Original Article
Effect on Blood Lipids of Very High Intakes of Fiber in Diets Low in Saturated Fat and Cholesterol
N Engl J Med 1993; 329:21-26July 1, 1993
- Abstract
Background
It is known that soluble fiber in the diet can lower blood lipid levels. It is less certain, however, that eating foods with soluble fiber will further lower blood lipids when the intake of saturated fat and cholesterol has already been reduced to very low levels. Furthermore, the mechanism of the lipid-lowering effect of fiber has not been elucidated.
Methods
To address these questions, we studied 43 volunteers with hyperlipidemia in a crossover study involving two four-month dietary periods. The two metabolic diets contained foods high in either soluble or insoluble fiber and were separated by a two-month National Cholesterol Education Program Step 2 diet. The metabolic diets were low in saturated fat (<4 percent of total calories) and cholesterol (<25 mg per 1000 kcal), high in carbohydrate ( ≥ 60 percent of total calories), and very high in fiber (>24 g per 1000 kcal).
Results
Blood lipids fell to their lowest levels by week 4 of both study diets. When the soluble-fiber period was compared with the insoluble-fiber period, the subjects' total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol levels were found to be lower by a mean (±SE) of 4.9 ±0.9 percent (P<0.001), 4.8 ±1.3 percent (P<0.001), and 3.4 ±1.3 percent (P = 0.014), respectively. In contrast, the ratio of total to HDL cholesterol was not significantly different during the two dietary periods. The loss of fecal bile acids was 83 ±14 percent greater during the soluble-fiber period than during the insoluble-fiber period (P<0.001) and was related to the differences in total and LDL cholesterol and apolipoprotein B levels (r = 0.42, P = 0.005; r = 0.49, P<0.001; and r = 0.33, P = 0.035, respectively). The difference in serum cholesterol levels between the two dietary periods was greater among the men (7.5 ±1.2 percent, P<0.001) than among the women (3.4 ±1.2 percent, P = 0.008).
Conclusions
Very high intakes of foods rich in soluble fiber lower blood cholesterol levels even when the main dietary modifiers of blood lipids -- namely, saturated fat and cholesterol -- are greatly reduced.
Media in This Article
Figure 1
Mean (±SE) Fasting Blood Lipid and Lipoprotein Levels during the Soluble-Fiber Diet (open circle) and the Insoluble-Fiber Diet (solid circle).Figure 2
Mean (±SE) Differences between the Soluble-Fiber Diet and the Insoluble-Fiber Diet in the Excretion of Bile Acids and Neutral Sterols at Week 15.Article Activity
- Article
To reduce blood cholesterol levels and prevent coronary heart disease, major agencies recommend reduced consumption of saturated fat and cholesterol1,2 and increased intake of carbohydrate foods high in fiber, especially soluble fiber. One benefit of eating high-carbohydrate foods is that they displace saturated fat and cholesterol from the diet3,4. Indeed, it has been doubted whether a high intake of fiber can further reduce plasma lipids after marked reductions in dietary saturated fat and cholesterol have been achieved3.
To address this issue and the possible mechanisms involved, we fed volunteers with hyperlipidemia foods high in soluble fiber that had been reported to lower serum lipid levels,5-9 as part of metabolic diets that were high in carbohydrate and very low in saturated fat and cholesterol. The control diet was high in wheat fiber, an insoluble fiber that is generally regarded as lipid neutral9.
Methods
We studied 43 healthy subjects (15 men and 28 postmenopausal women). The subjects were predominantly of normal weight (mean [±SE] percent of ideal body weight, 107 ±4; range, 95 to 172), and their mean age was 58 ±3 years (range, 29 to 70). They had previously been found to have mild-to-severe hyperlipidemia. After following a National Cholesterol Education Program Step 2 diet1 for at least two months, all but 2 subjects had plasma lipid levels above the desirable range (22 had low-density lipoprotein [LDL] cholesterol levels >160 mg per deciliter [4.1 mmol per liter]; 5 had triglyceride levels >200 mg per deciliter [2.3 mmol per liter]; and 14 had both LDL cholesterol levels >160 mg per deciliter and triglyceride levels >200 mg per deciliter)1. The subjects were randomly assigned to two metabolically controlled diets, each for four months. One diet was high in soluble fiber, and the other high in insoluble fiber. No attempt was made to blind the subjects or study personnel to the dietary assignments. The metabolic diets were separated by a two-month return to an ad libitum Step 2 diet (total fat, <30 percent of calories; saturated fat, <7 percent of calories; and cholesterol, <200 mg daily). None of the subjects had clinical or biochemical evidence of diabetes, hepatic disease, or renal disease, and none were taking hypolipidemic agents. Three women were taking estrogen-replacement therapy, one man and one woman were taking levothyroxine, and one man and two women were taking beta-blocking agents. Dosage levels were the same for both study periods, except that one subject took a low dose of propranolol during the soluble-fiber period only. All the subjects were asked to keep their level of physical activity constant.
Before the study began and at weeks 2, 4, 8, 12, 14, and 16 of each metabolic diet, blood samples were taken for lipid analysis while the subjects were fasting. Buffy coat was obtained to determine the apolipoprotein E genotype10. During the last two weeks of each dietary period, the subjects spent two separate days in the clinical nutrition center. On one, a day profile was determined. The subjects were given their usual breakfast and, four hours later, their lunch. Blood samples were obtained at the outset and 30, 60, 120, and 240 minutes after each meal for the measurement of lipids, glucose, insulin, metabolites, and short-chain fatty acids. Results are reported for the first 11 patients. On a separate day, usually the last day of each dietary period, a fat-tolerance test was conducted involving the consumption of a “milkshake” containing 5 ml of water, 0.5 g of corn oil, 1.38 g of skim-milk powder, and 0.5 g of glucose per kilogram of body weight and a total of 50,000 units of vitamin A palmitate. Blood was obtained at the outset and after 30, 60, 180, 240, and 300 minutes for glucose and insulin measurements and every hour for 10 hours for retinyl palmitate and lipid measurements. Results are reported for the first eight patients.
Three-day fecal collections were made on an outpatient basis at the end of week 15 of both metabolic diets, placed on frozen carbon dioxide in a polystyrene container, and returned by courier to the laboratory, where the samples were weighed and stored at -20 °C before freeze-drying. Seventy-four complete three-day collections were obtained, of a possible total of 86 for both metabolic diets. Seven subjects provided only two-day collections for one or both diets, one subject provided a single-day collection during the soluble-fiber diet, and one subject did not collect his feces. Values for feces are expressed as mean output per day.
