NIH Research Festival
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FAES Terrace
NIDDK
CLINICAL-7
Background: High quality plant-based diets (PBD) are recommended for decreasing atherosclerotic cardiovascular disease (ASCVD) risk. Optimal quantity of dietary fat, particularly extra virgin olive oil (EVOO), within a PBD diet is unclear. Objective: To compare effects of high (4 tablespoon/day) vs low (<1 teaspoon/day) EVOO consumption within a whole-food PBD (WFPBD) on low density lipoprotein (LDL-C) and cardiometabolic markers. Methods: In a randomized, crossover trial, adults with >5% ASCVD risk followed a high to low (H2L) or low to high (L2H) EVOO WFPBD for 4 weeks each, separated by a 1-week washout. Linear mixed models assessed changes between phases. Results: In 40 participants (75% female, age 64+9 years), fat intake comprised 48% and 32% of energy in the high and low EVOO phases, respectively. Both diets comparably reduced LDL-C, total cholesterol, apolipoprotein B, HDL-C, glucose, and hs-CRP (all P<0.05), with diet-sequence interactions for LDL-C (P=0.003). Differences in LDL-C between diets were detected by diet order (H2L: Δ-12.7 mg/dl, P=0.04 vs L2H: Δ+15.8 mg/dl, P=0.02). Similarly, L2H order led to increased glucose, total cholesterol, and HDL-C (all P<0.05). Over period one, greater LDL-C reductions occurred after low-EVOO (-25.5+5.1 mg/dl) vs high-EVOO (-16.7+4.2 mg/dl), P=0.162, diminished over period two (-4.0+4.3 vs -9.7+5.1 mg/dl, P=0.382). Conclusions: Both patterns, containing >30% energy from dietary fat, improved cardiometabolic risk compared to baseline. More robust LDL-C decreases potentially indicates low-EVOO may be more optimal for lowering CVD risk than high-EVOO within a WFPBD. Addition of EVOO after following a low-EVOO pattern may impede further LDL reductions.
Scientific Focus Area: Clinical Research
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