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A substitution model of dietary manipulation is an effective means of optimising lipid profile, reducing C-reactive protein and increasing insulin-like growth factor-1

Published online by Cambridge University Press:  09 March 2007

Adrian H. Heald ,
Cheryl Golding ,
Reena Sharma ,
Kirk Siddals ,
Sara Kirk ,
Clare Lawton ,
Simon Anderson ,
J. Martin Gibson  and
Janet E. Cade
Adrian H. Heald*
Affiliation:
Nutritional Epidemiology Group and
Cheryl Golding
Affiliation:
Nutritional Epidemiology Group and
Reena Sharma
Affiliation:
Department of Diabetes and Endocrinology, Salford Royal Hospitals NHS Trust, Hope Hospital, Stott Lane, Salford M6 8HD, UK
Kirk Siddals
Affiliation:
Department of Diabetes and Endocrinology, Salford Royal Hospitals NHS Trust, Hope Hospital, Stott Lane, Salford M6 8HD, UK
Sara Kirk
Affiliation:
Nutritional Epidemiology Group and
Clare Lawton
Affiliation:
Department of Psychology, University of Leeds, 71–75 Clarendon Road, Leeds, LS2 9P, UK
Simon Anderson
Affiliation:
Department of Diabetes and Endocrinology, Salford Royal Hospitals NHS Trust, Hope Hospital, Stott Lane, Salford M6 8HD, UK
J. Martin Gibson
Affiliation:
Department of Diabetes and Endocrinology, Salford Royal Hospitals NHS Trust, Hope Hospital, Stott Lane, Salford M6 8HD, UK
Janet E. Cade
Affiliation:
Nutritional Epidemiology Group and
*
*Corresponding author: Dr Adrian Heald, fax +44 161 787 5989, email, aheald@fs1.ho.man.ac.uk
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Abstract

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There are two key methods in which fat intake may be manipulated; the ‘substitution model’ and the ‘reduction model’. However insufficient information is known about the mechanisms of dietary fat reduction in individuals who have successfully reduced their fat intake, to be clear as to which strategy offers the greatest chance of success. Our objective was to ascertain the most effective dietary intervention for improving cardiovascular risk profile. Eighty female volunteers (high fat consumers) were recruited. Each subject was randomly allocated into one of the following groups. Substitution of high-fat foods was made with reduced-fat products, by the reduction of high-fat foods, by a combination of substitution and reduction strategies, or no advice was given. Each intervention lasted 3 months. Anthropometric measures and fasting blood samples were taken at baseline and follow-up. The substitution intervention resulted in weight loss (mean −1.4 (95% CI −2.4, −0.2) kg) and reduced percentage body fat (mean −1.3 (95% CI −2.0, −0.5)%). There was no significant weight change with the other interventions. Fasting triacylglycerols (−0.2 (SEM 0.07) mM; P=0.04), cholesterol and C-reactive protein (CRP) levels (0.8 (SEM 0.2) mg/l; P=0.04) fell with the substitution intervention, but not with the other interventions. Insulin-like growth factor-1 increased with both substitution and reduction (P=0.02). There was no significant change in fasting insulin or glucose with any intervention. The substitution model of dietary intervention is effective even over a relatively short interval of time in reducing fasting total cholesterol, triacylglycerols and CRP. Although the group size for the present study was small and involved females only, it has significant implications for population intervention strategies.

Keywords

Dietary interventionsSubstitution modelCardiovascular risk factorsLipidsC-reactive protein
Type
Research Article
Information
British Journal of Nutrition , Volume 92 , Issue 5 , November 2004 , pp. 809 - 818
Copyright
Copyright © The Nutrition Society 2004

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