On completing both metabolic diets, the subjects were asked to rate their feelings of satiety using a seven-point scale, with -3 representing extremely hungry, 0 neutral, and +3 completely satiated.
The study was approved by the ethics committee of the University of Toronto. Informed consent was obtained from all the subjects.
Diet
The two metabolic diets shared a common core, to which foods high in soluble or insoluble fiber or prepared dishes containing the fiber under study were added. Our aim was to provide 20 percent or less of the dietary calories as fat, 20 percent as protein, and 60 percent or more as available carbohydrate (with 2.5 to 3 g of fiber per 100 kcal), and to provide less than 50 mg of dietary cholesterol daily. Two-week repeating menus were planned to suit individual tastes.
The foods high in soluble fiber were barley, dried lentils, peas and beans in precooked form (as instant soups, in cans or glass jars, or as frozen dinners such as kidney-bean chili), oat bran, and a commercially available breakfast cereal enriched with psyllium. The foods high in insoluble fiber included a wheat-bran breakfast cereal, high-fiber crackers, and a high-fiber bread containing fine ground wheat bran and added gluten, chosen to resemble the nutrient profile of dried legumes. The gluten was added to maintain the same proportion of vegetable protein in both diets.
Very low intakes of fat and cholesterol were achieved through the use of low-fat dairy foods (skim milk, low-fat yogurt, cottage cheese, and skim-milk cheese) and vegetable-protein products (including soybean products, tofu, and foods containing wheat gluten). We assessed caloric requirements using standard Lipid Research Clinics tables,11 with adjustment for the subject's physical activity and seven-day dietary record. We devised the diets using a data base in which the majority of the foods had been analyzed in the laboratory with Association of Official Analytical Chemists methods for macronutrients12 and fiber13. The fatty-acid composition was determined by gas chromatography14. The food-composition tables of the U.S. Department of Agriculture were used15 for foods that had not been analyzed directly. The percentage figures for soluble and insoluble fiber were derived from tables16 and were applied to our values for total dietary fiber to give the absolute amounts of soluble and insoluble fiber. Certain products that were not listed in the tables were analyzed specifically for soluble and insoluble fiber13. At each clinic visit, the dietitian assessed compliance using the subject's menus, on which each food was checked when eaten. Additional items were noted in a blank column opposite the prescribed diet. Body weight was measured at each clinic visit, and the results were used to adjust total caloric intake. All diet foods were packed at a central location and delivered weekly by courier to the subjects' homes at a time convenient to them.
Analyses
Total, LDL, and high-density lipoprotein (HDL) cholesterol and triglyceride were measured in fresh plasma after ultracentrifugal flotation into fractions with densities of ≤ 1.006 and >1.006 g per milliliter on the day of collection. Quality-control procedures were followed as described in the Manual of Laboratory Operations of the Lipid Research Clinics17. Apolipoproteins AI and B were measured by nephelometry at the end of the study in serum stored at -70 °C18. The average within-run coefficients of variation, as determined in seven runs with six replicates per run for each of three pools, were 3.36 percent for apolipoprotein AI (range, 3.04 to 3.54) and 2.74 percent for apolipoprotein B (range, 1.82 to 2.91). Serum samples from each subject were analyzed in a single batch. Lipoprotein(a) was measured with a commercial enzyme-linked immunosorbent assay (Terumo, Elkton, Md.).
Fecal acidic and neutral sterols were measured in finely ground freeze-dried feces from the three-day collections after extraction, thin-layer chromatography, and methylation and trimethylsylylation for bile acids and neutral steroids followed by gas-liquid chromatography with a DB-1 column (J&W Scientific, Folsom, Calif.), with 5beta-cholinic acid and 5alpha-cholestane, respectively, as internal standards5.
Glucose was measured in capillary blood19. Serum insulin20 and urinary C-peptide21 levels were estimated by radioimmunoassay at the end of the study in samples stored at -70 °C. Serum formate and acetate were measured by high-performance liquid chromatography22. Retinyl palmitate was measured in duplicate in the chylomicron fraction and the fractions with flotation coefficients of <400 and densities of ≤ 1.006 or >1.006 g per milliliter by high-performance liquid chromatography23.
Statistical Analysis
The results are expressed as means ±SE. Weight change in grams per week was estimated for each metabolic diet from the regression of each subject's body weight against time. The significance of the difference between diets was assessed by Student's t-test (two tailed) for paired data and by the general-linear-model procedure with SAS software,24 with sex and base-line values included in the basic model as covariates. Weight change and total caloric intake were also included in mechanistic analyses to allow for differences between diets in amount of exercise.
Results
A total of 22 subjects received the soluble-fiber diet first, and 21 received the insoluble-fiber diet first. The diets were well accepted, and compliance was good, as judged by close agreement between the macronutrient profile of the prescribed diets and the diet recorded as consumed (Table 1Table 1
Mean (±SE) Daily Intake of the Study Diets.). On the soluble-fiber and insoluble-fiber diets, the subjects consumed 91.4 ±1.4 percent and 91.4 ±1.6 percent, respectively, of the calories prescribed. The corresponding figures for total fiber were 91.6 ±1.5 percent and 90.9 ±1.8 percent.During both diets, the subjects ate as much food as they desired. The satiety rating was 1.8 ±0.2 units for the soluble-fiber diet and 1.5 ±0.2 units for the insoluble-fiber diet. There was a mean weight loss of 29 ±16 g per week with the soluble-fiber diet and 62 ±19 g per week with the insoluble-fiber diet. This difference approached significance (P = 0.058).
Fasting Blood Lipids and Apolipoproteins
During both diets, blood lipids had fallen to their lowest levels by week 4 (Figure 1Figure 1
Mean (±SE) Fasting Blood Lipid and Lipoprotein Levels during the Soluble-Fiber Diet (open circle) and the Insoluble-Fiber Diet (solid circle).). These declines were sustained for the remaining three months of each study period (Figure 1). Simple paired comparison showed that the mean lipid values from week 4 to week 16 of the soluble-fiber diet were in general lower than the values during the insoluble-fiber diet (Table 2Table 2
Mean (±SE) Plasma Lipid and Lipoprotein Levels before and during the Study Diets, Day-Profile Measurements, and Fecal Bile Acid Output at the End of Both Diets.). The percentage differences between dietary periods were as follows: total cholesterol, 4.9 ±0.9 percent (P<0.001); LDL cholesterol, 4.8 ±1.3 percent (P<0.001); HDL cholesterol, 3.4 ±1.3 percent (P = 0.014); ratio of total cholesterol to HDL cholesterol, 0.7 ±1.4 percent (P = 0.60); triglyceride, 1.3 ±2.5 percent (P = 0.59); apolipoprotein AI, 3.3 ±1.0 percent (P = 0.001); apolipoprotein B, 5.8 ±1.1 percent (P = 0.001); ratio of apolipoprotein B to apolipoprotein AI, 2.3 ±1.3 percent (P = 0.07); and lipoprotein(a) levels, 3.2 ±2.3 percent (P = 0.17). When the significant differences were expressed as absolute values, their significance was maintained, and the reduction in the ratio of apolipoprotein B to apolipoprotein AI was also significant (P = 0.001) after adjustment for sex and base-line values in the general linear model (Table 2).After additional adjustment (for weight change and caloric intake), the ratio of total cholesterol to HDL cholesterol and the lipoprotein(a) level were significantly lower during the soluble-fiber diet than during the insoluble-fiber diet (P = 0.011 and P = 0.021, respectively).
