Cholesterol-lowering Foods Research Articles

Efek Pendidikan Kesehatan terhadap Pengetahuan Lansia dalam Pencegahan Kolestrol

Prevention of cholesterol can be carried out for all individuals with cholesterol issues. Several natural, safe, and effective ways to reduce cholesterol levels include consuming cholesterol-lowering foods, exercising regularly, reducing sugar intake, avoiding smoking, limiting alcohol consumption, managing stress, and taking additional cholesterol-lowering supplements. The purpose of this study is to determine the relationship between health education and elderly knowledge regarding cholesterol prevention. The research method used is a quasi-experimental design. The population in this study consisted of 40 elderly individuals in Karampuang Village, with a total sampling technique used to select all 40 participants. Data were analyzed using a paired test to determine the p-value. Before receiving health education, the majority of the elderly participants (57.5%) had poor knowledge, and none were categorized as having good knowledge. After health education, 85.0% of the participants reached the good knowledge category, while the moderate knowledge category decreased to 15.0%, and no participants remained in the poor knowledge category. Health education significantly improved the level of knowledge among the elderly regarding cholesterol prevention.

The effects of portfolio moderate-carbohydrate and ketogenic diets on anthropometric indices, metabolic status, and hormonal levels in overweight or obese women with polycystic ovary syndrome: a randomized controlled trial

BackgroundPolycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders in reproductive-age women caused by hyperinsulinemia. The portfolio Moderate-carbohydrate diet (PMCD) is a plant-based diet with a carbohydrate content of 40% and incorporates five cholesterol-lowering foods. While, the ketogenic diet is a high-fat diet with 70% fat, promoting a ketosis state. To the best of our knowledge, no study compared the therapeutic effects of these two diets in PCOS patients. Thus, this study aimed to compare the impact of PLCD and KD on anthropometric indices, metabolic status, and hormonal levels in overweight or obese women with PCOS.MethodsThis open-label, randomized clinical trial was conducted on forty-six PCOS women. 21 women in PMCD and 19 in the KD group completed the study. The anthropometric indices including body mass index (BMI) and fat body mass (FBM), metabolic markers (fasting blood glucose (FBG)) and plasma lipid profiles including low-density lipoprotein (LDL), triglycerides, and high-density lipoproteins (HDL) were measured. Reproductive hormones such as luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-s) and free testosterone were assessed at the baseline and after the intervention.ResultsHowever, after 8 weeks both diets demonstrated enhancement in anthropometric indices (BMI, FBM, lean body mass), metabolic status (FBG, insulin serum levels), and reproductive hormones such as LH, free testosterone, and DHEA-s. The mean difference in the KD improved more than the PMCD in the field of BMI reduction (MD (SD) 2.73 (0.351) vs. MD (SD) 1.71 (0.775)) and LH (MD 4.13 (1.375) vs.MD 2.46 (1.105)). Nevertheless, the lipid profile including LDL-C and triglycerides improved more in the PMCD compared to the KD (MD 33.95 (7.345) vs. MD 23.34 (14.136)) and (MD 38.20 (10.757) vs. MD 57.62 (21.688)) respectively. There were no significant changes in the Ferriman-Gallwey score within or between the two groups.ConclusionThe findings revealed that both diets were effective in improving PCOS manifestations. However, the KD exhibited greater effectiveness in enhancing body measurements, metabolic factors, and reproductive hormone levels compared to the PMCD in obese PCOS women. Furthermore, PMCD could be more beneficial for PCOS women with lipide disorders.Registration number of clinical trialIRCT20200912048693N3, Trial registered 2022–12–14. https://www.irct.ir/trial/67548

Physicochemical and Functional Properties of DND358 (A Hypocholesterolemic Soybean) Protein Isolate.

