Postprandial Flow-mediated Dilation Research Articles

Anthocyanins attenuate vascular and inflammatory responses to a high fat high energy meal challenge in overweight older adults: A cross-over, randomised, double-blind clinical trial

Postprandial metabolic imbalances are important indicators of later developing cardiovascular disease (CVD)(1). This study investigated the effects of food anthocyanins on vascular and microvascular function, and CVD associated biomarkers following a high fat high energy (HFHE) meal challenge in overweight older adults. Sixteen subjects (13 female, 3 male, mean age 65.9 SD 6.0 and body mass index 30.6 kg/m 2 SD 3.9) participated in a crossover, randomised, controlled, double-blind clinical trial (Australian New Zealand Clinical Trials Registry # ACTRN12620000437965). Participants consumed a HFHE breakfast meal (65g total fat; 33g saturated fat) together with a 250 mL dose of either intervention (Queen Garnet Plum providing 201 mg anthocyanins) or control (apricot) juice. A wash-out period of 14 days occurred between meal challenges, with a 4-day run-in period for juice consumption before each challenge. Blood samples and blood pressure measures were collected at baseline, 2 h and 4 h following the HFHE meal. Vascular function, assessed using flow mediated dilatation (FMD), and microvascular cutaneous vascular reactivity, measured using Laser Speckle Contrast Imaging (LSCI), were evaluated at baseline and 2 h after the HFHE meal. Participants had a higher 2 h postprandial FMD (+1.14%) and a higher microvascular post-occlusive reactive hyperaemia (+0.10 perfusion units per mmHg) when allocated to the anthocyanin compared to the control arm (P = 0.019 and P = 0.049, respectively). C-reactive protein was lower 4 h postprandially in the anthocyanins (1.80 mg/L, IQR 0.90) vs control arm (2.30 mg/L, IQR 1.95) (P = 0.026), accompanied by a trend for lower concentrations of interleukin-6 (P = 0.075). No significant postprandial differences were observed between treatments for blood pressure, triacylglycerol, total cholesterol, serum derivatives of reactive oxidative metabolites, tumor necrosis factor α, interleukin-1 β, or maximum microvascular perfusion following iontophoresis of acetylcholine. Fruit-based anthocyanins attenuated the potential postprandial detrimental effects of a HFHE challenge on parameters of vascular and microvascular function, and inflammatory biomarkers in overweight older adults. Anthocyanins may reduce cardiovascular risk associated with endothelial dysfunction and inflammatory responses to a typical high fat ‘Western’ meal.

Improving the Effects of Imeglimin on Endothelial Function: A Prospective, Single-Center, Observational Study.

Endothelial dysfunction is a risk factor for cardiovascular disease in patients with diabetes. We hypothesized that imeglimin, a novel oral hypoglycemic agent, would improve endothelial function. In this study, imeglimin was administered to patients with type2 diabetes and HbA1c ≥ 6.5% who were not receiving insulin therapy. A meal tolerance test (592kcal, glucose 75.0g, fat 28.5g) was performed before and 3months after administration, and endothelial function, blood glucose, insulin, glucagon, and triglycerides were evaluated. Endothelial function was assessed by flow-mediated dilation (FMD). Twelve patients (50% male) with a median age of 55.5years old (interquartile range [IQR] 51.3-66.0) were enrolled. Fasting FMD did not differ before or 3months after imeglimin administration (from 6.1 [3.9-8.5] to 6.6 [3.9-9.0], p = 0.092), but 2h postprandial FMD was significantly improved 3months after imeglimin administration (from 2.3 [1.9-3.4] to 2.9 [2.4-4.7], p = 0.013). In terms of the glucose profile, imeglimin administration significantly improved HbA1c (from 7.2 ± 0.6% to 6.9 ± 0.6%, p = 0.007), fasting glucose (from 138 ± 19mg/dL to 128 ± 20mg/dL, p = 0.020), and 2h postprandial glucose (from 251 ± 47mg/dL to 215 ± 68mg/dL, p = 0.035). The change in 2h postprandial FMD between before and 3months after imeglimin administration (Δ2h postprandial FMD) was negatively correlated with Δ2h postprandial glucose (r = - 0.653, p = 0.021) in a univariate correlation coefficient analysis. Both patients with and without decreased postprandial glucose 3months after imeglimin administration had improved postprandial FMD. In this small study, imeglimin administration improved 2h postprandial FMD. Both glycemic control-dependent and -independent mechanisms might contribute to improved endothelial function. This research was registered in the University Hospital Medical Information Network (UMIN, UMIN000046311).

