The selective lipid-lowering effect of vegetarianism on low density lipoproteins in a cross-over experiment. The Effect of a Plant-Based Diet on Plasma Lipids in Hypercholesterolemic Adults Plasma lipids and lipoproteins in vegetarians and controls. Cardiovascular disease risk factors in free-living men: comparison of two prudent diets, one based on lactoovovegetarianism and the other allowing lean meat. Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. The effects of a soy rich diet on serum lipids: the Menfis randomized trial. Effectiveness of a low-fat vegetarian diet in altering serum lipids in healthy premenopausal women. Toward improved management of NIDDM: A randomized, controlled, pilot intervention using a lowfat, vegetarian diet. Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors. Biochemical and neurohormonal responses to the introduction of a lacto-ovovegetarian diet Limited Lipid-Lowering Effects of Regular Consumption of Whole Soybean Foods Long-term intake of soy protein improves blood lipid profiles and increases mononuclear cell low-density-lipoprotein receptor messenger RNA in hypercholesterolemic, postmenopausal women. Plasma lipidomic profiles and cardiovascular events in a randomized intervention trial with the Mediterranean diet. A RANDOMIZED CONTROL TRIAL OF A VEGETARIAN DIET IN THE TREATMENT OF MILD HYPERTENSION Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study
In a cross-over experiment the effect of  short-term vegetarianism  on serum lipids , lipoproteins and apoproteins was studied . The experimental diet was free of animal products , with the exception of skim milk , and consequently low in saturated fat and cholesterol . Fifteen free-living individuals were r and omly assigned to 3-week periods on either the experimental diet or a control diet which closely approximated the usual intake in the U.S.A. Significant reductions in total cholesterol ( 12.5 % ) , low density lipoprotein cholesterol ( 14.7 % ) , and apo B ( 13.2 % ) were observed , accompanied by a non-significant decrease in high density lipoprotein cholesterol ( 10 % ) , apo A-I ( 3 % ) and a non-significant increase in apo-II ( 4 % ) . These data suggest that a fat-modified diet low in total fat , saturated fat and cholesterol , and moderate ( not high ) in polyunsaturated fat may not lower HDL-C or its apoproteins as much as a diet high in polyunsaturated fat , while having similar effects on LDL-C , and would therefore be preferable as the basis for primary prevention of atherosclerosis Context People can achieve recommended fat intake while consuming high or low amounts of vegetables , fruits , legumes , and whole grains . Contribution This 4-week r and omized trial compared 2 diets with different vegetable , fruit , legume , and whole-grain content but identical total fat , saturated fat , protein , carbohydrate , and cholesterol content . The 59 adults who consumed high amounts of vegetables , fruits , legumes , and whole grains  had greater improvements in total and low-density lipoprotein cholesterol levels than the 61 adults who ate low amounts of these foods . Implication s At least over the short term , greater improvements in low-density lipoprotein and total cholesterol are an additional benefit of diets high in vegetables , fruits , legumes , and whole grains . The Editors It is well established that elevated low-density lipoprotein ( LDL ) cholesterol concentrations are a risk factor for cardiovascular diseases and that dietary modification is considered a first approach to their treatment and control ( 1 , 2 ) . For several decades , dietary modification for lipid management traditionally focused on avoiding saturated fat and cholesterol ( 3 - 5 ) . Previous examples of dietary interventions targeting LDL cholesterol level often reported only modest lipid improvements , leading some to consider diet a relatively ineffective therapy ( 6 ) . However , recent developments have suggested that the traditional focus of lipid management may have been overly simplistic and that diets might be more effective if more attention was focused on including certain foods or factors rather than just avoiding saturated fat and cholesterol . Effective refinements of dietary strategies for lipid management could decrease the gap in effectiveness between dietary approaches and drug therapy . Several dietary factors or foods , including soy protein , soy isoflavones , plant sterols , soluble fiber , oats , nuts , and garlic , have established