Nutritional composition of ultra-processed plant-based foods in the out-of-home environment: a multi-country survey with plant-based burgers.

Ultra-processed plant-based foods, such as plant-based burgers, have gained in popularity. Particularly in the out-of-home (OOH) environment, evidence regarding their nutritional profile and environmental sustainability is still evolving. Plant-based burgers available at selected OOH sites were randomly sampled in Amsterdam, Copenhagen, Lisbon and London. Plant-based burgers (patty, bread and condiment) (n 41) were lab analysed for their energy, macronutrients, amino acids and minerals content per 100 g and serving and were compared with reference values. For the plant-based burgers, the median values per 100 g were 234 kcal, 20·8 g carbohydrates, 3·5 g dietary fibre and 12·0 g fat, including 0·08 g TFS and 2·2 g SFA. Protein content was 8·9 g/100 g, with low protein quality according to amino acid composition. Median Na content was 389 mg/100 g, equivalent to 1 g salt. Compared with references, the median serving provided 31% of energy intake based on a 2000 kcal per day and contributed to carbohydrates (17-28%), dietary fibre (42%), protein (40%), total fat (48%), SFA (26%) and Na (54%). One serving provided 15-23% of the reference values for Ca, K and Mg, while higher contributions were found for Zn, Mn, P and Fe (30-67%). The ultra-processed plant-based burgers provide protein, dietary fibre and essential minerals and contain relatively high levels of energy, Na and total fats. The amino acid composition indicated low protein quality. The multifaceted nutritional profile of plant-based burgers highlights the need for manufacturers to implement improvements to better support healthy dietary habits, including reducing energy, Na and total fats.

Less meat in the shopping basket. The effect on meat purchases of higher prices, an information nudge and the combination: a randomised controlled trial.

BACKGROUND: Reduced meat consumption benefits human and planetary health. Modelling studies have demonstrated the significant health and environmental gains that could be achieved through fiscal measures targeting meat. Adding other interventions may enhance the effect of a fiscal measure. The current study aimed to examine the effect of higher meat prices, an information nudge and a combination of both measures on meat purchases in a three-dimensional virtual supermarket. METHODS: A parallel designed randomised controlled trial with four conditions was performed. Participants (≥ 18 years) were randomly assigned to the control condition or one of the experimental conditions: a 30% price increase for meat ('Price condition'), an information nudge about the environmental impact of meat production and consumers' role in that regard ('Information nudge condition') or a combination of both ('Combination condition'). Participants were asked to shop for their household for one week. The primary outcome was the difference in the total amount of meat purchased in grams per household per week. RESULTS: Between 22 June 2020 and 28 August 2020, participants were recruited and randomly assigned to the control and experimental conditions. The final sample included 533 participants. In the 'Combination condition', - 386 g (95% CI: - 579, - 193) meat was purchased compared with the 'Control condition'. Compared to the 'Control condition' less meat was purchased in the 'Price condition' (- 144 g (95%CI: - 331, 43)), although not statistically significant, whereas a similar amount of meat was purchased in the 'Information nudge condition' (1 g (95%CI: - 188, 189)). CONCLUSION: Achieving the most pronounced effects on reduced meat purchases will require a policy mixture of pricing and informational nudging. Less meat is purchased in a virtual supermarket after raising the meat price by 30% combined with an information nudge. The results could be used to design evidence-based policy measures to reduce meat purchases. TRIAL REGISTRATION: The trial was registered in the Netherlands Trial Register identifier NL8628 . Registered on 18/05/2020. ICTRP Search Portal (who.int) NTR (trialregister.nl).

Average daily nitrate and nitrite intake in the Belgian population older than 15 years.

