P M Kris-Etherton

William Penn University, Worcester, Massachusetts, United States

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Publications (218)1110.17 Total impact

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    ABSTRACT: Proteins from plant-based compared with animal-based food sources may have different effects on cardiovascular disease (CVD) risk factors. Numerous epidemiologic and intervention studies have evaluated their respective health benefits; however, it is difficult to isolate the role of plant or animal protein on CVD risk. This review evaluates the current evidence from observational and intervention studies, focusing on the specific protein-providing foods and populations studied. Dietary protein is derived from many food sources, and each provides a different composite of nonprotein compounds that can also affect CVD risk factors. Increasing the consumption of protein-rich foods also typically results in lower intakes of other nutrients, which may simultaneously influence outcomes. Given these complexities, blanket statements about plant or animal protein may be too general, and greater consideration of the specific protein food sources and the background diet is required. The potential mechanisms responsible for any specific effects of plant and animal protein are similarly multifaceted and include the amino acid content of particular foods, contributions from other nonprotein compounds provided concomitantly by the whole food, and interactions with the gut microbiome. Evidence to date is inconclusive, and additional studies are needed to further advance our understanding of the complexity of plant protein vs. animal protein comparisons. Nonetheless, current evidence supports the idea that CVD risk can be reduced by a dietary pattern that provides more plant sources of protein compared with the typical American diet and also includes animal-based protein foods that are unprocessed and low in saturated fat.
    No preview · Article · Nov 2015 · Advances in Nutrition
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    ABSTRACT: An Expert Panel convened by the National Lipid Association previously developed a consensus set of recommendations for the patient-centered management of dyslipidemia in clinical medicine (part 1). These were guided by the principle that reducing elevated levels of atherogenic cholesterol (non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol) reduces the risk for atherosclerotic cardiovascular disease. This document represents a continuation of the National Lipid Association recommendations developed by a diverse panel of experts who examined the evidence base and provided recommendations regarding the following topics: (1) lifestyle therapies; (2) groups with special considerations, including children and adolescents, women, older patients, certain ethnic and racial groups, patients infected with human immunodeficiency virus, patients with rheumatoid arthritis, and patients with residual risk despite statin and lifestyle therapies; and (3) strategies to improve patient outcomes by increasing adherence and using team-based collaborative care.
    Full-text · Article · Sep 2015 · Journal of Clinical Lipidology
  • Geeta Sikand · Penny Kris-Etherton · Nancy Mariam Boulos
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    ABSTRACT: A healthy dietary pattern is a cornerstone for the prevention and treatment of cardiovascular disease (CVD) and type 2 diabetes (T2DM). Compelling scientific evidence has shown many health effects of individual foods (including herbs and spices), beverages, and their constituent nutrients and bioactive components on risk of chronic disease and associated risk factors. The focus of functional foods research that is reviewed herein has been on assessing the health effects and underlying mechanisms of action of fruits and vegetables, whole grains, dairy products including fermented products, legumes, nuts, green tea, spices, olive oil, seafood, red wine, herbs, and spices. The unique health benefits of these functional foods have been the basis for recommending their inclusion in a healthy dietary pattern. A better understanding of strategies for optimally including functional foods in a healthy dietary pattern will confer greater benefits on the prevention and treatment of CVD and T2DM.
    No preview · Article · Jun 2015 · Current Cardiology Reports
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    Full-text · Article · Apr 2015 · Journal of the American Academy of Nutrition and Dietetics
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    Cheryl A. M. Anderson · Rachel K. Johnson · Penny M. Kris-Etherton · Emily Ann Miller