or potential lipid benefits ( 7 - 13 ) . Each is derived from plant food sources , and it is inclusion of these factors , rather than avoidance , that is reported to confer benefits . However , given that most plant foods contain low or negligible amounts of saturated fat and that all plant foods are devoid of cholesterol , it follows that a plant-based diet is inherently low in saturated fat and cholesterol . Therefore , it is difficult to distinguish between plasma lipid benefits derived from the actual plant-based dietary components and those derived from avoidance of saturated fat and cholesterol . Several studies have been design ed to test the effects on plasma lipids of diets with identical saturated fat and cholesterol intake but varied amounts of 1 or 2 additional dietary components ( 14 - 16 ) . Data are more limited on dietary approaches that hold saturated fat and cholesterol intake constant while modifying multiple other dietary components simultaneously ( 17 ) . Modifying multiple dietary components simultaneously ( for example , increasing intake of vegetables , fruits , and low-fat dairy ) while holding sodium intake constant has been shown to effectively lower elevated blood pressure in the Dietary Approaches to Stop Hypertension trials ( DASH I and II ) ( 18 , 19 ) . Testing a parallel approach to refining dietary intervention for lipid management is warranted . In 2000 , the American Heart Association ( AHA ) reported revised dietary guidelines that substantially modified its 1993 and 1996 guidelines ( 2 , 4 , 5 ) . All 3 versions of the guidelines recommended keeping saturated fat intake at less than 10 % of energy and cholesterol intake below 300 mg/d . A notable modification of the 2000 guidelines was to emphasize foods and overall eating patterns , including increased intakes of vegetables and whole grains ( in general , a plant-based diet ) . It was our hypothesis that a plant-based diet consistent with the revised AHA 2000 guidelines would increase the LDL cholesterol-lowering benefits of the previous AHA Step I guidelines . We theorized that this improvement would be independent of the plant-based diet 's saturated fat and cholesterol content . Therefore , we design ed 2 diets that had identical levels of total fat ( 30 % of energy ) , saturated fat ( 10 % of energy ) , and cholesterol ( < 300 mg/d ) but differed substantially in content of nutrient- and phytochemical-dense plant-based foods . The purpose of the study was to determine whether LDL cholesterol-lowering benefits among adults with moderately elevated cholesterol levels  would be greater under weight-stable conditions with a plant-based low-fat diet than with a more typical , convenience-oriented low-fat diet that was identical in intake of total fat , saturated fat , and cholesterol . Methods Participants Participants were recruited from the local community , primarily through newspaper advertisements , letters to previous study participants , and flyers sent to university employees . Men and women were invited to enroll if they were 30 to 65 years of age with fasting plasma LDL cholesterol levels of 3.3 to 4.8 mmol/L ( 130 to 190 mg/dL ) , fasting plasma triglyceride levels less than 2.83 mmol/L ( < 250 mg/dL ) , body mass index between 19 and 31 kg/m2 , and a current diet estimated to derive at least 10 % of energy from saturated fat . Pregnant women , persons who smoked , persons with prevalent heart disease or diabetes , or persons who had been using lipid-lowering or blood pressure-lowering medications within the past month ( all determined through self-report ) were excluded . During the recruitment phase , 1096 individuals were screened by telephone interview and 345 who met the initial inclusion criteria were considered eligible for cholesterol testing . Of these 345 persons , 188 who were found to have eligible concentrations of LDL cholesterol and triglycerides attended an orientation meeting . Fifty-one persons decided not to participate ( primarily because of the time commitment ) , and an additional 12 potential participants were excluded after a 3-day food record showed that their estimated average intake of saturated fat was already less than 10 % of energy . One hundred twenty-five participants were r and omly assigned to 1 of the 2 diet groups . The Stanford University Human Subjects Committee review ed and approved the investigation , all participants signed an informed consent form before enrollment , and the study was performed according