The aim of this study was to assess the dietary intake of nitrate and nitrite in Belgium. The nitrate content of processed vegetables, cheeses and meat products was analysed. These data were completed by data from non-targeted official control and from the literature. In addition, the nitrite content of meat products was measured. Concentration data for nitrate and nitrite were linked to food consumption data of the Belgian Food Consumption Survey. This study included 3245 respondents, aged 15 years and older. Food intakes were estimated by a repeated 24-h recall using EPIC-SOFT. Only respondents with two completed 24-h recalls (n=3083) were included in the analysis. For the intake assessment, average concentration data and individual consumption data were combined. Usual intake of nitrate/nitrite was calculated using the Nusser method. The mean usual daily intake of nitrate was 1.38 mg kg(-1) bodyweight (bw) day(-1) and the usual daily intake at the 97.5 percentile was 2.76 mg kg(-1) bw day(-1). Exposure of the Belgian population to nitrate at a mean intake corresponded to 38% of the ADI (while 76% at the 97.5 percentile). For the average consumer, half of the intake was derived from vegetables (especially lettuce) and 20% from water and water-based drinks. The average daily intake of nitrate and nitrite from cheese and meat products was low (0.2% and 6% of the ADI at average intake, respectively). Scenario analyses with a higher consumption of vegetables or a higher nitrate concentration in tap water showed a significant higher intake of nitrate. Whether this is beneficial or harmful must be further assessed.

L-ascorbic acid improves the serum folate response to an oral dose of [6S]-5-methyltetrahydrofolic acid in healthy men.

OBJECTIVE: To investigate the effect of simultaneous administration of [6S]-5-methyltetrahydrofolic acid ([6S]-5-CH(3)H(4)PteGlu) with L-ascorbic acid (L-AA) on serum folate concentrations in healthy male subjects. SUBJECTS AND METHODS: A total of nine healthy male volunteers were recruited. Serum folate concentrations were measured before and up to 8 h after administration of each treatment (1) placebo, (2) 343 microg [6S]-5-CH(3)H(4)PteGlu), (3) 343 microg [6S]-5-CH(3)H(4)PteGlu) with 289.4 mg L-AA and (4) 343 microg [6S]-5-CH(3)H(4)PteGlu) with 973.8 mg L-AA (n=10 samples per treatment). RESULTS: Serum folate concentrations significantly increased compared with baseline values, starting from 30 min after [6S]-5-CH(3)H(4)PteGlu administration and remained significantly higher than baseline values during the first 6 h for treatments 3 and 4, and during the first 4 h for treatment 2. Maximal serum folate responses were observed between 0.5 and 1.5 h after [6S]-5-CH(3)H(4)PteGlu consumption and significantly differed between treatments 2 and 4 (P<0.05). When [6S]-5-CH(3)H(4)PteGlu was concurrently administered with 289.4 or 973.8 mg L-AA, the total serum folate response, calculated as the area under the curve (AUC), was significantly improved (46.5+/-4.0 and 53.0+/-4.0 vs 34.3+/-3.8 h nmol/l, P<0.05). No significant difference in AUC was found between the 289.4 and the 973.8 mg L-AA treatments. CONCLUSIONS: Administration of a physiological dose of [6S]-5-CH(3)H(4)PteGlu with L-AA significantly improved the measured serum folate response in folate saturated healthy men.

Does vitamin C supplementation influence the levels of circulating oxidized LDL, sICAM-1, sVCAM-1 and vWF-antigen in healthy male smokers?

OBJECTIVE: To examine the effects of vitamin C supplementation on the concentration of oxidation markers, in particular, circulating oxidized LDL (OxLDL) and on endothelial activation markers. DESIGN: Randomized double-blind, placebo-controlled crossover trial. SETTING: Belgian population of the city of Leuven. SUBJECTS: A total of 34 healthy male smokers aged 26-73 y. INTERVENTION: Smokers were randomly assigned to receive either vitamin C (250 mg twice daily) or placebo capsules, each to be taken for 4 weeks. After a 1-week washout period, participants then crossed over to the alternative capsules for further 4 weeks. MEAN OUTCOME MEASURES: Markers of oxidation (bilirubin, uric acid, alpha-tocopherol, retinol, malondialdehyde, circulating Oxidized LDL (OxLDL)) and markers of endothelial activation (sICAM-1, sVCAM-1, vWF-antigen) were analysed. RESULTS: Plasma ascorbate concentrations significantly increased from 46.6+/-17.6 to 70.1+/-21.2 mumol/l after a 4-week treatment with 500 mg vitamin C per day. The other plasma antioxidants concentrations, including bilirubin, uric acid, alpha-tocopherol and retinol, were similar in both treatment periods. Vitamin C did not change plasma malondialdehyde and circulating OxLDL compared with placebo (vitamin C 0.73+/-0.25 mg/dl OxLDL; placebo 0.72+/-0.21 mg/dl OxLDL). After vitamin C supplementation, neither sICAM-1 and sVCAM-1 levels nor the concentration of vWF-antigen significantly differed from placebo condition. CONCLUSIONS: Oral supplementation of vitamin C is not associated with changes in markers of oxidation or endothelial activation in healthy male smokers.