A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis

ABSTRACTBackgroundEndothelial dysfunction is a predictive risk factor for the development of atherosclerosis and is assessed by flow-mediated dilation (FMD). Although it is known that NO-dependent endothelial dysfunction occurs after consuming a high-fat meal, the magnitude of the effect and the factors that affect the response are unquantified.ObjectivesWe conducted a systematic review and meta-analysis exploring the quantitative effects of a single high-fat meal on endothelial function and determined the factors that modify the FMD response.MethodsSix databases were systematically searched for original research published up to January 2022. Eligible studies measured fasting and postprandial FMD following consumption of a high-fat meal. Meta-regression was used to analyze the effect of moderator variables.ResultsThere were 131 studies included, of which 90 were suitable for quantitative meta-analysis. A high-fat meal challenge transiently caused endothelial dysfunction, decreasing postprandial FMD at 2 hours [−1.02 percentage points (pp); 95% CI: −1.34 to −0.70 pp; P < 0.01; I2 = 93.3%], 3 hours [−1.04 pp; 95% CI: −1.48 to −0.59 pp; P < 0.001; I2 = 84.5%], and 4 hours [−1.19 pp; 95% CI: −1.53 to −0.84 pp; P < 0.01; I2 = 94.6%]. Younger, healthy-weight participants exhibited a greater postprandial reduction in the FMD percentage change than older, heavier, at-risk groups after a high-fat meal ( P < 0.05). The percentage of fat in the meals was inversely associated with the magnitude of postprandial changes in FMD at 3 hours (P < 0.01).ConclusionsA single, high-fat meal adversely impacts endothelial function, with the magnitude of the impact on postprandial FMD moderated by the fasting FMD, participant age, BMI, and fat content of the meal. Recommendations are made to standardize the design of future postprandial FMD studies and optimize interpretation of results, as high-fat meals are commonly used in clinical studies as a challenge to assess endothelial function and therapeutics. This trial was registered at PROSPERO as CRD42020187244.

Postprandial triglycerides, endothelial function, and inflammatory cytokines as potential candidates for early risk detection in normal-weight obesity

ProblemNormal-weight obesity (NWO) is associated with increased cardiovascular disease (CVD) risk. However, NWO’s clinical presentation is often unremarkable based on common risk factors. We examined whether CVD risk factors not routinely measured clinically including postprandial triglycerides, flow-mediated dilation (FMD), and inflammatory cytokines would be abnormal in NWO, consistent with their future risk. MethodsIndividuals were recruited into 3 groups (n = 10/ group): controls (Con), NWO, and metabolic syndrome (MetS). Con was defined as a normal body mass index (BMI), < 25% (M) or < 35% (F) body fat, and < 1 International Diabetes Federation (IDF) criteria. NWO were above this body fat cutoff while maintaining a normal BMI and MetS was defined per the IDF. Participants underwent an abbreviated fat tolerance test (i.e., difference in fasting and 4 h triglycerides following a high-fat meal [9 kcal/kg; 73% fat)] and fasting and postprandial lipid and glucose metrics, as well as FMD were measured. A T cell cytokine bioplex was also performed using fasting serum. ResultsNWO and MetS had similar body fat% and both were higher than Con (p < 0.0001). Despite having similar fasting triglycerides to Con, NWO had 4-hour triglycerides 66% greater than Con, but 46% lower than MetS (p < 0.01). FMD decreased in all groups after the high-fat meal (p < 0.0001). MetS displayed lower fasting FMD than Con, and NWO was similar to both groups (p < 0.05). No group differences were observed with postprandial FMD and the majority of fasting cytokines assessed. However, MetS exhibited higher fasting TNF-α than Con (p < 0.05), and NWO was similar to both groups. ConclusionsOverall, NWO was associated with higher postprandial triglycerides than Con, but displayed little evidence of impaired vascular health or inflammation.

Effect of heat-moisture treated brown rice crackers on postprandial flow-mediated dilation in adults with mild endothelial dysfunction

BackgroundEndothelial dysfunction is an early pathophysiological feature and independent predictor of a poor prognosis in most forms of cardiovascular disease. We evaluated the effect of brown rice crackers (BR-C) on endothelial function. MethodsEffect of heat-moisture treated (HMT) -BR-C on postprandial flow-mediated dilation (FMD) in adults with mild endothelial dysfunction was compared with that of BR-C and white rice crackers (WR-C) in 12 adults with mild endothelial dysfunction (less than 7.0% of FMD) by a randomized, single-blind, three-treatment three-period crossover trial (UMIN 000034898). Since we considered that the FMD increase was associated with the treatment of HMT-BR-C, we examined the effect of three possible factors: postprandial glucose levels, polyphenol content, and polyphenol release from the food matrix. ResultsMean pre-intake baseline FMD values of HMT-BR-C, BR-C, and WR-C were 4.9%, 5.1%, and 4.9%, respectively, and those values 1 h post-intake were 6.3%, 5.1%, and 4.8%, respectively. There was no difference in intergroup comparisons of FMD using Dunnett's multiple comparison test. There was a significant increase in FMD only in HMT-BR-C in intragroup comparisons (P = 0.042 by paired-t test). In comparison with BR-C, no significant difference was noted in the postprandial glucose level nor in the content of total polyphenols and ferulic acid derivatives in HMT-BR-C. However, the 70% ethanol extracted from HMT-BR-C contained a significantly larger amount of free and bound ferulic acids than from BR-C. ConclusionHMT-BR-C intake increased the postprandial FMD response.

