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Publications (84)
Empirical evidence supporting the benefits of dietary recommendations for patients with advanced heart failure is scarce. We prospectively evaluated the relation of dietary habits to pre-transplant clinical outcomes in the multisite observational Waiting for a New Heart Study.
A total of 318 heart transplant candidates (82% male, age 53 ± 11 years)...
Carotenoids may interact differently in their absorption and transport in animals and humans. The simultaneous administration of large amounts of lutein, zeaxanthin and beta carotene would affect not only plasma values but also their concentrations in the retina and other tissues.
In this study, we investigated the transport, distribution and inter...
Fish and fish oils contain the very-long-chained and highly polyunsaturated n–31 fatty acids which are derived from phytoplankton, the base of the food chain in the oceans, lakes, and rivers (1). Phytoplankton
synthesize the n–3 fatty acids, eicosapentaenoic (20:5) (EPA) and docosahexaenoic acids (22:6) (DHA), which are subsequently incorporated
in...
The relationship of plasma cholesterol-reducing interventions to emotional states, such as depression and hostility, remains a topic of debate. The present study employed a randomised, controlled design, and was conducted at a clinical research center to test the effect of dietary cholesterol-lowering on psychological symptoms. Ten women and eight...
Breast milk and blood were obtained from 38 lactating women. Twenty one of these women took a lutein supplement of 12 mg per day weeks five through eight of lactation. Blood was also obtained from five preterm infants whose mothers took the supplement. Breast milk and plasma carotenoids were analyzed by high‐pressure liquid chromatography. Maternal...
Low dietary intakes and low plasma concentrations of lutein and zeaxanthin are associated with an increased risk of age-related macular degeneration (AMD). No studies have challenged AMD patients with a diet high in lutein and zeaxanthin.
The objective was to examine the effect of diets low or high in lutein and zeaxanthin on plasma carotenoids and...
Lutein and zeaxanthin are pigmented oxygenated carotenoids, or xanthophylls, derived from plants and concentrated in the retina of primates and birds. We investigated the transport, distribution and depletion of lutein and zeaxanthin in the plasma and tissues of newly hatched chicks fed xanthophyll-free diets. One-day-old Leghorn chicks were random...
This work was supported by research grants from the Oregon Sea Grant Program, National Oceanic and Atmospheric Administration, Department of Commerce, No. NA89AA-D-SG108 (Proj. No. R/SH-4) and from the General Clinical Research Center (No. RR00334) of the Division of Research Resources.
Since the dawn of civilization, carbohydrate has comprised the largest source of energy in the diet for most populations. The source of the carbohydrate has been from plants in the form of complex carbohydrate high in fiber. Only in affluent cultures has sugar contributed so much of the total energy. When carbohydrate is consumed as a major compone...
Key Points
Animal studies, epidemiological studies, and clinical trials have shown that fish and fish oil may reduce sudden death by preventing cardiac arrhythmias.
n-3 fatty acids have an antithrombotic effect through the diminution of thromboxane A2 that produces platelet aggregation and vasoconstriction.
Eicosapentaenoic and docosahexaenoic acid...
To test our hypothesis that lower intakes of previously identified cardioprotective nutrients would be associated with the coronary epidemic in Central and Eastern Europe.
We conducted a survey of coronary mortality in 16 countries and diet in 19 countries.
Countries were placed in four groups with different cultural patterns (Central and Eastern E...
In a recent meta-analysis, human milk feeding of low birth-weight (LBW) infants was associated with a 5.2 point improvement in IQ tests. However, in the studies in this meta-analysis, feeding regimens were used (unfortified human milk, term formula) that no longer represent recommended practice.
To compare the growth, in-hospital feeding tolerance,...
Objective:
Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are long-chain polyunsaturated fatty acids found in breast milk and recently added to infant formulas. Their importance in infant nutrition was recognized by the rapid accretion of these fatty acids in the brain during the first postnatal year, reports of enhanced intellectual develo...
