Dietary Cholesterol Intake Research Articles

Relationship between dietary fats and serum antioxidants with atheromatic index in regular blood donors.

Nutritional choices, which include dietary fatty acids (FA), vitamins and sugars, have an important significant impact on the development of atheromatic index levels. Controversial opinions exist in the literature regarding the role of different fat types and their association with atheromatic index. We investigated the relationship between dietary intake with different atheromatic index groups of volunteer regular blood donors (rBDs) recognizing them as a healthy population excluding drug and supplements intake and we correlated their values with serum total antioxidant status (sTAS). 150 individuals used in this study were divided in 3 groups according to their atheromatic index (AI=Total cholesterol/HDL) (AI): Group 1 (AI<3.5) comprised of 50 rBDs, Group 2 (AI 3.5-4.49) of 52 rBDs and Group 3 of 48 rBDs (AI>4.5). Dietary intake was assessed using the 3 day food recall and the Food Processor, computer program for nutrient analysis. sTAS was measured in all samples and correlated with atheromatic index too. Our study showed that rBDs with low dietary intake of all vitamins, Ω3 fatty acids, trans fatty acids and dietary cholesterol presented an increased atheromatic index. On the other hand rBDs with high dietary intake of saturated fat, total fats, monounsaturated and polyunsaturated fats and sugar showed increased atheromatic index. In addition, groups with the higher atheromatic index presented statistically significant higher total antioxidant status. Trans FA are also positively associated with sTAS and on the other hand dietary cholesterol is negatively associated with sTAS and positively in groups B and C. The results of the present study showed that dietary intake of different types of fatty acids should be used separately as atheromatic index predictors. Moreover, sTAS is correlated with dietary intake of SFA, MUFA, PUFA, Cholesterol, Trans FA and sugar. Finally, the measurement of each fatty acid would be of great value for the screening of lipid metabolism disorders in atheromatic index control.

Dietary fatty acids and risk of Alzheimer's disease and related dementias: Observations from the Washington Heights-Hamilton Heights-Inwood Columbia Aging Project (WHICAP).

Introduction:High dietary intake of long chain, polyunsaturated fatty acids is associated with lower Alzheimer’s disease (AD) risk.Methods:Washington Heights-Hamilton Heights-Inwood Columbia Aging Project is a multiethnic, prospective observational study of aging and dementia among elderly (≥ 65 years). Dietary intake was measured using a food frequency questionnaire. Dietary short-, medium-, and long-chain fatty acid intakes were categorized by number of carbons and double bonds. Consensus AD diagnoses were made. Associations between AD risk and dietary fatty acid and cholesterol intakes were estimated using multivariable Cox proportional hazards regression models.Results:Of 2612 multiethnic women (67%) and men (baseline age 76.3 [6.4] years), 380 developed AD over an average 4.5 years follow-up. Lower risk of AD was associated with increasing intakes of docosahexaenoic acid (DHA; hazard ratio [HR] = 0.73, 95% confidence interval [CI]: 0.57 to 0.95, P = 0.018) and eicosapentaenoic acid (EPA; HR = 0.74, 95% CI: 0.57 to 0.95, P = 0.021), and longer AD-free survival (P < 0.05).Discussion:Higher intake of DHA and EPA are protective for AD.

Cholesterol as an Endogenous Ligand of ERRα Promotes ERRα-Mediated Cellular Proliferation and Metabolic Target Gene Expression in Breast Cancer Cells.

Breast cancer is the 2nd leading cause of cancer-related death among women. Increased risk of breast cancer has been associated with high dietary cholesterol intake. However, the underlying mechanisms are not known. The nuclear receptor, estrogen-related receptor alpha (ERRα), plays an important role in breast cancer cell metabolism, and its overexpression has been linked to poor survival. Here we identified cholesterol as an endogenous ligand of ERRα by purification from human pregnancy serum using a GST-ERRα affinity column and liquid chromatography-tandem mass spectrometry (LC-MS/MS). We show that cholesterol interacts with ERRα and induces its transcriptional activity in estrogen receptor positive (ER+) and triple negative breast cancer (TNBC) cells. In addition, we show that cholesterol enhances ERRα-PGC-1α interaction, induces ERRα expression itself, augments several metabolic target genes of ERRα, and increases cell proliferation and migration in both ER+ and TNBC cells. Furthermore, the stimulatory effect of cholesterol on metabolic gene expression, cell proliferation, and migration requires the ERRα pathway. These findings provide a mechanistic explanation for the increased breast cancer risk associated with high dietary cholesterol and possibly the pro-survival effect of statins in breast cancer patients, highlighting the clinical relevance of lowering cholesterol levels in breast cancer patients overexpressing ERRα.

