Effect of protein, unsaturated fat, and carbohydrate intakes on plasma apolipoprotein B and VLDL and LDL containing apolipoprotein C-III: Results from the OmniHeart Trial

Harvard University, Cambridge, Massachusetts, United States
American Journal of Clinical Nutrition (Impact Factor: 6.77). 07/2008; 87(6):1623-30.
Source: PubMed


Plasma apolipoprotein B (apo B) and VLDL and LDL with apolipoprotein C-III (apo C-III) are independent risk factors for cardiovascular disease (CVD). Dietary intake affects lipoprotein concentration and composition related to those apolipoproteins.
We studied differences in apo B lipoproteins with and without apo C-III after 3 healthy diets based on the Dietary Approaches to Stop Hypertension Trial diet.
Healthy participants (n = 162) were fed each of 3 healthy diets for 6 wk in a crossover design. Diets differed by emphasis of either carbohydrate (Carb), unsaturated fat (Unsat), or protein (Prot). Blood was collected at baseline and after diets for analysis.
Compared with the Carb diet, the Prot diet reduced plasma apo B and triglycerides in VLDL with apo C-III (16%, P = 0.07; 11%, P = 0.05, respectively) and apo B in LDL with apo C-III (16%, P = 0.04). Compared with the Unsat diet, the Prot diet reduced triglycerides in VLDL with apo C-III (16%, P = 0.02). Compared with baseline (subjects' usual diet was higher in saturated fat), the Prot diet reduced apo B in LDL with apo C-III (11%, P = 0.05), and all 3 diets reduced plasma total apo B (6-10%, P < 0.05) and apo B in the major type of LDL, LDL without apo C-III (8-10%, P < 0.01). All 3 diets reduced the ratio of apo C-III to apo E in VLDL.
Substituting protein for carbohydrate in the context of a healthy dietary pattern reduced atherogenic apo C-III-containing LDL and its precursor, apo C-III-containing VLDL, resulting in the most favorable profile of apo B lipoproteins. In addition, compared with a typical high-saturated fat diet, healthy diets that emphasize carbohydrate, protein, or unsaturated fat reduce plasma total and LDL apo B and produce a lower more metabolically favorable ratio of apo C-III to apo E.

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    • "Additionally, compared with the CARB diet, there was a greater reduction in triglycerides with consumption of both the PROT and UNSAT diets, and the UNSAT diet comparatively increased HDL. In a secondary analysis of this trial, the PROT diet reduced harmful apolipoprotein C-III more than the CARB diet and was found to be more effective in white participants than black participants (36,37). Another analysis reported associations between the UNSAT diet and improvement of high-molecular-weight and total adiponectin when compared with the CARB or PROT diets (38). "
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    • "Immuno-affinity chromatography was conducted with affinity-purified anti-human apoC-III (Academy Biomedical Company, Inc., Houston, TX) to separate the plasma into fractions with and without apoC-III. Detailed methods have been published previously.34 Subsequently, apoC-III-bound and apoC-III-unbound fractions were ultracentrifuged to isolate the very low-density (d<1.006 "
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