The properties and applications of soybean protein isolates (SPIs) have been extensively investigated. In this study, we determined the optimal conditions for the preparation of the DND358 soybean protein isolate (DND358-SPI), assessed its physicochemical and functional properties, and investigated its potential applications in the food industry. According to the results, the highest extraction rate of DND358-SPI was observed when the pH was 9.5, the temperature was 55 °C, the duration was 80 min, and the material-to-liquid ratio was 1:20 (w/v). With regard to the functional properties, the water-holding capacity (WHC) and oil-binding capacity (OBC) of DND358-SPI were higher than those of other varieties, reaching 4.73% and 11.04%, respectively. In addition, the hardness, adhesiveness, chewiness, and resilience of DND358-SPI were higher than those of other varieties, reaching 159.27 g, 186.07 g, 6.78 mj, and 1.88, respectively. These findings indicate that DND358-SPI can reduce cholesterol levels and may be used to produce cholesterol-lowering food products.

The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials.

(1) Background: The Portfolio Diet, a dietary pattern of cholesterol-lowering foods, is also rich in low glycemic index (GI) foods. While strong evidence supports clinically meaningful reductions in cholesterol, evidence on the relationship between the Portfolio Diet and diabetes management is lacking. (2) Objective: To evaluate the relationship between the Portfolio Diet and glycated hemoglobin (HbA1c) as a determinant of glycemic control among adults living with type 2 diabetes mellitus (T2DM). (3) Methods: Patient-level data was pooled from two randomized dietary trials of low glycemic index interventions compared to high cereal fibre control diets in adults living with T2DM where HbA1c was collected (clinicaltrials.gov identifiers: NCT00438698, NCT00438698). Dietary exposure was assessed using weighed 7-day diet records. Adherence to the Portfolio Diet and its pillars (nuts and seeds, plant protein, viscous fibre, plant sterols, monounsaturated fatty acid [MUFA] oils) was determined using the validated clinical Portfolio Diet Score (c-PDS). Multiple linear regression was used to assess the association between change in the c-PDS and change in HbA1c over 6-months with covariate adjustments. (4) Results: A total of 267 participants, predominantly White (67%) and male (63%), were included, with a mean ± standard error age of 62 ± 0.5 years, baseline BMI of 30.2 ± 0.3 kg/m2, HbA1c of 7.08 ± 0.03%, and a c-PDS of 4.1 ± 0.3 points out of 25. Change in the c-PDS was significantly associated with a change in HbA1c (β: -0.04% per point, 95% CI: -0.07, -0.02, p = 0.001). A 7.5-point (30%) increase in the c-PDS was associated with a 0.3% reduction in HbA1c. Of the individual pillars, a 1-point change in nut and seeds intake (β: -0.07%, 95% CI: -0.12, -0.02, p = 0.009) or in plant protein intake (β: -0.11%, 95% CI: -0.18, -0.03, p = 0.009) was associated with a change in HbA1c. Further analysis of plant protein intake revealed that an increase in dietary pulse intake, a particularly low-GI food, was significantly associated with a reduction in HbA1c (β: -0.24% per 1-cup points cooked pulses (226 g) or 2 c-PDS points, 95% CI: -0.45, -0.03, p = 0.028). (5) Conclusions: Among adults living with T2DM, the Portfolio Diet was associated with lower HbA1c over a 6-month period, predominantly driven by two pillars: nuts and seeds and plant protein, particularly dietary pulses. These data have implications for including the Portfolio Diet in dietary recommendations for glycemic control in T2DM. A trial demonstrating the direct causal effect of the Portfolio Diet in a diverse group is warranted.

Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies.