Quantitative analysis of 8-isoprostane and hydrogen peroxide in exhaled breath condensate.

Exhaled breath condensate (EBC) provides a noninvasive means of sampling the lower respiratory tract. Collection of EBC might be useful in the assessment of airway oxidative stress in smokers. The aim of this study was to determine 8-isoprostane and hydrogen peroxide levels in EBC, and, in addition, to investigate the reproducibility of these measurements. EBC samples were collected from 12 healthy male smokers at three time points within 1 week. 8-isoprostane and H2O2 were measured in nonconcentrated EBC using immunochemical and colorimetric assays, respectively. 8-isoprostane and H2O2 were detected in only 36 and 47% of all EBC samples, respectively. It was not possible to calculate the within-subject variation in a reliable manner since only three of the 12 smokers exhibited detectable 8-isoprostane concentrations on all three occasions (mean 4.6 pg x mL(-1); range 3.9-7.7 pg x mL(-1)), whereas H2O2 could not be detected on all three occasions in any of the smokers. Spiking experiments revealed a recovery of 83.5-109.5% for 8-isoprostane and 69.9-129.0%, for H2O2 in fresh EBC samples. It was concluded that levels of 8-isoprostane and hydrogen peroxide cannot be reproducibly assessed in exhaled breath condensate from healthy smokers because of their low concentration and/or the lack of sensitivity of the available assays.

Tea consumption and iron status.

OBJECTIVE: To give an overview of the association between tea consumption and iron status. METHODS: A PUBMED search was performed (up to June 2001) for all publications containing the words: tea and ferritin, h(a)emoglobin, iron status or an(a)emia. Sixteen studies were evaluated in groups with high (infants, children and premenopausal women) or low prevalence of iron deficiency (men and the elderly). RESULTS AND DISCUSSION: Of the 16 studies reviewed, six included infants and children, six premenopausal women, two men and two the elderly. In study groups with high prevalence of iron deficiency, tea consumption was inversely associated with serum ferritin and/or haemoglobin. The association disappeared when adjusting for confounding (dietary) factors, except for one study including 40% of iron deficient women. In groups with low prevalence of iron deficiency, tea consumption was not inversely associated with serum ferritin and/or haemoglobin. In those at risk for iron overload, such as middle-aged men, tea consumption may lower serum ferritin concentrations as reported in one study. This finding awaits further confirmation. CONCLUSION: This overview shows that tea consumption does not influence iron status in Western populations in which most people have adequate iron stores as determined by serum ferritin concentrations. Only in populations of individuals with marginal iron status does there seem to be a negative association between tea consumption and iron status.

Alcohol drinkers overreport their energy intake in the BIRNH study: evaluation by 24-hour urinary excretion of cations. Belgian Interuniversity Research on Nutrition and Health.

