFR, methylenetetrahydrofolate reductase
- Milk phospholipids
- PC, phosphatidylcholine
- PL, phospholipid
- Plasma lipids
- SM, sphingomyelin
- Soya phospholipids
- TC, total cholesterol
- tHcy, total homocysteine
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Leblanc V, Hudon AM, Royer MM, Corneau L, Dodin S, Bégin C, Lemieux S. Differences between men and women in dietary intakes and metabolic profile in response to a 12-week nutritional intervention promoting the Mediterranean diet. J Nutr Sci 2015; 4:e13. [PMID: 26090094 DOI: 10.1017/jns.2015.2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 06/27/2014] [Accepted: 12/15/2014] [Indexed: 01/22/2023] Open
Abstract
Few studies have compared men and women in response to nutritional interventions but none
has assessed differences between men and women in the response to a nutritional
intervention programme based on the self-determination theory (SDT) and using the
Mediterranean diet (MedDiet) as a model of healthy eating, in a context of CVD prevention
and within a non-Mediterranean population. The present study aimed to document differences
between men and women in changes in dietary, anthropometric and metabolic variables, in
response to a nutritional intervention programme promoting the adoption of the MedDiet and
based on the SDT. A total of sixty-four men and fifty-nine premenopausal women presenting
risk factors for CVD were recruited through different media advertisements in the Québec
City Metropolitan area (Canada). The 12-week nutritional programme used a motivational
interviewing approach and included individual and group sessions. A validated FFQ was
administered to evaluate dietary intakes from which a Mediterranean score (Medscore) was
derived. Both men and women significantly increased their Medscore in response to the
intervention (P < 0·0001). Men showed a significantly greater
decrease in red and processed meat (−0·4 (95 % CI −0·7, −0·1) portions per d) and a
greater increase in fruit (0·9 (95 % CI 0·2, 1·6) portions per d) intakes than women.
Significant decreases were observed for BMI and waist circumference in both men and women
(P ≤ 0·04). Significant greater decreases were found for total
cholesterol (total-C):HDL-cholesterol (HDL-C) (−0·2; 95 % CI −0·4, −0·03) and TAG:HDL-C
(−0·2; 95 % CI −0·4, −0·04) ratios in men than in women. When adjusting for the baseline
value of the response variable, differences between men and women became non-significant
for red and processed meat and fruit intakes whereas significant differences between men
and women (i.e. larger increases in men than women) were observed for legumes, nuts and
seeds (0·6 (95 % CI 0·2, 1·0) portions per d) and whole-grain products (0·5 (95 % CI 0·01,
1·0) portions per d) intakes. For metabolic variables, differences between men and women
became non-significant for total-C:HDL-C and TAG:HDL-C ratios when adjusted for the
baseline value of the response variable. The present results suggest that the nutritional
intervention promoting the adoption of the Mediterranean diet and based on the SDT led to
greater improvements in dietary intakes in men than in women, which appear to have
contributed to beneficial anthropometric and metabolic changes, more particularly in men.
However, the more deteriorated metabolic profile found in men at baseline seems to
contribute to a large extent to the more beneficial changes in CVD risk factors observed
in men as compared with women.
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Zeba AN, Delisle HF, Renier G. Dietary patterns and physical inactivity, two contributing factors to the double burden of malnutrition among adults in Burkina Faso, West Africa. J Nutr Sci 2014; 3:e50. [PMID: 26101618 PMCID: PMC4473138 DOI: 10.1017/jns.2014.11] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 10/19/2012] [Accepted: 12/04/2012] [Indexed: 01/24/2023] Open
Abstract
A population-based cross-sectional study was carried out in the northern neighbourhoods of Ouagadougou (Burkina Faso), to examine the relationship of nutritional deficiencies and cardiometabolic risk factors (CMRF) with lifestyle in adults. We randomly selected 330 households stratified by income tertile. In each income stratum, 110 individuals aged 25-60 years and having lived in Ouagadougou for at least 6 months were randomly selected. We performed anthropometric, dietary intake and physical activity measurements, and blood sample collection. Cluster analysis of dietary intake identified two dietary patterns: 'urban' (29 % of subjects) and 'traditional' (71 %). The 'urban' cluster exhibited a higher intake of fat and sugar, whereas a higher intake of plant protein, complex carbohydrate and fibre was observed in the 'traditional' pattern. Female sex, low income and lack of education were associated with the 'traditional' cluster, as well as Fe and vitamin A deficiency. CMRF prevalence (abdominal obesity, hypertension, hyperglycaemia, dyslipidaemia) was similar in both clusters. Subjects in the 'traditional' cluster spent more time in physical activity and had less sedentary time than those in the 'urban' cluster. 'Traditional' dietary pattern, low income, female sex and sedentary time were significant contributing factors to the double burden of malnutrition. The rapid nutrition transition is reflected in this co-occurrence of CMRF and nutritional deficiencies. This stresses the need for prevention strategies addressing both ends of the nutrition spectrum.
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Affiliation(s)
- Augustin N. Zeba
- Département de Nutrition, Faculté de Médecine, Université de Montréal, C.P. 6128 succ. Centre-ville, Montréal, QC, CanadaH3C 3J7
- Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest (IRSS/DRO), 01 BP 545 Bobo Dioulasso 01, Burkina Faso
| | - Hélène F. Delisle
- Département de Nutrition, Faculté de Médecine, Université de Montréal, C.P. 6128 succ. Centre-ville, Montréal, QC, CanadaH3C 3J7
| | - Genevieve Renier
- Centre Hospitalier Universitaire de Montréal, Département de Médecine, Université de Montréal, 1560 Sherbrooke East, Montréal, QC, CanadaH2L 4M1
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