The men had greater percentage reductions than the women for total and LDL cholesterol and apolipoprotein B when following the soluble-fiber as compared with the insoluble-fiber diet (respective reductions among the men: 7.5 ±1.2 percent, P<0.001; 9.6 ±1.9 percent, P<0.001; and 9.2 ±1.5 percent, P<0.001; among the women: 3.4 ±1.2 percent, P = 0.008; 2.2 ±1.4 percent, P = 0.141; and 4.0 ±1.4 percent, P = 0.006) (Figure 1). These percentage differences were all significantly greater for the men than for the women (P = 0.033, P = 0.004, and P = 0.024, respectively).
The 22 subjects with only a high LDL cholesterol level had a significant percentage difference in LDL cholesterol between the soluble-fiber and insoluble-fiber diets (4.6 ±1.3 percent, P = 0.001); there was a similar but nonsignificant reduction in the 14 subjects who had high LDL cholesterol and triglyceride levels (2.6 ±2.7 percent, P = 0.351).
Five subjects were classified as having the E3/E2 genotype, 18 were homozygous for E3, and 20 either had E4/E3 (n = 18) or were homozygous for E4 (n = 2). E3 homozygotes and E4 carriers had similar percentage reductions in LDL cholesterol levels (5.4 ±2.0 percent [P = 0.017] vs. 5.4 ±1.1 percent [P<0.001], respectively).
Fecal Bile Acids and Neutral Steroids
Total fecal excretion of bile acid was 83 ±14 percent higher during the soluble-fiber diet than during the insoluble-fiber diet (241 ±27 vs. 147 ±16 mg per day, P<0.001) (Table 2). The output of bile acid among the men was significantly greater than the output among the women during both the soluble-fiber diet (P = 0.008) and the insoluble-fiber diet (P = 0.014). For men (n = 14), the percentage increase in fecal bile acid excretion during the soluble-fiber diet as compared with the insoluble-fiber diet was 75 ±15 percent (341 ±56 vs. 202 ±36 mg per day, P<0.001); and for women (n = 28) the corresponding increase was 88 ±19 percent (190 ±26 vs. 119 ±15 mg per day, P<0.001). These differences were reflected in values for the individual bile acids (Figure 2Figure 2
Mean (±SE) Differences between the Soluble-Fiber Diet and the Insoluble-Fiber Diet in the Excretion of Bile Acids and Neutral Sterols at Week 15.).Total excretion of neutral steroids was similar during both diets: 441 ±34 mg per day during the soluble-fiber diet and 431 ±35 mg per day during the insoluble-fiber diet (Figure 2). The mean fecal cholesterol excretion was 38 ±18 percent higher during the soluble-fiber diet than during the insoluble-fiber diet, a difference that was marginally significant (134 ±21 vs. 113 ±14 mg per day, P = 0.047).
The difference between diets in fecal bile acid output was significantly related to the differences in total and LDL cholesterol levels and apolipoprotein B levels (r = -0.42, P = 0.005; r = -0.49, P<0.001; and r = -0.33, P = 0.035, respectively; n = 42) (Figure 3Figure 3
Relation between the Difference in Plasma Total Cholesterol and the Difference in Daily Fecal Bile Acid Excretion between the Soluble-Fiber Diet and the Insoluble-Fiber Diet.). No significant difference between diets was seen in mean fecal wet weight.Other Tests
The reduction in fasting total and LDL cholesterol levels during the soluble-fiber diet was maintained in the 11 subjects whose day profiles were studied. No differences were seen between the mean levels of short-chain fatty acids, blood glucose, serum insulin, or 24-hour urinary C peptide.
In the eight subjects studied, the area under the chylomicron-triglyceride response curve was significantly greater after the soluble-fiber diet than after the insoluble-fiber diet (5.60 ±1.16 vs. 4.4 ±1.12 mmol-hr per liter, P = 0.024), but in none of the lipid fractions measured did the difference in retinyl palmitate levels reach significance.
No difference was seen in the postprandial blood glucose or serum insulin responses assessed as part of the fat-tolerance test.
Discussion
Our study shows that a diet containing a high amount of soluble fiber, as compared with a diet high in insoluble fiber, reduced plasma LDL cholesterol and apolipoprotein B levels. Part of the value of soluble fiber may be in replacing saturated fat and cholesterol in the diet1. However, even after dietary saturated fat and cholesterol have been reduced, a further reduction in blood lipid levels can result from the consumption of foods high in soluble fiber. These data therefore support current recommendations to increase the consumption of soluble-fiber foods in the context of a low-fat, low-cholesterol diet.
Levels of LDL cholesterol and apolipoprotein B fell in the subjects who consumed the maximal acceptable amounts of foods rich in soluble fiber in diets that were already very low in saturated fat and cholesterol. These reductions in blood lipid levels were generally well maintained. HDL cholesterol and apolipoprotein AI levels also fell. Similar decreases in HDL cholesterol have also been seen consistently in studies involving dried legumes25. Some reduction in HDL cholesterol is associated with many of the currently recommended dietary changes that reduce serum lipid levels,26 and this has prompted the development of additional strategies27,28. Lower total cholesterol and apolipoprotein B levels relative to HDL cholesterol and apolipoprotein AI levels are associated with a reduced risk of coronary heart disease29-34. The lipid changes we observed, although small, provide additional support for dietary advice to increase the intake of foods high in soluble fiber. Qualitatively similar lipid changes were noted in studies on the regression of human arteriosclerosis that incorporated dietary change35-37. It has been suggested that a 5-to-10-g increase in dietary soluble fiber will reduce serum total cholesterol by approximately 5 percent,38 a reduction comparable to that observed in our study.
