Role of a prudent breakfast in improving cardiometabolic risk factors in subjects with hypercholesterolemia: a randomized controlled trial

Clin Nutr. 2015 Feb;34(1):20-6. doi: 10.1016/j.clnu.2014.04.009. Epub 2014 Apr 21.

Abstract

Background & aims: It is unclear whether advising a prudent breakfast alone is sufficient to improve blood lipids and cardiometabolic risk factors in overweight hypercholesterolemic subjects. The aim of this study was to investigate whether a prudent low-fat breakfast (PB) rich in dietary fiber lowers low-density lipoprotein cholesterol (LDL-C) and other cardiometabolic risk factors in subjects with elevated LDL-cholesterol levels.

Methods: In a parallel, controlled, 12-week study, 79 healthy overweight subjects (all regular breakfast eaters) were randomly allocated to a group that received a PB based on Nordic foods provided ad libitum or a control group that consumed their usual breakfast. The primary outcome was plasma LDL-C. Secondary outcomes were other blood lipids, body weight, sagittal abdominal diameter (SAD), glucose tolerance, insulin sensitivity and inflammation markers (C-reactive protein [CRP] and tumor necrosis factor receptor-2 [TNF-R2]), and blood pressure. The PB was in accordance with national and Nordic nutrition recommendations and included oat bran porridge with low-fat milk or yogurt, bilberry or lingonberry jam, whole grain bread, low-fat spread, poultry or fatty fish, and fruit.

Results: No differences were found in LDL-C, other blood lipids, body weight, or glucose metabolism, but SAD, plasma CRP, and TNF-R2 decreased more during PB compared with controls (p < 0.05). In the overall diet, PB increased dietary fiber and β-glucan compared with controls (p < 0.05).

Conclusions: Advising a prudent breakfast for 3 months did not influence blood lipids, body weight, or glucose metabolism but reduced markers of visceral fat and inflammation. The trial was registered in the Current Controlled Trials database (http://www.controlled-trials.com); International Standard Randomized Controlled Trial Number (ISRCTN): 84550872.

Keywords: Cardiometabolic risk factors; Inflammation; LDL-cholesterol; Nordic diet; Prudent breakfast; Visceral fat.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism
  • Blood Pressure
  • Breakfast*
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol, LDL / blood*
  • Diet, Fat-Restricted
  • Dietary Fiber / administration & dosage
  • Female
  • Humans
  • Hypercholesterolemia / diet therapy*
  • Inflammation
  • Insulin Resistance
  • Intra-Abdominal Fat
  • Lipids / blood
  • Male
  • Metabolic Diseases / prevention & control*
  • Middle Aged
  • Receptors, Tumor Necrosis Factor, Type II / blood
  • Risk Factors

Substances

  • Blood Glucose
  • Cholesterol, LDL
  • Dietary Fiber
  • Lipids
  • Receptors, Tumor Necrosis Factor, Type II
  • C-Reactive Protein