OBJECTIVE: Alcohol drinkers are generally considered to underreport their alcohol intake, but little is known about whether they correctly report their energy intake (EI). We assessed the validity of the reported energy intake of alcohol drinkers using the 24-hour urinary (U) excretion of potassium (K) and sodium (Na) as biomarkers. METHODS: A total of 2,124 men and 1,998 women 25 to 74 years of age with a 24-hour urine collection, a random sample of the Belgian Interuniversity Research on Nutrition and Health (BIRNH). were studied. Dietary intake (D), including alcohol consumption, was assessed by a one-day food record. Basal metabolic rate (BMR) was predicted from age, gender and weight. As a measure for the degree of reporting error, D-K/U-K, D-Na/U-Na, EI/U-K, Non-alcohol EI/U-Na (NAEI/U-Na), EI/U-Na, EI/U-creatinine and EI/BMR ratios were calculated and compared among non-, moderate and heavy drinkers in both genders. RESULTS: EI, NAEI and all seven ratios examined generally increased with the level of alcohol intake in both genders. After adjustment for age, body mass index, smoking and educational level, most ratios were significantly higher in moderate drinkers (p < 0.02 to p < 0.0001) and in heavy drinkers (all p < 0.0001) than in non-drinkers. These differences were most significant in male heavy drinkers. The exceptions were D-K/U-K, D-Na/U-Na and NAEI/U-Na in moderate and female heavy drinkers and EI/U-K in male moderate drinkers. The estimated amount of the overreporting of EI by heavy drinkers was 27.8% in men and 13.7% in women. CONCLUSIONS: This study provides evidence that EI and NAEI obtained from the BIRNH study was overreported among alcohol drinkers, especially among male heavy drinkers. It also indicates that EI from alcohol replaced EI from food.

Serum bilirubin and 10-year mortality risk in a Belgian population.

OBJECTIVE: The endogenous antioxidant serum bilirubin may scavenge free radicals and protect against free radical-related diseases. METHODS: Using the 10-year follow-up mortality data from the Belgium Inter-university Research on Nutrition and Health (BIRNH) study the association between serum bilirubin and all-cause, cardiovascular, and cancer mortality in 5460 men and 4843 women was investigated. RESULTS: In men, with the highest (> or = 0.6 mg/dl) compared with the lowest serum bilirubin concentration (< or = 0.2 mg/dl), the adjusted relative risk (RR) was 0.73 (95% confidence interval (CI) 0.57-0.94) for all-cause and 0.42 (95% Cl 0.26-0.68) for cancer mortality. The risk for cancer mortality decreased with increasing concentrations of serum bilirubin (p for trend = 0.004) especially for non-lung cancer mortality (p for trend = 0.02). The associations persisted after adjusting for smoking. In women the associations between serum bilirubin and cancer mortality were in the same direction, but did not reach statistical significance (RR = 0.76, 95% CI 0.39-1.5). No significant associations were found between serum bilirubin and cardiovascular mortality in men and women. CONCLUSIONS: In this population high serum bilirubin, however, within normal ranges, was associated with low cancer mortality, especially in men. This may be due to the antioxidant activity of bilirubin. Measurement of serum bilirubin concentrations may contribute to cancer risk estimation.

Serum bilirubin concentration in a Belgian population: the association with smoking status and type of cigarettes.

BACKGROUND: The endogenous antioxidant serum bilirubin may scavenge free radical species from cigarette smoke. Smokers are expected to have lower serum bilirubin levels than never smokers, but this has never been evaluated in a random population sample of women and men. In addition, in vitro studies indicate that filter cigarette smoke might enhance bilirubin oxidation more than non-filter cigarette smoke. METHODS: In this paper, data were analysed from the Belgian Interuniversity Research on Nutrition and Health (BIRNH) study. We investigated the association of smoking and type of cigarettes with serum bilirubin concentrations in men and women using multiple regression models taking into account differences in baseline and smoking characteristics. RESULTS: In men, current smokers had lower crude and adjusted serum bilirubin concentrations compared with never smokers (P = 0.0001). For women, the association between smoking and serum bilirubin concentrations adjusted for age was in the same direction as for men, but did not reach statistical significance. Male former smokers had serum bilirubin concentrations in between those of current smokers and never smokers, while female former smokers had even higher (+ 0.50 micromol/l) serum bilirubin concentrations than never smokers. Male subjects smoking filter cigarettes showed a higher serum bilirubin concentration than those smoking cigarettes without a filter (adjusted difference: 0.49 micromol/l; P = 0.03). The duration of smoking was inversely and significantly related to serum bilirubin concentrations (P = 0.0003). CONCLUSION: Smoking may lower serum bilirubin concentrations in men, especially in those smoking non-filter cigarettes. The duration of smoking is a more important determinant for serum bilirubin concentrations than the number of cigarettes smoked per day, which may indicate the cumulative negative effects of smoking on the endogenous antioxidant system. Results for females pointed in the same direction, but were less clear, possibly due to low numbers of smoking women, who were largely young and smoked mainly filter cigarettes for a shorter period of time.