Alteration of Serum Phospholipid n-6 Polyunsaturated Fatty Acid Compositions in Nonalcoholic Fatty Liver Disease in the Japanese Population: A Cross-Sectional Study.

We performed a cross-sectional study on 215 Japanese employees aged 20-68 years to investigate the association between NAFLD and serum phospholipid fatty acid composition. NAFLD was diagnosed by ultrasonography. The fatty acid composition between the control and NAFLD groups was compared, and the inverse probability of treatment weighting (IPTW) was performed to eliminate each confounding effect of sex, smoking status, BMI, insulin resistance, dietary cholesterol, and salt intake. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the NAFLD prediction accuracy of fatty acids. Seventy-one subjects were diagnosed with NAFLD. Their serum phospholipid dihomo-γ-linolenic acid (DGLA) level was significantly higher after adjusting for each variable using IPTW. In the ROC analysis, the ratio of ARA to DGLA had an area under the curve (AUC) of 0.763. By combining the ratio of ARA to DGLA with the ratio of AST to ALT, AUC increased to 0.871. In conclusion, NAFLD subjects in a Japanese working population have higher serum phospholipid DGLA. Results of the IPTW and ROC analysis indicated that serum PL DGLA and the ratio of ARA to DGLA provide diagnosis information on the fatty liver that is different to AST and ALT and improve the accuracy of fatty liver prediction, owning potential value as serum biomarkers.

Prevalence of Chronic Constipation and Irritable Bowel Syndrome, and their Overlap, among Female Undergraduate Students in Japan

Chronic constipation and irritable bowel syndrome (IBS) are two of the most common functional gastrointestinal disorders, both of which negatively affect the quality of life of the patients. Since people may have co-existing symptoms of multiple disorders, chronic constipation and IBS with predominant constipation cannot be clearly distinguished. In this cross-sectional study, data were obtained from self-administered questionnaires to assess the prevalence of chronic constipation and IBS, and their overlap, among female undergraduate students in Japan. We also assessed the participants’ mental status, physical activity, lifestyle, and dietary intake, each of which can influence chronic constipation and IBS. These parameters were assessed using a Japanese version of the hospital anxiety and depression scale, and an established semi-quantitative questionnaire available for clinical investigation (FFQg).Among the 131 participants, 9.2% had chronic constipation and 18.0% had IBS, while 2 (1.7%) participants had both constipation and IBS. Increased body mass index and higher dietary intake of protein (energy ratio), fat (energy ratio), cholesterol, animal protein (ratio), animal fat (ratio), and meat and eggs, and decreased carbohydrate energy ratio and vegetable fat ratio, were associated with chronic constipation. A state of anxiety tended to be associated with IBS, but in contrast to the results for chronic constipation, the dietary intake of the nutrients and types of food examined were not associated with IBS, except for the “snacks food group”. The results suggest that overlap between chronic constipation and IBS was not common, and that these two disorders had different clinical characteristics and backgrounds.

Dietary Intakes of Eggs and Cholesterol in Relation to All-Cause and Heart Disease Mortality: A Prospective Cohort Study.

