Original Article
European Journal of Clinical Nutrition (2007) 61, 483–492. doi:10.1038/sj.ejcn.1602551; published online 29 November 2006
Effect on hematologic risk factors for coronary heart disease of a cholesterol reducing diet
Guarantor: DJA Jenkins.
Contributors: DJAJ, CWCK and DAF contributed to study concept and design. DJAJ, CWCK, THN, JT, AM, MC, AYT, DAF, TK, AM, JMWW, RdeS, AE, CH, RGJ, LAL and WS contributed to acquisition of data. DJAJ, CWCK, THN, JT, MC, DAF, TK, RGJ, LAL, WS contributed to analysis and interpretation of data. DJAJ, CWCK, THN contributed to drafting of the paper. DJAJ, CWCK, THN, JT, AM, MC, AYT, DAF, TK, AM, JMWW, RdeS, AE, EAT, KGL, CH, RGJ, LAL and WS contributed to critical revision of the paper for important intellectual content. MC contributed to statistical expertise. DJAJ and CWCK contributed to obtained funding. THN, JT, AM, AYT, DAF, JMWW, RdeS, AE, EAT, KGL, CH, RGJ, LAL and WS contributed to administrative, technical or material support. DJAJ, CWCK and DAF contributed to study supervision.
D J A Jenkins1,2,3,4, C W C Kendall1,3, T H Nguyen1,3, J Teitel2,4, A Marchie1,3, M Chiu5,6, A Y Taha1,3, D A Faulkner1,3, T Kemp7, J M W Wong1,3, R de Souza1,3, A Emam1,3, E A Trautwein8, K G Lapsley9, C Holmes1, R G Josse1,2,3,4, L A Leiter1,2,3,4 and W Singer1,2,3,4
- 1Division of Endocrinology and Metabolism, Clinical Nutrition & Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada
- 2Division of Endocrinology and Metabolism, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada
- 3Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 4Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 5Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 6Cancer Care Ontario, Toronto, Ontario, Canada
- 7Dewsbury and District Hospital, UK
- 8Unilever Food and Health Research Institute, Unilever R&D Vlaardingen, The Netherlands
- 9The Almond Board of California, Modesto, California, USA
Correspondence: Professor DJA Jenkins, Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, 61 Queen St East, Toronto, Ontario, Canada M5C 2T2. E-mail: cyril.kendall@utoronto.ca
Received 31 January 2006; Revised 11 August 2006; Accepted 15 August 2006; Published online 29 November 2006.
Abstract
Background:
A dietary portfolio of cholesterol-lowering ingredients has proved effective in reducing serum cholesterol. However, it is not known whether this dietary combination will also affect hematologic risk factors for coronary heart disease (CHD). Reductions in hematocrit and polymorphonuclear leukocytes have been reported to improve cardiovascular risk. We, therefore, report changes in hematological indices, which have been linked to cardiovascular health, in a 1-year assessment of subjects taking an effective dietary combination (portfolio) of cholesterol-lowering foods.
Methods:
For 12 months, 66 hyperlipidemic subjects were prescribed diets high in plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers (10 g/1000kcal) and almonds (23 g/1000kcal). Fifty-five subjects completed the study.
Results:
Over the 1 year, data on completers indicated small but significant reductions in hemoglobin (-1.5
0.6 g/l, P=0.013), hematocrit (-0.0070.002 l/l, P<0.001), red cell number (-0.070.02 109/l, P<0.001) and neutrophils (-0.340.13 109/l, P=0.014). Mean platelet volume was also increased (0.160.07 fl, P=0.033). The increase in red cell osmotic fragility (0.050.03 g/l, P=0.107) did not reach significance.
Conclusions:
These small changes in hematological indices after a cholesterol-lowering diet are in the direction, which would be predicted to reduce CHD risk. Further research is needed to clarify whether the changes observed will contribute directly or indirectly to cardiovascular benefits beyond those expected from reductions previously seen in serum lipids and blood pressure.
Keywords:
erythrocyte fragility, blood lipids, almonds, soy protein, viscous dietary fiber, plant sterols
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