Serum cholesterol response to replacing butter with a new trans-free margarine in hypercholesterolemic subjects.

UNLABELLED: Margarine leads to lower total and LDL cholesterol (LDL-C) levels than butter but may contain trans fatty acids that increase atherogenic lipids. A food company has used data concerning the cholesterolemic effects of individual fatty acids, including trans fatty acids, to develop a commercially available and virtually trans-free margarine. OBJECTIVE: The effect of this novel margarine on serum lipids and lipoproteins was compared with that of butter in free-living, hypercholesterolemic subjects. DESIGN AND SETTING: A two-period, outpatient cross-over trial at a university hospital lipid clinic. SUBJECTS: The study involved 77 subjects, and was completed by 53 men and 19 women aged 35-65 years with total serum cholesterol levels of between 6.0 and 7.9 mmol/L. INTERVENTION: Two 23-day regimens, separated by a 4-week washout period, included individualised dietary prescriptions supplemented with butter or margarine designed to provide 15% of total dietary energy. RESULTS: In comparison with butter, margarine intake lowered total and LDL-C levels by respectively 11.1% (99% CI: 8.1-14.1) and 11.3% (99% CI: 7.6-15.1). The reduction in LDL-C was < 3% in nearly one-fifth of the subjects despite appropriate changes in serum triglyceride fatty acids. Of the tested clinical and demographic variables, only the percentage of energy obtained from saturated fat during the margarine intake period was associated with dietary responsiveness (explaining 12% of the variation; p < 0.01). CONCLUSION: Our results suggest that a margarine designed to meet nutritional recommendations for hypercholesterolemia is more efficacious than butter in reducing atherogenic lipid levels in hypercholesterolemic subjects.

[The diet of patients with atherosclerotic disease compared with the standard diet in the population]. / Kostholdet hos pasienter med aterosklerotisk sykdom sammenliknet med befolkningen.

BACKGROUND: In the guidelines for follow-up of patients with established atherosclerotic disease, the importance of diet and other life style intervention strategies in reducing cardiovascular risk is emphasised. MATERIAL AND METHODS: In a survey in 363 general practices in 1997-99 we examined the diet of 3,160 patients with established atherosclerosis treated with a lipid lowering agent, and compared it with the diet of 530 persons interviewed in an omnibus survey, representative of the general Norwegian population above 40 years of age. A simple questionnaire was used for diet registration. We compared the quality of the patients' diet with their lipid levels and fulfilled treatment goals. RESULTS: A greater proportion of the patients used skimmed milk, polyunsaturated margarine and vegetable oil, and they ate less fat cheese and less fat meat compared to the other group. There were only small differences in the use of fish, fruit and vegetables. A more healthy diet in the patients reflected a better achievement of the treatment goals for blood lipids. INTERPRETATION: Patients with established cardiovascular disease seemed to have a more healthy diet than the general population. The use of fruit and vegetables has to be encouraged.

Effect of Norwegian fish powder on risk factors for coronary heart disease among hypercholesterolemic individuals.

BACKGROUND AND AIM: Numerous studies suggest an association between high intake of fatty fish and reduced risk of coronary heart disease. Very long-chain omega-3 fatty acids are thought to be responsible for the benefits observed, though other fatty fish components may act in concert with them. Norwegian fish powder is a dry herring product that contains essential amino acids, marine omega-3 fatty acids, vitamins and minerals. The aim of the present study was to determine whether it has beneficial effects on risk factors for coronary heart disease in man. METHODS AND RESULTS: A single center, randomized, double-blind, parallel-treatment study was carried out for 12 weeks. Subjects with primary hypercholesterolemia were randomly allocated to 10 g fish powder or placebo (20 tablets/day). Participants were instructed to follow National Cholesterol Education Program (NCEP) Step I Diet during a 4-week diet run-in phase and during the study. Concentrations of lipids, lipoproteins, hemostatic variables and endothelial cell markers were determined before and after supplementation. Our data showed that the fish powder supplement was well tolerated. A significant decrease and increase respectively were observed in plasma alpha-linolenic acid (p = 0.03) and docosahexaenoic acid (DHA) (p = 0.03). Concentrations of lipids, lipoproteins, homocysteine, factor VII, fibrinogen, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI)-1, soluble intercellular adhesion molecule (ICAM)-1, P-selectin and interleukin (IL)-8 were not beneficially affected. CONCLUSIONS: Fish powder supplementation does not seem an effective approach to improve risk factors for coronary heart disease in hypercholesterolemic subjects following the NCEP Step I Diet.

[Diet and lipid status in pregnant women]. / Kosthold og lipidstatus hos gravide kvinner.

Pregnancy increases the requirement for nutrients and changes the metabolism of lipids and other compounds. We investigated the dietary composition and followed the changes in serum lipids during pregnancy among 20 women age 25-36 years. The women's diet was stable during pregnancy, but the intake of vitamin D, iron and fibre was lower than the national recommendations. Fat provided about 31% of the energy, saturated fat 12%. The total cholesterol concentration rose from 4.4 (95% confidence interval 4.2-4.6) to 7.0 mmol/l (6.5-7.5) (p < 0.0001) without changes in dietary composition. Even in this group of health-conscious, pregnant women the diet did not meet the national dietary recommendations. In addition, the composition of the fat in the diet was unfavourable. Optimal follow-up of pregnant women should include dietary counselling.