The plant-based Portfolio dietary pattern includes recognized cholesterol-lowering foods (ie, plant protein, nuts, viscous fiber, phytosterols, and plant monounsaturated fats) shown to improve several cardiovascular disease (CVD) risk factors in randomized controlled trials. However, there is limited evidence on the role of long-term adherence to the diet and CVD risk. The primary objective was to examine the relationship between the Portfolio Diet Score (PDS) and the risk of total CVD, coronary heart disease (CHD), and stroke. We prospectively followed 73 924 women in the Nurses' Health Study (1984-2016), 92 346 women in the Nurses' Health Study II (1991-2017), and 43 970 men in the Health Professionals Follow-up Study (1986-2016) without CVD or cancer at baseline. Diet was assessed using validated food frequency questionnaires at baseline and every 4 years using a PDS that positively ranks plant protein (legumes), nuts and seeds, viscous fiber sources, phytosterols (mg/day), and plant monounsaturated fat sources, and negatively ranks foods high in saturated fat and cholesterol. During up to 30 years of follow-up, 16 917 incident CVD cases, including 10 666 CHD cases and 6473 strokes, were documented. After multivariable adjustment for lifestyle factors and a modified Alternate Healthy Eating Index (excluding overlapping components), comparing the highest with the lowest quintile, participants with a higher PDS had a lower risk of total CVD (pooled hazard ratio [HR], 0.86 [95% CI, 0.81-0.92]; Ptrend<0.001), CHD (pooled HR, 0.86 [95% CI, 0.80-0.93]; Ptrend=0.0001), and stroke (pooled HR, 0.86 [95% CI, 0.78-0.95]; Ptrend=0.0003). In addition, a 25-percentile higher PDS was associated with a lower risk of total CVD (pooled HR, 0.92 [95% CI, 0.89-0.95]), CHD (pooled HR, 0.92 [95% CI, 0.88-0.95]), and stroke (pooled HR, 0.92 [95% CI, 0.87-0.96]). Results remained consistent across sensitivity and most subgroup analyses, and there was no evidence of departure from linearity for CVD, CHD, or stroke. In a subset of participants, a higher PDS was associated with a more favorable blood lipid and inflammatory profile. The PDS was associated with a lower risk of CVD, including CHD and stroke, and a more favorable blood lipid and inflammatory profile, in 3 large prospective cohorts.

A comparison of the portfolio low-carbohydrate diet and the ketogenic diet in overweight and obese women with polycystic ovary syndrome: study protocol for a randomized controlled trial

BackgroundPolycystic ovary syndrome (PCOS) is one of the most frequent endocrine disorders among women of fertile age. Women with PCOS manifest clinical symptoms like menstrual dysfunction, hirsutism, insulin resistance, and hyperinsulinemia. As excessive amounts of insulin levels directly increase ovarian production of androgens, hyperinsulinemia and insulin resistance are considered as the pathogenesis factors of PCOS. The portfolio low-carbohydrate diet (PLCD) is a plant-based diet with 40% carbohydrates combined with five cholesterol-lowering foods and nutrients. On the other hand, the ketogenic diet (KD) is a nutritional protocol with 10% carbohydrates. The purpose of this study is to determine whether PLCD or KD is more effective in alleviating PCOS symptoms.MethodsForty-six overweight or obese women diagnosed with PCOS will be randomly stratified to receive either PLCD or KD for 8 weeks. Measures related to anthropometric and body composition, glucose, and insulin level, HOMA-IR, sex hormones, lipid profile, quality of life, dietary intake, physical activity, and Ferriman-Gallwey score of all participants will be accessed before and after the intervention.DiscussionSince the first line treatment of PCOS is lifestyle adjustment including diet control and exercise, there has not been determined the optimal diet for this population of women yet. Hence, the goal of conducting this study is to determine whether the PLCD or the KD could have more advantageous effects on attenuating PCOS manifestations. The result of this investigation will give us new insight into curing this disease and will provide evidence-based recommendations for prescribing an optimal diet for PCOS women.Trial registrationIRCT20200912048693N3, Trial registered 2022–12-14.https://www.irct.ir/trial/67548

Anti-proliferative potential and oxidative reactivity of thermo-oxidative degradation products of stigmasterol and stigmasteryl esters for human intestinal cells