A further reason for concern over claims that dietary fiber has a lipid-lowering effect is the lack of a clear mechanism. Originally, it was proposed that fiber increased the binding and fecal loss of bile acids39. Soluble fibers increase the fecal output of bile acids9 and the size of the bile acid pool,40 but the increased steroid losses (20 to 80 percent) have not been considered sufficient to account fully for the reduction in plasma cholesterol levels9. However, the larger differences in fiber-induced sterol losses observed in our study could contribute to the reduction in plasma cholesterol, as indicated by the significant relation between increased loss of bile acid and reduced serum lipid levels.
There is concern that increasing concentrations of fecal bile acids may enhance the risk of colon cancer9. In our subjects, however, the concentration of total bile acids during the soluble-fiber diet was, if anything, lower than that observed during the prestudy Step 2 diet.
Men had greater lipid reductions than women during the soluble-fiber diet. Nonetheless, there was no significant difference in response to the diets on the basis of lipid phenotypes or apolipoprotein E polymorphism.
The fiber intakes in our study were higher than those generally recommended,9 and the levels of saturated fat and cholesterol were lower than those normally advised even in therapeutic situations1. After marked reductions in the intake of saturated fat and cholesterol, the additional lipid-lowering effect of fiber was small. Other studies have noted greater reductions in serum lipid levels with lower intakes of fiber in subjects following more normal diets5,9.
Supported by grants from the Heart, Lung, and Blood Institute, National Institutes of Health (R01 HL 39689), and Loblaw Companies Limited.
We are indebted to the following companies for the donation of products: Archer Daniels Midland, Decatur, Ill.; Danby Products, Guelph, Ont.; Kellogg Company, Battle Creek, Mich., for breakfast cereals; President's Choice Too Good To Be True Products, Loblaw International Merchants, Toronto; Lumen Food Corporation, Lake Charles, La.; Mandarin Enterprises, Richmond, B.C.; MGM Brands, Scarborough, Ont.; Nestle, Don Mills, Ont., and Vevey, Switzerland; Spring Creek Natural Foods, Spencer, W.Va.; Uncle Ben's, Toronto; Westbrae Natural Foods, Commerce, Calif.; Will-Pak Foods, San Pedro, Calif.; Yves Fine Foods, Vancouver, B.C.; and T.J. Lipton, Toronto. We are also indebted to Mr. Larry Griffin and Mr. Bill Snelling for help in carrying out the study and ensuring quality control, and to Mrs. Anna Maria Spadafora and her team, whose diligence in diet preparation made this study possible.
Source Information
From the Departments of Nutritional Sciences (D.J.A.J., T.M.S.W., A.V.R., S.J.M., T.P.P.R., D.L.B., P.J.S., C.M., L.K.R.) and Preventive Medicine and Biostatistics (P.C.), Faculty of Medicine, University of Toronto, Toronto; the Clinical Nutrition and Risk Factor Modification Center (D.J.A.J., T.M.S.W., R.A.H., A.L.J.) and Division of Endocrinology and Metabolism (D.J.A.J., T.M.S.W., R.A.H., P.W.C.), St. Michael's Hospital, University of Toronto, Toronto; the Department of Foods and Nutrition, Purdue University, West Lafayette, Ind. (J.A.S., E.J.F.); and the Carbohydrate Research Division, Nestle Research Center, Lausanne, Switzerland (P.W.).
Address reprint requests to Dr. David Jenkins at the Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, 61 Queen St. East, Toronto, ON M5C 2T2, Canada.
- References
References
1
National Cholesterol Education Program. Report of the expert panel on population strategies for blood cholesterol reduction. Washington, D.C.: Department of Health and Human Services, 1990. (NIH publication no. 90-3046.)
2
The Surgeon General's report on nutrition and health. Washington, D.C.: Government Printing Office, 1988. (DHHS publication no. (PHS) 88-50210.)
3
Food labelling: health claims; dietary fiber and cardiovascular disease. Washington, D.C.: Food and Drug Administration, 1991. (Docket no. 91N-0099).
4
Swain JF ,Rouse IL ,Curley CB ,Sacks FM . Comparison of the effects of oat bran and low-fiber wheat on serum lipoprotein levels and blood pressure. N Engl J Med 1990;322:147-152
Full Text | Web of Science | Medline5
Anderson JW ,Story L ,Sieling B ,Chen WJ ,Petro MS ,Story J . Hypocholesterolemic effects of oat-bran or bean intake for hypercholesterolemic men. Am J Clin Nutr 1984;40:1146-1155
Web of Science | Medline6
Newman RK ,Lewis SE ,Newman CW ,Boik RJ ,Ramage RT . Hypocholesterolemic effect of barley foods on healthy men. Nutr Rep Int 1989;39:749-7607
Bell LP ,Hectorne KJ ,Reynolds H ,Balm TK ,Hunninghake DB . Cholesterol-lowering effects of psyllium hydrophilic mucilloid: adjunct therapy to a prudent diet for patients with mild to moderate hypercholesterolemia. JAMA 1989;261:3419-3423
CrossRef | Web of Science | Medline8
Van Horn L ,Moag-Stahlberg A ,Liu KA , et al. Effects on serum lipids of adding instant oats to usual American diets. Am J Public Health 1991;81:183-188
CrossRef | Web of Science | Medline9
Federation of American Societies for Experimental Biology. Physiological effects and health consequences of dietary fiber. Washington, D.C.: Department of Health and Human Services, 1987.
10
Hixson JE ,Vernier DT . Restriction isotyping of human apolipoprotein E by gene amplification and cleavage by HhaI. J Lipid Res 1990;31:545-548
Web of Science | Medline11
The Lipid Research Clinics population studies data book. Vol. 2. The prevalence study -- nutrient intake. Washington, D.C.: Government Printing Office, 1982. (NIH publication no. 82-2014.)
12
AOAC official methods of analysis. Washington, D.C.: Association of Official Analytical Chemists, 1980.
13
Prosky L ,Asp N-G ,Schweizer TF ,DeVries JW ,Furda I . Determination of insoluble, soluble, and total dietary fiber in foods and food products: interlaboratory study. J Assoc Off Anal Chem 1988;71:1017-1023
Medline14
Cunnane SC ,Armstrong JK . Long-chain fatty acid composition of maternal liver lipids during pregnancy and lactation in the rat: comparison of triglyceride to phospholipid. J Nutr 1990;120:338-345
Web of Science | Medline15
Watt BK, Merrill AL. Composition of foods. Washington, D.C.: Department of Agriculture, 1963. (Agriculture handbook no. 8).
16
Anderson JW ,Bridges SR . Dietary fiber content of selected foods. Am J Clin Nutr 1988;47:440-447
Web of Science | Medline17
Manual of laboratory operations: Lipid Research Clinics Program. Vol. 1. Lipid and lipoprotein analysis. Bethesda, Md.: National Institutes of Health, 1974. (DHEW publication no. (NIH) 75-628).
