The Type and Amount of Dietary Fat Affect Plasma Factor VIIc, Fibrinogen, and PAI-1 in Healthy Individuals and Individuals at High Cardiovascular Disease Risk: 2 Randomized Controlled Trials.

Pubmed ID: 32492148

Pubmed Central ID: PMC7398773

Journal: The Journal of nutrition

Publication Date: Aug. 1, 2020

MeSH Terms: Humans, Male, Adult, Female, Aged, Cardiovascular Diseases, Risk Factors, Middle Aged, Diet, Young Adult, Fibrinogen, Gene Expression Regulation, Plasminogen Activator Inhibitor 1, Dietary Fats, Hemostasis, Factor VII

Grants: M01 RR000645, M01 RR000400

Authors: Tracy RP, Rodriguez C, Johnson C, Ginsberg HN, Stewart P, Anderson N, Jones J, Proschan M, Martin L, Williams B, Tracy R, Ramakrishnan R, Ramakrishnan R, Cornell E, Davis C, Davis C, Reed R, Smiciklas-Wright H, Van Heel N, Karmally W, Karmally W, Ershow AG, Kris-Etherton PM, Berglund L, Berglund L, Lefevre M, Lefevre M, Elmer PJ, Stewart PW, Ershow A, Pearson TA, Dennis BH, Roheim PS, Stewart K, Champagne C, Phillips K, Farhat-Wood A, Kris-Etherton P, Dennis B, Pearson T, Holleran S, Siddiqui M, Chen NT, Holeman R, Chirgwin K, Stennett K, Ganga L, Myers M, Ngai C, Fontenez N, Useche N, Ryan D, Champagne CM, Williamson D, Tulley R, Brock R, Bodin D, Kennedy B, Barkate M, Foust E, York D, Derr J, Meaker K, Mills E, Tilley MA, Sigman-Grant M, Sechevich P, Mastro AM, Hosking J, Bryan H, Abolafia J, Foley M, Zien C, Leu SY, Youngblood M, Goodwin T, Miles M, Wehbie J, Rifkind B, Guinard JX, Holden J, Cooper AD, Holleran SF, Ginsberg H, Towolawai T, Most M, Jonnalagadda S, Mustad V, Yu S, Reddy CC, Elmer P, Folsom A, Wold C, Fritz K, Slavin J, Jacobs D, Blackwell S, Stewart WB, McGee B, Beecher G, Gordon D

Cite As: Kris-Etherton PM, Stewart PW, Ginsberg HN, Tracy RP, Lefevre M, Elmer PJ, Berglund L, Ershow AG, Pearson TA, Ramakrishnan R, Holleran SF, Dennis BH, Champagne CM, Karmally W, DELTA Investigators. The Type and Amount of Dietary Fat Affect Plasma Factor VIIc, Fibrinogen, and PAI-1 in Healthy Individuals and Individuals at High Cardiovascular Disease Risk: 2 Randomized Controlled Trials. J Nutr 2020 Aug 1;150(8):2089-2100.

Studies:

Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA)

Abstract

BACKGROUND: Factor VIIc, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) are cardiovascular disease (CVD) risk factors and are modulated, in part, by fat type and amount. OBJECTIVE: We evaluated fat type and amount on the primary outcomes: factor VIIc, fibrinogen, and PAI-1. METHODS: In the Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA) Trial, 2 controlled crossover feeding studies evaluated substituting carbohydrate or MUFAs for SFAs. Study 1: healthy participants (n = 103) were provided with (8 wk) an average American diet [AAD; designed to provide 37% of energy (%E) as fat, 16% SFA], a Step 1 diet (30%E fat, 9% SFA), and a diet low in SFA (Low-Sat; 26%E fat, 5% SFA). Study 2: participants (n = 85) at risk for CVD and metabolic syndrome (MetSyn) were provided with (7 wk) an AAD, a step 1 diet, and a high-MUFA diet (designed to provide 37%E fat, 8% SFA, 22% MUFA). RESULTS: Study 1: compared with AAD, the Step 1 and Low-Sat diets decreased mean factor VIIc by 1.8% and 2.6% (overall P = 0.0001), increased mean fibrinogen by 1.2% and 2.8% (P = 0.0141), and increased mean square root PAI-1 by 0.0% and 6.0% (P = 0.0037), respectively. Study 2: compared with AAD, the Step 1 and high-MUFA diets decreased mean factor VIIc by 4.1% and 3.2% (overall P < 0.0001), increased mean fibrinogen by 3.9% and 1.5% (P = 0.0083), and increased mean square-root PAI-1 by 2.0% and 5.8% (P = 0.1319), respectively. CONCLUSIONS: Replacing SFA with carbohydrate decreased factor VIIc and increased fibrinogen in healthy and metabolically unhealthy individuals and also increased PAI-1 in healthy subjects. Replacing SFA with MUFA decreased factor VIIc and increased fibrinogen but less than carbohydrate. Our results indicate an uncertain effect of replacing SFA with carbohydrate or MUFA on cardiometabolic risk because of small changes in hemostatic factors and directionally different responses to decreasing SFA. This trial was registered at https://clinicaltrials.gov/ct2/show/NCT00000538?term=NCT00000538&rank=1 as NCT00000538.