BackgroundThe aim of this study was to identify associations between dietary intakes of eggs and cholesterol and all‐cause and heart disease mortality in a US population.Methods and ResultsData from the National Health and Nutrition Examination Survey 1999–2014 were used in this study, which included 37 121 participants ≥20 years of age. Dietary information was assessed via 24‐hour dietary recalls at baseline. Mortality status was documented until December 31, 2015. Cox proportional hazards models were used to examine the associations between dietary intakes of eggs and cholesterol and all‐cause and heart disease mortality. During a median follow‐up of 7.8 years, 4991 deaths were documented, including 870 deaths from heart disease. No significant association was observed between additional daily consumption of half an egg and all‐cause mortality (multivariable‐adjusted hazard ratio, 1.04; 95% CI, 0.96–1.13), or heart disease mortality (0.96; 0.80–1.14). Each 50‐mg/day increase of cholesterol intake was inversely associated with all‐cause mortality among participants with daily intake <250 mg (0.87; 0.77–0.98), but positively associated with all‐cause mortality among participants with daily intake ≥250 mg (1.07; 1.01–1.12). No significant association was found between dietary cholesterol intake and heart disease mortality.ConclusionsNo significant association was found between egg consumption and mortality in US adults. The association between dietary cholesterol intake and all‐cause mortality depended on the baseline intake levels, with an inverse association in those with lower intake levels (<250 mg/day) but a positive association in those with higher intake levels (≥250 mg/day).

Three Musketeers for Lowering Cholesterol: Statins, Ezetimibe and Evolocumab.

Coronary heart disease (CHD) is closely related to hypercholesterolemia, and lowering serum cholesterol is currently the most important strategy in reducing CHD. In humans, the serum cholesterol level is determined mainly by three metabolic pathways, namely, dietary cholesterol intake, cholesterol synthesis, and cholesterol degradation in vivo. An intervention that targets the key molecules in the three pathways is an important strategy in lowering serum lipids. Statins inhibit 3-hydroxyl-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase) to reduce low-density lipoprotein (LDL) by about 20% to 45%. However, up to 15% of patients cannot tolerate the potential side effects of high statin dosages, and several patients also still do not reach their optimal LDL goals after being treated with statins. Ezetimibe inhibits cholesterol absorption by targeting the Niemann-Pick C1-like 1 protein (NPC1L1), which is related to cholesterol absorption in the intestines. Ezetimibe lowers LDL by about 18% when used alone and by an additional 25% when combined with statin therapy. The proprotein convertase subtilisin/kexin type 9 (PCSK9) increases hepatic LDLR degradation, thereby reducing the liver's ability to remove LDL, which can lead to hypercholesterolemia. Evolocumab, which is a PCSK9 monoclonal antibody, can reduce LDL from baseline by 53% to 56%. The three drugs exert lipid-lowering effects by regulating the three key pathways in lipid metabolism. Combining any with the two other drugs on the basis of statin treatment has improved the lipid-lowering effect. Whether the combination of the three musketeers will reduce the side effects of monotherapy and achieve the lipid-lowering effect should be studied further in the future.

Dietary Cholesterol is Responsible for Statin-Induced Hepatic Toxicity in Experimental Hamsters and Chinese Cohort Studies

Background: Statins are the inhibitors of HMG-CoA reductase in cholesterol synthesis as widely used lipid-lowering drugs. The major side-effects of statins include muscle- and liver- related toxicity. Muscle-toxicity is highly associated with the polymorphism of CYP predictable by pharmacogenomics. However, the mechanisms of hepatotoxicity is not well understood. Due to the differences in cholesterol metabolism, statins are well tolerated in mice. In contrast, hamsters exhibit metabolic traits close to humans and would be suitable to study hepatotoxicity of statins. Methods: We investigated the effect of statins on liver damage in high cholesterol diet (HCD)-fed wild-type (WT) hamsters, LDLR knockout (LDLR -/- ) hamsters with spontaneous hypercholesterolemia. Two cohorts of clinical subjects (Clinical registry number: 2017001) on statins were recruited for direct (assessment of cholesterol intake individually, n=44) and indirect (party meal times/holiday season, n=1,993) examination of dietary cholesterol intake and liver damage indicated by elevation of ALT. Results: Statins at a dose of 10mg/kg caused fatal liver damage only in HCD-fed WT hamsters, while LDLR -/- hamsters with the same cholesterol levels were resistant to this toxic effect. In human studies, we observed that the incidence of hepatic toxicity in patients with a long-term statin treatment was higher in those who had more dietary cholesterol intake and in those who ate more during a Chinese holiday. Conclusions: Our results for the first time propose a hypothesis that dietary or exogenous, but not endogenous cholesterol, significantly contributes to the statin-related hepatotoxicity, then providing a valuable insight into the clinical use of statins. Funding: This project was supported by NSFC 31520103909 and 91739105 to G.L.; National KeyResearch and Development Program of China (2016YFE0126000), NSFC 81570787 and 81770449 to Y.W. G.L. is a fellow at the Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University. Declaration of Interest: The authors declare no conflict of interest. Ethical Approval: The study protocol was approved by the ethics committee of Shanxi Cardiovascular Hospital (Clinical registry number: 2017001), and the written informed consent was provided by each patient at the time of registration. All experimental procedures were conducted under the guide of Care and Use of Laboratory Animals published by the US National Institutes of Health (No.85Y23, revised 1996) and were approved by the Animal Care Committee of Peking University Health Science Center (LA2010-059)

