Sidika E Kasim-Karakas

Effects of protein versus simple sugar intake on weight loss in polycystic ovary syndrome (according to the National Institutes of Health criteria)

OBJECTIVE To compare the effects of protein vs. simple sugars on weight loss, body composition, and metabolic and endocrine parameters in polycystic ovary syndrome (PCOS). DESIGN A 2-month, free-living, randomized, single-blinded study. SETTING University PCOS clinic. PATIENT(S) Thirty-three patients with PCOS. INTERVENTION(S) To achieve a final energy reduction of 450 kcal/day, first the daily energy intake was reduced by 700 kcal; then a 240-kcal supplement containing either whey protein or simple sugars was added. MAIN OUTCOME MEASURE(S) Changes in weight, fat mass, fasting glucose and insulin, plasma lipoproteins, and sex steroids. RESULT(S) Twenty-four subjects (13 in the simple sugars group and 11 in the protein group) completed the study. The protein group lost more weight (-3.3 +/- 0.8 kg vs. -1.1 +/- 0.6 kg) and more fat mass (-3.1 +/- 0.9 kg vs. -0.5 +/- 0.6 kg) and had larger decreases in serum cholesterol (-33.0 +/- 8.4 mg/dL vs. -2.3 +/- 6.8 mg/dL), high-density lipoprotein cholesterol (-4.5 +/- 1.3 mg/dL vs. -0.4 +/- 1.3 mg/dL), and apoprotein B (-20 +/- 5 mg/dL vs. 3 +/- 5 mg/dL). CONCLUSION(S) In patients with PCOS, a hypocaloric diet supplemented with protein reduced body weight, fat mass, serum cholesterol, and apoprotein B more than the diet supplemented with simple sugars.

Effects of dietary fat restriction on particle size of plasma lipoproteins in postmenopausal women

Hypertriglyceridemia is an independent risk factor for coronary artery disease (CAD) and is also commonly associated with other coronary risk factors, ie, small, dense low-density lipoprotein (LDL) particles and low plasma levels of high-density lipoprotein cholesterol (HDL-C). Dietary fat restriction is recommended for the prevention of nutrition-related cancers. Low-fat, high-carbohydrate intake can increase plasma triglyceride (TG) and decrease HDL-C. In general, plasma TG levels are inversely related to the particle size of LDL. We investigated the effects of dietary fat restriction on the concentration and particle size of plasma lipoproteins in 14 healthy postmenopausal women (aged 61 +/- 11 years). During a 4-month period of eucaloric controlled feeding, dietary fat was reduced stepwise from a habitual intake of 33% +/- 8% to 23% and then to 14% of daily energy. Changes in the plasma lipid level and particle size of very-low-density lipoprotein (VLDL), LDL, and HDL were determined at the end of each dietary phase. Increasing carbohydrate intake without weight loss was associated with an increase in plasma TG (1.86 +/- 0.30 v 2.47 +/- 0.37 mmol/L) and decreases in total cholesterol (5.82 +/- 0.25 v 5.40 +/- 0.21 mmol/L), LDL-C (3.07 +/- 0.18 v 2.61 +/- 0.21 mmol/L), HDL-C (1.42 +/- 0.1 v 1.24 +/- 0.1 mmol/L), and apolipoprotein (apo) A1 (5.14 +/- 0.25 v 4.61 +/- 0.36 mmol/L), whereas plasma apo B did not change. The particle size of VLDL increased (42.7 +/- 1.4 v 47.0 +/- 0.9 nm). However, there was no change in either LDL (25.1 +/- 0.2 v 25.3 +/- 0.2 nm) or HDL particle size. Although at each level of dietary fat intake LDL particle size correlated inversely with plasma TG and apo B, there was no relationship between the increase in plasma TG and LDL particle size. These results show that hypertriglyceridemia caused by a eucaloric high-carbohydrate intake is not associated with a decrease in LDL particle size. Therefore, carbohydrate-induced hypertriglyceridemia may not have the same atherogenic potential as genetic hypertriglyceridemias.

Hepatic microsomal triglyceride transfer protein gene expression in carbohydrate-induced hypertriglyceridemia

The microsomal triglyceride transfer protein (MTP) facilitates the assembly of very low density lipoproteins (VLDL). To investigate the effects of carbohydrate (CHO)-induced hypertriglyceridemia (HTG) on the hepatic expression of the MTP gene, Golden Syrian hamsters were fed fructose (FR) and sucrose (SUC) enriched diets. Changes in fasting plasma glucose (FPG), insulin, free fatty acids (FFA), TG, VLDL-TG and VLDL-protein were determined. Abundance of hepatic MTP-mRNA was compared to those of albumin (ALB)-mRNA and glyceraldehyde 3-phosphate dehydrogenase (GAPDH)-mRNA. Hepatic secretion rates (SR) of VLDL-TG and VLDL-PR were assessed after intravenous Triton WR-1339 injection. Lipoprotein lipase (LpL) activity of the epididymal fat pads was determined. As compared to the control and SUC, FR increased plasma insulin (FR = 238+24, SUC = 115±17, control = 82±16 μU/ml, p < 0.0001), FFA (FR = 1.93±0.24, SUC = 1.35±0.1, control = 1.47±0.13 mEq/L, p < 0.03) and TG (FR = 215±47, SUC = 93±7, control = 71±16 mg/dl, p < 0.01), without affecting FPG. There was no change in LpL activity. Fructose-feeding increased VLDL-TG-SR (FR = 2.95±0.26, SUC = 1.28±0.34, control = 2.18±0.26 mg/kg.wt/h−1, p < 0.004), but not VLDL-protein-SR. MTP-mRNA abundance did not change when compared to albumin mRNA, however FR-fed hamsters had lower MTP mRNA abundance when compared to GAPDH mRNA (FR = 0.96±0.13, SUC = 1.15±0.14, control = 1.49±0.14 MTPGAPDH-mRNA, p < 0.05). The finding that FR-feeding increased VLDL-TG secretion without any increase in MTP mRNA proves that CHO-induced HTG can occur without an increase in hepatic MTP gene expression.