18
Fink PC ,Romer M ,Haeckel R , et al. Measurement of proteins with the Behring Nephelometer: a multicentre evaluation. J Clin Chem Clin Biochem 1989;27:261-276
Medline19
Clark LC Jr. A polarographic enzyme electrode for the measurement of oxidase substrates. In: Kessler M, Bruley DF, Leland CC, Lubbers DW, Silver IA, Strauss J, eds. Oxygen supply. Munich, Germany: Urban & Schwarzenberg, 1977:120-8.
20
Herbert V ,Lau K-S ,Gottlieb CW ,Bleicher SJ . Coated charcoal immunoassay of insulin. J Clin Endocrinol Metab 1965;25:1375-1384
CrossRef | Web of Science | Medline21
Kuzuya T ,Saito T ,Yoshida S ,Matsuda A . Human C-peptide immunoreactivity (CPR) in blood and urine -- evaluation of a radioimmunoassay method and its clinical applications. Diabetologia 1976;12:511-518
CrossRef | Web of Science | Medline22
Guerrant GO ,Lambert MA ,Moss CW . Analysis of short-chain acids from anaerobic bacteria by high-performance liquid chromatography. J Clin Microbiol 1982;16:355-360
Web of Science | Medline23
Nierenberg DW ,Lester DC . Determination of vitamins A and E in serum and plasma using a simplified clarification method and high-performance liquid chromatography. J Chromatogr 1985;345:275-284
CrossRef | Web of Science | Medline24
SAS/STAT user's guide, version 6 ed. Cary, N.C.: SAS Institute, 1985.
25
Anderson JW. Cholesterol-lowering effects of soluble fiber in humans. In: Kritchevsky D, Bonfield CT, eds. Vahouny fiber symposium. New York: Plenum Press (in press).
26
Schaefer EJ ,Levy RI ,Ernst ND ,Van Sant FD ,Brewer HB Jr . The effects of low cholesterol, high polyunsaturated fat, and low fat diets on plasma lipid and lipoprotein cholesterol levels in normal and hypercholesterolemic subjects. Am J Clin Nutr 1981;34:1758-1763
Web of Science | Medline27
Grundy SM . Comparison of monounsaturated fatty acids and carbohydrates for lowering plasma cholesterol. N Engl J Med 1986;314:745-748
Full Text | Web of Science | Medline28
Ginsberg HN ,Barr SL ,Gibert A , et al. Reduction of plasma cholesterol levels in normal men on an American Heart Association Step 1 diet or a Step 1 diet with added monounsaturated fat. N Engl J Med 1990;322:574-579
Full Text | Web of Science | Medline29
Kannel WB ,Castelli WP ,Gordon T . Cholesterol in the prediction of atherosclerotic disease: new perspectives based on the Framingham study. Ann Intern Med 1979;90:85-91
Web of Science | Medline30
Lipid Research Clinics ProgramThe Lipid Research Clinics Coronary Primary Prevention Trial results. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 1984;251:365-374
CrossRef | Web of Science31
Grundy SM ,Chait A ,Brunzell JD . Familial combined hyperlipidemia workshop. Arteriosclerosis 1987;7:203-20732
Sniderman AD ,Wolfson C ,Teng B ,Franklin FA ,Bachorik PS ,Kwiterovich PO Jr . Association of hyperapobetalipoproteinemia with endogenous hypertriglyceridemia and atherosclerosis. Ann Intern Med 1982;97:833-839
Web of Science | Medline33
Goldstein JL ,Schrott HG ,Hazzard WR ,Bierman EL ,Motulsky AG . Hyperlipidemia in coronary heart disease. II. Genetic analysis of lipid levels in 176 families and delineation of a new inherited disorder, combined hyperlipidemia. J Clin Invest 1973;52:1544-1568
CrossRef | Web of Science | Medline34
Levy RI ,Brensike JF ,Epstein SE , et al. The influence of changes in lipid values induced by cholestyramine and diet on progression of coronary artery disease: results of NHLBI Type II Coronary Intervention Study. Circulation 1984;69:325-337
CrossRef | Web of Science | Medline35
Ornish D ,Brown SE ,Scherwitz LW , et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-133
CrossRef | Web of Science | Medline36
Blankenhorn DH ,Johnson RL ,Mack WJ ,el Zein HA ,Vailas LI . The influence of diet on the appearance of new lesions in human coronary arteries. JAMA 1990;263:1646-1652
CrossRef | Web of Science | Medline37
Watts GF ,Lewis B ,Brunt JNH , et al. Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas' Atherosclerosis Regression Study (STARS). Lancet 1992;339:563-569
CrossRef | Web of Science | Medline38
Brown WV. A review of the cholesterol-lowering effects of soluble fiber. Presented at the Second International Conference on Preventive Cardiology. Washington, D.C., June 18-22, 1989.
39
Kritchevsky D ,Story JA . Binding of bile salts in vitro by nonnutritive fiber. J Nutr 1974;104:458-464
Web of Science | Medline40
Turley SD ,Daggy BP ,Dietschy JM . Cholesterol-lowering action of psyllium mucilloid in the hamster: sites and possible mechanisms of action. Metabolism 1991;40:1063-1073
CrossRef | Web of Science | Medline
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Pat M. Burton, John A. Monro, Laura Alvarez, Eimear Gallagher. (2011) Glycemic Impact and Health: New Horizons in White Bread Formulations. Critical Reviews in Food Science and Nutrition 51:10, 965-982
CrossRef3
Raghunatha R. L. Reddy, Krishnapura Srinivasan. (2011) Dietary fenugreek and onion attenuate cholesterol gallstone formation in lithogenic diet-fed mice. International Journal of Experimental Pathology 92:5, 308-319
CrossRef4
H.B. SOWBHAGYA, S. MAHADEVAMMA, D. INDRANI, P. SRINIVAS. (2011) PHYSICOCHEMICAL AND MICROSTRUCTURAL CHARACTERISTICS OF CELERY SEED SPENT RESIDUE AND INFLUENCE OF ITS ADDITION ON QUALITY OF BISCUITS. Journal of Texture Studies 42:5, 369-376
CrossRef5
Sebely Pal, Alireza Khossousi, Colin Binns, Satvinder Dhaliwal, Simone Radavelli-Bagatini. (2011) The effects of 12-week psyllium fibre supplementation or healthy diet on blood pressure and arterial stiffness in overweight and obese individuals. British Journal of Nutrition1-10
CrossRef6
Caren E. Smith, Katherine L. Tucker. (2011) Health benefits of cereal fibre: a review of clinical trials. Nutrition Research Reviews 24:01, 118-131
CrossRef7
L.P. Lobato, D. Anibal, M.M. Lazaretti, M.V.E. Grossmann. (2011) Extruded puffed functional ingredient with oat bran and soy flour. LWT - Food Science and Technology 44:4, 933-939
CrossRef8
M. Madhava Naidu, B.N. Shyamala, J. Pura Naik, G. Sulochanamma, P. Srinivas. (2011) Chemical composition and antioxidant activity of the husk and endosperm of fenugreek seeds. LWT - Food Science and Technology 44:2, 451-456
CrossRef9
Neil A Smart, Belinda J Marshall, Maxine Daley, Elie Boulos, Janelle Windus, Nadine Baker, Nigel Kwok, Neil A Smart. 2011. Low-fat diets for acquired hypercholesterolaemia. .
