Krista A. Varady

Are functional foods redefining nutritional requirements

Functional foods are increasing in popularity owing to their ability to confer health and physiological benefits. Nevertheless, the notion that functional foods improve health when providing nutrients at levels above and beyond existing recommended intakes is inconsistent with the definition of requirement. This disparity highlights the need for an alternative definition of nutrient requirement. The present objective is to examine distinctions between optimization of health, as defined by what we currently deem as required intakes, versus adding physiological benefit using bioactive agents found in functional foods. Presently, requirement is defined as the lowest amount of intake of a nutrient that will maintain a defined level of nourishment for a specific indicator of adequacy. In contrast, functional foods are described as ingredients that are not necessary for body function, yet provide added physiological benefit that confer better overall health. Plant sterols are one example of such an ingredient. Plant sterols lower plasma cholesterol concentrations, and may thus be considered essential nutrients in physiological situations where circulating cholesterol concentrations are high. Similarly, intakes of omega-3 fats beyond existing requirement may confer additional health benefits such as hypolipidemic and anti-diabetic effects. These examples underscore the inconsistencies between what is defined as a nutrient requirement versus what is identified as a health benefit of a functional food. Such discrepancies emphasize the need for a more all-encompassing definition of a nutrient requirement; that is, one that moves beyond the prevention of overt deficiency to encompass improved health and disease risk reduction.

Effect of plant sterols and endurance training on LDL particle size and distribution in previously sedentary hypercholesterolemic adults.

Background:Plant sterols and exercise favourably alter lipid profiles in a way that protect against future coronary heart disease (CHD). However, their effects on other indicators of CHD risk, such as LDL particle size, still need further clarification.Objective:This study examined the effect of plant sterols, exercise, and the combination of plant sterols and exercise, on LDL particle size and distribution in previously sedentary, hypercholesterolemic adults.Design:In an 8-week, placebo-controlled, parallel-arm clinical trial, 84 subjects were randomized to one of four intervention groups: (1) combination of sterols and exercise, (2) exercise, (3) sterol, or (4) control.Results:Exercise significantly (P<0.05) reduced post-treatment LDL peak particle size from 255 to 253 Å. Additionally, exercise significantly (P<0.05) decreased the proportion of large LDL particles within plasma. Sterol supplementation significantly (P<0.05) decreased the estimated cholesterol concentrations within small, medium, and large LDL particles by 13.4, 13.5, and 14.4%, respectively, yet had no effect on the distribution of cholesterol among various LDL particle sizes. Furthermore, decreased body weight post-training was associated with increased cholesterol in small LDL particles (r=−0.52, P<0.0001). Decrease in body fat percent (BF%) post-training was associated with increased cholesterol concentrations in small LDL particles (r=−0.29, P<0.01).Conclusion:On the basis of modulating LDL electrophoretic characteristics, the present study demonstrates that plant sterols have no effect on CHD risk, while short-term exercise may potentially increase CHD risk by decreasing LDL peak particle size.Sponsorship:This study was sponsored by The Heart and Stroke Foundation of Canada.

Modulation of apolipoprotein A1 and B, adiponectin, ghrelin, and growth hormone concentrations by plant sterols and exercise in previously sedentary humans.

Plant sterols combined with exercise beneficially alter lipid levels in hypercholesterolemic adults. The effect of this combination therapy on other indicators of coronary heart disease risk, however, has yet to be determined. The objective of this trial was to investigate the effect of plant sterols and exercise, alone and in combination, on levels of apolipoprotein (apo) A1 and B, adiponectin, ghrelin, and growth hormone in previously sedentary hypercholesterolemic adults. In an 8 week, parallel-arm trial, 84 subjects were randomized to 1 of 4 groups: combination, exercise, plant sterols, or control. Body mass decreased by 1.1% (p < 0.01) and 0.9% (p < 0.05) in the combination and exercise group, respectively. Low-density lipoprotein cholesterol levels decreased (p < 0.01) by 0.30 mmol/L in the combination group and by 0.49 mmol/L in the plant sterol group. High-density lipoprotein cholesterol levels increased by 7.5% and 9.5% (p < 0.01) in the combination and exercise groups, respectively. Plant sterols increased (p < 0.05) adiponectin levels by 16%. No change in apoA1, apoB, ghrelin, or growth hormone levels were noted in any intervention group. ApoA1 was correlated with high-density lipoprotein cholesterol (r = 0.33, p = 0.01), whereas apoB was weakly related to low-density lipoprotein cholesterol levels (r = 0.13, p = 0.002). Adiponectin was associated with body mass index (r = -0.10, p = 0.006) and high-density lipoprotein cholesterol (r = 0.17, p = 0.0003). These findings suggest that plant sterols can increase adiponectin levels, thereby possibly reducing the risk of future coronary heart disease.