Can diet and weight loss reverse carotid atherosclerosis?

Penurunan berat badan dapat menurunkan ketebalan lapisan intima media arteri carotis

Circulation 121:1200-1208, March 2010 © 2010 American Heart Association, Inc.
Dietary Intervention to Reverse Carotid Atherosclerosis. Iris Shai, J. David Spence, Dan Schwarzfuchs, et al. 

Background— It is currently unknown whether dietary weight loss interventions can induce regression of carotidatherosclerosis.

Methods and Results— In a 2-year Dietary Intervention Randomized Controlled Trial–Carotid (DIRECT-Carotid) study, participants were randomized to low-fat, Mediterranean, or low-carbohydrate diets and were followed for changes in carotid artery intima-media thickness, measured with standard B-mode ultrasound, and carotid vessel wall volume (VWV), measured with carotid 3D ultrasound. Of 140 complete images of participants (aged 51 years; body mass index, 30 kg/m²; 88% men), higher baseline carotid VWV was associated with increased intima-media thickness, age, male sex, baseline weight, blood pressure, and insulin levels (P<0.05 for all). After 2 years of dietary intervention, we observed a significant 5% regression in mean carotidVWV (–58.1 mm^3; 95% confidence interval, –81.0 to –35.1 mm³; P<0.001), with no differences in the low-fat, Mediterranean, or low-carbohydrate groups (–60.69 mm³, –37.69 mm³, –84.33 mm³, respectively; P=0.28). Mean change in intima-media thickness was –1.1% (P=0.18). A reduction in the ratio of apolipoprotein B₁₀₀ to apolipoprotein A1 was observed in the low-carbohydrate compared with the low-fat group (P=0.001). Participants who exhibited carotidVWV regression (mean decrease, –128.0 mm³; 95% confidence interval, –148.1 to –107.9 mm³) compared with participants who exhibited progression (meanincrease, +89.6 mm³; 95% confidence interval, +66.6 to +112.6 mm³) had achieved greater weight loss (–5.3 versus –3.2 kg; P=0.03), greater decreases in systolic blood pressure (–6.8 versus –1.1 mm Hg; P=0.009) and total homocysteine (–0.06 versus +1.44 µmol/L; P=0.04), and a higher increase of apolipoprotein A1 (+0.05 versus –0.00 g/L; P=0.06). In multivariate regression models, only the decrease in systolic blood pressure remained a significant independent modifiablepredictor of subsequent greater regression in both carotid VWV (β=0.23; P=0.01) and intima-media thickness (β=0.28; P=0.008) levels.

Conclusions— Two-year weight loss diets can induce a significant regression of measurable carotid VWV. The effect is similar in low-fat, Mediterranean, or low-carbohydrate strategies and appears to be mediated mainly by the weight loss–induced decline in blood pressure.

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Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
@
www.kliniknutrisi.com
kliniknutrisi.blogspot.com

Fruits or vegetables

As you know fruits and vegetables are at the pinnacle of the Healthiest Way of Eating.

That being said, Readers ask me whether fruits and vegetables are equally important. Here's what I tell them:We included a long list of both fruits and vegetables in the World's Healthiest Foods, and we did so not only for health and nourishment reasons, but also because of the beauty and diversity of these foods.

There are so many unique fruits and vegetables growing on the earth! The colors, shapes, and tastes of these foods are totally unique and unsurpassed within the food world! It's impossible for us to imagine the experience of the World's Healthiest Foods without ample amounts of fruits and vegetables.

When you compare fruits and vegetables on a nutritional basis, however, there is no question that vegetables are more nutrient dense and contain a much wider variety of nutrients than fruits.

If you think about the lives of the plants, this difference makes sense. In the world of vegetables, we eat many parts of the plants that either grow very close to the soil (like stems and stalks) or beneath the ground itself (like roots) This closeness to the soil brings the plant into contact with the diversity of soil minerals, and almost all vegetables are richer in minerals than fruits for this reason.

Fruits are also more of an end-stage occurrence: in the case of an apple tree, for example, the tree has already lived and developed for a good number of years before it produces a significant amount of edible fruit. Unlike a root, which is in charge of nutrient delivery from the soil up into the rest of the plant, the fruit (like an apple) is not nearly as active in supporting the life of the plant (although it's seeds are dramatically important in allowing the tree to produce new offspring and create future generations of apple trees).

Because the stems and stalks and roots are more involved in the plant's life support, they also tend to have a greater variety of vitamins (especially B complex vitamins) than fruits.Most fruits have a concentrated amount of sugar, and for this reason, are higher-calorie and less nutrient dense than most vegetables.

Starchy root vegetables like potatoes are closer to fruits in calorie content, but green leafy vegetables are enormously lower in calories and greater in nutrient density.

In summary, if you had to choose between fruits and vegetables as a foundation for your health, you would do best to select vegetables because of their greater nutrient diversity and nutrient density. Luckily, however, it is not an either-or situation, and you can take pleasure in the delights of both fruits and vegetables while increasing your reliance on the World's Healthiest Foods!

By George Mateljan

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Cholesterol content of foods

Dairy Products	Portion	Cholesterol (mg)	Total Fat (g)	Saturated Fat (mg)
Milk (non-fat)	1 cup	4	0	0
Milk (low-fat)	1 cup	10	3	2
Milk (whole)	1 cup	33	8	5
Yogurt (non-fat)	1 cup	10	0	0
Yogurt (whole)	1 cup	29	7	5
Cheddar Cheese	1 oz	30	9	6
Cottage Cheese (low-fat)	1 cup	10	2	2

Fats	Portion	Cholesterol (mg)	Total Fat (g)	Saturated Fat (mg)
Butter	1 tsp	11	4	3
Margarine	1 tsp	0	4	1
Vegetable Oils	1 tsp	0	5	1 - 2

Meats & Protein	Portion	Cholesterol (mg)	Total Fat (g)	Saturated Fat (mg)
Tofu	1/2 cup	0	11	2
Pinto beans	1/2 cup	0	1	0
Egg	1	212	5	2
Halibut	3 ½ oz	41	3	0
Salmon	3 ½ oz	63	12	2
Oysters	3 ½ oz	55	2	1
Crab	3 ½ oz	52	1	0
Lobster	3 ½ oz	71	1	0
Tuna (in water)	3 ½ oz	30	1	0
Shrimp	3 ½ oz	194	1	0
Squid	3 ½ oz	231	1	0
Beef (ground, lean)	3 ½ oz	78	18	7
Beef (short ribs)	3 ½ oz	94	42	18
Beef (sirloin)	3 ½ oz	89	12	5
Beef Liver	3 ½ oz	389	5	2
Veal (top round)	3 ½ oz	135	5	2
Lamb (foreshank)	3 ½ oz	106	14	6
Ham	3 ½ oz	53	6	2
Pork (tenderloin)	3 ½ oz	79	6	2
Pork (chop)	3 ½ oz	85	25	10
Chicken Liver	3 ½ oz	631	6	2
Chicken (no skin)	3 ½ oz	85	5	1