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    ABSTRACT: Sodium reduction is an important component of a healthy dietary pattern to reduce cardiovascular disease risk. Numerous authoritative scientific bodies and professional health organizations have issued population sodium intake recommendations, all of which are at least 1000 mg/d lower than the current average American sodium intake of nearly 3500 mg/d. Recent research has called these recommendations into question, but a number of methodological issues may account for the inconsistency of results in observational studies examining the relationship between sodium intake and health outcomes. Health and nutrition professionals must consider that public health recommendations are made after weighing all of the evidence, including studies of greater and lesser strength of design and some with conflicting results.
    Full-text · Article · Mar 2015 · Nutrition Today
  • W Virgil Brown · Jo Ann S Carson · Rachel K Johnson · Penny Kris-Etherton
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    ABSTRACT: The availability of food quickly prepared at lower cost and with consistent quality and convenience has made a variety of restaurant chains extremely popular. Commonly referred to as the fast food industry, these companies have stores on virtually every street corner in cities large and small. Fast foods contribute to energy intake, and depending on the food choices made, provide foods and nutrients that should be decreased in the diet. As Americans have become more conscious of their risk factors for heart disease and recognized eating patterns as a contributor to blood cholesterol levels, high blood pressure, obesity, and diabetes, the fast food industry has attempted to adjust their menus to provide more healthful choices. The Roundtable discussion in this issue of the Journal will focus on the importance of this industry as a source of foods that could help address our population-wide efforts to reduce cardiovascular disease. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Feb 2015 · Journal of Clinical Lipidology
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    ABSTRACT: Dietary supplementation with almonds has demonstrated dose-dependent decreases in low-density lipoprotein cholesterol (LDL-C), likely because of their composition of beneficial nutrients including mono- and polyunsaturated fatty acids, fiber, and protein. The primary objective of this study was to determine the changes in the lipid profile (LDL-C, high-density lipoprotein cholesterol [HDL-C], triglycerides, total cholesterol, non-HDL-C), LDL-C particle size, and lipoprotein (a) when 100 g of almonds daily were added to background statin therapy for 4 weeks. Subjects (N = 48) receiving a consistent statin dose were randomized to 100 g of almonds daily and to The National Cholesterol Education Program Adult Treatment Panel's third report Therapeutic Lifestyle Changes Diet counseling (almond group; n = 22) or solely Adult Treatment Panel's third report Therapeutic Lifestyle Changes Diet counseling (non-almond group; n = 26), for 4 weeks. No significant changes in weight and weekly physical activity were noted between the 2 groups from baseline. However, the almond group consumed significantly more calories at 4 weeks compared with controls. The almond group experienced a 4.9% reduction in non-HDL-C compared with a 3.5% increase for the non-almond group (P = .02). Additionally, notable improvements were observed in LDL-C and triglycerides, but did not achieve statistical significance (P = .068 for both parameters). There was also a shift from LDL pattern A to pattern B particles (P = .003) in the almond group. No significant differences in total cholesterol (P = .1), HDL-C (P = .3), or lipoprotein (a) (P = .1) were observed. Adding 100 g of almonds daily to chronic statin therapy for 4 weeks significantly reduced non-HDL-C. clinicaltrials.gov Identifier: NCT00603876. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.
    Full-text · Article · Feb 2015 · Journal of Clinical Lipidology
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    ABSTRACT: Most health care professionals are not adequately trained to address diet and nutrition-related issues with their patients, thus missing important opportunities to ameliorate chronic diseases and improve outcomes in acute illness. In this symposium, the speakers reviewed the status of nutrition education for health care professionals in the United States, United Kingdom, and Australia. Nutrition education is not required for educating and training physicians in many countries. Nutrition education for the spectrum of health care professionals is uncoordinated, which runs contrary to the current theme of interprofessional education. The central role of competencies in guiding medical education was emphasized and the urgent need to establish competencies in nutrition-related patient care was presented. The importance of additional strategies to improve nutrition education of health care professionals was highlighted. Public health legislation such as the Patient Protection and Affordable Care Act recognizes the role of nutrition, however, to capitalize on this increasing momentum, health care professionals must be trained to deliver needed services. Thus, there is a pressing need to garner support from stakeholders to achieve this goal. Promoting a research agenda that provides outcome-based evidence on individual and public health levels is needed to improve and sustain effective interprofessional nutrition education. © 2015 American Society for Nutrition.