Effect of fat-reformulated dairy food consumption on postprandial flow-mediated dilatation and cardiometabolic risk biomarkers compared with conventional dairy: a randomized controlled trial

ABSTRACTBackgroundLonger-term consumption of SFA-reduced, MUFA-enriched dairy products has been reported to improve fasting flow-mediated dilatation (FMD). Yet, their impact on endothelial function in the postprandial state warrants investigation.ObjectivesThe aim was to compare the impact of a fatty acid (FA) modified with a conventional (control) dairy diet on the postprandial %FMD (primary outcome) and systemic cardiometabolic responses to representative meals, and retrospectively explore whether treatment effects differ by apolipoprotein E (APOE) or endothelial NO synthase (eNOS) Glu298Asp gene polymorphisms.MethodsIn a crossover-design randomized controlled study, 52 adults with moderate cardiovascular disease risk consumed dairy products [38% of total energy intake (%TE) from fat: FA-modified (target: 16%TE SFAs; 14%TE MUFAs) or control (19%TE SFAs; 11%TE MUFAs)] for 12 wk, separated by an 8-wk washout. Blood sampling and FMD measurements (0–480 min) were performed pre- and postintervention after sequential mixed meals that were representative of the assigned dairy diets (0 min, ∼50 g fat; 330 min, ∼30 g fat).ResultsRelative to preintervention (∆), the FA-modified dairy diet and meals (treatment) attenuated the increase in the incremental AUC (iAUC), but not AUC, for the %FMD response observed with the conventional treatment (–135 ± 69% vs. +199 ± 82% × min; P = 0.005). The ∆ iAUC, but not AUC, for the apoB response decreased after the FA-modified treatment yet increased after the conventional treatment (–4 ± 3 vs. +3 ± 3 mg/mL × min; P = 0.004). The ∆ iAUC decreased for plasma total SFAs (P = 0.003) and trans 18:1 (P < 0.0001) and increased for cis-MUFAs (P < 0.0001) following the conventional relative to the FA-modified treatment. No treatment × APOE or eNOS genotype interactions were evident for any outcome.ConclusionsThis study provides novel insights into the longer-term effects of FA-modified dairy food consumption on postprandial cardiometabolic responses.

Abstract 10758: Individuals with Normal-Weight Obesity Exhibit Higher Postprandial Triglycerides, but Similar Endothelial Function and Inflammation Compared to Normal-Weight Controls

Introduction: Normal-weight obesity (NWO) is defined as having a normal BMI yet high body fat % and is linked to increased cardiovascular disease (CVD) risk. However, the current understanding of NWO’s risk profile is incomplete and, in many cases, their clinical presentation is arguably unremarkable based on common risk factors. Hypothesis: We hypothesized that other indictors of CVD risk such as postprandial triglycerides (TG), flow-mediated dilation (FMD), and inflammatory cytokines would be elevated in NWO, consistent with their future CVD risk. Methods: Individuals were recruited into 3 groups (n = 10/ group): healthy controls (Con), NWO, and metabolic syndrome (MetS) based on results from a fasting metabolic panel, blood pressure, and DEXA. All participants underwent an abbreviated fat tolerance test where fasting TG were measured, a high-fat shake was consumed (9 kcal/kg; 73% fat), and then TG measured again 4 hrs later. Brachial FMD was measured during the fasted state and postprandially, and a high-sensitivity T cell cytokine bioplex (Millipore; Burlington, MA) was performed with fasting serum. Data were analyzed using one-way ANOVA followed by Fisher’s LSD. Results: NWO and MetS had similar body fat % and both were higher than Con ( p &lt; 0.01). All groups differed with respect to visceral adipose tissue mass, with MetS &gt; NWO &gt; Con ( p &lt; 0.01). Despite having similar fasting TG to Con, NWO (122.5 ± 46.4 mg/dL) had 4-hr TG intermediate to Con (73.7 ± 13.9 mg/dL) and MetS (178.3 ± 76.4 mg/dL; p &lt; 0.01). Across the entire sample, FMD decreased ( p &lt; 0.01) after the high-fat meal. MetS (3.3 ± 1.2 %) displayed lower fasting FMD than Con (5.1 ± 1.1 %), and NWO (4.5 ± 2.0 %) was similar to both groups ( p &lt; 0.05). No group differences were observed with postprandial FMD. The majority of cytokines assessed were not different across groups. However, MetS (7.8 ± 2.1 pg/mL) exhibited higher TNF-α than Con (4.8 ± 1.9 pg/mL; p &lt; 0.05), and NWO (6.6 ± 3.4 pg/mL) was not different from either group. Conclusions: In conclusion, NWO was associated with higher postprandial TG than Con, but displayed little evidence of impaired vascular health or inflammation. MetS had the greatest 4-hr TG, as well as impaired vascular function and signs of inflammation compared to Con.