Background: Flaxseed oil is a rich source of 18:3n-3 (alpha-linolenic acid, or ALA), which is ultimately converted to 22:6n - 3 (docosahexaenoic acid, or DHA), a fatty acid important for the development of the infant brain and retina. Objective: The objective of this study was to determine the effect of flaxseed oil supplementation on the breast-mi...
Flaxseed oil is a rich source of 18:3n-3 (alpha-linolenic acid, or ALA), which is ultimately converted to 22:6n-3 (docosahexaenoic acid, or DHA), a fatty acid important for the development of the infant brain and retina.
The objective of this study was to determine the effect of flaxseed oil supplementation on the breast-milk, plasma, and erythrocy...
Dietary cholesterol has been known as a dominant factor in the genesis of atherosclerosis since 1908. The evidence for the role of dietary cholesterol is based upon animal experiments, the chemistry of atherosclerotic plaques, worldwide epidemiology, and human feeding studies. All lines of evidence converge to indicate that dietary cholesterol is a...
Smith-Lemli-Opitz syndrome (SLOS) is a genetic disorder characterized by low plasma cholesterol and high 7-dehydrocholesterol (7-DHC). Synthesis of cholesterol and 7-DHC and its metabolites is regulated by HMG-CoA reductase, whose activity can be measured by 24-h excretion of its product mevalonate. We devised a simple, non-invasive method for coll...
To examine the relationship between parents' attitudes toward nutrition and plasma lipid levels of their children.
Parents' nutrition attitudes were assessed with the Nutritional Attitude Scale, a self-report questionnaire measuring attitudes toward the adoption of a low-fat, low-cholesterol diet. Parents' and children's plasma lipid and lipoprotei...
A randomized, masked, controlled trial was conducted to assess effects of supplementing premature infant formulas with oils containing the long-chain polyunsaturated fatty acids, arachidonic acid (AA; 20:4 n6), and docosahexaenoic acid (DHA; 22:6 n3) on growth, visual acuity, and multiple indices of development.
Infants (N = 470) with birth weights...
Premenopausal African American women have a 2-3 times greater incidence of coronary heart disease (CHD) than do white women. The plasma lipid responsiveness to dietary fat, which may be associated with CHD, has not been adequately studied in premenopausal African American or white women.
The objective of our study was to compare the effect of diet...
Premenopausal black women have a two to threefold greater rate of coronary heart disease than premenopausal white women. This study was designed to provide greater insight into the reasons for this difference which is currently unclear. Coronary heart disease risk factors were compared in 100 black and 100 white, healthy premenopausal women, ages 1...
Assessment of essential fatty acid status requires collection of blood or adipose tissue samples. However, these invasive techniques cannot always be used in studies involving infants, young children, or subjects from whom it is difficult to obtain blood. A body tissue that is easy to access is the buccal mucosa (cheek cells).
The objective was to...
Premenopausal black women have a greater rate of coronary artery disease (CAD) than do premenopausal white women. Plasma total homocysteine concentrations, a risk factor for CAD, have not been reported in premenopausal black women.
The purpose of this study was to compare plasma total homocysteine, folate, and vitamin B-12 concentrations in premeno...
Premenopausal black women have a 2- to 3-fold greater rate of coronary heart disease (CHD) than premenopausal white women. The purpose of this study was to provide greater insight into the reasons for this difference, which are currently unclear. We compared CHD risk factors in 99 black and 100 white, healthy premenopausal women, aged 18 to 45 year...
Premenopausal black women have more coronary heart disease (CHD) than white women. This study compares two dietary variables that influence CHD: 1) the magnitude of plasma lipid-lipoprotein response to a chronic high fat diet and 2) the degree of postprandial lipemia after an acute fat load. 13 healthy black and 9 white women were randomized to a l...
Although it is known that the fatty acid profile of human milk is altered by diet, the rapidity with which this occurs has not been addressed. We hypothesized that after absorption the fatty acids of a given meal would be transferred rapidly from the chylomicrons of the blood into human milk. Fourteen lactating women drank six test formulas, each c...