Under- and overreporting of energy intake using urinary cations as biomarkers: relation to body mass index.

Under- and overreporting of energy intake in relation to body mass index (BMI, kg/m2) were examined by using 24-hour urinary sodium and potassium as biomarkers. The data were obtained from 2,124 men and 1,998 women aged 25-74 years who participated in the 1981-1984 Belgian Interuniversity Research on Nutrition and Health study conducted in Belgium. The ratios of dietary intake to urinary excretion of sodium and potassium, as a measure for relative underreporting, were inversely associated with BMI (for men, beta = -0.019 for sodium ratio and beta = -0.026 for potassium ratio; for women, beta = -0.017 for sodium ratio and beta = -0.019 for potassium ratio; all p < 0.0001) independent of age, smoking, alcohol intake, and educational level. Since 77% of dietary potassium was reported to be excreted in the urine, subjects for whom the (dietary potassium x 0.77)/urinary potassium ratio was <1 were considered underreporters and >1 as overreporters. The percentage of underreporters increased with increasing pooled sex-specific deciles of BMI (beta = 1.88, p < 0.0001) and was higher than the percentage of overreporters in 13 of 20 deciles. At a BMI of 25.4, the percentage of under- and overreporters equalized. In conclusion, the relative underreporting of energy intake and the percentage of underreporters increased with increasing BMI.

Fish consumption is inversely associated with male lung cancer mortality in countries with high levels of cigarette smoking or animal fat consumption.

BACKGROUND: A striking difference in fish consumption and lung cancer mortality (LCM) exists among populations worldwide. This study investigated the relation between fish consumption and LCM at the population level. METHODS: Sex-specific LCM data, mostly around 1993 and fish consumption data for 10 periods 1961-1994 in 36 countries were obtained from WHO and FAO, respectively. RESULTS: A significant inverse correlation exists between log fish consumption and LCM rate in 9 out of the 10 time periods (r = -0.34 to r = -0.46, P = 0.044 to P = 0.005). After adjusting for smoking and other confounders, log fish consumption (% of total energy [% E]) was inversely and significantly associated with LCM rate (per 100 000 per year) in all 10 time periods (beta = -26.3 to beta = -36.7; P = 0.0039 to P < 0.0001). The stratified analysis showed that this inverse relation was significant only in countries with above median level of smoking (>2437 cigarettes/adult/year) or animal fat minus fish fat consumption (22.4% E). An increase in fish consumption by 1% E was calculated to reduce mean male LCM rate of the populations examined in the age class of 45-74 years by 8.4%. In women, no significant relation between fish consumption and LCM could be established. CONCLUSIONS: Fish consumption is associated with a reduced risk from LCM, but this possible protective effect is clear-cut only in men and in countries with high levels of cigarette smoking or animal fat consumption.

Sex ratio of total energy intake in adults: an analysis of dietary surveys.