Differences in Nutrient Intake and Diet Quality Between Non-Hispanic Black and Non-Hispanic White Men in the United States.

Non-Hispanic black (NHB) men have higher rates of chronic disease than men in other racial/ethnic groups. Poor diet quality is one risk factor for chronic disease, but research on the diet quality and nutrient intake of NHB men is sparse. The objective of this study was to describe and compare the diet quality and nutrient intake of NHB and non-Hispanic white (NHW) men in the United States. We analyzed cross-sectional data on 5050 men (31.3% NHB, 68.7% NHW) who participated in the National Health and Nutrition Examination Survey (NHANES) during 2007-2012. To assess diet quality, we calculated Healthy Eating Index (HEI)-2010 scores from each participant's 24-hour recall data. We used logistic regression models to determine if NHB men had lower odds of meeting dietary recommendations for nutrient intake than NHW men. We used linear regression models to identify significant differences in HEI-2010 scores between NHB and NHW men. After adjusting for sociodemographic measures, NHB and NHW men had similar diet quality (P = .59). Compared with NHW men, NHB men had lower odds of meeting recommendations for dietary fiber and cholesterol intake and higher odds of meeting recommendations for saturated fat and sodium intake. Differences between NHB and NHW men in the intake of certain nutrients may be related to chronic disease disparities. Future research should consider racial/ethnic differences in dietary intake among men and the impact these differences have on men's health.

Abstract P508: Association of Egg and Dietary Cholesterol Intake With Incident Cardiovascular Disease and All-cause Mortality

Introduction: The association of egg or dietary cholesterol intake with risk of cardiovascular disease (CVD) and overall mortality remains a topic of active debate. Hypothesis: Higher egg or dietary cholesterol intake is associated with elevated risk of CVD and all-cause mortality. Methods: We analyzed data from 96,755 women aged 50-79 years who were free of CVD and cancer at baseline (1993-1998)(Women’s Health Initiative). Baseline dietary data were collected using a validated food frequency questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals of CVD or mortality ascertained through February, 2018. Results: After multivariable adjustment (model 1 in Figure ), higher intakes of egg and dietary cholesterol both were associated with increased risk of CVD (HRs: 1.09 [1.06-1.13] for ½ eggs/day and 1.13 [1.09-1.17] for cholesterol intake of 100 mg/1000 Kcal/day) and all-cause mortality (HRs: 1.10 [1.07-1.12] for egg and 1.16 [1.12-1.19] for cholesterol intake). These associations persisted with further adjustment for other major food groups (e.g. red/processed meat) or nutrients (e.g. saturated fat), or for several potential intermediators (model 2 in Figure ). For both egg and cholesterol intakes, the positive associations with CVD were limited to obese individuals and the associations with all-cause mortality were more pronounced in individuals with diabetes (all P -interaction≤0.002). Among 9451 participants with blood cholesterol measurements, egg or cholesterol intake remained associated with increased CVD and mortality, and the associations were not altered by further adjustment for LDL and HDL cholesterol despite the expected associations of both lipid measures with CVD and mortality ( Figure ). Conclusions: A higher intake of eggs or dietary cholesterol was associated with higher risk of CVD in obese women and overall mortality predominantly in women diagnosed with diabetes. These associations appeared not attributable to blood cholesterol.

Targeted genotyping to identify potential functional variants associated with cholesterol content in bovine milk.

