Penny M Kris-Etherton

Pennsylvania State University | Penn State · Department of Nutritional Sciences

Background: Poor diet quality accounts for approximately half of all deaths from cardiometabolic diseases. Food pattern modelling using nationally representative U.S. data suggests that replacing typical snacks consumed with tree nuts will improve diet quality. However, few clinical trials have assessed the potential for tree nuts to improve diet q...

Linoleic acid (LA), as a part of the wider debate about saturated, omega-6 and omega-3 fatty acids (FAs) and health, continues to be at the center of controversy in the world of fatty acid research. A robust evidence base, however, demonstrates that higher intakes and blood levels of LA are associated with improved cardiometabolic health outcomes....

Background Abdominal obesity is associated with endothelial dysfunction and poorer vascular health. Avocado consumption improves postprandial endothelial function; however, the longer‐term effects remain unclear. It was hypothesized that the daily addition of 1 avocado to a habitual diet for 6 months would improve flow‐mediated dilation (FMD) and c...

Background Few clinical trials have evaluated diet quality change as a predictor of intervention effectiveness. Objectives The aim of this study was to examine changes in the Healthy Eating Index (HEI)-2015 after a food-based intervention, and assess the associations between HEI-2015 change and intervention effects on cardiometabolic risk–related...

Introduction: Berries are a rich source of antioxidant polyphenols and other nutrients that are associated with good health. Allostatic load (AL) is an aggregate measure of chronic stress-induced physiological dysregulations across cardiovascular, metabolic, autonomic, and immune systems; the extent of these dysregulations, collectively or in each...

Background Nut intake is associated with better glycemic control and lower cardiovascular disease (CVD) risk. It remains unclear if nut intake timing affects glycemic control and CVD risk factors. Intake of pistachios as a nighttime snack may attenuate morning glucose production and lower fasting plasma glucose (FPG). Objectives We assessed the ef...

Introduction: Poor sleep is associated with numerous adverse health outcomes. Berries are rich in micronutrients and antioxidants that may improve sleep quality and duration. We determined the association of berry consumption and sleep duration and sleep difficulty among adult participants in NHANES. Methods: We analyzed the diet of US adults ag...

The objective of this study was to assess Mediterranean diet (MD) scores (i.e., alignment with a MD pattern) among students and professors, in addition to assessing how adherence to the MD was associated with other lifestyle behaviors. A cross-sectional observational study was conducted with a sample of 127 university professors and 272 students of...

Context Cottonseed oil (CSO) is higher in polyunsaturated fatty acids (PUFA) and saturated fatty acids (SFAs) than many liquid plant oils. Objectives To conduct a systematic review of randomized controlled trials (RCTs) examining effects of CSO on markers of lipid metabolism and evaluate lipid and lipoprotein effects of incorporating CSO into a he...

Background: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death in the United States. Case-based learning using electronic delivery of the modules can educate clinicians and improve translation of evidence-based guidelines into practice for high-risk ASCVD patients. Objective: To develop and optimize module design,...

The aryl hydrocarbon receptor (AHR) is a ligand activated transcription factor that plays an integral role in homeostatic maintenance by regulating cellular functions such as cellular differentiation, metabolism, barrier function, and immune response. An important but poorly understood class of AHR activators are compounds derived from host and bac...

Palmitic acid is the predominant dietary saturated fatty acid (SFA) in the US diet. Plasma palmitic acid is derived from dietary fat and also endogenously from de novo lipogenesis (DNL) and lipolysis. DNL is affected by excess energy intake resulting in overweight and obesity, and the macronutrient profile of the diet. A low-fat diet (higher carboh...

Background: Foods lower in saturated fat, sodium, and added sugars (i.e., overconsumed dietary components) must have an acceptable flavor profile to promote intake. Objective: The aim of this research was to model the impact of using herbs/spices as flavor-enhancers when reducing overconsumed dietary components in commonly consumed foods and eva...

Non-communicable diseases, such as cardiovascular disease, cancer, diabetes, obesity, and hypertension, represent the cause of 60% of all deaths around the globe. With proper diet and natural dietary antioxidant supplements, these diseases can be prevented by up to 40% according to the British Nutrition Foundation. This book provides a comprehensiv...