Stigmasterol in free and esterified form is incorporated in LDL cholesterol-lowering food products, intended for direct consumption and cooking, baking, and frying. Under thermal treatment, stigmasterol compounds may constitute a source of thermo-oxidative degradation products and oxyderivatives with potentially adverse health effects. This study aimed to analyze the anti-proliferative potential and genotoxicity of thermo-oxidatively treated stigmasterol (ST), stigmasteryl linoleate (ST-LA), and oleate (ST-OA). The effects on cell viability and proliferation, cell cycle progression, intracellular reactive oxygen species (ROS) generation, and DNA damage were analyzed in normal human intestinal cells. The mutagenic potential was assessed in a bacterial reverse mutation test using Salmonella enterica serovar Typhimurium strains involving metabolic activation. Stigmasteryl esters showed a significantly lower potential to affect intestinal cell viability and proliferation than non-esterified ST, regardless of heating. Thermo-oxidatively treated ST suppressed intestinal cell proliferation by arresting the cell cycle in the G2/M phase and DNA synthesis inhibition. The enhanced intracellular ROS generation and caspase 3/7 activity suggest targeting intestinal cells to the apoptosis pathway. Also, heated ST-LA intensified ROS production and elicited pro-apoptotic effects. Thermo-oxidative derivatives of ST and ST-LA may evoke harmful gastrointestinal effects due to their high oxidative reactivity towards intestinal cells.

Abstract P214: The Portfolio Dietary Pattern and Risk of Cardiovascular Disease in US Adults

Introduction: The plant-based portfolio dietary pattern includes recognized cholesterol-lowering foods shown to improve several cardiovascular disease (CVD) risk factors in clinical trials. Epidemiological evidence on the association between longer-term adherence to the portfolio dietary pattern and CVD risk remains more limited. Objective: To examine whether the portfolio dietary pattern is associated with the risk of total CVD, coronary heart disease (CHD, including myocardial infarction and fatal coronary deaths), and stroke. Methods: Participants included 73,925 women in the Nurses’ Health Study (NHS) (1984-2014), 92,354 women in the NHS2 (1991-2017) and 43,970 men from the Health Professionals Follow-up Study (HPFS) (1986-2016) without CVD and cancer at baseline. Diet was assessed using validated food frequency questionnaires at baseline and every four years using a portfolio diet score (PDS) which positively ranks plant protein (soy &amp; pulses), nuts, viscous fiber sources, phytosterols (mg/day) and plant monounsaturated fat sources, and negatively ranks foods high in saturated fat and dietary cholesterol. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for covariates. Results: During up to 30 years of follow-up, 16,917 incident CVD cases, including 10,666 CHD cases and 6,473 stroke cases, were documented. After multivariable adjustment of lifestyle and other dietary factors, comparing the highest to the lowest quintile, participants with a higher PDS had a lower risk of total CVD (pooled HR: 0.84; 95% CI: 0.80-0.89, P trend&lt;0.001), CHD (pooled HR: 0.82; 95% CI: 0.76-0.87, P trend&lt;0.001) and stroke (pooled HR: 0.88; 95% CI: 0.81-0.97, P trend=0.001). In addition, a 25-percentile higher PDS was associated with a lower risk of total CVD (pooled HR: 0.91; 95% CI: 0.88-0.93), CHD (pooled HR: 0.89; 95% CI: 0.86-0.92) and stroke (pooled HR: 0.93; 95% CI: 0.89-0.97). Results remained largely consistent across sensitivity and subgroup analyses. Conclusions: Greater adherence to the portfolio dietary pattern was consistently associated with lower risk of CVD, including CHD and stroke, in three large prospective cohorts of U.S. men and women.

A Web-Based Health Application to Translate Nutrition Therapy for Cardiovascular Risk Reduction in Primary Care (PortfolioDiet.app): Quality Improvement and Usability Testing Study.

