TY - JOUR
T1 - The type and amount of dietary fat affect plasma factor VIIc, fibrinogen, and PAI-1 in healthy individuals and individuals at high cardiovascular disease risk
T2 - 2 randomized controlled trials
AU - DELTA Investigators
AU - Kris-Etherton, Penny M.
AU - Stewart, Paul W.
AU - Ginsberg, Henry N.
AU - Tracy, Russell P.
AU - Lefevre, Michael
AU - Elmer, Patricia J.
AU - Berglund, Lars
AU - Ershow, Abby G.
AU - Pearson, Thomas A.
AU - Ramakrishnan, Rajasekhar
AU - Holleran, Stephen F.
AU - Dennis, Barbara H.
AU - Champagne, Catherine M.
AU - Karmally, Wahida
N1 - Funding Information:
Supported by National Heart, Lung, and Blood Institute grants 5-U01-HL49644, 49648, 49649, 49651, and 49659. Supported in part by grants MO1-RR00400 and MO1-RR00645 from the National Center for Research Resources. Author disclosures: The authors report no conflicts of interest. Supplemental Figures 1–6 and Supplemental Tables 1 and 2 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn. Present address for ML: Department of Nutrition, Dietetics and Food Sciences, Utah State University, 9815 Old Main Hill, Logan, UT 84322-9815 Present address for PJE: Portland, OR. Present address for LB: Clinical and Translational Science Center, UC-Davis, School of Medicine, Sacramento, CA. Present address for AGE: Office of Dietary Supplements, National Institutes of Health, Bethesda, MD. Present address for TAP: Department of Epidemiology, University of Florida, Gainesville, FL. Present address for BHD: Chapel Hill, NC. See the Acknowledgments for a list of the DELTA investigators. Address correspondence to PMK-E (e-mail: pmk3@psu.edu). Abbreviations used: AAD, average American diet; ACC, American College of Cardiology; AHA, American Heart Association; BTG, B-thromboglobulin; CHD, coronary heart disease; CRP, C-reactive protein; CVD, cardiovascular disease; DASH, Dietary Approaches to Stop Hypertension; DD, D-dimer; DELTA, Dietary Effects on Lipoproteins and Thrombogenic Activity; F1.2, prothrombin fragments; HOMA, homeostasis model assessment; HTE, heterogeneity of treatment effect; MetSyn, metabolic syndrome; PAI-1, plasminogen activator inhibitor 1; PAP, plasmin-antiplasmin complex; TG, plasma triglyceride.
Publisher Copyright:
Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background: Factor VIIc, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) are cardiovascular disease (CVD) risk factors and are modulated, in part, by fat type and amount. Objective: We evaluated fat type and amount on the primary outcomes: factor VIIc, fibrinogen, and PAI-1. Methods: In the Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA) Trial, 2 controlled crossover feeding studies evaluated substituting carbohydrate or MUFAs for SFAs. Study 1: healthy participants (n = 103) were provided with (8 wk) an average American diet [AAD; designed to provide 37% of energy (%E) as fat, 16% SFA], a Step 1 diet (30%E fat, 9% SFA), and a diet low in SFA (Low-Sat; 26%E fat, 5% SFA). Study 2: participants (n = 85) at risk for CVD and metabolic syndrome (MetSyn) were provided with (7 wk) an AAD, a step 1 diet, and a high-MUFA diet (designed to provide 37%E fat, 8% SFA, 22% MUFA). Results: Study 1: compared with AAD, the Step 1 and Low-Sat diets decreased mean factor VIIc by 1.8% and 2.6% (overall P = 0.0001), increased mean fibrinogen by 1.2% and 2.8% (P = 0.0141), and increased mean square root PAI-1 by 0.0% and 6.0% (P = 0.0037), respectively. Study 2: compared with AAD, the Step 1 and high-MUFA diets decreased mean factor VIIc by 4.1% and 3.2% (overall P < 0.0001), increased mean fibrinogen by 3.9% and 1.5% (P = 0.0083), and increased mean square-root PAI-1 by 2.0% and 5.8% (P = 0.1319), respectively. Conclusions: Replacing SFA with carbohydrate decreased factor VIIc and increased fibrinogen in healthy and metabolically unhealthy individuals and also increased PAI-1 in healthy subjects. Replacing SFA with MUFA decreased factor VIIc and increased fibrinogen but less than carbohydrate. Our results indicate an uncertain effect of replacing SFA with carbohydrate or MUFA on cardiometabolic risk because of small changes in hemostatic factors and directionally different responses to decreasing SFA.term=NCT00000538&rank=1 as NCT00000538.
AB - Background: Factor VIIc, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) are cardiovascular disease (CVD) risk factors and are modulated, in part, by fat type and amount. Objective: We evaluated fat type and amount on the primary outcomes: factor VIIc, fibrinogen, and PAI-1. Methods: In the Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA) Trial, 2 controlled crossover feeding studies evaluated substituting carbohydrate or MUFAs for SFAs. Study 1: healthy participants (n = 103) were provided with (8 wk) an average American diet [AAD; designed to provide 37% of energy (%E) as fat, 16% SFA], a Step 1 diet (30%E fat, 9% SFA), and a diet low in SFA (Low-Sat; 26%E fat, 5% SFA). Study 2: participants (n = 85) at risk for CVD and metabolic syndrome (MetSyn) were provided with (7 wk) an AAD, a step 1 diet, and a high-MUFA diet (designed to provide 37%E fat, 8% SFA, 22% MUFA). Results: Study 1: compared with AAD, the Step 1 and Low-Sat diets decreased mean factor VIIc by 1.8% and 2.6% (overall P = 0.0001), increased mean fibrinogen by 1.2% and 2.8% (P = 0.0141), and increased mean square root PAI-1 by 0.0% and 6.0% (P = 0.0037), respectively. Study 2: compared with AAD, the Step 1 and high-MUFA diets decreased mean factor VIIc by 4.1% and 3.2% (overall P < 0.0001), increased mean fibrinogen by 3.9% and 1.5% (P = 0.0083), and increased mean square-root PAI-1 by 2.0% and 5.8% (P = 0.1319), respectively. Conclusions: Replacing SFA with carbohydrate decreased factor VIIc and increased fibrinogen in healthy and metabolically unhealthy individuals and also increased PAI-1 in healthy subjects. Replacing SFA with MUFA decreased factor VIIc and increased fibrinogen but less than carbohydrate. Our results indicate an uncertain effect of replacing SFA with carbohydrate or MUFA on cardiometabolic risk because of small changes in hemostatic factors and directionally different responses to decreasing SFA.term=NCT00000538&rank=1 as NCT00000538.
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U2 - 10.1093/jn/nxaa137
DO - 10.1093/jn/nxaa137
M3 - Article
C2 - 32492148
AN - SCOPUS:85089128941
VL - 150
SP - 2089
EP - 2100
JO - Journal of Nutrition
JF - Journal of Nutrition
SN - 0022-3166
IS - 8
ER -