Lifestyle habits can have a profound impact on atherosclerotic cardiovascular disease (ASCVD) risk. The National Lipid Association previously published recommendations for lifestyle therapies to manage dyslipidemia. This Clinical Perspective provides an update with a focus on nutrition interventions for the three most common dyslipidemias in adults...

Lipids and lipoproteins play a central role in the development of atherosclerotic cardiovascular disease (ASCVD). Dietary fatty acids and refined and simple carbohydrates (CHO) affect the risk of developing ASCVD by modulating circulating lipids and lipoproteins. Replacing saturated fatty acids (SFA) with polyunsaturated fatty acids (PUFA), monouns...

Dried fruits contain many bioactive compounds broadly classified as phytochemicals including phenolics, flavonoids, carotenoids, proanthocyanidins, stilbenes, chalcones/dihydrochalcones, and phytoestrogens. These compounds have antioxidant effects that may benefit health. Dried fruits are also a diverse group of foods with varying fibre contents. T...

Oxidative stress and inflammation are mediators in the pathophysiology of several non-communicable diseases (NCDs). Tree nuts and peanuts lower risk factors of cardiometabolic disease, including blood lipids, blood pressure and insulin resistance, among others. Given their strong antioxidant/anti-inflammatory potential, it is plausible that nuts ma...

The manuscript ‘Saturated Fat: Villain and Bogeyman in the Development of Cardiovascular Disease?’ was recently published in European Journal of Preventive Cardiology.¹ Given the extraordinary importance of nutrition on health, we would like to contextualize this review and help avoid unnecessary public confusion. We agree with the authors that com...

The aryl hydrocarbon receptor (AHR) is a ligand activated transcription factor that plays an integral role in homeostatic maintenance by regulating cellular functions such as cellular differentiation, metabolism, barrier function, and immune response. An important but poorly understood class of AHR activators are compounds derived from host and bac...

In the present review, we provide a comprehensive narrative overview of the current knowledge on the effects of total and specific types of nut consumption (excluding nut oil) on blood lipids and lipoproteins. We identified a total of 19 systematic reviews and meta-analyses of randomized controlled trials (RCTs) that were available in PubMed from t...

Purpose of Review The recent rise in cardiovascular disease (CVD) deaths in the USA has sparked interest in identifying and implementing effective strategies to reverse this trend. Healthy lifestyle behaviors (i.e., healthy diet, regular physical activity, achieve and maintain a healthy weight, avoid tobacco exposure, good quality sleep, avoiding a...

This article describes the structure, function and metabolism of lipoprotein particles, which are complex macromolecules involved in the transport of lipids in the body. The primary lipids that are packaged in lipoproteins are cholesterol and triglycerides. Metabolism of lipoprotein particle involves many metabolic pathways that function to regulat...

Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease and a healthy lifestyle is the first line of therapy for treatment A healthy dietary pattern is a cornerstone for treating elevated low-density lipoprotein-cholesterol (LDL-C) and triglycerides (TG), both of which are hallmarks of dyslipidemia. Much research has been con...

Approximately 40% of patients with type 2 diabetes (T2D) experience an early-morning rise in fasting glucose that is not effectively treated by available oral hypoglycemic agents. This study aimed to determine the acute effect of consuming almond butter as an evening snack on fasting and overnight interstitial glucose, compared to a no-snack contro...

Background Herbs and spices are rich in polyphenolic compounds that may influence gut bacterial composition. The effect of culinary doses of herbs and spices consumed as part of a well-defined dietary pattern on gut bacterial composition has not been previously studied. Objectives The aim of this pre-specified exploratory analysis was to examine g...

Partial replacement of saturated fatty acids (SFA) with unsaturated fatty acids is recommended to reduce cardiovascular disease (CVD) risk. Monounsaturated fatty acids (MUFA), including oleic acid, are associated with lower CVD risk. Measurement of flow-mediated dilation of the brachial artery (FMD) is the gold standard for measuring endothelial fu...

Background Tree nuts have glucoregulatory effects and influence gut microbiota composition. The effect of peanuts on the microbiota has not been investigated. Objectives The aim was to examine the effect of 28 g/d of peanuts for 6-wks, compared to an isocaloric lower-fat higher-carbohydrate (LFHC) snack, on gut microbiota composition. A secondary...