BackgroundThe Portfolio Diet, or Dietary Portfolio, is a therapeutic dietary pattern that combines cholesterol-lowering foods to manage dyslipidemia for the prevention of cardiovascular disease. To translate the Portfolio Diet for primary care, we developed the PortfolioDiet.app as a patient and physician educational and engagement tool for PCs and smartphones. The PortfolioDiet.app is currently being used as an add-on therapy to the standard of care (usual care) for the prevention of cardiovascular disease in primary care. To enhance the adoption of this tool, it is important to ensure that the PortfolioDiet.app meets the needs of its target end users.ObjectiveThe main objective of this project is to undertake user testing to inform modifications to the PortfolioDiet.app as part of ongoing engagement in quality improvement (QI).MethodsWe undertook a 2-phase QI project from February 2021 to September 2021. We recruited users by convenience sampling. Users included patients, family physicians, and dietitians, as well as nutrition and medical students. For both phases, users were asked to use the PortfolioDiet.app daily for 7 days. In phase 1, a mixed-form questionnaire was administered to evaluate the users’ perceived acceptability, knowledge acquisition, and engagement with the PortfolioDiet.app. The questionnaire collected both quantitative and qualitative data, including 2 open-ended questions. The responses were used to inform modifications to the PortfolioDiet.app. In phase 2, the System Usability Scale was used to assess the usability of the updated PortfolioDiet.app, with a score higher than 70 being considered acceptable.ResultsA total of 30 and 19 users were recruited for phase 1 and phase 2, respectively. In phase 1, the PortfolioDiet.app increased users’ perceived knowledge of the Portfolio Diet and influenced their perceived food choices. Limitations identified by users included challenges navigating to resources and profile settings, limited information on plant sterols, inaccuracies in points, timed-logout frustration, request for step-by-step pop-up windows, and request for a mobile app version; when looking at positive feedback, the recipe section was the most commonly praised feature. Between the project phases, 6 modifications were made to the PortfolioDiet.app to incorporate and address user feedback. At phase 2, the average System Usability Scale score was 85.39 (SD 11.47), with 100 being the best possible.ConclusionsBy undertaking user testing of the PortfolioDiet.app, its limitations and strengths were able to be identified, informing modifications to the application, which resulted in a clinical tool that better meets users’ needs. The PortfolioDiet.app educates users on the Portfolio Diet and is considered acceptable by users. Although further refinements to the PortfolioDiet.app will continue to be made before its evaluation in a clinical trial, the result of this QI project is an improved clinical tool.

Reduction in Serum LDL Cholesterol Using a Nutrient Compendium in Hyperlipidemic Adults Unable or Unwilling to Use Statin Therapy: A Double-Blind Randomized Crossover Clinical Trial

BackgroundMany hyperlipidemic patients prescribed β-hydroxy-β-methylglutaryl coenzyme A reductase inhibitors (statins) are unable or unwilling to take them. A hedonically acceptable snack-based solution formulated from cholesterol-lowering food ingredients could represent a therapeutic alternative but has not been tested in this population. ObjectivesTo evaluate the effect of snacks containing a compendium of functional bioactives on fasting LDL cholesterol in statin candidates unwilling to use or intolerant to ≥1 statin drug. Secondary outcomes included changes in circulating total cholesterol (TC), triglycerides, HDL cholesterol, fasting glucose, insulin, and high-sensitivity C-reactive protein concentrations, as well as effects of single-nucleotide polymorphisms (SNPs) on outcome. MethodsThis multicenter, randomized, double-blind, free-living crossover study was composed of 2 regimented phases of 4 wk each, separated by a 4-wk washout. Eighteen men and 36 women, with a mean ± SD age of 49 ± 12 y and mean ± SD LDL cholesterol of 131 ± 32.1 mg/dL, were instructed to ingest a variety of ready-to-eat snacks twice daily as a substitute for something they were consuming already. Other behavior changes were actively discouraged. Treatment products provided ≥5 g fiber, 1000 mg ω-3 (n–3) fatty acids, 1000 mg phytosterols, and 1800 μmol antioxidants per serving. Control products were calorie-matched like-items drawn from the general grocery marketplace. Serum lipids were measured at baseline and the end of each phase and compared using the ANOVA model. Compliance to study foods was confirmed by serum 18:3n–3 concentration assessment. ResultsComparing intervention phase endpoints, LDL cholesterol was reduced a mean ± SD of 8.80 ± 1.69% (P < 0.0001), and TC was reduced a mean ± SD of 5.08 ± 1.12% (P < 0.0001) by treatment foods compared with control foods, whereas effects on other analytes did not differ between treatments. SNPs were not significantly related to outcomes (P ≥ 0.230). Compliance with study foods was 95%. ConclusionsConsumption of hedonically acceptable snacks containing a compendium of cholesterol-lowering bioactive compounds can rapidly and meaningfully reduce LDL cholesterol in adult patients unable or unwilling to take statin drugs. This trial was registered at clinicaltrials.gov as NCT02341924.