Supplemental Watermelon Juice Attenuates Acute Hyperglycemia-Induced Macro-and Microvascular Dysfunction in Healthy Adults

BackgroundAcute hyperglycemia reduces NO bioavailability and causes macro- and microvascular dysfunction. Watermelon juice (WMJ) is a natural source of the amino acid citrulline, which is metabolized to form arginine for the NO cycle and may improve vascular function. ObjectivesWe examined the effects of 2 weeks of WMJ compared to a calorie-matched placebo (PLA) to attenuate acute hyperglycemia-induced vascular dysfunction. MethodsIn a randomized, placebo-controlled, double-blind, crossover trial, 6 men and 11 women (aged 21–25; BMI, 23.5 ± 3.2 kg/m2) received 2 weeks of daily WMJ (500 mL) or a PLA drink followed by an oral-glucose-tolerance test. Postprandial flow-mediated dilation (FMD) was measured by ultrasound (primary outcome), while postprandial microvascular blood flow (MVBF) and ischemic reperfusion were measured by near-infrared spectroscopy (NIRS) vascular occlusion test (VOT). ResultsThe postprandial FMD area AUC was higher after WMJ supplementation compared to PLA supplementation (838 ± 459% · 90 min compared with 539 ± 278% · 90 min; P = 0.03). The postprandial MVBF (AUC) was higher (P = 0.01) following WMJ supplementation (51.0 ± 29.1 mL blood · 100 mL tissue–1 · min–1 · 90 min) compared to the PLA (36.0 ± 20.5 mL blood · 100 mL tissue–1 · min–1 · 90 min; P = 0.01). There was a significant treatment effect (P = 0.048) for WMJ supplementation (71.2 ± 1.5%) to increase baseline tissue oxygen saturation (StO2%) when compared to PLA (65.9 ± 1.7%). The ischemic-reperfusion slope was not affected by WMJ treatment (P = 0.83). ConclusionsTwo weeks of daily WMJ supplementation improved FMD and some aspects of microvascular function (NIRS-VOT) during experimentally induced acute hyperglycemia in healthy adults. Preserved postprandial endothelial function and enhanced skeletal muscle StO2% are likely partially mediated by increased NO production (via citrulline conversion into arginine) and by the potential antioxidant effect of other bioactive compounds in WMJ.

Postprandial Triglycerides, Flow-Mediated Dilation, and the Inflammatory Cytokine Milieu in Metabolically Healthy Obesity: A Cross-Sectional Pilot Study

The cardiovascular disease (CVD) risk of metabolically healthy obesity (MHO) remains controversial. We sought to further characterize the CVD risk profile in MHO by evaluating postprandial triglycerides, vascular function, and systemic inflammatory markers. Control individuals that were normal-weight and metabolically healthy (Con), MHO, and metabolic syndrome (MetS) were recruited (n = 10–11/group). Each participant underwent an abbreviated fat tolerance test, fasting and postprandial flow-mediated dilation (FMD), and had a panel of inflammatory cytokines measured. MHO displayed postprandial triglycerides similar to those in Con and both MHO and Con had lower values than those for MetS (p &lt; 0.01). Fasting FMD was lower in MHO and MetS compared to that of Con (p &lt; 0.01), but during the postprandial period the vasodilatory response of MHO was similar to that while fasting (p = 0.39), while FMD in Con and MetS decreased after the high-fat meal (p values &lt; 0.01). MHO displayed a number of inflammatory cytokines greater than those of Con and MetS (all p values &lt; 0.05), while MetS and MHO had higher TNF-α than did Con (p &lt; 0.05). In conclusion, MHO was associated with lower fasting FMD and a greater inflammatory burden but did not suffer the same negative postprandial effects as did MetS.

A Single High Fat Meal Adversely Affects Postprandial Endothelial Function: A Systematic Review and Meta-Analysis

Abstract Objectives High-fat diets are associated with endothelial dysfunction, the first step in the progression to atherosclerosis and cardiovascular disease. We aimed to determine the postprandial endothelial response (flow-mediated dilation (FMD)) to a high-fat meal in various populations and define how the response varies by conducting a systematic review of the literature. Methods Six electronic databases were systematically searched for original research published from database inception to May 2020. Eligible studies measured both fasting and postprandial FMD following consumption of a meal containing ≥ 30 g fat or ≥ 40% energy from fat. A random-effects model was used to analyse the pooled effect size change from the fasting FMD, presented as mean difference. Moderator variables were analysed by meta-regression. Results One-hundred and twenty articles reporting on 3821 adults were included in the review. High fat meal consumption significantly attenuated FMD at 2 hours (MD: −1.61; 95% CI −2.02 −1.19, p &amp;lt; 0.001), 3 hours (−1.73; −2.30 −1.17, p &amp;lt; 0.001) and 4 hours (−1.54; −1.88 −1.20, p &amp;lt; 0.001), though heterogeneity (I2) was &amp;gt; 90%. Meta-regression revealed that fasting FMD significantly impacted the reported effect size (p &amp;lt; 0.0001) at all postprandial timepoints. Age and BMI were inversely correlated with FMD response at 2 and 4 hours (p &amp;lt; 0.0001). Conclusions Younger, healthy-weight participants exhibited a larger postprandial reduction in FMD compared to older, heavier groups after a high-fat meal. Vulnerable populations could be more likely to exhibit endothelial dysfunction, as evident through lower fasting FMD, together with impaired metabolic flexibility. A single high fat meal adversely impacts endothelial function and the magnitude of the impact on postprandial FMD was influenced by fasting FMD, participant age, and BMI. Funding Sources Monash University

Postprandial Fatty Acid Profile, but Not Cardiometabolic Risk Markers, Is Modulated by Dairy Fat Manipulation in Adults with Moderate Cardiovascular Disease Risk: The Randomized Controlled REplacement of SaturatEd fat in dairy on Total cholesterol (RESET) Study.

