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Metabolic effects of wheat fiber supplementation in diet in subjects with metabolic cardiovascular syndrome
Posters 14. Nutrition
IP265
[2] Agnilar-Sslinas et al. Atherosclerosis, 1998; 141: 203-207 [3] J&visa10 et al. Atherosclerosis, 1999; 147: 237-242
2 baseline
6 weeks
Pvaluc
bapelim
6 w4ce
P valve
237zk32.6
1W.lf21.8
0
228.0h73.6
187.2f54.4
0.029
162176.0
123.4iz57.8 0.016
174.6i69.4
159.8c'c81.9 0.313
37.97zk7.89 40.56f9.79
0.119
8.56zk1.75
9.74f4.73
0.25,
29.4f6.21
30.81zk5.3
0.057
0.*9*0.02
0.30fO.l
0.391
138.6k29.5
L41.8h25.2
0.570
144.Ozk42.6 133.4dc34.3 0.340 3.38zk3.31
7.1zt1.49
lp2641
0.045
113 EFFECT OF THE AUSTRALIAN FOUNDATION RECOMMENDED IN DIALYSIS PATIENTS
NATIONAL HEART LIPID-LOWERING DIET
J. Westhuyzen, D. Saltissi, C. Morgan, B. Knight, R.J. Rigby, W. Chang. Departments of Renal Medicine, Royal Brikbane/Keperra and Princess Alexandra Hospitals, Brisbane, Australia Dyslipidaemia and atherosclerotic cardiovascular disease are common in patients with end-stage renal failure (ESRF). Dietary manipulation is the recommended first line therapy in people with normal renal function; however complex dietary requirements of dialysis-treated patients impose significant constraints. We have evaluated the effect of trying to comply with Australian National Heart Foundation (NHF) lipid-lowering recommendations superimposed on our normally prescribed dialysis diet over 14 weeks in stable subjects treated with either haemodialysis (HD, n = 47) or chronic peritoneal dialysis (PD, n = 28). Sixty seven patients completed the study. With HD, saturated fat intake decreased by a mean of 18% and cholesterol intake by 16%. This was associated with a fall in mean total cholesterol (&SE) from 6.0f0.2 to 5.4fO.l mmol/L (p = 0.007) and LDL cholesterol from 3.8&O. 1 to 3.4fO.l mmoYL (p = 0.009). Total energy intake however dropped by almost 10%. There were no significant changes in the PD patients. Only 24.4% (10/41) of HD and 15.4% (4/26) of PD subjects normalised their lipids. This study demonstrates that, if adhered to, properly constructed dialysis diets are close to NHF lipid-lowering recommendations. Further dietary manipulation is difficult, leads to little benefit in the majority, and is accompanied by added problems of adherence. We conclude that the majority of dyslipidaemic ESRF patients require pharmacological therapy. Supported in part by a grant from Merck Sharp & Dohme (Australia). lp2661 METABOLIC EFFECTS OF WHEAT FIBER SUPPLEMENTATION IN DIET IN SUBJECTS WITH METABOLIC CARDIOVASCULAR SYNDROME S. Lavre, I. Keber. University Medical Center; Internal MedicineDepartment of Angiology, Ljubljana, Slovenia
hypertriglyceridemia.
:/-pL(DI
IO I
3 Hours After Meal
Food rich in cereal fiber, especially wheat fiber, has been shown to protect against atherosclerotic cardiovascular disease. Patients with metabolic cardiovascular syndrome (MCVS), which includes insulin resistance, dyslipidemia, arterial hypertension and increased blood thrombogenic potential, are at risk for accelerated atherosclerosis. We examined the effects of wheat fiber supplementation on cardiovascular risk factors in these patients. Thirty-seven subjects with MCVS, 26 males and 11 females, aged 27 to 65 years, mean 47 years, with body mass index (BMI) 30.8f3.4 kg/m* were randomly assigned to two groups. Subjects in study group consumed 21 g of wheat husk fiber granules (Trifyba@) daily for 5 weeks in addition to their regular diet. Subjects in control group maintained their regular diet only. Blood pressure and serum level of glucose, insulin, lipids and plasma fibrinolytic variables were determined before and after treatment and after four weeks of washout period. Oral glucose tolerance test (OGTT) was also performed and index of insulin resistance (IIR) was calculated as insulini(22.5 e-In glucose). After five weeks of treatment period patients in both groups lost on average one percent of body weight. Diastolic blood pressure decreased only in treated group (from 97.2flO to 90.2f13 mmHg, p = 0.03), while the decrease of systolic blood pressure was higher in treated than in control group. After treatment we observed the decrease of median fasting glucose (from 5.0 to 4.6 mmol/l, p = 0.03), glucose level after 60 minutes of OGTT (from 9.2 to 7.9 mmol/l, p = 0.03), the mean total cholesterol (6.5 to 5.6 mmol/l, p = O.OOl), LDL cholesterol (from 3.8 to 3.2 mmol/l, p = 0.002) and HDL cholesterol (from 1.1 to 1.0 mmol, p = 0.03), while atherogenic index LDLHDL cholesterol did not changed significantly. After treatment we also observed lower median fasting insulin level (12.7 vs. 16.6 IU/ml, p = 0.04) and lower median IIR (2.6 vs. 3.3, P = 0.03) in study than in control group. No significant changes in plasma fibrinolytic activity during the study were observed in either group. In conclusion, our result showed that wheat husk supplementation decreased blood pressure and has favorable effects on glucose and lipid metabolism, but does not affect blood fibrinolysis in subjects with MCVS.