    Full-text · Article · Jan 2015 · Advances in Nutrition
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    ABSTRACT: Despite the popularity of dietary nitrate supplementation and the growing evidence base of its potential ergogenic and vascular health benefits, there is no direct information about its effects on exercising limb blood flow in humans. We hypothesized that acute dietary nitrate supplementation from beetroot juice would augment the increases in forearm blood flow, as well as the progressive dilation of the brachial artery, during graded handgrip exercise in healthy young men. In a randomized, double-blind, placebo-controlled crossover study, 12 young (22 ± 2 years) healthy men consumed a beetroot juice (140 mL Beet-It Sport, James White Juice Company) that provided 12.9 mmol (0.8 g) of nitrate or placebo (nitrate-depleted Beet-It Sport) on 2 study visits. At 3 h postconsumption, brachial artery diameter, flow, and blood velocity were measured (Doppler ultrasound) at rest and during 6 exercise intensities. Nitrate supplementation raised plasma nitrate (19.5-fold) and nitrite (1.6-fold) concentrations, and lowered resting arterial pulse wave velocity (PWV) versus placebo (all p < 0.05), indicating absorption, conversion, and a biological effect of this supplement. The supplement-associated lowering of PWV was also negatively correlated with plasma nitrite (r = -0.72, p = 0.0127). Despite these systemic effects, nitrate supplementation had no effect on brachial artery diameter, flow, or shear rates at rest (all p ≥ 0.28) or during any exercise workload (all p ≥ 0.18). These findings suggest that acute dietary nitrate supplementation favorably modifies arterial PWV, but does not augment blood flow or brachial artery vasodilation during nonfatiguing forearm exercise in healthy young men.
    Full-text · Article · Oct 2014 · Applied Physiology Nutrition and Metabolism
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    Paolo Boffetta · Frank Thies · Penny Kris-Etherton
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    ABSTRACT: A review of epidemiological studies on the intake of oats and oat-based products and its effect on the risk of chronic disease and deaths was performed. Seven studies were identified of cancer risk (two each on prostate and colorectal cancer, and one each on pancreatic, breast and endometrial cancer), and one study on overall mortality. With the exception of a case-control study of pancreatic cancer, all studies were of cohort design: five studies were based on a single cohort from Denmark. The results of most cohort studies suggest a weak protective effect of a high intake of oats on cancer risk (relative risks in the order of 0·9). Potential limitations of the studies are dietary exposure misclassification, low statistical power because of limited exposure contrast and residual confounding. Despite the evidence from experimental and mechanistic studies of a protective effect of oats intake on CVD and diabetes, no epidemiological studies have been conducted on these conditions.
    Full-text · Article · Oct 2014 · British Journal Of Nutrition
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    Frank Thies · Lindsey F Masson · Paolo Boffetta · Penny Kris-Etherton
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    ABSTRACT: Whole-grain foods such as oats may protect against colorectal cancer and have benefits on inflammatory bowel disease and coeliac disease. The present study aimed to systematically review the literature describing intervention studies that investigated the effects of oats or oat bran on risk factors for bowel disease. A literature search was conducted using Embase, Medline and the Cochrane library, which identified 654 potential articles. Thirty-eight articles describing twenty-nine studies met the inclusion criteria. Two studies carried out in participants with a history of colorectal adenomas found no effects of increased oat-bran intake on indirect risk makers for colorectal cancer. One of two interventions with oat bran in patients with ulcerative colitis showed small improvements in the patients' conditions. Most of the eleven studies carried out in adults with coeliac disease showed no negative effects of uncontaminated oat consumption. The fourteen studies carried out in volunteers with no history of bowel disease suggest that oats or oat bran can significantly increase stool weight and decrease constipation, but there is a lack of evidence to support a specific effect of oats on bowel function compared with other cereals. A long-term dietary intake of oats or oat bran could benefit inflammatory bowel disorders, but this remains to be proven. A protective effect on colorectal adenoma and cancer incidence has not yet been convincingly shown. The majority of patients with coeliac disease could consume up to 100 g/d of uncontaminated oats, which would increase the acceptability of, and adherence to, a gluten-free diet.