ABSTRACTBackgroundChronic consumption of dairy products with an SFA-reduced, MUFA-enriched content was shown to impact favorably on brachial artery flow-mediated dilatation (FMD). However, their acute effect on postprandial cardiometabolic risk biomarkers requires investigation.ObjectiveThe effects of sequential high-fat mixed meals rich in fatty acid (FA)–modified or conventional (control) dairy products on postprandial FMD (primary outcome) and systemic cardiometabolic biomarkers in adults with moderate cardiovascular risk (≥50% above the population mean) were compared.MethodsIn a randomized crossover trial, 52 participants [mean ± SEM age: 53 ± 2 y; BMI (kg/m2) 25.9 ± 0.5] consumed a high-dairy-fat breakfast (0 min; ∼50 g total fat: modified: 25 g SFAs, 20 g MUFAs; control: 32 g SFAs, 12 g MUFAs) and lunch (330 min; ∼30 g total fat; modified: 15 g SFAs, 12 g MUFAs; control: 19 g SFAs, 7 g MUFAs). Blood samples were obtained before and until 480 min after breakfast, with FMD assessed at 0, 180, 300, and 420 min. Data were analyzed by linear mixed models.ResultsPostprandial changes in cardiometabolic biomarkers were comparable between the different dairy meals, with the exception of a tendency for a 4% higher AUC for the %FMD response following the modified-dairy-fat meals (P = 0.075). Plasma total lipid FA analysis revealed that incremental AUC responses were 53% lower for total SFAs, 214% and 258% higher for total cis-MUFAs (predominantly cis-9 18:1), and trans-18:1, respectively, following the modified relative to the control dairy meals (all P < 0.0001).ConclusionsIn adults at moderate cardiovascular risk, acute consumption of sequential high-fat meals containing FA-modified dairy products had little impact on postprandial endothelial function or systemic cardiometabolic biomarkers, but a differential effect on the plasma total lipid FA profile, relative to conventional dairy fat meals.This trial was registered at clinicaltrials.gov as NCT02089035.

Anthocyanins attenuate vascular and inflammatory responses to a high fat high energy meal challenge in overweight older adults: A cross-over, randomized, double-blind clinical trial

Postprandial metabolic imbalances are important indicators of later developing cardiovascular disease (CVD). This study investigated the effects of food anthocyanins on vascular and microvascular function, and CVD associated biomarkers following a high fat high energy (HFHE) meal challenge in overweight older adults. Sixteen subjects (13 female, 3 male, mean age 65.9 SD 6.0 and body mass index 30.6kg/m2 SD 3.9) participated in a crossover, randomized, controlled, double-blind clinical trial (registered under Australian New Zealand Clinical Trials Registry, identifier no. ACTRN12620000437965). Participants consumed a HFHE meal with a 250mL dose of either intervention (anthocyanins-rich Queen Garnet Plum) or control (apricot) juice. Blood samples and blood pressure measures were collected at baseline, 2h and 4h following the HFHE meal. Vascular and microvascular function were evaluated at baseline and 2h after the HFHE meal. Participants had a higher 2h postprandial flow-mediated dilatation (+1.14%) and a higher microvascular post-occlusive reactive hyperaemia (+0.10 perfusion units per mmHg) when allocated to the anthocyanin compared to the control arm (P=0.019 and P=0.049, respectively). C-reactive protein was lower 4h postprandially in the anthocyanins (1.80mg/L, IQR 0.90) vs control arm (2.30mg/L, IQR 1.95) (P=0.026), accompanied by a trend for lower concentrations of interleukin-6 (P=0.075). No significant postprandial differences were observed between treatments for blood pressure, triacylglycerol, total cholesterol, serum derivatives of reactive oxidative metabolites, tumor necrosis factor alpha, interleukin-1 beta, or maximum microvascular perfusion following iontophoresis of acetylcholine. Fruit-based anthocyanins attenuated the potential postprandial detrimental effects of a HFHE challenge on parameters of vascular and microvascular function, and inflammatory biomarkers in overweight older adults. Anthocyanins may reduce cardiovascular risk associated with endothelial dysfunction and inflammatory responses to a typical high fat 'Western' meal. Further studies are required to better elucidate the clinical implications of postprandial biomarkers of CVD.

Acute partial sleep deprivation and high-intensity interval exercise effects on postprandial endothelial function.