6 Hours A&r Meal
72nd EAS Congress
IP265
[2] Agnilar-Sslinas et al. Atherosclerosis, 1998; 141: 203-207 [3] J&visa10 et al. Atherosclerosis, 1999; 147: 237-242
2 baseline
6 weeks
Pvaluc
bapelim
6 w4ce
P valve
237zk32.6
1W.lf21.8
0
228.0h73.6
187.2f54.4
0.029
162176.0
123.4iz57.8 0.016
174.6i69.4
159.8c'c81.9 0.313
37.97zk7.89 40.56f9.79
0.119
8.56zk1.75
9.74f4.73
0.25,
29.4f6.21
30.81zk5.3
0.057
0.*9*0.02
0.30fO.l
0.391
138.6k29.5
L41.8h25.2
0.570
144.Ozk42.6 133.4dc34.3 0.340 3.38zk3.31
7.1zt1.49
lp2641
0.045
113 EFFECT OF THE AUSTRALIAN FOUNDATION RECOMMENDED IN DIALYSIS PATIENTS
NATIONAL HEART LIPID-LOWERING DIET
J. Westhuyzen, D. Saltissi, C. Morgan, B. Knight, R.J. Rigby, W. Chang. Departments of Renal Medicine, Royal Brikbane/Keperra and Princess Alexandra Hospitals, Brisbane, Australia Dyslipidaemia and atherosclerotic cardiovascular disease are common in patients with end-stage renal failure (ESRF). Dietary manipulation is the recommended first line therapy in people with normal renal function; however complex dietary requirements of dialysis-treated patients impose significant constraints. We have evaluated the effect of trying to comply with Australian National Heart Foundation (NHF) lipid-lowering recommendations superimposed on our normally prescribed dialysis diet over 14 weeks in stable subjects treated with either haemodialysis (HD, n = 47) or chronic peritoneal dialysis (PD, n = 28). Sixty seven patients completed the study. With HD, saturated fat intake decreased by a mean of 18% and cholesterol intake by 16%. This was associated with a fall in mean total cholesterol (&SE) from 6.0f0.2 to 5.4fO.l mmol/L (p = 0.007) and LDL cholesterol from 3.8&O. 1 to 3.4fO.l mmoYL (p = 0.009). Total energy intake however dropped by almost 10%. There were no significant changes in the PD patients. Only 24.4% (10/41) of HD and 15.4% (4/26) of PD subjects normalised their lipids. This study demonstrates that, if adhered to, properly constructed dialysis diets are close to NHF lipid-lowering recommendations. Further dietary manipulation is difficult, leads to little benefit in the majority, and is accompanied by added problems of adherence. We conclude that the majority of dyslipidaemic ESRF patients require pharmacological therapy. Supported in part by a grant from Merck Sharp & Dohme (Australia). lp2661 METABOLIC EFFECTS OF WHEAT FIBER SUPPLEMENTATION IN DIET IN SUBJECTS WITH METABOLIC CARDIOVASCULAR SYNDROME S. Lavre, I. Keber. University Medical Center; Internal MedicineDepartment of Angiology, Ljubljana, Slovenia
hypertriglyceridemia.
:/-pL(DI
IO I
3 Hours After Meal
Food rich in cereal fiber, especially wheat fiber, has been shown to protect against atherosclerotic cardiovascular disease. Patients with metabolic cardiovascular syndrome (MCVS), which includes insulin resistance, dyslipidemia, arterial hypertension and increased blood thrombogenic potential, are at risk for accelerated atherosclerosis. We examined the effects of wheat fiber supplementation on cardiovascular risk factors in these patients. Thirty-seven subjects with MCVS, 26 males and 11 females, aged 27 to 65 years, mean 47 years, with body mass index (BMI) 30.8f3.4 kg/m* were randomly assigned to two groups. Subjects in study group consumed 21 g of wheat husk fiber granules (Trifyba@) daily for 5 weeks in addition to their regular diet. Subjects in control group maintained their regular diet only. Blood pressure and serum level of glucose, insulin, lipids and plasma fibrinolytic variables were determined before and after treatment and after four weeks of washout period. Oral glucose tolerance test (OGTT) was also performed and index of insulin resistance (IIR) was calculated as insulini(22.5 e-In glucose). After five weeks of treatment period patients in both groups lost on average one percent of body weight. Diastolic blood pressure decreased only in treated group (from 97.2flO to 90.2f13 mmHg, p = 0.03), while the decrease of systolic blood pressure was higher in treated than in control group. After treatment we observed the decrease of median fasting glucose (from 5.0 to 4.6 mmol/l, p = 0.03), glucose level after 60 minutes of OGTT (from 9.2 to 7.9 mmol/l, p = 0.03), the mean total cholesterol (6.5 to 5.6 mmol/l, p = O.OOl), LDL cholesterol (from 3.8 to 3.2 mmol/l, p = 0.002) and HDL cholesterol (from 1.1 to 1.0 mmol, p = 0.03), while atherogenic index LDLHDL cholesterol did not changed significantly. After treatment we also observed lower median fasting insulin level (12.7 vs. 16.6 IU/ml, p = 0.04) and lower median IIR (2.6 vs. 3.3, P = 0.03) in study than in control group. No significant changes in plasma fibrinolytic activity during the study were observed in either group. In conclusion, our result showed that wheat husk supplementation decreased blood pressure and has favorable effects on glucose and lipid metabolism, but does not affect blood fibrinolysis in subjects with MCVS.
6 Hours A&r Meal
72nd EAS Congress