The n-3 fatty acids of fish and fish oil have great potential for the prevention and treatment of patients with coronary artery disease. Unlike many of the pharmaceutical agents used in patients with coronary artery disease that have just a single mechanism of action, the eicosapentaenoic and docosahexaenoic acids of fish oil have multifaceted acti...
This study reports on standard coronary risk factors (plasma lipids and lipoproteins, blood pressure, heart rate, age, body mass index) and psychosocial variables (job strain, Type A behavior, hostility, illnesses, medical and psychological symptoms, health-damaging behavior) in a community sample of 324 employed men, 203 employed women, and 155 fe...
The CNS and the retina are enriched in long chain polyunsaturated (LCP) fatty acids, specifically docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6), which are present in human milk but not in most infant formulas. In the present study of 134 formula-fed and 63 breast-fed infants, we prospectively evaluated whether providing a s...
Fish and fish oils contain the very long chained and highly polyunsaturated Ω-3* fatty acids, which are derived from phytoplankton, the base of the food chain in the oceans, lakes, and rivers (1). Phytoplankton synthesize the Ω-3 fatty acids, eicosapentaenoic (20:5) (EPA) and docosahexaenoic (22:6) (DHA), which are subsequently incorporated into fi...
The importance of the maternal diet in infant nutrition is well established. Less well understood is the vital role of maternal dietary docosahexaenoic acid (DHA; 22:6n-3) and other n-3 fatty acids in the optimal development of the fetus and the breast-fed infant. DHA is a vital component of the phospholipid membrane of the brain, retina and sperma...
For decades, the coronary heart disease (CHD) mortality rate has been four or more times higher in Finland than in France despite comparable intakes of dietary cholesterol and saturated fat. A potential answer to this paradox is provided by this study of 40 countries and the analyses of other nutrients in the diets besides cholesterol and saturated...
The principal goal of dietary treatment of heterozygous familial hypercholesterolemia (hFH) is the reduction of the plasma low density lipoprotein (LDL) cholesterol. This is best accomplished by enhancing the activity of LDL receptors and, at the same time, depressing liver synthesis of cholesterol. Both cholesterol and saturated fat down-regulate...
In the experimental studies reported in this review, dietary n-3 fatty acids from fish and fish oil had profound hypolipidemic effects in normal subjects and in hypertriglyceridemic patients with combined hyperlipidemia (type II-b) and types IV and V hyperlipidemia. In these carefully controlled metabolic experiments, dramatic reductions occurred i...
To describe changes in negative emotions among participants of a cholesterol-lowering study.
Cohort study. Quantitative evaluation of changes in negative emotions in relation to diet and plasma cholesterol levels before and after a 5-year dietary intervention program aimed at reducing plasma cholesterol levels.
Community-dwelling families of the Fa...
This study examined children of 64 families for associations between a) family conflict and cohesion and b) plasma lipids, lipoproteins, and aggressiveness. Ratings of conflict and cohesion were obtained from parents. Children rated themselves on aggressiveness, one component of Type A behavior. The presence of conflict in the family was positively...
The Diet Habit Survey was designed to identify eating habits and measure dietary changes made over time by 442 adults in the Family Heart Study, a coronary heart disease prevention project. Reliability was determined by test-retest analysis. Validity was assessed by comparison with 24-hour dietary recalls and by comparing changes in diet with chang...
Major new public health problems occur in developing countries as they become more affluent and change their traditional dietary patterns. To study this phenomenon in microcosm, we substituted an "affluent" diet for the traditional diet of a group of Tarahumara Indians, a Mexican people known to consume a low-fat, high-fiber diet and to have a very...
A sudden increase in dietary carbohydrate invariably increases the plasma levels of very low density lipoprotein (VLDL) and triglyceride. The present studies were designed to test the hypothesis that dietary carbohydrate-induced hypertriglyceridemia need not occur. In the first study we fed gradually increasing amounts of carbohydrate and gradually...