High blood cholesterol concentration, mainly caused by high dietary cholesterol, is a potential risk factor for human health. Dairy products are important sources of human dietary cholesterol intake. Therefore, monitoring bovine milk cholesterol concentration is important for human health benefit. Genetic selection for improvement of cow milk cholesterol content requires understanding of the genetics of milk cholesterol. For this purpose, we performed analyses of additive and dominance effects of 126 potentially functional SNPs within 43 candidate genes with milk cholesterol content [expressed as mg of cholesterol in 100g of fat (CHL_fat) or in 100mg of milk (CHL_milk)]. The additive and dominance effects of SNPs rs380643365 in AGPAT1 (P=0.04) and rs134357240 in SOAT1 (P=0.035) genes associated significantly with CHL_fat. Moreover, five (rs109326954 and rs523413537 in DGAT1, rs109376747 in LDLR, rs42781651 in FAM198B and rs109967779 in ACAT2) and four (rs137347384 in RBM19, rs109376747 in LDLR, rs42016945 in PPARG and rs110862179 in SCAP) SNPs were significantly associated with CHL_milk (P<0.05) based on additive and dominance effect analyses respectively. Rs109326954 and rs523413537 in DGAT1 explained a considerable portion of the phenotypic variance of CHL_milk (7.54 and 6.84% respectively), and might be useful in selection programs for reduced milk cholesterol content. Several significantly associated SNPs were in genes (such as ACAT2 and LDLR) involved in cholesterol metabolism in the liver or cholesterol transport, suggesting multiple mechanisms regulating milk cholesterol content. Nine and seven SNPs identified by additive or dominance effect analyses associated significantly with milk yield and fat yield respectively. Further analyses are required to better understand the consequences of these variants and their potential use in genomic selection of the studied traits.

Interplay of an Obesity-Based Genetic Risk Score with Dietary and Endocrine Factors on Insulin Resistance.

This study aimed to nutrigenetically screen gene-diet and gene-metabolic interactions influencing insulin resistance (IR) phenotypes. A total of 232 obese or overweight adults were categorized by IR status: non-IR (HOMA-IR (homeostatic model assessment - insulin resistance) index ≤ 2.5) and IR (HOMA-IR index > 2.5). A weighted genetic risk score (wGRS) was constructed using 95 single nucleotide polymorphisms related to energy homeostasis, which were genotyped by a next generation sequencing system. Body composition, the metabolic profile and lifestyle variables were evaluated, where individuals with IR showed worse metabolic outcomes. Overall, 16 obesity-predisposing genetic variants were associated with IR (p < 0.10 in the multivariate model). The wGRS strongly associated with the HOMA-IR index (adj. R squared = 0.2705, p < 0.0001). Moreover, the wGRS positively interacted with dietary intake of cholesterol (P int. = 0.002), and with serum concentrations of C-reactive protein (P int. = 0.008) regarding IR status, whereas a negative interaction was found regarding adiponectin blood levels (P int. = 0.006). In conclusion, this study suggests that interactions between an adiposity-based wGRS with nutritional and metabolic/endocrine features influence IR phenotypes, which could facilitate the prescription of personalized nutrition recommendations for precision prevention and management of IR and diabetes.

Longitudinal and nonlinear relations of dietary and Serum cholesterol in midlife with cognitive decline: results from EMCOA study