Development of a Portfolio Diet Score and Its Concurrent and Predictive Validity Assessed by a Food Frequency Questionnaire.

The Portfolio Diet, a plant-based portfolio of cholesterol-lowering foods, has been shown to reduce low-density lipoprotein cholesterol (LDL-C), and other cardiovascular risk factors, in randomized controlled trials (RCTs). It is not known if these beneficial effects translate to a lower incidence OF cardiovascular disease (CVD). To support examinations between Portfolio Diet adherence and disease, a Portfolio Diet score (PDS) was developed and its predictive and concurrent validity was assessed within the Toronto Healthy Diet Study, a six-month RCT in overweight adults. Predictive validity was assessed using change in the PDS measured by food frequency questionnaire (FFQ) and concomitant change in LDL-C from baseline to six months using multiple linear regression, adjusted for potential confounders (n = 652). Concurrent validity was assessed in a subset of participants (n = 50) who completed the FFQ and a 7-day diet record (7DDR) at baseline. The PDS determined from each diet assessment method was used to derive correlation coefficients and Bland–Altman plots to assess the between-method agreement. The change in PDS was inversely associated with change in LDL-C (β coefficients: −0.01 mmol/L (95% confidence intervals (CIs): −0.02, −0.002; p = 0.02). The correlation between the PDS from the FFQ and 7DDR was 0.69 (95% CIs: 0.48, 0.85). The Bland–Altman plot showed reasonable agreement between the score from the FFQ and 7DDR. These findings indicate predictive validity of the PDS with lower LDL-C, and reasonable concurrent validity of the PDS as assessed by an FFQ against a 7DDR.

Protein Engineering of Mung Bean (Vigna radiata (L.) Wilczek) 8Sα Globulin with Lactostatin

Mung bean is a well-known good source of protein. To increase its bioactivity, economic value, and nutritional content as a functional food and food additive, lactostatin (IIAEK), a cholesterol-lowering bioactive peptide, was engineered into mung bean 8Sα globulin, a major storage protein. The results showed that the mutated 8Sα globulin has a significant bile acid binding capacity (cholesterol-lowering activity) up to 47.25%. Moreover, superimposed mutant (Mut2) and wild-type (Wt) 3D protein structures showed a 93–97% identity, indicating that the mutant proteins are stable. Ultra-performance liquid chromatography(UPLC)-based assay showed similar retention time for wild-type and mutant protein samples. Both IIAEK peptide standard and Mut2 digest had comparable baseline peaks corresponding to the same molecular size based on the liquid chromatography-mass spectrometry (LC-MS) data. A 573.36-Da mass spectrum was seen in Mut2, which indicates that Mut2 8Sα globulin has been successfully mutated and digested to release the bioactive peptide, IIAEK. In vitro bile acid binding capacity showed that the 6-h Wt and 12-h engineered protein (Mut2) digests had the highest activity. Lastly, potential allergenicity was checked in the Allergen Database for Food Safety (ADFS) and the AllerBase database, and the IIAEK peptide matched the Bos d 5 epitopes. This study provides a strong foundation and basis for mung bean nutrition improvement, development of cholesterol-lowering food supplements, and protein engineering of other food proteins.

Randomized parallel-group pilot trial (Best foods for your heart) comparing the effects of a Mediterranean Portfolio diet with a low saturated fat diet on HIV dyslipidemia