The purpose of this study was to examine high density lipoprotein cholesterol (HDL-C) levels in a sample of community-living women and men who consumed 1 drink of alcohol/day or less. Self-reports of alcohol consumption and clinical assessments of plasma lipid and lipoprotein levels were obtained twice, at 12 months apart. Among men, consumption of...
Diet is the primary therapy for hyperlipidemia of any cause. This review will examine the effects of the various components of the diet on the plasma cholesterol concentration and, thereby, develop a foundation upon which to devise a rational dietary strategy for the treatment of one of America's most prevalent health care problems.
The purpose of this study was to examine high density lipoprotein cholesterol (HDL-C) levels in a sample of community-living women and men who consumed 1 drink of alcohol/day or less. Self-reports of alcohol consumption and clinical assessments of plasma lipid and lipoprotein levels were obtained twice, at 12 months apart. Among men, consumption of...
The principal goal of dietary prevention and treatment of atherosclerotic coronary heart disease is the achievement of physiological levels of the plasma total and LDL cholesterol, triglyceride, and VLDL. These goals have been well delineated by the National Cholesterol Education Program of the National Heart, Lung and Blood Institute and the Ameri...
The potential of a food or a diet to raise the plasma level of total and low-density-lipoprotein cholesterol and to promote atherosclerosis is directly related to its cholesterol and saturated fat content. A new formula that indicates the concentrations of cholesterol and saturated fat in foods, termed the cholesterol-saturated fat index (CSI), has...
The principal goal of dietary treatment of familial hypercholesterolemia (FH) is the reduction of the plasma low density lipoprotein (LDL) cholesterol. This is best accomplished by enhancing the number of LDL receptors and, at the same time, depressing liver synthesis of cholesterol. Both cholesterol and saturated fat down-regulate the LDL receptor...
Hostility, Type A behavior, and plasma lipids were assessed in a community sample of 352 women and men. After the contribution of age and body mass index to the variation in plasma lipid and lipoproteins were controlled for, persons scoring high on Type A behavior as well as hostility had elevated levels of plasma and low-density lipoprotein (LDL)...
Although Type A behavior is recognized as an independent risk factor for coronary heart disease, little is known about its antecedents. The present study investigated relationships of Type A behavior as assessed by the Hunter-Wolf rating scale to physiologic coronary risk factors in children ranging from 8 to 15 years of age. In addition, gender di...
A food's hypercholesterolaemic-atherogenic potential lies in its cholesterol and saturated-fat content. To help understand the contribution of these two factors a cholesterol/saturated-fat index (CSI) has been calculated. This index is based on a modification of a regression equation computed from metabolic studies designed to lower plasma lipids....
This paper examines the application of social learning theory (SLT) in large-scale studies designed to investigate the effects
of dietary intervention in the lowering of plasma cholesterol level and prevention of coronary heart disease (CHD). Several
SLT-based intervention methods are reviewed including behavioral self-regulation techniques, group...
Attitudes play an important role in the adoption and maintenance of a variety of health habits. In the present study, the Nutrition Attitude Survey (NAS) was developed to measure attitudes pertaining to the adoption of a low-fat, low-cholesterol diet. Factor analysis identified four primary attitudinal factors: Helpless and Unhealthy, Food Explorat...
The Tarahumara Indians of Mexico are habituated to a very low cholesterol, low fat diet and have lifelong low plasma cholesterol concentrations. To study cholesterol metabolism in these unusual people, 8 Tarahumara men were fed sequentially a cholesterol-free diet and then a diet containing 900 mg cholesterol under controlled conditions. The intest...
This short demonstration accomplishes several goals. People see where fat comes from and learn amounts needed to be removed. They practice substituting complex carbohydrate foods for fat. Most important, they learn that changing is not an "all-or-nothing" proposition. They can reduce dietary fat and still eat many of their favorite foods. This demo...
