2003;78:4756.Printed in USA.2003 American Society for Clinical NutritionEffects of dietary monounsaturated fatty acids on lipoproteinVLDL apolipoprotein B kinetics: dose-dependent effects on LDLJason MR Gill,Jacqueline C Brown,Muriel J Caslake,Dawn M Wright,Josephine Cooney,Dorothy Bedford,David A Hughes,John C Stanley,and Chris J dietary saturated fatty acids (SFAs) withmonounsaturated fatty acids (MUFAs) lowers LDL cholesterol,but the underlying mechanisms remain unclear.Objective:We assessed the effects of replacing dietary SFAs withMUFAs on concentrations and subclass distributions of VLDL,intermediate-density lipoprotein,LDL,and HDL and on VLDLThirty-five moderately hypercholesterolemic,middle-aged volunteers consumed for 6 wk,in random order,diets con-taining low (L-MUFA; 7.8% of energy from MUFAs),moderate(M-MUFA; 10.3% from MUFAs),or high (H-MUFA; 13.7% fromMUFAs) amounts of MUFAs.Fasting blood samples were takenfrom all subjects after each intervention.
VLDL apolipoproteinB kinetic studies were performed in a subgroup after the L-MUFAand H-MUFA diets.dependent manner with increasing intakes of dietary MUFAs.Thischange was entirely accounted for by reduced LDL cholesterol0.49mmol/L after the M-MUFA and H-MUFAdiets,respectively,compared with the concentration after theL-MUFA diet; Pfor trend
0.01).Plasma triacylglycerol andHDL cholesterol were not significantly affected by the dietaryintervention,nor were the concentrations of VLDL2060),or intermediate-density lipoprotein (SProduction and catabolic rates for VLDLunaffected.HDL and LDL subclass distributions were not signi-ficantly altered,but as a consequence of the overall LDL lowering,concentrations of atherogenic LDL-III were 25% lower after theH-MUFA diet than after the L-MUFA diet (The effects of replacing dietary SFAs with MUFAson lipoprotein metabolism appear to be almost exclusively limitedKEY WORDSMonounsaturated fatty acids,saturated fattyacids,LDL,VLDL,lipoprotein elevated plasma concentration of LDL cholesterol is animportant risk factor for cardiovascular disease (1,2),and a largeproportion of the Western population would probably benefit fromcholesterol reduction (3,4).Although pharmacologic interventions,such as statins,are very effective at reducing LDL-cholesterolFrom the Department of Pathological Biochemistry,University of Glasgow,Glasgow,United Kingdom (JMRG,MJC,JC,DB,and CJP),and the Instituteof Food Research,Norwich,United Kingdom (JCB,DMW,DAH,and JCS).Supported by the UK Food Standards Agency.Address reprint requests to JMR Gill,Division of Neuroscience and Bio-medical Systems,Institute of Biomedical and Life Sciences,University of Glas-gow,West Medical Building,University Avenue,Glasgow G12 8QQ,UnitedKingdom. October 16,2002.Accepted for publication February 11,2003.concentrations and cardiovascular disease,such treatments areexpensive,and it is infeasible to provide these to the entire popu-lation at risk.Thus,to lower LDL-cholesterol concentrations inpopulations,nonpharmacologic interventions,such as dietarychanges,are necessary.Replacement of dietary saturated fattyacids (SFAs) with monounsaturated fatty acids (MUFAs) lowersLDL cholesterol,without inducing the hypertriacylglycerolemiasometimes observed when SFAs are replaced by carbohydrates(5).
Accordingly,this type of nutritional approach may provide aSeveral studies showed that isoenergetic replacement of SFAs withMUFAs lowers LDL cholesterol (69).However,these studies gen-and did not consider effects on the concentration and composition ofLDL particles as a whole or effects on the larger lipoproteinspecies [ie,VLDL and intermediate-density lipoprotein (IDL)].cholesterol-rich VLDLs (VLDLcursor particles for LDL,with LDL concentrations being positivelyrelated to the production rate of VLDLbut not of large,triacylglycerol-(10).We therefore hypothesized that substituting MUFAsfor SFAs would reduce the hepatic production rate of VLDLplasma concentrations of VLDLintermediate between VLDLand LDL) but would not inuence theproduction or plasma concentration of VLDLAlthough the effects of substituting MUFAs for SFAs on LDLcholesterol and,to a lesser extent,HDL cholesterol have beenwidely studied,the influence of this dietary change on subfrac-tion distributions of LDL and HDL is unclear.
Because the respec-tive atherogenic and atheroprotective characteristics of these12),this information is important when assessing the overalleffects of replacing dietary SFAs with MUFAs on lipoprotein-associated cardiovascular disease risk.by guest on October 3, 2012ajcn.nutrition.orgDownloaded from.