to Declaration of Helsinki guidelines ( 20 ) . Design The trial used a parallel design . We r and omly assigned participants in blocks of 20 by selecting , without replacement , from a set of indistinguishable envelopes containing 10 assignments to each of the 2 diet groups . R and omization of the envelopes was done by h and , without a computer algorithm . No stratification criteria were used . Each participant was provided with meals , snacks , and beverages on an outpatient basis for 28 days , as described later . Diets Both study diets were design ed to provide 30 % of energy from total fat , 10 % of energy from saturated fat , and approximately 100 mg of cholesterol per 1000 kcal per day . During the menu- design ing stage of the study , the nutrient composition of the diets was determined by using the data base of Food Processor software , version 7.0 ( ESHA Research , Salem , Oregon ) . Menus were design ed by using commonly available foods from local markets . The Low-Fat diet was design ed to include many reduced-fat prepared-food items ( for example , reduced-fat cheeses , low-fat frozen lasagna , and low-fat and sugar-rich snack foods ) . In contrast , the Low-Fat Plus diet was design ed to include considerably more vegetables , legumes , whole grains , and fruits . Butter , cheese , and eggs were added to the daily menus for the Low-Fat Plus diet , increasing the saturated fat and cholesterol content to match the Low-Fat diet . A 7-day menu cycle was design ed for each of the 2 study diets ; therefore , each menu was repeated 4 times during the 28 days . The diets included breakfast , lunch , dinner , beverages , and snacks for each day . Each weekday , the participants ate either lunch or dinner at the dining facility of the Stanford General Clinical Research Center . After their on-site meal , they were given coolers that contained meals and snacks to be consumed off-site . On Fridays , participants received weekend meals to be consumed off-site . Appendix Table 1 and Appendix Table 2 list the daily menus . One free-choice evening meal was allowed each weekend . For this meal , participants were given guidelines for choosing low-fat meals consistent with their diet assignments and were required to keep a record of foods consumed . These records were analyzed for nutritional content and were used to determine the impact of the free-choice meals on the overall study diets . Adherence was measured by using daily log sheets kept by participants that tracked incomplete consumption of study foods or consumption of any non study foods . The 28 daily food logs for each participant were examined for deviations from the diets . The energy contribution of each deviation was determined and then totaled for the entire 28-day protocol period . Each of the 14 daily menus ( 7-day cycle 2 diets ) was analyzed chemically for nutrient content before the study and then again during the study ( Covance Laboratories , Madison , Wisconsin ) . The chemical analyses performed before the study confirmed that the average composition of the daily menus provided 30 % of energy from total fat , 10 % of energy from saturated fat , and approximately 100 mg of cholesterol per 1000 kcal per day . When the 2 diets were first design ed , we attempted to match their mono- and polyunsaturated fat content . However , the data base used in the design phase was missing values for these nutrients for approximately 20 % of the foods . In addition , many of the specific products purchased locally for the study provided incomplete information for the content of these unsaturated fats . The first round of chemical analyses of the diets , performed before enrollment began , indicated a modest discrepancy The possible effect of diet on plasma lipids was investigated in a group of vegetarians . Seventy-three men and 43 women who had adhered to a vegetarian diet for an average of three years were studied in the fasting state and compared with a r and omly selected group of controls matched for age and sex . Mean cholesterol levels in milligrams per deciliter for vegetarians and controls , respectively , were 126 and 184 ; low-density lipoprotein , 73 and 118 ; very-low-density lipoprotein , 11.8 and 17.2 ; high-density lipoproteins , 42 and 49 ; and mean triglyceride levels 59 and 86 . Mean weight and subscapular skinfold thicknesses were 58 kg and 6 mm for vegetarians and 73 kg and 17 mm for controls . Similar differences in lipid levels were found between subgroups of 42 vegetarians