Effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile and inflammation markers in metabolic syndrome – a randomized study (SYSDIET)

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Abstract

Background

Uusitupa M, Hermansen K, Savolainen MJ, Schwab U, Kolehmainen M, Brader L, Mortensen LS, Cloetens L, Johansson-Persson A, Önning G, Landin-Olsson M, Herzig K-H, Hukkanen J, Rosqvist F, Iggman D, Paananen J, Pulkki KJ, Siloaho M, Dragsted L, Barri T, Overvad K, Bach Knudsen KE, Hedemann MS, Arner P, Dahlman I, Borge GIA, Baardseth P, Ulven SM, Gunnarsdottir I, Jónsdóttir S, Thorsdottir I, Orešič M, Poutanen KS, Risérus U, Åkesson B University of Eastern Finland; Kuopio University Hospital, Kuopio, Finland; Aarhus University Hospital, Aarhus, Denmark; University of Oulu, Oulu; Finland; Lund University; Skåne University Hospital, Lund, Sweden; University of Oulu, Oulu, Finland; Uppsala University, Uppsala; Center for Clinical Research Dalarna, Falun, Sweden; University of Eastern Finland; Kuopio, Finland; University of Copenhagen, Copenhagen, Aarhus University Hospital; Aarhus University, Aarhus, Denmark; Karolinska Institute, Stockholm, Sweden; Norwegian Institute of Food, Fisheries and Aquaculture Research, Ås; Oslo and Akershus University College of Applied Sciences Oslo, Norway; University of Iceland and Landspitali – The National University Hospital of Iceland, Reykjavik, Iceland; VTT Technical Research Centre of Finland, Espoo, Finland; Skåne University Hospital, Lund, Sweden Effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile and inflammation markers in metabolic syndrome – a randomized study (SYSDIET). J Intern Med 2013; 274: 52-66.

Background

Different healthy food patterns may modify cardiometabolic risk. We investigated the effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile, blood pressure and inflammatory markers in people with metabolic syndrome.

Methods

We conducted a randomized dietary study lasting for 18–24 weeks in individuals with features of metabolic syndrome (mean age 55 years, BMI 31.6 kg m−2, 67% women). Altogether 309 individuals were screened, 200 started the intervention after 4-week run-in period, and 96 (proportion of dropouts 7.9%) and 70 individuals (dropouts 27%) completed the study, in the Healthy diet and Control diet groups, respectively. Healthy diet included whole-grain products, berries, fruits and vegetables, rapeseed oil, three fish meals per week and low-fat dairy products. An average Nordic diet served as a Control diet. Compliance was monitored by repeated 4-day food diaries and fatty acid composition of serum phospholipids.

Results

Body weight remained stable, and no significant changes were observed in insulin sensitivity or blood pressure. Significant changes between the groups were found in non-HDL cholesterol (−0.18, mmol L−1 95% CI −0.35; −0.01, P = 0.04), LDL to HDL cholesterol (−0.15, −0.28; −0.00, P = 0.046) and apolipoprotein B to apolipoprotein A1 ratios (−0.04, −0.07; −0.00, P = 0.025) favouring the Healthy diet. IL-1 Ra increased during the Control diet (difference −84, −133; −37 ng L−1, P = 0.00053). Intakes of saturated fats (E%, beta estimate 4.28, 0.02; 8.53, P = 0.049) and magnesium (mg, −0.23, −0.41; −0.05, P = 0.012) were associated with IL-1 Ra.

Conclusions

Healthy Nordic diet improved lipid profile and had a beneficial effect on low-grade inflammation.

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