Two hundred thirty-three randomly selected families provided a population for studying the effects of familial relationships, age, diet, body weight, and urinary electrolyte excretion on blood pressure. There was a strong familial component for urinary sodium, potassium, and creatinine excretion and for systolic blood pressure. In individuals, age,...
In an effort to examine knowledge about heart disease and nutrition and attitudes toward dietary change, 754 women and 125 men were interviewed. The majority of respondents recognized the association between coronary heart disease and various risk factors, including dietary cholesterol. Although they acknowledged the value of dietary change in redu...
A random sample of 501 eligible families was selected from a designated neighborhood in Portland, Oregon, and given the opportunity to join a 5-year intervention program promoting a low-fat and low-cholesterol eating pattern designed to reduce risk for coronary heart disease. Participation entailed three baseline assessments of clinical, dietary, a...
Cigarette smoking is an important risk factor for coronary heart disease. However, its mechanisms of action remain to be fully explored. The hypothesis of the present study is that 1 mechanism whereby cigarette smoking enhances coronary disease might result from its effects upon the plasma lipids. Accordingly, we measured the plasma lipids and lipo...
Dietary cholesterol is important in the pathogenesis of atherosclerosis because of its strong influence in increasing the concentrations of plasma cholesterol and low-density lipoprotein (LDL). The cause and effect relationship of dietary cholesterol to atherosclerosis and plasma lipoproteins has been best demonstrated in the rhesus monkey: when fe...
Two hundred thirty-three families were randomly selected from a designated population base. Data from 619 persons ages 6--65 years had distributions of lipid and anthropometric values typical for the U.S. population. The typical rise in plasma cholesterol and triglyceride with age was also demonstrated. The plasma cholesterol and low-density lipopr...
Working from the foundation of the role of diet in the pathogenesis of hyperlipidemia, the authors present a rational, detailed therapy for treating the disorder. A three-phase approach is offered so that the patient can gradually incorporate new eating behavior into his or her lifestyle.
The relationships between medicine and psychology may be traced,to antiquity; more specifically, references to the exquisite relationship between mind and body, including one’s health and one’s behavior, will be found in humankind’s earliest writings, dating back to 5000 B.C. It is, however, an interesting historical fact that in the mountains or e...
To identify any metabolic effects of dietary fiber upon cholesterol metabolism in man, six adult volunteer subjects were fed eucaloric cholesterol-free formula diets, with and without added dietary fiber for two 4-wk periods. A large quantity of dietary fiber was fed, some 60 g of plant cell wall material (or 16 g of crude fiber) derived from corn,...
Almost all responsible organizations and individual authorities in the United States firmly suggest that atherosclerosis is a preventable disease. Recommendations to prevent atherosclerosis have centered upon five objectives which are: (1) The abolition of cigarette smoking; (2) the control of high blood pressure; (3) the institution of regular exe...
Para aminosalicylic acid (PAS-C) was assessed as a hypolipidemic agent in 29 outpatients in 3 different studies. All patients had type II-a or II-b hyperlipoproteinemia. Six to 8 grams of PAS-C per day were given in 4 divided doses. Blood samples were collected at two wk intervals during active and placebo periods. The first study involved 14 patie...
The serum lipid responses to the feeding of large quantities of either alcohol or carbohydrate were compared in a patient with endogenous hypertriglyceridemia. Eucaloric formula diets that contained different amounts of fat and carbohydrate were fed during 60 days of hospitalization in a metabolic unit. In one dietary period, alcohol was given in a...
Thepurposeofthisstudy was toexamine highdensity lipoprotein cholesterol (HDL-C) levels inasample ofcommunity-living women andmen whoconsumed 1drinkofalcohol/day orless. Self-reports ofalcohol consumption andclinical assessments ofplasmalipid andlipoprotein levels wereobtained twice, at12monthsapart. Amongmen, consumption of1drink/day orless was unr...