Two of the leading chronic diseases are cardiovascular disease (CVD) and cancer. A cornerstone of prevention for CVD and cancer is a healthy dietary pattern throughout the lifespan. Dietary patterns represent the totality of the diet and reflect habitual consumption of combinations and quantities of foods and nutrients that cumulatively affect heal...

A healthy eating pattern is recommended for all life stages and is central to achieving optimal pregnancy outcomes and successful lactation. The preconception period is a critical window of time during which good nutritional status benefits both the mother and the offspring. The ongoing overweight and obesity epidemic, especially in conjunction wit...

Background Excess visceral adiposity is associated with increased risk of cardiometabolic disorders. Short‐term well‐controlled clinical trials suggest that regular avocado consumption favorably affects body weight, visceral adiposity, and satiety. Methods and Results The HAT Trial (Habitual Diet and Avocado Trial) was a multicenter, randomized, c...

Background It is unknown whether the Dietary Approaches to Stop Hypertension (DASH) is associated with other blood pressure variables, beyond mean systolic (SBP) and diastolic blood pressures (DBP). Objectives The study aimed to study the associations between the DASH dietary pattern and daytime and nighttime mean BPs and BP variability independen...

Background: Elevated lipoprotein(a) [Lp(a)] is a significant contributor to residual CVD risk. Replacement of saturated fatty acids (SFA) with mono- and polyunsaturated fatty acids (MUFA and PUFA), carbohydrates (CHO) has established effects on traditional lipid parameters related to CVD; however, the evidence for Lp(a) is inconsistent. Moreover, s...

Background: Preclinical studies suggested that high intakes of sulfur amino acids (SAA), including methionine and cysteine, may increase risk of age-related chronic diseases. Until now, no epidemiologic studies have investigated habitual dietary intake of SAA in relation to risk of cardiovascular disease (CVD) and mortality. Methods: We prospective...

Objective: Recommended dietary patterns improve cardiovascular disease (CVD) risk factors such as blood pressure and LDL-C, as well as emerging markers that confer residual risk. Strawberry consumption has been shown to improve CVD risk factors, but further research is needed to better understand these effects using a dose-response model that eval...

Given the evidence of the health benefits of plant-based diets and long-chain n-3 fatty acids, there is keen interest in better understanding the role of alpha-linolenic acid (ALA), a plant-derived n-3 fatty acid, on cardiometabolic diseases and cognition. There is increasing evidence for ALA largely based on its major food sources (i.e., walnuts a...

The composition of the gut microbiota and their metabolites are associated with cardiometabolic health and disease risk. Intake of dietary fibers, including resistant starch (RS), has been shown to favorably affect the health of the gut microbiome. The aim of this research was to measure changes in the gut microbiota and fecal short-chain fatty aci...

In cardiology clinic visits, the discussion of optimal dietary patterns for prevention and management of cardiovascular disease is usually very limited. Herein, we explore the benefits and risks of various dietary patterns including intermittent fasting (IF), low carbohydrate, Paleolithic, whole food plant based diet and Mediterranean dietary patte...

Background Women with obesity and infertility are counseled to lose weight prior to conception and infertility treatment to improve pregnancy rates and birth outcomes, although confirmatory evidence from randomized trials is lacking. We assessed whether a preconception intensive lifestyle intervention with acute weight loss is superior to a weight...

Dietary fat is a macronutrient comprised of many different lipids and fatty acids some of which are essential nutrients. The fatty acid classes are saturated (SFA), monounsaturated (MUFA), polyunsaturated (PUFA) (omega-6 and omega-3 fatty acids), and trans (TFA). Unsaturated fatty acids typically exist in the cis configuration and differ structural...

High-oleic (HO) oils are defined as edible oils that contain at least 70% oleic acid per serving. Oils that meet this definition include both trait-enhanced (i.e., high-oleic sunflower or soybean) and naturally occurring high-oleic acid variants (i.e., olive oil). This chapter reviews the health aspects of HO oils with an emphasis on cardiovascular...