    Full-text · Article · Oct 2014 · The British journal of nutrition
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    ABSTRACT: This article summarizes presentations from “Insights and Perspectives on Dietary Modifications to Reduce the Risk of Cardiovascular Disease,” a symposium held at the ASN Annual Meeting and Scientific Sessions in conjunction with Experimental Biology 2014 in San Diego, CA on 26 April 2014. Presenters reviewed historic and current evidence on the relation between diet and cardiovascular disease (CVD) to identify gaps in knowledge, discuss the promises and pitfalls of macronutrient replacement strategies in the diet, and suggest various options for issuing dietary guidance aimed at reducing the burden of CVD morbidity and mortality. Observational studies and clinical trials indicate that overall diet quality have a marked impact on health benefits, which is shifting the emphasis on recommending healthful dietary patterns to focusing only on single nutrients or foods.
    Preview · Article · Sep 2014 · Advances in Nutrition
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    ABSTRACT: Background and Aims Little is known about the effect of various dietary fatty acids on pro- and anti-inflammatory processes. We investigated the effect of 5 oils containing various amounts of alpha-linolenic acid (ALA), linoleic acid (LA), oleic acid (OA) and docosahexaenoic acid (DHA) on plasma inflammatory biomarkers and expression levels of key inflammatory genes and transcription factors in whole blood cells. Methods and Results In a randomized, crossover controlled nutrition intervention, 114 adult men and women with abdominal obesity and at least one other criterion for the metabolic syndrome consumed 5 experimental isoenergetic diets for 4 weeks each, separated by 4-week washout periods. Each diet provided 60 g/3000 kcal of different oils: 1) control corn/safflower oil blend (CornSaff; LA-rich), 2) flax/safflower oil blend (FlaxSaff; ALA-rich), 3) conventional canola oil (Canola; OA-rich), 4) high oleic canola oil (CanolaOleic; highest OA content), 5) DHA-enriched high oleic canola oil (CanolaDHA; OA- and DHA-rich). Gene expression in whole blood cells was assessed in a subset of 62 subjects. CanolaDHA increased plasma adiponectin concentrations compared with the control CornSaff oil treatment (+4.5%, P=0.04) and FlaxSaff (+6.9%, P=0.0008). CanolaDHA also reduced relative expression levels of interleukin (IL)1B compared with CornSaff and Canola (-11% and -13%, respectively, both P=0.03). High-sensitivity C-reactive protein concentrations were lower after Canola than after FlaxSaff (-17.8%, P=0.047). Conclusion DHA-enriched canola oil exerts anti-inflammatory effects compared with polyunsaturated fatty acids from plant sources. Registration number NCT01351012.
    Full-text · Article · Aug 2014 · Nutrition Metabolism and Cardiovascular Diseases
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    Frank Thies · Lindsey F Masson · Paolo Boffeta · Penny Kris-Etherton
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    ABSTRACT: High consumption of whole-grain food such as oats is associated with a reduced risk of CVD and type 2 diabetes. The present study aimed to systematically review the literature describing long-term intervention studies that investigated the effects of oats or oat bran on CVD risk factors. The literature search was conducted using Embase, Medline and the Cochrane library, which identified 654 potential articles. Seventy-six articles describing sixty-nine studies met the inclusion criteria. Most studies lacked statistical power to detect a significant effect of oats on any of the risk factors considered: 59 % of studies had less than thirty subjects in the oat intervention group. Out of sixty-four studies that assessed systemic lipid markers, thirty-seven (58 %) and thirty-four (49 %) showed a significant reduction in total cholesterol (2-19 % reduction) and LDL-cholesterol (4-23 % reduction) respectively, mostly in hypercholesterolaemic subjects. Few studies (three and five, respectively) described significant effects on HDL-cholesterol and TAG concentrations. Only three out of twenty-five studies found a reduction in blood pressure after oat consumption. None of the few studies that measured markers of insulin sensitivity and inflammation found any effect after long-term oat consumption. Long-term dietary intake of oats or oat bran has a beneficial effect on blood cholesterol. However, there is no evidence that it favourably modulates insulin sensitivity. It is still unclear whether increased oat consumption significantly affects other risk markers for CVD risk, and comprehensive, adequately powered and controlled intervention trials are required to address this question.
    Full-text · Article · Jun 2014 · The British journal of nutrition
  • Kevin C Maki · Joanne L Slavin · Tia M Rains · Penny M Kris-Etherton