BackgroundPrevious studies regarding the cholesterol-cognition relationship in midlife have generated conflicting results. We thus investigated whether dietary and blood cholesterol were associated with cognitive decline.MethodsParticipants were drawn from a large cohort study entitled the Effects and Mechanism Investigation of Cholesterol and Oxysterol on Alzheimer’s disease (EMCOA) study. We included 2514 participants who completed a selection of comprehensive cognitive tests and were followed for an average of 2.3 years. Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were assessed and dietary intakes were investigated by food frequency questionnaire (FFQ) at baseline. Apolipoprotein E (APOE) was genotyped by Kompetitive Allele Specific PCR (KASP) sequencing. Non-high-density lipoprotein cholesterol (Non-HDL-C) and LDL-C/HDL-C ratio were calculated. The longitudinal effects of dietary and blood cholesterol on risk of global cognitive decline (decrease in Montreal Cognitive Assessment (MoCA) > 2 points) were examined using Cox proportional hazards models. The nonlinear associations with global and domain-specific cognitive decline was evaluated with mixed effect linear models.ResultsIn Cox proportional hazards models, neither cholesterol nor egg intake was associated with a higher risk of accelerated global cognitive decline. In contrast, the higher serum concentrations of TC, LDL-C, non-HDL-C and LDL-C/HDL-C ratio were positively associated with accelerated global cognitive decline regardless of being evaluated continuously or categorically while higher HDL-C was positively associated with accelerated global cognitive decline only when being evaluated categorically (all P < 0.05). In mixed effect linear models, quadratic and longitudinal relations of dietary cholesterol and egg intakes to global cognition, processing speed and executive function were observed. Moreover, there were inverted U-shaped relations of HDL-C, with processing speed and executive function but U-shaped relations of HDL-C and LDL-C/HDL-C ratio with verbal memory. Adverse linear associations of higher LDL-C and LDL-C/HDL-C ratio with multiple cognitive comes were also revealed. Additionally adjusting for APOE genotype did not modify cholesterol-cognition associations. Dietary and serum cholesterol had variable associations with global and domain-specific cognitive decline across educational groups.ConclusionDifferential associations between dietary/serum cholesterol and cognitive decline across different domains of function were observed in a particular population of middle-aged and elderly Chinese. Interventions to improve cognitive reserve regarding dietary instruction and lipid management should be tailored according to specific target.Trial registrationEMCOA, ChiCTR-OOC-17011882, Registered 5th, July 2017-Retrospectively registered, http://www.medresman.org/uc/project/projectedit.aspx?proj=2610

Threshold-Effect Association of Dietary Cholesterol Intake with Dyslipidemia in Chinese Adults: Results from the China Health and Nutrition Survey in 2015

The association of dietary cholesterol intake with dyslipidemia and subtypes is controversial. This study aimed to examine the association of dietary cholesterol intake with dyslipidemia and subtypes in Chinese adults. Using data from the China Health and Nutrition Survey (CHNS) in 2015, the present study selected 4383 participants aged 18–59 years who were free of diabetes, apoplexy, and myocardial infarction disease. Information was obtained on dietary intake, anthropometric measurements, and blood laboratory measurements. Dietary cholesterol intake was calculated based on the data collected by consecutive 3 days 24 h recalls combined with the weighing of household seasonings and categorized by 11 levels: The first 10 levels in ranges of 50 mg/day and the 11th level at ≥500 mg/day. Dyslipidemia, hypercholesterolemia, hypertriglyceridemia, low-density lipoprotein (LDL)-hypercholesterolemia, and high-density lipoprotein (HDL)-hypocholesterolemia were defined based on the Chinese adult dyslipidemia prevention guide (2016 edition). Multivariable logistic regressions were performed to examine the association of dietary cholesterol intake levels with dyslipidemia and subtypes. The prevalence of dyslipidemia was 37.5% among Chinese adults in 2015 (hypercholesterolemia 9.6%, HDL-hypocholesterolemia 21.1%, LDL-hypercholesterolemia 12.7%, and hypertriglyceridemia 15.2%). The lowest prevalence of hypercholesterolemia and LDL-hypercholesterolemia was 6.7% and 9.4%, respectively, which was relative to a dietary cholesterol intake level of 100.0 to <150.0 mg/day. After adjusting for all potential confounders, adults with the highest dietary cholesterol intake level of ≥500 mg/day compared with the dietary cholesterol intake of 100.0 to <150.0 mg/day showed one-time higher odds of hypercholesterolemia (odds ratios (OR) 2.0, 95% confidence intervals (CI) 1.3–3.3), as well as LDL-hypercholesterolemia (OR 2.0, 95% CI 1.3–3.0), but a null association of dietary cholesterol intake with dyslipidemia, hypertriglyceridemia, and HDL-hypocholesterolemia. The study suggested that a dietary cholesterol intake level of 500 mg/day and above may be a threshold point for high odds of hypercholesterolemia and LDL-hypercholesterolemia.

Low Carbohydrate and Low-Fat Diets: What We Don't Know and Why we Should Know It.