Mediterranean diets reduce the risk of cardiovascular disease (CVD). However, the effect is unknown in people living with HIV, who have an increased risk potentially due to the additional burdens of infection, inflammation and antiretroviral treatment (ART). We examined the feasibility of a 6-month dietary intervention in adults with HIV dyslipidemia using a sample size adequate to detect differences in LDL-cholesterol. Sixty adults with stable HIV infection on ART and LDL-cholesterol >3mmol/l were recruited. Participants were randomized (1:1) to receive dietary advice to reduce saturated fat intake to <10% of energy intake (Diet1), or supported to adopt the Mediterranean Portfolio Diet (Diet2) with additional cholesterol-lowering foods (nuts, stanols, soya, oats, beans) for 6 months. Recruitment, retention and intervention fidelity were monitored. Measurements were conducted at baseline, 6 and 12 months. A secondary analysis examined between group differences in CVD risk factors at month 6 adjusted for baseline values and potential confounders. Rates of recruitment, participation and attrition were 35%, 91%, and 12% respectively. Reported dietary adherence was 68% to Mediterranean foods and 59% to Portfolio components. At 6 months Diet2 participants (n=29) had a significantly lower LDL-cholesterol (mean difference adjusted for baseline-0.4mmol/l, 95%CI -0.7 to-0.1, P=0.01), and systolic blood pressure (-7mmHg, 95%CI -2 to-12, P=0.008) compared to those in Diet1 (n=31). These effects were not sustained at 1 year (LDL-cholesterol-0.05mmol/l, 95%CI -0.33 to 0.23, P=0.7; systolic blood pressure-3.5mmHg, 95%CI -9.4 to 2.5, P=0.2). We showed the feasibility of adopting a Mediterranean Portfolio diet in people living with HIV. Our findings suggest this intervention might equate to short term improvements in diet quality, blood pressure, and LDL-cholesterol. Further definitive evaluations are required to determine if this is a viable strategy to facilitate cardiovascular risk reduction. ISRCTN32090191 Best Foods For your heart trial.

Characterization and anti-hyper-lipidemic effect of micro encapsulated phytosterol enriched cheddar cheese

In modern research, fermented dairy products are considered as cholesterol-lowering food. In the current study, phytosterol esters were encapsulated and then incorporated in cheddar cheese to achieve a synergistic effect to enhance cholesterol-lowering properties. The microencapsulation efficacy was highest (84.12%) for gum arabic and maltodextrin with a ratio of 1:1. Sensory attributes showed high textural scores in all groups, but the taste decreased with increasing phytosterol percentage. Cheese hardness gradually increased with high levels of phytosterol. There were no significant changes in any metabolic syndrome in control and (PEC) fed rats. However, (PEC) fed animals showed a19% decrease in TC, TG by 11%, and 8% increase in HDL. Regarding the liver lipids, there was a decrease in TC by 9.3% and TG 17% but no significant change in body weight. These results suggested that encapsulated phytosterol is a worthy option to incorporate in cholesterol-lowering food, especially fermented dairy products.

Abstract P511: Adherence to the Dietary Portfolio is Associated With Lower Cardiovascular Disease Risk in the Women's Health Initiative Study

Introduction: The Dietary Portfolio is a plant-based dietary pattern of a combination of recognized cholesterol-lowering foods and has been shown to lower a number of cardiovascular disease (CVD) risk factors, including low-density lipoprotein cholesterol, blood pressure and C-reactive protein. However, no studies have assessed if following the Portfolio results in fewer CVD events. Hypothesis: Higher adherence to the Portfolio will be associated with fewer CVD events. Methods: We included 125,389 postmenopausal women from the Women’s Health Initiative Observational Study and Clinical Trials (from 1993 to 2017) who were free of CVD at baseline. Adherence to the Portfolio was assessed using an a priori diet index based on 6 food categories (high in plant protein [soy &amp; pulses], nuts, viscous fiber, plant sterols and monounsaturated fat, and low in saturated fat) that were found to lower CVD risk factors in the Portfolio trials. Adjusted hazard ratios (HRs) and 95% confidence intervals [CIs] for CVD were calculated using Cox regressions. We adjusted for CVD risk &amp; lifestyle factors and potential confounders (see Table 1). Results: During 1,826,176 person-years of follow-up, we documented 11,370 total CVD cases, including 5,739 coronary heart disease (CHD) cases, 4,451 stroke cases, 1,946 heart failure (HF) cases and 935 atrial fibrillation (AF) cases. Comparing the highest to the lowest quartile in the fully adjusted model, higher adherence to the Portfolio was associated with a reduced risk of total CVD (HR=0.89 [95% CI 0.84-0.95]), CHD (0.87 [0.79-0.95]) and HF (0.83 [0.70-0.98]). No association was found with stroke (0.97 [0.87-1.08]) and AF (1.09 [0.87-1.38]). Conclusions: In postmenopausal women, higher adherence to the Portfolio was inversely associated with total CVD, CHD and HF but not stroke or AF. These findings suggest that the Portfolio may assist with CVD, CHD and HF prevention and warrants further investigation. Table 1: Association of the Dietary Portfolio and risk of CVD in Postmenopausal Women

Dyslipidemia.

