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A Mediterranean-style Eating Pattern Lower in Lean Red Meat Reduced Plasma Trimethylamine N-Oxide in Adults Classified as Overweight or Obese (P08-030-19)

ABSTRACT: Abstract Objectives To determine the effect of adopting a Mediterranean-style eating pattern with different quantities of lean unprocessed red meat on the plasma concentration of Trimethylamine N-Oxide (TMAO), an emerging potential cardiovascular disease risk factor, in middle-aged adults classified as overweight or obese. Methods Thirty-nine adults (12 males and 27 females; age 46 ±10 years, BMI 30.6 ± 3.6 kg/m2; mean ± SD) participated in a randomized, crossover and controlled feeding trial. Each participant consumed a Mediterranean-style eating pattern for two 5-week intervention periods separated by ?4 weeks of consuming their unrestricted, self-selected diet (washout). The Mediterranean-style eating pattern contained either a commonly recommended amount of red meat (?200 g/wk, Med-200) or the average amount consumed in the U.S. (?500 g/wk, Med-500). Plasma samples were collected before (baseline) and at the end (post) of the two intervention periods and TMAO was measured by stable isotope dilution chromatography tandem mass spectrometry. Geometric means were compared with mixed model tests in SAS. Results Baseline TMAO concentrations were not different between interventions (Med-200 = 4.4 ± 2.7 and Med-500 = 5.2 ± 4.5 ?M, P = 0.476). These concentrations are similar to values reported in healthy adults. Post-intervention, TMAO was lower in Med-200 vs. Med-500 (3.1 ± 1.2 and 5.0 ± 2.6 ?M, P = 0.001). Conclusions The 2015–2020 Dietary Guidelines for Americans encourages adopting a Mediterranean-style eating pattern to promote cardiovascular health, including reduced blood pressure and improved lipid-lipoprotein profile. The current results suggest that adopting a Mediterranean-study eating pattern may also reduce the cardiovascular disease risk factor TMAO, but only when it contains a lower, recommended, amount of lean unprocessed red meat. The influences of animal- and plant-based foods consumed with a Mediterranean-style and other healthy eating patterns on emerging cardiovascular disease risk factors remain to be determined. This trial was registered at clinicaltrials.gov as NCT02573129. Funding Sources Supported by theBeef Checkoff, the Pork Checkoff, the NIH pre-doctoral training grant 5T32DK076540-08, the NIH-supported Indiana Clinical and Translational Sciences Institute and the USDA-ARS-Western Human Nutrition Research Center.

SUBMITTER: Gertz E

PROVIDER: S-EPMC6818854 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Project description:Background:A Mediterranean-style eating pattern (Mediterranean Pattern) is often described as being low in red meat. Research shows that lean, unprocessed red meat can be incorporated into healthy eating patterns to improve cardiometabolic disease (CMD) risk factors. Objective:We assessed the effects of consuming different amounts of lean, unprocessed red meat in a Mediterranean Pattern on CMD risk factors. We hypothesized that consuming a Mediterranean Pattern would improve CMD risk factors and that red meat intake would not influence these improvements. Design:In an investigator-blinded, randomized, crossover, controlled feeding trial, 41 subjects [mean ± SD age: 46 ± 2 y; mean ± SD body mass index (kg/m2): 30.5 ± 0.6] were provided with a Mediterranean Pattern for two 5-wk interventions separated by 4 wk of self-selected eating. The Mediterranean Patterns contained ∼500 g [typical US intake (Med-Red)] and ∼200 g [commonly recommended intake in heart-healthy eating patterns (Med-Control)] of lean, unprocessed beef or pork per week. Red meat intake was compensated by poultry and other protein-rich foods. Baseline and postintervention outcomes included fasting blood pressure, serum lipids, lipoproteins, glucose, insulin, and ambulatory blood pressure. The presented results were adjusted for age, sex, and body mass at each time point (P < 0.05). Results:Total cholesterol decreased, but greater reductions occurred with Med-Red than with Med-Control (-0.4 ± 0.1 and -0.2 ±0.1 mmol/L, respectively, intervention × time = 0.045]. Low-density lipoprotein decreased with Med-Red but was unchanged with Med-Control [-0.3 ± 0.1 and -0.1 ± 0.1 mmol/L, respectively, intervention × time = 0.038], whereas high-density lipoprotein (HDL) concentrations decreased nondifferentially [-0.1 ± 0.0 mmol/L]. Triglycerides, total cholesterol:HDL, glucose, and insulin did not change with either Med-Red or Med-Control. All blood pressure parameters improved, except during sleep, independent of the red meat intake amount. Conclusions:Adults who are overweight or moderately obese may improve multiple cardiometabolic disease risk factors by adopting a Mediterranean-style eating pattern with or without reductions in red meat intake when red meats are lean and unprocessed. This trial was registered at clinicaltrials.gov as NCT02573129.