In the 1940s, the diet-heart hypothesis proposed that high dietary saturated fat and cholesterol intake promoted coronary heart disease in “at-risk” individuals. This hypothesis prompted federal recommendations for a low-fat diet for “high risk” patients and as a preventive health measure for everyone except infants. The low carbohydrate diet, first used to treat type 1 diabetes, became a popular obesity therapy with the Atkins diet in the 1970s. Its predicted effectiveness was based largely on the hypothesis that insulin is the causa prima of weight gain and regain via hyperphagia and hypometabolism during and after weight reduction, and therefore reduced carbohydrate intake would promote and sustain weight loss. Based on literature reviews, there are insufficient randomized controlled inpatient studies examining the physiological significance of the mechanisms proposed to support one over the other. Outpatient studies can be confounded by poor diet compliance such that the quality and quantity of the energy intake cannot be ascertained. Many studies also fail to separate macronutrient quantity from quality. Overall, there is no conclusive evidence that the degree of weight loss or the duration of reduced weight maintenance are significantly affected by dietary macronutrient quantity beyond effects attributable to caloric intake. Further work is needed.

Effects of dietary inclusion of soybean meal and cholesterol on the growth, cholesterol status and metabolism of the giant grouper (Epinephelus lanceolatus)

The study evaluated effects of cholesterol supplementation in a diet with high soybean meal (SBM) on the growth and cholesterol metabolism of giant grouper (Epinephelus lanceolatus). All‐fish‐meal diet was used as control. The diet including SBM (replaced 50% of the fish meal protein, SBM diet) and the SBM diet supplemented with 10 g/kg cholesterol (SBM + cholesterol) were used as experimental diets. Three diets were each fed to triplicate groups of juvenile grouper (initial body weight: 12.39 ± 0.36 g) in a recirculating aquaculture system for 8 weeks. Grouper fed the control diet showed higher (p < .05) weight gain, feed intake, feed efficiency and protein efficiency ratio than the other two dietary treatments. Hepatic cholesterol concentrations and 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase gene expressions were higher in fish fed the control diet than fish fed the control diet and SBM + cholesterol diet. Hepatic cholesterol 7α‐hydroxylase gene expression was higher in fish fed the SBM + cholesterol diet than that in fish fed the control diet. Results indicate that giant grouper on a diet low in cholesterol can regulate cholesterol synthesis, suggesting that the reduced dietary cholesterol intake in the fish fed diet containing SBM is sufficiently compensated by increased cholesterol synthesis.

Dietary Quality Varies Among Adults on the Flathead Nation of the Confederated Salish and Kootenai Tribes in Montana.

Diet-related chronic disease is among the most pressing public health issues and represents a health disparity among Native American communities. A community-based participatory approach was taken to evaluate dietary quality of adult residents of the Flathead Reservationof the Confederated Salish & Kootenai Tribes in Montana (the Flathead Nation). A survey was administered to collect basic demographic information and food security status (N = 80). Dietary quality was assessed using the 24-h dietary recall method with subsequent calculation of Healthy Eating Index 2010 (HEI-2010) scores, modified HEI without a dairy category, and the Dietary Diversity Scores (DDS). Participants included 80 adults from different households across eight communities (n = 10 per community) at the Flathead Nation. Approximately 50% of participants reported low or very low food security status while the remainder scored high or marginal food security. The mean total HEI-2010 score of study participants was 45.5 out of 100 points with a range between 20.0 and 78.1. The mean DDS of study participants was 4.6 (± 1.365) out of a total of 9 points. Participants with higher DDS had significantly higher intake of dietary fiber (p < 0.0003), potassium (0.0024), and cholesterol (p < 0.0048) compared to the lower DDS group. No significant correlations were found between HEI-2010 scores with DDS, demographic information, or food security status while significant differences were found between food security status and income (p < 0.01) and enrollment in nutrition assistance programs (p < 0.03). This study highlights the need to evaluate multiple parameters of dietary quality coupled with a community-based participatory approach in order for findings to be culturally relevant and support food and nutrition interventions.

Liver X Receptors Regulate Cholesterol Metabolism and Immunity in Hepatic Nonparenchymal Cells.