OBJECTIVE: The ratio of the total energy intake (TEI) reported by men and women in the same dietary survey varies considerably among dietary surveys. The purpose of our study was to investigate the potential value of the sex ratio of TEI as a measure of misreporting dietary intake by comparing it with the sex ratio of biomarkers such as the 24 h urinary excretion of sodium, potassium and total nitrogen. METHODS: The sex ratio (m/f) of TEI in adults was calculated from 81 dietary surveys performed in 28 countries. The surveys were conducted in healthy and free-living populations, using the same methodology in both sexes. RESULTS: A mean sex ratio of 1.35 (s.d., 0.13) and 1.33 (s.d., 0.10) was obtained at the individual survey level and at the country level, respectively. The sex ratio of 1.40 in the younger age class (< or = 60/64 y) was significantly higher than the sex ratio of 1.27 in the older age class (> 60/64y) (P < 0.0001). The dietary assessment methodology also influenced the sex ratio (P = 0.03). Compared with the INTERSALT study, the sex ratio of TEI was higher than the sex ratios of the 24 h urinary sodium (1.23), potassium (1.20) and total nitrogen (1.25), biomarkers of dietary sodium, potassium and protein intake. Therefore the dietary survey data indicate a mean TEI of 10 476 kJ/d for men and 7784 kJ/d for women, which gives a mean sex difference of 2692 kJ/d. However if the biomarker sex ratio of 1.23, mean sex ratio of the 24 h urinary sodium, potassium and total nitrogen, is correct and the TEI of men is correctly assessed at 10476kJ/d, the TEI of women should be 8517kJ/d, a difference of only 1959 kJ/d. CONCLUSIONS: Calculated from dietary surveys, the mean sex ratio of TEI is 1.35. This sex ratio decreases with age and depends on the dietary assessment methods used. In many dietary surveys, the sex ratio of TEI is likely overestimated.

Effects of diets enriched in lauric, palmitic or oleic acids on blood coagulation and fibrinolysis.

In this study we compared the effects of specific saturated fatty acids (lauric acid and palmitic acid) with those of a monounsaturated fatty acid (oleic acid) on coagulation and fibrinolytic parameters in healthy women and men. Eighteen women and fourteen men consumed, in random order, three experimental diets, each for six weeks. The diets consisted of solid foods and approximately 70% [28 percent of energy (En%)] of the fat calories was supplied. As determined from duplicate portions, in the lauric acid diet 7.3 En% and in the palmitic acid diet 6.1 En% of oleic acid were exchanged for lauric or palmitic acid, respectively. The lauric acid diet also contained some (average 1.8 En%) more myristic acid. Compared with the oleic acid diet, factor VIIam in the female subjects was 9% higher with the lauric acid diet (P = 0.0036; 95% CI, 3 to 14%) and 10% higher with the palmitic acid diet (P = 0.0011; 95% CI, 5 to 16%). Changes in men were not significant. Plasminogen Activator Inhibitor (PAI-1) activity was higher on the palmitic acid compared with the oleic acid diet (difference between diets of 2.3 U/ml; P = 0.0098; 95% CI, 0.4 to 4.3 U/ml) and the lauric acid diet (difference between diets of 2.2 U/ml; P = 0.0123; 95% CI, 0.2 to 4.1 U/ml). No significant differences between diets were observed for antithrombin III activity, fibrinogen concentrations, fragment 1+2 concentrations, plasminogen or alpha2-antiplasmin activity. From this study, we conclude that diets rich in lauric or palmitic acid, compared with a diet rich in oleic acid, unfavourably influence factor VIIam activity, in a gender specific manner. In addition, the plasminogen activator inhibiting capacity of the plasma is impaired with a palmitic acid rich diet compared with an oleic or lauric acid rich diet.

Variations in serum cholesteryl ester transfer and phospholipid transfer activities in healthy women and men consuming diets enriched in lauric, palmitic or oleic acids.

Cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP) activities were measured in sera from 32 normolipidemic women and men consuming diets enriched in lauric, palmitic, or oleic acids. Serum CETP activity, measured as the rate of radiolabeled cholesteryl esters transferred from HDL toward serum apo B-containing lipoproteins, was higher with the palmitic acid diet (25.1+/-2.5%) than with the lauric acid (23.7+/-2.4%) and the oleic acid (24.0+/-2.7%) diets (P = 0.0028 and 0.0283, respectively). CETP mass concentrations, as measured with an enzyme-linked immunosorbent assay were increased after the lauric acid diet (2.57+/-0.63 mg/l) and the palmitic acid diet (2.49+/-0.64 mg/l) as compared with the oleic acid diet (2.34+/-0.45 mg/l) (P = 0.0035 and 0.0249, respectively). In contrast with CETP, serum PLTP activity, as measured as the rate of radiolabeled phosphatidylcholine transferred from liposomes toward serum HDL, was significantly higher with the lauric acid diet (23.5+/2.6%) than with the palmitic acid diet (22.5+/-2.5%) (P = 0.0013), while no significant differences were noted when comparing the saturated diets versus the oleic acid diet (23.0+/-2.3%). No significant alterations in the mean apparent diameter of LDL, and in the relative proportions of individual HDL subpopulations were observed from one dietary period to another. Nevertheless, lipid transfer activities correlated significantly with the relative abundance of HDL2b, HDL2a, HDL3b, and HDL3c, with opposite tendencies being observed for cholesteryl ester transfer and phospholipid transfer activities. In general, serum CETP activity correlated negatively with HDL cholesterol, but positively with triglyceride concentrations after the dietary interventions, and the relations with serum lipids were just the opposite for PLTP activity. In addition, CETP and PLTP activities correlated negatively when subjects consumed the standardized diets (P < 0.05 in all cases), but not when subjects consumed their habitual diet. It is concluded that serum lipid transfer activities in normolipidemic subjects can be significantly affected by the fatty acid content of the diet, with differential effects on CETP and PLTP activities.

