Abstract
PurposeWell-designed trials comparing side-by-side effects of macronutrients on postprandial endothelial function are missing. Therefore, we investigated under well-controlled and isocaloric condition effects of fat, carbohydrates, and protein on postprandial endothelial function as assessed by brachial artery flow-mediated vasodilation (FMD), an important non-invasive technique to assess endothelial function.MethodsEighteen apparently healthy overweight and slightly obese men (BMI 26.0–35.0 kg/m2) completed this randomized, double-blinded, cross-over trial. The study consisted of three test days each separated by a wash-out period of at least 1 week. After an overnight fast, men received an isocaloric meal providing 3987 kJ (953 kcal) that was either high in dietary fat (En% fat [F]/carbohydrates [C]/protein [P]: 52.3, 39.2, 8.0), carbohydrates (En% F/C/P: 9.6, 81.5, 8.6), or protein (En% F/C/P: 10.6, 51.5, 36.9). Fasting and 2-h postprandial FMD responses were measured.ResultsA postprandial decrease of 1.2% point in FMD was observed after the high-protein meal (P = 0.015). However, postprandial changes did not differ between meals (P = 0.45). An increase in baseline brachial artery diameters was observed after the high-protein meal (P < 0.001) and changes differed between meals (P = 0.020). A meal*time interaction was found for plasma glucose concentrations, with the most pronounced increases after the high-carbohydrate meal at T15, T30, T60, and T90 (P < 0.05). A significant time and meal (P < 0.001), but no time*meal effect (P = 0.06) was found for serum insulin concentrations. Increases in serum triacylglycerol concentrations did not differ between meals (P = 0.014).ConclusionMacronutrients did not differently affect postprandial endothelial function in apparently healthy overweight and slightly obese men.Trial registrationTrial registration number (ClinicalTrials.gov) NCT03139890 in May 2017
Highlights
An important mechanism in the development of cardiovascular disease (CVD), the leading cause of death worldwide, is a reduced nitric oxide (NO) bioavailability, which causes impaired function of the endothelial vascular cell layer [1,2,3]
It has been estimated that an increase of 1% point (PP) in fasting flowmediated vasodilation (FMD) is associated with a reduction of 8–13% in overall CVD risk [9, 10]
An significant increase in postprandial FMD was observed after consumption of a high-carbohydrate, highfiber meal, while other studies observed a decrease in FMD after an oral glucose load [14,15,16]
Summary
An important mechanism in the development of cardiovascular disease (CVD), the leading cause of death worldwide, is a reduced nitric oxide (NO) bioavailability, which causes impaired function of the endothelial vascular cell layer [1,2,3]. Most studies in healthy and overweight individuals observed a decrease in FMD after consumption of a high-fat meal [11,12,13]. An significant increase in postprandial FMD was observed after consumption of a high-carbohydrate, highfiber meal, while other studies observed a decrease in FMD after an oral glucose load [14,15,16]. Effects of protein intake on FMD have been studied less, Westphal et al [17] observed that a postprandial impairment in FMD was counteracted by adding proteins to a high-fat challenge. A possible explanation for the observed differences in postprandial FMD responses between studies may be the macronutrient composition of meals
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