Project description:BackgroundReducing red meat intake is commonly recommended. Limited observational studies suggest that healthy eating patterns with red meat are associated with improved quality of life.ObjectiveThe secondary objectives of this randomized crossover controlled-feeding trial were to assess the effects of following a Mediterranean-style eating pattern (Med-Pattern) with different amounts of red meat on indexes of personal well-being (i.e., perceived quality of life, mood, and sleep) in overweight or obese adults. We hypothesized that following a Med-Pattern would improve these outcomes, independent of red meat intake amount.MethodsForty-one participants [aged 46 ± 2 y; body mass index (kg/m2): 30.5 ± 0.6; n = 28 women, n = 13 men) were provided Med-Pattern foods for two 5-wk periods separated by 4 wk of self-selected eating. The Med-Red Pattern contained ∼500 g/wk (typical US intake), and the Med-Control Pattern contained ∼200 g/wk (commonly recommended intake in heart-healthy eating patterns) of lean, unprocessed beef or pork compensated with mainly poultry and dairy. Baseline and postintervention outcomes measured were perceived quality of life via the MOS 36-Item Short-Form Health Survey, version 2 (SF-36v2), daily mood states via the Profile of Mood States (POMS), sleep perceptions via the Pittsburgh Sleep Quality Index, and sleep patterns via actigraphy. Data were analyzed via a doubly repeated-measures ANOVA adjusted for age, sex, and body mass at each time point.ResultsFollowing a Med-Pattern did not change domains of physical health, mental health, total mood disturbances, sleep perceptions, and sleep patterns but improved subdomains of physical health role limitations (SF-36v2: 93.6-96.7%; P = 0.038), vitality (SF-36v2: 57.9-63.0%; P = 0.020), and fatigue (POMS: 2.9-2.5 arbitrary units; P = 0.039). There were no differences between the Med-Red and Med-Control Patterns (time × pattern, P-interaction > 0.05).ConclusionFollowing a Med-Pattern, independent of lean, unprocessed red meat intake, may not be an effective short-term strategy to meaningfully improve indexes of personal well-being in adults who are overweight or obese. This trial was registered at clinicaltrials.gov as NCT02573129.

Project description:BackgroundA Mediterranean-style eating pattern is consistently associated with a decreased diabetes risk in Mediterranean and European populations. However, results in U.S. populations are inconsistent. The objective of this study was to assess whether a Mediterranean-style eating pattern would be associated with diabetes risk in a large, nationally representative U.S. cohort of black and white men and women.MethodsParticipants from the Atherosclerosis Risk in Communities study prospective cohort without diabetes, cardiovascular disease, or cancer at baseline (visit 1, 1987-1989; n?=?11,991) were included (mean age 54 years, 56% female, 75% white). Alternate Mediterranean Diet scores (aMed) were calculated using the mean dietary intake self-reported at visit 1 and visit 3 (1993-1995) or visit 1 only for participants censored before visit 3. Participants were followed from visit 1 through 31 December 2016 for incident diabetes. We used Cox regression models to characterize associations of aMed (quintiles as well as per 1-point higher) with incident diabetes adjusted for energy intake, age, sex, race and study center, and education (Model 1) for all participants then stratified by race and body mass index (BMI). Model 2 included potential mediating behavioral and clinical measures associated with diabetes. Results are presented as hazard ratios and 95% confidence intervals.ResultsOver a median follow-up of 22 years, there were 4024 incident cases of diabetes. Higher aMed scores were associated with lower diabetes risk [Model 1: 0.83 (0.73-0.94) for Q5 vs Q1 (p-trend?<?0.001) and 0.96 (0.95-0.98) for 1-point higher]. Associations were stronger for black vs white participants (interaction p?<?0.001) and weaker for obese vs normal BMI (interaction p?<?0.01). Associations were attenuated but statistically significant in Model 2.ConclusionsAn eating pattern high in fruits, vegetables, whole grains, legumes, nuts, and fish, and moderate in alcohol was associated with a lower risk of diabetes in a community-based U.S.Population

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A Mediterranean-style Eating Pattern Lower in Lean Red Meat Reduced Plasma Trimethylamine N-Oxide in Adults Classified as Overweight or Obese (P08-030-19)

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