CrossRef10
A.-S. Sandberg. 2011. Developing functional ingredients: a case study of pea protein. , 358-382.
CrossRef11
J C Brand-Miller, F S Atkinson, R J Gahler, V Kacinik, M R Lyon, S Wood. (2010) Effects of PGX, a novel functional fibre, on acute and delayed postprandial glycaemia. European Journal of Clinical Nutrition 64:12, 1488-1493
CrossRef12
Pasquale Pignatelli, Stefania Basili. (2010) Nutraceuticals in the Early Infancy. Cardiovascular Therapeutics 28:4, 236-245
CrossRef13
Ibrahim Sari, Yasemin Baltaci, Cahit Bagci, Vedat Davutoglu, Ozcan Erel, Hakim Celik, Orhan Ozer, Nur Aksoy, Mehmet Aksoy. (2010) Effect of pistachio diet on lipid parameters, endothelial function, inflammation, and oxidative status: A prospective study. Nutrition 26:4, 399-404
CrossRef14
Heather E. Rasmussen, Kara R. Blobaum, Elliot D. Jesch, Chai Siah Ku, Young-Ki Park, Fan Lu, Timothy P. Carr, Ji-Young Lee. (2009) Hypocholesterolemic effect of Nostoc commune var. sphaeroides Kützing, an edible blue-green alga. European Journal of Nutrition 48:7, 387-394
CrossRef15
R.L.R. Reddy, K. Srinivasan. (2009) Dietary fenugreek seed regresses preestablished cholesterol gallstones in mice. Canadian Journal of Physiology and Pharmacology 87:9, 684-693
CrossRef16
Tiny Hoekstra, Joline W.J. Beulens, Yvonne T. van der Schouw. (2009) Cardiovascular disease prevention in women: Impact of dietary interventions. Maturitas 63:1, 20-27
CrossRef17
T. Oyama, S. Fukuda, T. Shimoyama, I. Takahashi, T. Umeda, K. Danjo, D. Saito, D. Chinda, J. Sakamoto, S. Nakaji. (2008) The Oro-Ileal Transit of Cellulose. Journal of Food Science 73:9, H229-H234
CrossRef18
A. Khossousi, C. W. Binns, S. S. Dhaliwal, S. Pal. (2008) The acute effects of psyllium on postprandial lipaemia and thermogenesis in overweight and obese men. British Journal of Nutrition 99:05,
CrossRef19
David J.A. Jenkins, Cyril W.C. Kendall, Tri H. Nguyen, Augustine Marchie, Dorothea A. Faulkner, Christopher Ireland, Andrea R. Josse, Edward Vidgen, Elke A. Trautwein, Karen G. Lapsley, Candice Holmes, Robert G. Josse,, Lawrence A. Leiter, Philip W. Connelly, William Singer. (2008) Effect of plant sterols in combination with other cholesterol-lowering foods. Metabolism 57:1, 130-139
CrossRef20
Marsha Read. 2007. Health-Promoting Diet for Adults. , 345-357.
CrossRef21
Masamitsu Hinata, Masami Ono, Sanae Midorikawa, Koji Nakanishi. (2007) Metabolic improvement of male prisoners with type 2 diabetes in Fukushima Prison, Japan. Diabetes Research and Clinical Practice 77:2, 327-332
CrossRef22
Sarah AM Kelly, Carolyn D Summerbell, Audrey Brynes, Victoria Whittaker, Gary Frost, Sarah AM Kelly. 2007. Wholegrain cereals for coronary heart disease. .
CrossRef23
Oranong Kangsadalampai, Kulwara Meksawan, Nutthagamol Buranaprapruk. (2007) Ocimum canum seed supplementation did not influence serum lipid levels in hypercholesterolemic patients. Nutrition Research 27:4, 206-211
CrossRef24
H.B. Sowbhagya, P. Florence Suma, S. Mahadevamma, R.N. Tharanathan. (2007) Spent residue from cumin – a potential source of dietary fiber. Food Chemistry 104:3, 1220-1225
CrossRef25
A. Kocyigit, A.A. Koylu, H. Keles. (2006) Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Nutrition, Metabolism and Cardiovascular Diseases 16:3, 202-209
CrossRef26
David J. A. Jenkins, Cyril W. C. Kendall. (2006) The Garden of Eden. Epidemiology 17:2, 128-130
CrossRef27
Augustine Marchie, Azadeh Emam, Cyril Kendall, Julia Wong, David Jenkins, Russell de Souza. 2005. Synergy of Portfolio Diet Components and Drugs in Coronary Heart Disease. , 63-76.