    No preview · Article · May 2014 · Advances in Nutrition
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    ABSTRACT: Nutrition is a recognized determinant in 3 (ie, diseases of the heart, malignant neoplasms, cerebrovascular diseases) of the top 4 leading causes of death in the United States. However, many health care providers are not adequately trained to address lifestyle recommendations that include nutrition and physical activity behaviors in a manner that could mitigate disease development or progression. This contributes to a compelling need to markedly improve nutrition education for health care professionals and to establish curricular standards and requisite nutrition and physical activity competencies in the education, training, and continuing education for health care professionals. This article reports the present status of nutrition and physical activity education for health care professionals, evaluates the current pedagogic models, and underscores the urgent need to realign and synergize these models to reflect evidence-based and outcomes-focused education.
    Full-text · Article · Apr 2014 · American Journal of Clinical Nutrition
  • Claire Berryman · Sheila West · Jennifer Fleming · Peter Bordi · Penny Kris-Etherton

    No preview · Conference Paper · Apr 2014
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    Penny M Kris-Etherton · Charlotte A Pratt · Edward Saltzman · Linda Van Horn

    Full-text · Article · Mar 2014 · American Journal of Clinical Nutrition
  • Penny M Kris-Etherton
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    ABSTRACT: Given the pressing need to reduce cardiovascular disease (CVD) morbidity and mortality, there has been a focus on optimizing dietary patterns to reduce the many contributing risk factors. Over the past 2 decades, many studies have been conducted that have evaluated the effects of walnut consumption on CVD risk factors. Walnuts have been shown to decrease low density lipoprotein cholesterol (by ∼9-16%) and blood pressure (diastolic blood pressure by ∼2-3 mm Hg), 2 major risk factors for CVD. In addition, walnuts improve endothelial function, decrease both oxidative stress and some markers of inflammation, and increase cholesterol efflux. The effect of walnuts on multiple CVD targets over relatively short periods of time supports recommendations for their inclusion in a heart-healthy diet.
    No preview · Article · Feb 2014 · Journal of Nutrition
  • Kevin C Maki · Joanne L Slavin · Tia M Rains · Penny M Kris-Etherton
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    ABSTRACT: Data from randomized controlled trials (RCTs) provide the strongest evidence for establishing relations between exposures, including dietary exposures, and health outcomes. However, not all diet and health outcome relations can be practically or ethically evaluated by using RCTs; therefore, many dietary recommendations are supported by evidence primarily from observational data, particularly those from prospective cohort studies. Although such evidence is of critical importance, limitations are often underappreciated by nutrition scientists and policymakers. This editorial review is intended to 1) highlight some of these limitations of observational evidence for diet-disease relations, including imprecise exposure quantification, collinearity among dietary exposures, displacement/substitution effects, healthy/unhealthy consumer bias, residual confounding, and effect modification; and 2) advocate for greater caution in the communication of dietary recommendations for which RCT evidence of clinical event reduction after dietary intervention is not available.
    No preview · Article · Jan 2014 · Advances in Nutrition

Publication Stats

14k Citations
1,110.17 Total Impact Points


  • 1993-2015
    • William Penn University
      Worcester, Massachusetts, United States
  • 1980-2015
    • Pennsylvania State University
      • • Department of Nutritional Sciences
      • • Department of Food Science
      • • Department of Statistics
      • • Department of Animal Science
      University Park, Maryland, United States
  • 2005-2011
    • American Heart Association
      Dallas, Texas, United States
    • Hospital Universitario Reina Sofía
      Cordoue, Andalusia, Spain
  • 2009
    • University of Colorado
      • Division of Endocrinology, Metabolism and Diabetes
      Denver, CO, United States
  • 2007
    • University of Illinois, Urbana-Champaign
      • Department of Food Science and Human Nutrition
      Urbana, IL, United States
  • 1994-2007
    • National Institutes of Health
      • Branch of Risk Factor Monitoring and Methods
      Bethesda, MD, United States
  • 1999
    • Columbia University
      New York, New York, United States
  • 1998
    • Vanguard Group
      Bhaganagar, Telangana, India
    • University of North Carolina at Chapel Hill
      • Department of Nutrition
      Chapel Hill, NC, United States
  • 1997
    • Rutgers, The State University of New Jersey
      • Department of Nutritional Sciences
      Нью-Брансуик, New Jersey, United States
  • 1981
    • University of Minnesota Duluth
      Duluth, Minnesota, United States
  • 1979
    • Saint Catherine University
      Minneapolis, Minnesota, United States