Obesity-induced oxidative stress and inflammation are strongly associated with cardiovascular disease (CVD). Accumulating evidence suggests that spices can help lower oxidative stress and inflammation, which may reduce the risk of CVD. The objective of the current review was to comprehensively summarize the findings from clinical studies that exami...

Cardiovascular disease (CVD) is caused by risk factors that can present at all ages, including early life. Healthy lifestyle practices can delay or prevent the onset of CVD risk factors. Consistent evidence demonstrates that a healthy dietary pattern in childhood prevents the early onset of CVD risk factors and lowers CVD risk in adulthood. Healthy...

Background: Dietary factors are a leading contributor to cardiovascular disease. Cardiologists are ideally positioned to initiate dietary discussions with patients and to make appropriate referrals to dietitians/nutritionists, yet the frequency of such referrals is unknown. Methods: A national survey was distributed to cardiologists to assess the f...

Individual responses to diet vary but causes other than genetics are poorly understood. This study sought to determine whether baseline values of homeostasis model assessment (HOMA-IR) was related to changes in small, dense low-density lipoprotein (sdLDL, i.e., LDL4, d = 1.044–1.063 g/mL) amounts quantified by isopycnic density profiling, in mildly...

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in the U.S. and globally. Dietary risk factors contribute to over half of all CVD deaths and CVD-related disability. The aim of this narrative review is to describe methods used to assess diet quality and the current state of evidence on the relationship between diet qua...

Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. This scientific statement emphasizes the importance of dietary patterns beyond individual foods or nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns, and highlights str...

Engagement in healthy lifestyle behaviors is suboptimal. The vast majority of the US population does not meet current recommendations. A healthy lifestyle is defined by consuming a healthy dietary pattern, engaging in regular physical activity, avoiding exposure to tobacco products, habitually attaining adequate amounts of sleep, and managing stres...

At a population level, engagement in healthy lifestyle behaviors is suboptimal in the United States. Moreover, marked disparities exist in healthy lifestyle behaviors and cardiovascular risk factors as a result of social determinants of health. In addition, there are specific challenges to engaging in healthy lifestyle behaviors related to age, dev...

Background Numerous studies demonstrate acute anti-inflammatory properties of individual spices, but none have examined the effect of longer-term consumption of a spice blend incorporated in a meal. Objective We investigated the effect of longer-term spice consumption on inflammatory cytokines and monocyte subsets [classical (CM), intermediate (IM...

Background The glycemic effects of peanuts are not well-studied and no trials have been conducted in adults with elevated fasting plasma glucose (FPG). Furthermore, intake of peanuts as a nighttime snack, an eating occasion affecting FPG, has not been examined. Objective The aim was to determine the effect of consuming 28 g/d of peanuts as a night...

Background Intake of a single meal containing herbs and spices attenuates postprandial lipemia, hyperglycemia, and oxidative stress, and improves endothelial function. There has been limited investigation of the effect of longer-term intake of mixed herbs and spices on risk factors for cardiometabolic diseases. Objectives The objective was to asse...

Excess visceral adiposity is associated with increased risk of diabetes and cardiovascular disease. In the U.S. approximately 60% of adults have visceral obesity. Despite high calorie and fat, small, well-controlled clinical studies suggest that avocado consumption has favorable effects on body weight and visceral adiposity. Additionally, short-ter...

Emerging cardiovascular disease (CVD) risk factors, including central vascular function and HDL efflux, may be modifiable with food-based interventions such as cranberry juice. A randomized, placebo-controlled, crossover trial was conducted in middle-aged adults with overweight/obesity (n = 40; mean BMI: 28.7 ± 0.8 kg/m2; mean age: 47 ± 2 years) an...

Bifidobacterium animalis subsp. lactis BB-12 is a probiotic strain that has been used worldwide since 1985. It has commonly been delivered in fermented dairy products for perceived benefits associated with gut health and enhanced immune function.

Herbs and spices are recommended to increase flavor and displace salt in the diet. Accumulating evidence suggests herbs and spices may improve risk factors for cardiometabolic diseases. In this narrative review, an overview of evidence from human clinical trials examining the effect of herbs and spices on risk factors for cardiometabolic diseases i...