Individual saturated fatty acids and effects on whole blood aggregation in vitro.

OBJECTIVES: In two studies we have compared the effects of four different saturated fat diets (medium chain fatty acids (MCFA), and lauric, myristic and palmitic acids) with those of a monounsaturated oleic acid diet on in-vitro whole blood aggregation in healthy women and men. DESIGN: Study 1 had a cross-over design with three diet periods of each six weeks, and studied the effects of diets enriched in lauric, palmitic or oleic acids. Study 2 had a parallel design. After a three week oleic acid run-in diet, three groups of subjects were formed which consumed either an MCFA, myristic acid or oleic acid rich diet for six weeks. SUBJECTS: Eighteen women and 14 men in Study 1 and 37 women and 23 men in Study 2. All subjects were healthy and were aged 20-60 y. INTERVENTIONS: The experimental diets were the same in nutrient composition except for on average 8 En% (Study 1) or 10 En% (Study 2) which was provided by either MCFA, lauric acid, myristic acid, palmitic acid or oleic acid. Blood samples were taken at the end of each dietary period. Whole blood platelet aggregation, anticoagulated with recombinant hirudin was assessed after administration of collagen (final concentration (fc): 0.38 microgram/mL) in Study 1 and collagen (fc: 0.22 microgram/mL) or ADP (fc: 1.25 mumol/L) in Study 2. Collagen-induced formation of thromboxane (Tx)A2, measured as thromboxane (Tx)B2, was evaluated in Study 1 only. RESULTS: The aggregation velocity between the saturated fatty acid diets and the monounsaturated fatty acid diet did not differ. TxB2 concentrations measured in collagen activated blood samples, which correlated significantly with aggregation velocity, did not differ between the lauric or the palmitic compared with the oleic acid diet. A stepwise regression analysis indicated that collagen-induced aggregation was negatively correlated with the number of red blood cells. ADP-induced aggregation also correlated negatively with red blood cell count, and positively with platelet count. CONCLUSIONS: The exchange of 7-10 En% from oleic acid for MCFA, lauric, myristic or palmitic acid does not affect in-vitro whole blood aggregation induced by collagen. ADP-induced aggregation is not affected when 10 En% from oleic acid is exchanged for MCFA or myristic acid.

Effects of medium chain fatty acids (MCFA), myristic acid, and oleic acid on serum lipoproteins in healthy subjects.