University of WollongongResearch OnlineDevelopment of food groupings to guide dietaryadvice in people with diabetesL.J.GillenUniversity of WollongongLinda C
TapsellUniversity of WollongongDevelopment of food groupings to guide dietary advice in people DetailsThe development of food groupings to guide dietary advice for people with diabetes
Food advice for diabetes Lynda J Gillen, B Nutr Diet [Hons] APD, PhD candidateLinda C Tapsell, PhD,MHPEd, APD, Professor Smart Foods Centre and Department of Biomedical Science, University of Wollongong NSW 2522 Australia
Corresponding author and address for reprints: Ms Lynda Gillen Smart Foods Centre University of Wollongong Northfields Ave Wollongong NSW 2522 Australia Phone 4221 5197 Fax 4221 4844 Email email@example.com Word count:
Text: 4740 Abstract: 254
Tables: 4 Figures: 2 Acknowledgement: Supported by the Smart Foods Centre and Australian Research Council.The development of food groupings to guide dietary advice for people with diabetes
Objective: To describe the development and characteristics of a food categorisation system and its application to guide advice for diabetes treatment.Research Design and Methods: Foods reported as commonly consumed by 16 adults with diabetes were grouped according to macronutrient content and the type of fat to form a set of reference food groups for dietary advice purposes.Means for energy and macronutrients from individual food groups were then used to construct an overall pattern of intake targeting 8,000kJ and relative amounts of carbohydrate, protein and different types of fat (SFA10%E and PUFA~10%E).Variation in energy and macronutrients contributed by all foods partitioned into each food group was assessed by the coefficient of variation (CV) of data on the whole diet.
Results: To differentiate between sources of fat, 13 food groups emerged and 10 were deemed acceptable according to nutritional guidelines for diabetes treatment.The food group pattern was judged adequate for the achievement of dietary recommendations with low potential variation in total energy (5%) and macronutrient proportions (protein 6%, fat 6%, carbohydrate 3%), but higher variation for different types of fat (SFA 22%, MUFA 11%, PUFA 12%).Targeted proportions for these fat types were achieved only when daily servings of PUFA-rich, oils, nuts and oily fish or soy were included in an ideal intake pattern.
Conclusions: In theory, a dietary pattern constructed from food group sources of macronutrients and individual fat types results in low potential variation from recommended nutrient targets and, therefore, is appropriate to guide advice for the treatment of diabetes.
Keywords: diabetes, food groups, dietary advice, types of fat Diet is often quoted as the cornerstone of treatment for diabetes, and there is considerable evidence that advice targeting specific dietary change offers substantial benefit [1-5].Current guidelines for the treatment of diabetes and related complications provide nutrient intake recommendations, the most specific of which target the proportions of different types of fat in the diet..
Where dietary advice necessarily refers to foods, the system of advice generation, however, needs to assure that nutrient targets can be met.
A number of food guidance systems are available with varying purposes.For example, to support glycaemic control, the carbohydrate counting system  focuses on the distribution of carbohydrate and the Glycaemic Index (GI)  focuses on the type of carbohydrate throughout meals.General food guidance systems, such as the Australian Guide to Healthy Eating (AGHE)  and the Food Guide Pyramid , outline the number of servings from core food groups required to meet nutritional requirements for the general population.
Exchange lists published by the American Dietetic Association (ADA)  take a total diet approach, where all foods can fit into a healthful eating style ,and provide some information on the type of fat contained in foods .
While certain food groups are generally recognised for contributing a particular type of fat, for example meat and dairy for providing saturated fat, none of the current guidance systems provide adequate reference to food sources high in monounsaturated or polyunsaturated fats.Hence, general low-fat advice strategies based on these systems do not necessarily address specific relative amounts of different types of dietary fat .While it is acknowledged that individualising advice is fundamental to the treatment of diabetes, a structured food-based advice strategy to guide the achievement of appropriate targets for each type of fat is also required and must satisfy both recommended and practical evaluations in order to determine whether the resultant intake pattern does indeed achieve the nutrients targeted.
The aim of this paper, therefore, is to describe the development and characteristics of a food categorisation system resulting in a set of food groups inclusive of the type of fat (vegetables, cereals, fruits, milk/soymilk, meat, oily fish/soy, and MUFA and PUFA fat) and its application to guide advice to meet energy and nutrient targets with minimal potential variation for the treatment of diabetes.
Methods The process for the systematic development and evaluation of a specific food group intake pattern to guide advice for the achievement of overall energy and nutrient targets is summarised in Fig.1, and outlined in detail below: [INSERT FIG 1] Development of food groups as sources of macronutrients and fat types Identification of foods to include in the food groupsFoods to be included in a set of food groups for the achievement of specific nutrient targets were identified from foods commonly consumed by 16 women with gestational diabetes mellitus (GDM) from Wollongong, Australia.Characteristics of the study sample have been pr
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