CrossRef28
Joanne L. Slavin. (2005) Dietary fiber and body weight. Nutrition 21:3, 411-418
CrossRef29
Peter J. Jones, Mahmoud Raeini-Sarjaz, David J. A. Jenkins, Cyril W. C. Kendall, Edward Vidgen, Elke A. Trautwein, Karen G. Lapsley, Augustine Marchie, Stephen C. Cunnane, Philip W. Connelly. (2005) Effects of a diet high in plant sterols, vegetable proteins, and viscous fibers (dietary portfolio) on circulating sterol levels and red cell fragility in hypercholesterolemic subjects. Lipids 40:2, 169-174
CrossRef30
Eiji Yamazaki, Kazumi Murakami, Osamu Kurita. (2005) Easy Preparation of Dietary Fiber with the High Water-Holding Capacity from Food Sources. Plant Foods for Human Nutrition 60:1, 17-23
CrossRef31
David J.A Jenkins, Cyril W.C Kendall, Augustine Marchie, Dorothea Faulkner, Edward Vidgen, Karen G Lapsley, Elke A Trautwein, Tina L Parker, Robert G Josse, Lawrence A Leiter, Philip W Connelly. (2003) The effect of combining plant sterols, soy protein, viscous fibers, and almonds in treating hypercholesterolemia. Metabolism 52:11, 1478-1483
CrossRef32
David J.A. Jenkins, Cyril W.C. Kendall, Augustine Marchie, Alexandra L. Jenkins, Philip W. Connelly, Peter J.H. Jones, Vladimir Vuksan. (2003) The Garden of Eden—plant based diets, the genetic drive to conserve cholesterol and its implications for heart disease in the 21st century. Comparative Biochemistry and Physiology - Part A: Molecular & Integrative Physiology 136:1, 141-151
CrossRef33
Jue Li, Takashi Kaneko, Li-Qiang Qin, Jing Wang, Yuan Wang, Akio Sato. (2003) Long-term effects of high dietary fiber intake on glucose tolerance and lipid metabolism in GK rats: comparison among barley, rice, and cornstarch. Metabolism 52:9, 1206-1210
CrossRef34
Joanne Slavin. (2003) Impact of the proposed definition of dietary fiber on nutrient databases. Journal of Food Composition and Analysis 16:3, 287-291
CrossRef35
Daniel Bunout, Gladys Barrera, Pia de la Maza, Vivien Gattas, Sandra Hirsch. (2003) Seasonal Variation in Insulin Sensitivity in Healthy Elderly People. Nutrition 19:4, 310-316
CrossRef36
Neil J. Stone, Linda Horn. (2002) Therapeutic lifestyle change and adult treatment panel III: Evidence then and now. Current Atherosclerosis Reports 4:6, 433-443
CrossRef37
Judith A Marlett, Michael I McBurney, Joanne L Slavin. (2002) Position of the American Dietetic Association. Journal of the American Dietetic Association 102:7, 993-1000
CrossRef38
Simin Liu, Julie E Buring, Howard D Sesso, Eric B Rimm, Walter C Willett, JoAnn E Manson. (2002) A prospective study of dietary fiber intake and risk of cardiovascular disease among women. Journal of the American College of Cardiology 39:1, 49-56
CrossRef39
J. A. Ingelbrecht, K. Moers, J. Abécassis, X. Rouau, J. A. Delcour. (2001) Influence of Arabinoxylans and Endoxylanases on Pasta Processing and Quality. Production of High-Quality Pasta with Increased Levels of Soluble Fiber. Cereal Chemistry 78:6, 721-729
CrossRef40
David L. Katz, Haq Nawaz, Josette Boukhalil, Wendy Chan, Ramin Ahmadi, Vanessa Giannamore, Philip M. Sarrel. (2001) Effects of Oat and Wheat Cereals on Endothelial Responses. Preventive Medicine 33:5, 476-484
CrossRef41
Neil J. Stone. (2001) Lowering low-density cholesterol with diet: the important role of functional foods as adjuncts. Coronary Artery Disease 12:7, 547-552
CrossRef42
Linda Van Horn, Arline McDonald, Eileen Peters, Niki Gernhofer. (2001) Dietary Management of Cardiovascular Disease: A Year 2002 Perspective. Nutrition in Clinical Care 4:6, 314-331
CrossRef43
LINDA VAN HORN, KIANG LIU, JUDY GERBER, LINDA SCHIFFER, NIKI GERNHOFER, PHILIP GREENLAND. (2001) Oats and Soy in Lipid-Lowering Diets for Women with Hypercholesterolemia. Journal of the American Dietetic Association 101:11, 1319-1325
CrossRef44
Marsha Read. 2001. The Health-Promoting Diet throughout Life. .
CrossRef45
David Cameron-Smith, Gregory Collier. 2001. Dietary Fiber and Glucose Metabolism and Diabetes. .
CrossRef46
Judith Marlett. 2001. Dietary Fiber and Cardiovascular Disease. .
CrossRef47
Maria Luz Fernandez. 2001. Pectin. .
CrossRef48
David J. A. Jenkins, Mette Axelsen, Cyril W. C. Kendall, Livia S. A. Augustin, Vladimir Vuksan, Ulf Smith. (2000) Dietary fibre, lente carbohydrates and the insulin-resistant diseases. British Journal of Nutrition 83:S1,
CrossRef49
Nuria Mart
n-Carr
CrossRef50
Alice Lichtenstein. 2000. Fat and Cholesterol. , 155-172.
CrossRef51
David J.A. Jenkins, Cyril W.C. Kendall, Mette Axelsen, Livia S.A. Augustin, Vladimir Vuksan. (2000) Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease. Current Opinion in Lipidology 11:1, 49-56
CrossRef52
A. S. Sandberg. 2000. Developing functional ingredients. , 209-232.
CrossRef53
NAUMAN TARIQ, DAVID J.A. JENKINS, EDWARD VIDGEN, NEIL FLESHNER, CYRIL W.C. KENDALL, JON A. STORY, WILLIAM SINGER, MARIO D’COSTA, NORMAN STRUTHERS. (2000) EFFECT OF SOLUBLE AND INSOLUBLE FIBER DIETS ON SERUM PROSTATE SPECIFIC ANTIGEN IN MEN. The Journal of Urology 163:1, 114-118
CrossRef54
NAUMAN TARIQ, DAVID J. A. JENKINS, EDWARD VIDGEN, NEIL FLESHNER, CYRIL W. C. KENDALL, JON A. STORY, WILLIAM SINGER, MARIO D???COSTA, NORMAN STRUTHERS. (2000) EFFECT OF SOLUBLE AND INSOLUBLE FIBER DIETS ON SERUM PROSTATE SPECIFIC ANTIGEN IN MEN. The Journal of Urology114
CrossRef55
David J.A. Jenkins, Cyril W.C. Kendall, Edward Vidgen, Christine C. Mehling, Tina Parker, Hilda Seyler, Dorothea Faulkner, Marcella Garsetti, Larry C. Griffin, Sanjiv Agarwal, A. Venket Rao, Stephen C. Cunnane, Mary Ann Ryan, Philip W. Connelly, Lawrence A. Leiter, Vladimir Vuksan, Robert Josse. (2000) The effect of serum lipids and oxidized low-density lipoprotein of supplementing self-selected low-fat diets with soluble-fiber, soy, and vegetable protein foods. Metabolism 49:1, 67-72