Acute-total and chronic-partial sleep deprivation increase the risks for cardiovascular disease (CVD). Cardiovascular function assessed by flow mediated dilation (FMD) is reduced after sleep deprivation. High-intensity interval exercise (HIIE) improves postprandial FMD. Sleep-deprived individuals may practice HIIE followed by a high-fat breakfast. This study investigated the acute-partial sleep deprivation (APSD) and HIIE interaction on postprandial FMD. Fifteen healthy males (age 31 ± 5years) participated in: (a) reference sleep (~ 9.5h) with no HIIE (RS), (b) RS and HIIE (RSX), and (c) APSD and HIIE (SSX). HIIE was performed in 3:2min intervals at 90% and 40% of VO2 reserve. FMD was assessed the night before (D1), the morning of the next day (D2), 1h (1hrPE) and 4h post HIIE (4hrPE). FMD% change was lower at RS compared to both RSX (F1,14 = 23.96, p < 0.001, η2 = 0.631) and SSX (F1,14 = 4.8, p = 0.47, η2 = 0.253) at 1hrPE. RSX and SSX did not differ at 1hrPE (F1,14 = 0.2, p = 0.889, η2 = 0.001), but SSX elicited greater FDM responses. Absolute FMD change was lower at RS compared to both RSX (F1,14 = 21.5, p < 0.001, η2 = 0.606) and SSX (F1,14 = 7.01, p = 0.019, η2 = 0.336) at 1hrPE. RSX and SSX did not differ at 1hrPE (F1,14 = .03, p = 0.858, η2 = 0.002), but SSX elicited greater FDM responses. HIIE short-term effects on cardiovascular function remain cardioprotective even after an acute-partial sleep deprivation.

The effect of egg and its derivatives on vascular function: A systematic review of interventional studies.

Cardiovascular diseases (CVDs) are considered as a major cause of health loss for all regions of the world. Atherosclerosis is one of the most important underlying causes of CVDs. Vascular dysfunction is the primary marker of atherosclerosis. Various studies have investigated the effect of egg intake on CVDs. This study aimed to determine the effect of egg and its derivatives consumption on vascular function. Using a comprehensive search strategy, the searching was conducted on PubMed, Scopus and Google Scholar search engines resources (from inception up to Feb 2020). Intended exposure and outcome were egg or its derivatives intake, and vascular function measuring methods, respectively. A total of 35 papers were found through search databases. Finally, seven trials were included, which were published between 2005 and 2018. Results showed that acute and chronic consumption of whole eggs did not have a significant adverse effect on flow-mediated dilatation (FMD). Also, lutein-enriched egg yolk and egg ovalbumin-derived protein hydrolysate did not have significant positive effects on FMD and pulse wave velocity (PWV), respectively. However, one month egg-yolk-derived phospholipid (PL) preparation intervention increased FMD by 3.4% (p<0.05), and replacing a portion of a glucose challenge with whole eggs or egg whites improved postprandial FMD (p<0.05). We concluded that consumption of whole egg, despite being rich in cholesterol, has no adverse effect on vascular function, and even some of egg derivatives may improve vascular function. Further research is needed to justify the potential effects of egg or its derivatives on vascular function.

Impact of Short-Term Continuous and Interval Exercise Training on Endothelial Function and Glucose Metabolism in Prediabetes.

Introduction The impact of interval (INT) vs. continuous (CONT) exercise training on endothelial function in relation to glucose metabolism prior to clinically meaningful weight loss is unknown in adults with prediabetes. Methods Twenty-six subjects with prediabetes (60 ± 1 y; 33 ± 1 kg/m2; 2-hr-PG OGTT: 145 ± 7 mg/dl) were randomized to 60 min of CONT (n = 12; 70% of HRpeak) or work-matched INT exercise training (n = 14; alternating 3 min at 90 and 50% HRpeak) for 2 weeks. Aerobic fitness (VO2peak) and body composition (bioelectrical impedance) were assessed before and after training. Flow-mediated dilation (FMD) was measured during a 2 h 75 g OGTT (0, 60, and 120 min) to assess endothelial function. Postprandial FMD was calculated as incremental area under the curve (iAUC). Glucose tolerance and insulin were also calculated by iAUC. Fasting plasma VCAM, ICAM, and hs-CRP were also assessed as indicators of vascular/systemic inflammation. Results Both interventions increased VO2peak (P = 0.002) but had no effect on body fat (P = 0.20). Although both treatments improved glucose tolerance (P = 0.06) and insulin iAUC (P = 0.02), VCAM increased (P = 0.01). There was no effect of either treatment on ICAM, hs-CRP, or fasting as well as postprandial FMD. However, 57% of people improved fasting and iAUC FMD following CONT compared with only 42% after INT exercise (each: P = 0.04). Elevated VCAM was linked to blunted fasting FMD after training (r = −0.38, P = 0.05). But, there was no correlation between fasting FMD or postprandial FMD with glucose tolerance (r = 0.17, P = 0.39 and r = 0.02, P = 0.90, respectively) or insulin iAUC following training (r = 0.34, P = 0.08 and r = 0.04, P = 0.83, respectively). Conclusion Endothelial function is not improved consistently after short-term training, despite improvements in glucose and insulin responses to the OGTT in obese adults with prediabetes.