Excess dietary cholesterol intake and the dysregulation of cholesterol metabolism are associated with the pathogenesis and progression of nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and fibrosis. Hepatic accumulation of free cholesterol induces activation of nonparenchymal cells, including Kupffer cells, macrophages, and hepatic stellate cells, which leads to persistent inflammation and fibrosis. The nuclear receptors liver X receptor α (LXRα) and LXRβ act as negative regulators of cholesterol metabolism through the induction of hepatocyte cholesterol catabolism, excretion, and the reverse cholesterol transport pathway. Additionally, LXRs exert an anti-inflammatory effect in immune cell types, such as macrophages. LXR activation suppresses acute hepatic inflammation that is mediated by Kupffer cells/macrophages. Acute liver injury, diet-induced steatohepatitis, and fibrosis are exacerbated by significant hepatic cholesterol accumulation and inflammation in LXR-deficient mice. Therefore, LXRs regulate hepatic lipid metabolism and immunity and they are potential therapeutic targets in the treatment of hepatic inflammation that is associated with cholesterol accumulation.

Association of dietary lipid intake with low-density lipoprotein cholesterol levels: analysis of two independent population-based studies.

Serum low-density lipoprotein cholesterol (LDL-C) concentration is associated with the risk of cardiovascular disease. However, whether cholesterol and fat intake independently affect serum LDL-C levels remains controversial. We aimed to explore the differential effects of dietary cholesterol and fats on blood lipid profiles according to the presence of dyslipidemia. A cross-sectional study was conducted based on data from the sixth Korean National Health and Nutrition Examination Survey (2013-2015), and a prospective cohort study was conducted using data from the Korean Genome Epidemiology Study. The analyses used data from 10,068 adults and from 9652 adults, respectively. Adjusted mean values of blood lipids were calculated according to cholesterol and fat intake using analysis of covariance. A repeated-measures covariance pattern linear mixed model with unstructured covariance within participants was used to examine longitudinal associations between cholesterol intake and serum concentrations of total cholesterol and LDL-C. Substitutional analysis was conducted to estimate carbohydrate substitution with saturated fat or unsaturated fat. Serum LDL-C level was significantly higher in dyslipidemic subjects who consumed more than 300mg cholesterol per day than in those who consumed less than 300mg cholesterol per day. At a mean 9-year follow-up, levels of total cholesterol and LDL-C were significantly higher in dyslipidemic individuals with higher baseline cholesterol intake after adjustment for potential confounders. In regard to dietary fats, replacing carbohydrate with unsaturated fat was associated with lower level of LDL-C in subjects with dyslipidemia. Serum LDL-C is associated with the intake of dietary cholesterol, especially in individuals with dyslipidemia.

The prevalence of food addiction and its associations with plasma oxytocin level and anthropometric and dietary measurements in Iranian women with obesity

Obesity is a prevalent public health problem, and food addiction (FA) is one of the most controversial factors in its management. Therefore, this study was designed to validate an FA questionnaire for Iranian women with obesity and to determine the prevalence of FA and its associations with plasma oxytocin (OT) levels as well as anthropometric and dietary measurements.In this descriptive-analytical study, 450 adult women with obesity were included. The prevalence of FA was determined with a valid Yale food addiction scale (YFAS). Macronutrient intakes were measured by a valid semi-quantitative food frequency questionnaire (FFQ). In addition, plasma OT was measured after eight hours of fasting. In this study, the prevalence of FA was 26.2% in women with obesity. In comparison with class I obesity, the odds ratios (95% CI) of FA for class II and class III obesity were 2.5 (CI: 1.29–5.09) and 3.3 (CI: 1.69–6.4) respectively. Dietary intakes of energy, protein, carbohydrate, fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were significantly higher in food-addicted (FAD) women compared to non-food-addicted (NFA) ones (p < 0.001). Moreover, plasma OT level was lower in FAD women with obesity than in NFA subjects (p = 0.02).In conclusion, the results of this study indicate that FA is prevalent in Iranian women with obesity. In addition, FA is related to obesity severity, dietary intakes of energy, carbohydrate, protein, fat, cholesterol, and plasma OT level.