In this study we investigated the effects on lipoproteins of medium chain fatty acids (MCFA) and myristic acid relative to those of oleic acid. Thirty-seven women and 23 men consumed a 3-wk run-in diet enriched in oleic acid followed by a 6-wk test diet rich in MCFA (n = 21), myristic (n = 20), or oleic acid (n = 19). Experimental fats were incorporated into solid foods. Total fat intake was 40 En% fat. The dietary compositions were the same except for 10 En%, which was provided by MCFA, myristic, or oleic acids, respectively. With the myristic acid diet, low density lipoprotein (LDL) cholesterol was 0.37 mmol/L higher compared with the oleic acid diet (P = 0.0064 for difference in changes). The MCFA diet increased LDL cholesterol, though not significantly, with 0.23 mmol/L relative to the oleic acid diet (P = 0.0752). Compared with the oleic acid diet, HDL cholesterol concentrations increased with the myristic acid diet by 0.10 mmol/L (P = 0.0273) but not with the MCFA diet. The MCFA diet slightly elevated triacylglycerol concentrations, but responses did not significantly differ between the diets. The MCFA diet significantly decreased the apoA-I to apoB ratio compared with both other diets (P < 0.02). We conclude that MCFA raise LDL cholesterol concentrations slightly and affect the apoA-I to apoB ratio unfavorably compared with oleic acid. Myristic acid is hypercholesterolemic, although less than predicted earlier, and raises both LDL and HDL cholesterol concentrations compared with oleic acid.

Comparison of the effects of diets enriched in lauric, palmitic, or oleic acids on serum lipids and lipoproteins in healthy women and men.

The degree to which different saturated fatty acids exert their cholesterol-raising effects is still unknown. Therefore, we studied the effect on serum lipids and lipoproteins of diets rich in lauric, palmitic, or oleic acids. Eighteen women and 14 men consumed in random order three experimental diets, each for 6 wk. The diets consisted of solid foods and contained 40% of energy as fat, of which 28% was supplied by the experimental fats. The fat high in lauric acid was a mixture of palm kernel oil (75%) and a high-oleic acid sunflower oil (25%); the fat high in palmitic acid consisted of dairy fat (55%), palmstearin (36%), and sunflower oil (9%); and the fat high in oleic acid consisted of dairy fat (37%) and sunflower oil (63%). The calculated nutrient composition was the same in each diet except for approximately equal to 8.5% of energy, which was provided by lauric, palmitic, or oleic acids. With the lauric acid diet the subjects' serum total cholesterol concentration increased by 0.22 mmol/L (P = 0.0121; 95% CI: 0.02, 0.41 mmol/L) as compared with the palmitic acid diet and by 0.48 mmol/L (P < 0.0001; 95% CI: 0.29, 0.67 mmol/L) compared with the oleic acid diet. Total cholesterol concentrations with the palmitic acid diet were 0.26 mmol/L (P = 0.0012; 95% CI: 0.07, 0.46 mmol/L) higher than with the oleic acid diet. High-density-lipoprotein (HDL)-cholesterol concentrations increased by 0.12 mmol/L (P = 0.006; 95% CI: 0.04, 0.20 mmol/L) with the lauric acid compared with the palmitic acid diet and by 0.14 mmol/L (P < 0.001; 95% CI: 0.07, 0.22 mmol/L) compared with the oleic acid diet. HDL-cholesterol concentrations with the palmitic acid and the oleic acid diet were the same. No effects were seen in serum triacylglycerol and lipoprotein(a) concentrations. We conclude that both lauric and palmitic acids are hypercholesterolemic compared with oleic acid. Lauric acid raises total cholesterol concentrations more than palmitic acid, which is partly due to a stronger rise in HDL cholesterol.

Dietary saturated and trans fatty acids and lipoprotein metabolism.

Earlier studies have shown that not all saturated fatty acids are equally hypercholesterolaemic: stearic acid (C18:0) and saturated fatty acids with less than 12 carbon atoms are thought not to raise serum cholesterol levels. This suggests that the cholesterol-raising effects of saturated fatty acids can be attributed to lauric acid (C12:0), myristic acid (C14:0) and palmitic acid (C16:0). These three saturated fatty acids also have different effects on serum total cholesterol levels. Results from recent controlled dietary experiments suggest that lauric acid raises serum total and low-density lipoprotein (LDL) cholesterol levels slightly less, and myristic acid more, as compared with palmitic acid. Myristic acid, however, also causes higher levels of high-density lipoprotein (HDL) cholesterol. Stearic acid has only a slight effect on serum LDL and HDL cholesterol levels as compared with oleic acid. Trans monounsaturated fatty acids, however, increase LDL and decrease HDL cholesterol levels. Precise effects on lipoproteins of short and medium chain triglycerides (C4:0-C10:0) have never been examined.