Effects of Low-Fat and High-Fat Meals, with and without Dietary Fiber, on Postprandial Endothelial Function, Triglyceridemia, and Glycemia in Adolescents.

The consumption of fiber-rich foods may negate the deleterious effects of high-fat meals on postprandial triglyceridemia and endothelial function. Despite supportive data in adults, little is known about the effects of high-fat and high-fiber foods on cardiovascular health parameters in pediatric populations. In this crossover trial, male and female adolescents (n = 10; 14.1 + 2.6 years; range 10–17 years) consumed (1) low-fat, low-fiber, (2) low-fat, high-fiber, (3) high-fat, low-fiber, and (4) high-fat, high-fiber breakfast meals in randomized order, each following an overnight fast. Baseline and 4 h post-meal blood was obtained for determination of glucose, insulin and triglyceride concentrations. Endothelial function was assessed via brachial artery flow-mediated dilation (FMD). Postprandial FMD was not significantly changed after any meal. However, regression analyses revealed a significant inverse relationship between the change in 4 h triglyceride concentration and change in 4 h FMD for the high-fat, low-fiber meal (β = −0.087; 95% CI = −0.138 to −0.037; p = 0.001) that was no longer significant in the high-fat, high-fiber meal (β = −0.044; 95% CI = −0.117 to 0.029; p = 0.227). Interpretation of these analyses must be qualified by acknowledging that between-meal comparison revealed that the two regression lines were not statistically different (p = 0.226). Addition of high-fiber cereal to the high-fat meal also reduced 4 h postprandial triglyceride increases by ~50% (p = 0.056). A high-fiber breakfast cereal did not attenuate postprandial glucose and insulin responses after consumption of a low-fat meal. While further work is needed to confirm these results in larger cohorts, our findings indicate the potential importance of cereal fiber in blunting the inverse relationship between postprandial hypertriglyceridemia and FMD after consumption of a high-fat meal in adolescents.

Aerobic or resistance exercise performed the previous day does not attenuate postprandial hyperglycemia-induced endothelial dysfunction in overweight/obese adults.

Postprandial hyperglycemia (PPH) impairs vascular endothelial function (VEF). A single bout of aerobic exercise (AE) attenuates PPH-induced decreases in brachial artery flow-mediated dilation (FMD), a non-invasive measure of VEF, in healthy adults for up to 17h post-exercise. Studies examining the effects of resistance exercise (RE) on postprandial FMD responses are lacking. We hypothesized that a single bout of exercise performed the prior evening would attenuate PPH-induced decreases in FMD, independent of exercise modality. In a randomized, cross-over design, overweight/obese adults [n = 11 (8 women); 22 ± 4years; 32.3 ± 5.8kgm-2] completed 3 separate trials: control (seated rest), AE (30min at ~ 60% VO2max), or whole-body RE (30min, 6 exercises, 3 × 10-repetition maximum). Each trial occurred 14-17h prior to an oral glucose tolerance test (OGTT). Brachial artery FMD and plasma glucose and insulin were measured prior to and at 30-min intervals for 2h following the OGTT. Repeated-measures ANOVA and Bonferroni post hoc tests were used to evaluate differences within and between trials. Trials occurred 15.3 ± 1.0h prior to the OGTT. Relative to baseline, FMD transiently decreased (P < 0.05) at 30-60min post-ingestion, plasma glucose increased (P < 0.01) at 30-90min post-ingestion, and plasma insulin increased (P < 0.01) at 30-120min post-ingestion. No between trial differences were observed for FMD, glucose, or insulin. Aerobic or resistance exercise performed the evening prior to an OGTT does not attenuate postprandial decreases in brachial artery FMD in overweight/obese adults.

Effect of Strawberry Intake for 4 Weeks on Vascular Endothelial Function and Blood Pressure in Adults with Moderate Hypercholesterolemia (P06-128-19)

ObjectivesThe aim of this study is to investigate the effect of chronic strawberry intake on cardiovascular risk factors including fasting lipids concentrations, vascular endothelial function and blood pressure in middle-age overweight or obese individuals with moderate hypercholesterolemia. We hypothesized that 4-week strawberry intake would improve the lipids profile and concomitantly improve measures of vascular function. MethodsIn this randomized, double-blinded, controlled, crossover trial, thirty-four subjects (age 53 ± 1 years, BMI 31 ± 1 kg m-2, mean ± SD) consumed a strawberry beverage containing 25 gram freeze-dried strawberry powder or energy-matched control beverage in random order twice a day for 4 weeks. Treatment periods were separated by 4-week washout period. Fasting lipids, glucose, insulin, high sensitive c-reactive protein (hs-CRP), and postprandial flow-mediated dilation (FMD) and blood pressure, were measured at weeks 0, 4, 8 and 12. ResultsFasting lipids, glucose, insulin, and hs-CRP did not differ between strawberry and control beverage interventions. In contrast, vascular function as measured by change in %FMD was significantly increased after strawberry compared to control after 4 weeks supplementation (4.3 ± 0.3% versus 3.6 ± 0.3%, respectively, p = 0.0096). In addition, %FMD was acutely increased from 0 to 1 hour after consuming strawberry beverage (p < 0.0001), which was consistent with reduced meal-induced increases in systolic blood pressure (SBP) postmeal (mean 2 hour changes in SBP after strawberry compared to control beverage, 2.3 ± 0.4 versus 3.4 ± 0.4 mmHg, p = 0.048). ConclusionsDaily intake of strawberries may improve endothelial function and acute changes in blood pressure, independent of other metabolic changes, and may be considered a specific food/fruit to include in a heart-healthy diet in overweight or obese subjects with moderate hypercholesterolemia. Funding SourcesCalifornia Strawberry Commission, Watsonville, CA, USA. Supporting Tables, Images and/or Graphs▪