CrossRef56
I Carabin. (1999) Evaluation of Safety of Inulin and Oligofructose as Dietary Fiber. Regulatory Toxicology and Pharmacology 30:3, 268-282
CrossRef57
Noriyuki Nakanishi, Koji Nakamura, Kenji Suzuki, Kozo Tatara. (1999) Lifestyle and the development of dyslipidemia: a 4-year follow-up study of middle-aged Japanese Male Office Workers. Environmental Health and Preventive Medicine 4:3, 140-145
CrossRef58
David J.A. Jenkins, Cyril W.C. Kendall, Christine C. Mehling, Tina Parker, A.Venket Rao, Sanjiv Agarwal, Renato Novokmet, Peter J.H. Jones, Mahmoud Raeini, Jon A. Story, Emily Furumoto, Edward Vidgen, Larry C. Griffin, Stephen C. Cunnane, Mary Ann Ryan, Philip W. Connelly. (1999) Combined effect of vegetable protein (soy) and soluble fiber added to a standard cholesterol-lowering diet. Metabolism 48:6, 809-816
CrossRef59
Wayne H Schwesinger, William E Kurtin, Carey P Page, Ronald M Stewart, Robbie Johnson. (1999) Soluble dietary fiber protects against cholesterol gallstone formation. The American Journal of Surgery 177:4, 307-310
CrossRef60
Robert A. Hegele. (1998) A review of intestinal fatty acid binding protein gene variation and the plasma lipoprotein response to dietary components. Clinical Biochemistry 31:8, 609-612
CrossRef61
Anna Macintosh. (1998) Fiber Supplements. Alternative and Complementary Therapies 4:4, 267-275
CrossRef62
Linda Horn, Rae-Ellen Kavey. (1997) Diet and cardiovascular disease prevention: What works?. Annals of Behavioral Medicine 19:3, 197-212
CrossRef63
A. A. RIVELLESE. (1997) Monounsaturated and Marine ?-3 Fatty Acids in NIDDM Patients. Annals of the New York Academy of Sciences 827:1 Lipids and Sy, 302-309
CrossRef64
Dawn J. O’Byrne, David A. Knauft, Rachel B. Shireman. (1997) Low fat-monounsaturated rich diets containing high-oleic peanuts improve serum lipoprotein profiles. Lipids 32:7, 687-695
CrossRef65
David J.A. Jenkins, David G. Popovich, Cyril W.C. Kendall, Edward Vidgen, Nauman Tariq, Thomas P.P. Ransom, Thomas M.S. Wolever, Vladimir Vuksan, Christine C. Mehling, Dana L. Boctor, Claudia Bolognesi, James Huang, Robert Patten. (1997) Effect of a diet high in vegetables, fruit, and nuts on serum lipids. Metabolism 46:5, 530-537
CrossRef66
Frederick J Veldman, Chenicheri H Nair, Hester H Vorster, Willem J.H Vermaak, Johann C Jerling, Welma Oosthuizen, Christine S Venter. (1997) DIETARY PECTIN INFLUENCES FIBRIN NETWORK STRUCTURE IN HYPERCHOLESTEROLAEMIC SUBJECTS. Thrombosis Research 86:3, 183-196
CrossRef67
U. Martin, C. Eagles. (1997) Non-pharmacological modification of cardiac risk factors: part 2. The role of diet. Journal of Clinical Pharmacy and Therapeutics 22:2, 99-108
CrossRef68
W. Y. Zhang, A. Li Wan Po. (1997) Do codeine and caffeine enhance the analgesic effect of aspirin?-A systematic overview. Journal of Clinical Pharmacy and Therapeutics 22:2, 79-97
CrossRef69
C. Cherbut, A.-C. Aube, N. Mekki, C. Dubois, D. Lairon, J.-L. Barry. (1997) Digestive and metabolic effects of potato and maize fibres in human subjects. British Journal of Nutrition 77:01, 33
CrossRef70
I. I. Dedov, G. A. Gerasimov, M. I. Bronshtein, G. F. Aleksandrova, E. A. Troshina, J. Figge. (1996) Immunoreactivity of p53 nuclear protein in differentiated thyroid cancer. Bulletin of Experimental Biology and Medicine 122:6, 1208-1209
CrossRef71
Lillian M. Sonnenberg, Paula A. Quatromoni, David R. Gagnon, L.Adrienne Cupples, Mary M. Franz, Jose M. Ordovas, Peter W.F. Wilson, Ernst J. Schaefer, Barbara E. Milien. (1996) Diet and plasma lipids in women. II. Macronutrients and plasma triglycerides, high-density lipoprotein, and the ratio of total to high-density lipoprotein cholesterol in women: The Framingham Nutrition Studies. Journal of Clinical Epidemiology 49:6, 665-672
CrossRef72
Barbara E Millen, Mary M Franz, Paula A Quatromoni, David R Gagnon, Lillian M Sonnenberg, Jose M Ordovas, Peter W.F Wilson, Ernst J Schaefer, L.Adrienne Cupples. (1996) Diet and plasma lipids in women. I. Macronutrients and plasma total and low-density lipoprotein cholesterol in women: The Framingham Nutrition Studies. Journal of Clinical Epidemiology 49:6, 657-663
CrossRef73
S Lemieux. (1995) Do elevated levels of abdominal visceral adipose tissue contribute to age-related differences in plasma lipoprotein concentrations in men?. Atherosclerosis 118:1, 155-164
CrossRef74
I. U. Haq, W. W. Yeo, P. R. Jackson, L. E. Ramsay. (1995) The effects of dietary change on serum cholesterol. Proceedings of the Nutrition Society 54:03, 601-616
CrossRef75
David J.A. Jenkins, Aneal Khan, Alexandra L. Jenkins, Roger Illingworth, Anuradhe S. Pappu, Thomas M.S. Wolever, Vladimir Vuksan, Gloria Buckley, A.Venketeshwer Rao, Stephen C. Cunnane, Furio Brighenti, Meredith Hawkins, Mohamed Abdolell, Paul Corey, Robert Patten, Robert G. Josse. (1995) Effect of nibbling versus gorging on cardiovascular risk factors: Serum uric acid and blood lipids. Metabolism 44:4, 549-555
CrossRef76
T.M.S. Wolever, R. Radmard, J.-L. Chiasson, J.A. Hunt, R.G. Josse, C. Palmason, N.W. Rodger, S.A. Ross, E.A. Ryan, M.H. Tan. (1995) One-year Acarbose Treatment Raises Fasting Serum Acetate in Diabetic Patients. Diabetic Medicine 12:2, 164-172
CrossRef77
JAN M. SHANE, PAUL M. WALKER. (1995) Corn Bran Supplementation of a Low-Fat Controlled Diet Lowers Serum Lipids in Men with Hypercholesterolemia. Journal of the American Dietetic Association 95:1, 40-45
CrossRef78
G. Frost, J. Wilding, J. Beecham. (1994) Dietary Advice Based on the Glycaemic Index Improves Dietary Profile and Metabolic Control in Type 2 Diabetic Patients. Diabetic Medicine 11:4, 397-401
CrossRef