Dyslipidemia.

Mediterranean diet supplemented with cholesterol-lowering foods and health-related quality of life in adults with HIV infection

Mediterranean diet supplemented with cholesterol-lowering foods and health-related quality of life in adults with HIV infection

Randomised controlled pilot study to assess the feasibility of a Mediterranean Portfolio dietary intervention for cardiovascular risk reduction in HIV dyslipidaemia: a study protocol

IntroductionHIV drug treatment has greatly improved life expectancy, but increased risk of cardiovascular disease remains, potentially due to the additional burdens of infection, inflammation and antiretroviral treatment. The Mediterranean Diet...

Evidence Supports the Use of Soy Protein to Promote Cardiometabolic Health and Muscle Development

Consumption of adequate amounts of dietary protein can help individuals maintain a healthy body composition, especially when combined with resistance exercise and during weight loss. It is well established that dietary protein intake supports muscle development and helps reduce loss of lean body mass during weight loss. Numerous studies have demonstrated the efficacy of soy protein intake for promoting fat loss while preserving muscle mass and supporting lean body mass gains. In fact, soy protein and animal-based proteins both support weight loss and weight maintenance equally as part of an energy-restricted diet; however, soy protein offers additional cardiometabolic advantages.Key teaching points:• Soy protein is a high-quality, plant-based protein that can be consumed throughout the life span.• More human clinical studies have been conducted to assess the cholesterol-lowering effects of soy protein than any other cholesterol-lowering food ingredient.• Ingestion of proteins with unique and complementary characteristics like soy, whey, and casein helps resistance-trained individuals achieve significant muscle growth.• Recent research supports the efficacy of consuming a combination of soy, whey, and casein after resistance exercise to extend the time period that muscle building occurs.

Effects of raw red onion consumption on metabolic features in overweight or obese women with polycystic ovary syndrome: A randomized controlled clinical trial

We aimed to evaluate the effects of raw red onion consumption on metabolic features in overweight and obese women with polycystic ovary syndrome. In this randomized controlled clinical trial, the patients (n=54) were randomly allocated to the intervention group as 'high-onion' (raw red onions: 2 × 40-50 g/day if overweight and 2 × 50-60 g/day if obese) or to the control group as 'low-onion' (raw red onions: 2 × 10-15 g/day) along with limited liliaceous vegetables for 8 weeks. Body mass index, dietary record, and metabolic parameters (fasting blood sugar, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and lipoprotein (a)) were evaluated in the follicular phase of the menstrual cycle at baseline and after 8 weeks. Hormonal variables (progesterone, prolactin, and 17-OH progesterone) were also measured at baseline. Onion significantly decreased the levels of total cholesterol within each group; however, these changes were stronger in the high-onion group (weighted mean differences [WMD]: -5.60 [95% confidence interval [CI]: -9.16, -2.03]; P=0.003) than in the low-onion group (WMD: -6.42 [95%CI: -11.97, -0.87]; P=0.025). Similarly, low-density lipoprotein cholesterol decreased significantly (WMD: -5.13 [95%CI: -9.46, -0.81); P=0.022) in the high-onion group, and (WMD: -2.90 [95%CI -5.57, -0.21]; P=0.035) in the low-onion group after treatment. The levels of fasting blood sugar, triglycerides, high-density lipoprotein cholesterol and lipoprotein (a) did not differ significantly after 8-week onion treatment. Adjustment for confounders did not make any significant changes in any of the parameters in post-treatment levels. Raw red onion consumption appears to be effective as a cholesterol-lowering food agent in women with polycystic ovary syndrome. However, further investigation is warranted.