A single high-fat meal provokes pathological erythrocyte remodeling and increases myeloperoxidase levels: implications for acute coronary syndrome

High-fat meal (HFM) consumption can produce acute lipemia and trigger myocardial infarction in patients with atherosclerosis, but the mechanisms are poorly understood. Erythrocytes (red blood cells, RBCs) intimately interact with inflammatory cells and blood vessels and play a complex role in regulating vascular function. Chronic high-fat feeding in mice induces pathological RBC remodeling, suggesting a novel link between HFM, RBCs, and vascular dysfunction. However, whether acute HFM can induce RBC remodeling in humans is unknown. Ten healthy individuals were subjected to biochemical testing and assessment of endothelial-dependent flow-mediated dilation (FMD) before and after a single HFM or iso-caloric meal (ICM). Following the HFM, triglyceride, cholesterol, and free fatty acid levels were all significantly increased, in conjunction with impaired post-prandial FMD. Additionally, peripheral blood smears demonstrated microcytes, remodeled RBCs, and fatty monocytes. Increased intracellular ROS and nitration of protein band 3 was detected in RBCs following the HFM. The HFM elevated plasma and RBC-bound myeloperoxidase (MPO), which was associated with impaired FMD and oxidation of HDL. Monocytic cells exposed to lipid in vitro released MPO, while porcine coronary arteries exposed to fatty acids ex vivo took up MPO. We demonstrate in humans that a single HFM induces pathological RBC remodeling and concurrently elevates MPO, which can potentially enter the blood vessel wall to trigger oxidative stress and destabilize vulnerable plaques. These novel findings may have implications for the short-term risk of HFM consumption and alimentary lipemia in patients with atherosclerosis.A single high fat meal can induce pathological red blood cell (RBC) remodeling and oxidative stress, in conjunction with elevations in plasma, RBC-bound myeloperoxidase (MPO) and MPO-mediated high-density lipoprotein oxidation. These findings demonstrate that consumption of heavy meals enriched in fat may promote destabilization of vulnerable plaques leading to acute myocardial infarction.

Two Weeks of Interval vs. Continuous Exercise Training on Endothelial Function in Adults with Prediabetes

Hyperglycemia promotes vascular complications through, in part, an inflammatory-mediated impairment in endothelial function. However, the effects of interval (INT) vs. continuous (CONT) training on endothelial function prior to clinically meaningful weight loss is unknown in adults with prediabetes. Twenty-six subjects with prediabetes (60±1y; 33±1kg/m2; 2h-PG OGTT: 145±7mg/dl) were randomized to 60min of CONT (n=12; 70% of HRpeak) or work-matched INT exercise training (n=14; alternating 3-min at 90 and 50% HRpeak) for 2 weeks. Aerobic fitness (VO2peak) and body composition (bioelectrical impedance) were assessed before and after training. Flow-mediated dilation (FMD) was measured after an overnight fast during a 2-h 75g OGTT (0, 60 and 120min) to assess endothelial function. Post-prandial FMD stimulation was averaged and defined as the percent change from fasting. Glucose tolerance was calculated by total area under the curve. Fasting plasma VCAM and ICAM were also assessed as indicators of vascular inflammation. Both interventions improved VO2peak and reduced body fat (P&amp;lt;0.004). Although VCAM (P=0.009) and glucose tolerance (P=0.08) were reduced following both treatments, there was no effect on ICAM or fasting and post-prandial FMD. However, impaired fasting FMD prior to training was correlated with enhanced fasting FMD (r=-0.81, P=0.001) as well as FMD stimulation (r=0.46, P=0.03) post-training. Further, adults with the greatest improvement in fasting FMD after training had the smallest change in post-prandial FMD (r=-0.59, P=0.004). Lowering of VCAM after training was linked to this smaller change in post-prandial FMD (r=0.41, P=0.06) and enhanced fasting FMD (r=-0.38, P=0.05). Taken together, endothelial function is not improved after short-term training, regardless of intensity. However, prediabetic adults with impaired endothelial function at baseline exhibit exercise-induced improvement in FMD, which is linked to vascular inflammation. Disclosure S.K. Malin: None. N.M. Gilbertson: None. N. Eichner: None. E.M. Heiston: None. E. Barrett: None. A. Weltman: None. S.L. Miller: None.