and controls with identical mean weights . Multiple regression analyses showed that consumption of dairy foods and eggs , but not body weight , was associated with the lipoprotein and cholesterol findings In general , vegetarians have lower serum lipids and blood pressures than omnivores have . We tested the blood pressure and serum lipid lowering effects of two fat-modified diets differing primarily in their source of protein . Twenty-six men were r and omized in an incomplete block design to two of three diets : a high-fat diet , a fat-modified lactoovovegetarian diet ( LOV ) and a diet in which 60 % of plant protein in the LOV was replaced with lean meat ( LM ) . Compared with the high-fat diet both prudent diets significantly lowered blood pressure , serum total cholesterol ( TC ) , and LDL cholesterol but significantly increased serum triglycerides . The LOV diet had a significantly greater cholesterol-lowering effect than did the LM diet ( 10 % vs 5 % decrease ) but blood pressure reductions were similar . The partial substitution of lean meat for plant protein in a fat-modified diet did not negate the overall cardiovascular-risk lowering of the lactoovovegetarian diet BACKGROUND A vegetarian diet may lead to numerous health benefits , including weight loss . OBJECTIVE We examined the joint effects of personal preference of dietary treatment and a calorie-restricted , low-fat lactoovovegetarian diet ( LOV-D ) compared with a st and ard calorie-restricted , low-fat omnivorous diet ( STD-D ) on changes in weight , total cholesterol , ratio of LDL to HDL cholesterol ( LDL : HDL cholesterol ) , triacylglycerols , insulin resistance , and macronutrient intake during an 18-mo study . DESIGN This was a r and omized clinical trial of 176 overweight and obese adults who were recruited and r and omly assigned first to 1 of 2 preference conditions ( yes or no ) . If assigned to Preference-No , they were r and omly assigned to 1 of the 2 diet conditions ( STD-D or LOV-D ) . If assigned to Preference-Yes , they were assigned to the diet they indicated as preferred at screening . The 12-mo intervention was followed by a 6-mo maintenance phase . RESULTS Participants were mainly women ( 86.9 % ) and white ( 70.5 % ) ; 75 % completed the 18-mo study . A significant interaction between preference and dietary treatment was not observed for any of the outcome variables . However , participants in the Preference-No groups significantly decreased their triacylglycerols ( P = 0.04 ) . The only effect observed for diet was a borderline significant decrease in LDL : HDL cholesterol for the LOV-D group ( P = 0.06 ) . Within the LOV-D groups , those who were 100 % adherent to the LOV-D had significant and marginally significant reductions in monounsaturated fat ( P = 0.02 ) and total fat ( P = 0.05 ) intakes at 18 mo . CONCLUSIONS Our findings suggest that neither prescribing a vegetarian diet nor allowing persons to choose their preferred diet had a significant effect on outcome measures . However , all participants had a significant reduction in total energy and fat intakes and an increase in energy expenditure , which was reflected in reduced body weight . This clinical trial was registered at www . clinical trials.gov as NCT00330629 BACKGROUND Low-fat vegetarian and vegan diets are associated with weight loss , increased insulin sensitivity , and improved cardiovascular health . OBJECTIVE We compared the effects of a low-fat vegan diet and conventional diabetes diet recommendations on glycemia , weight , and plasma lipids . DESIGN Free-living individuals with type 2 diabetes were r and omly assigned to a low-fat vegan diet ( n = 49 ) or a diet following 2003 American Diabetes Association guidelines ( conventional , n = 50 ) for 74 wk . Glycated hemoglobin ( Hb A(1c ) ) and plasma lipids were assessed at weeks 0 , 11 , 22 , 35 , 48 , 61 , and 74 . Weight was measured at weeks 0 , 22 , and 74 . RESULTS Weight loss was significant within each diet group but not significantly different between groups ( -4.4 kg in the vegan group and -3.0 kg in the conventional diet group , P = 0.25 ) and related significantly to Hb A(1c ) changes ( r = 0.50 , P = 0.001 ) . Hb A(1c ) changes from baseline to 74 wk or last available values were -0.34 and -0.14 for vegan and conventional diets , respectively ( P = 0.43 ) . Hb A(1c ) changes from baseline to last available value or last value before any medication adjustment were -0.40 and 0.01 for vegan and conventional diets , respectively ( P = 0.03 ) . In analyses before alterations in lipid-lowering medications , total cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet groups , respectively ( P = 0.01 ) ; LDL cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan and conventional groups , respectively ( P = 0.03 ) . CONCLUSIONS Both diets were associated with sustained reductions in weight and plasma lipid concentrations . In an analysis controlling for medication changes , a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations . Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established . This trial was registered at clinical trials.gov as NCT00276939 OBJECTIVE To assess beneficial effects of a soy rich diet on the main biomarkers of cardiovascular health in menopause , compared with the effects of the hormone replacement therapy ( HRT ) . METHODS 187 healthy asymptomatic postmenopausal women , aged 39 - 60 , were recruited and r and omized into three groups : a soy rich diet group , a HRT group , and a control group .  Lipid profile , body mass index , blood pressure , endometrial thickness , uterine artery resistance index ( RI ) , were evaluated in all the participants at the baseline , after 6 months , and at the end of the study . RESULTS After a 6-month intervention period , the lipid profile in the soy rich diet group showed a favourable outcome , similar to that observed in the HRT group , but compliance to the diet was low . CONCLUSION Soy products may be used in the prevention of cardiovascular risk in postmenopausal women because of their efficacy in contrasting the negative effects of menopause on the cardiovascular system , but our findings should be confirmed ; moreover , suitable strategies to improve the compliance have to be considered Few controlled trials have studied cholesterol-lowering diets in premenopausal women . None has examined the cholesterol-lowering effect of a low-fat vegetarian diet , which , in other population groups , leads to marked reductions in serum cholesterol concentrations and , in combination with other life-style changes , a regression of atherosclerosis . We tested the hypothesis that a low-fat , vegetarian diet significantly reduces serum total and low-density lipoprotein ( LDL ) cholesterol concentrations in premenopausal women . In a crossover design , 35 women , aged 22 to 48 , followed a low-fat vegetarian diet deriving approximately 10 % of energy from fat for 2 menstrual cycles . For 2 additional cycles , they followed their customary diet while also taking a " supplement " ( placebo ) pill .  Serum lipid concentrations were assessed at baseline and during each intervention phase . Mean serum LDL , high-density lipoprotein ( HDL ) , and total cholesterol concentrations decreased 16 . 9 % , 16.5 % , and 13.2 % , respectively , from baseline to the intervention diet phase ( p<0.001 ) , whereas mean serum triacylglycerol concentration increased 18.7 % ( p<0.01 ) . LDL/HDL ratio remained unchanged . Thus , in healthy premenopausal women , a low-fat vegetarian diet led to rapid and sizable reductions in serum total , LDL , and HDL cholesterol concentrations OBJECTIVE To investigate whether glycemic and lipid control in patients with non-insulin-dependent diabetes ( NIDDM ) can be significantly improved using a low-fat , vegetarian ( vegan ) diet in the absence of recommendations regarding exercise or other lifestyle changes . METHODS Eleven subjects with NIDDM recruited from the Georgetown University Medical Center or the local community were r and omly assigned to a low-fat vegan diet ( seven subjects ) or a conventional low-fat diet ( four subjects ) . Two additional subjects assigned to the control group failed to complete the study . The diets were not design ed to be isocaloric . Fasting serum glucose , body weight , medication use , and blood pressure were assessed at baseline and biweekly thereafter for 12 weeks . Serum lipids , glycosylated hemoglobin , urinary albumin , and dietary macronutrients were assessed at baseline and 12 weeks . RESULTS Although the sample was intentionally small in accordance with the pilot study design , the 28 % mean reduction in fasting serum glucose of the experimental group , from 10.7 to 7.75 mmol/L ( 195 to 141 mg/dl ) , was significantly greater than the 12 % decrease , from 9.86 to 8.64 mmol/L ( 179 to 157 mg/dl ) , for the control group ( P < 0.05 ) . The mean weight loss was 7.2 kg in the experimental group , compared to 3 . 8 kg for the control group ( P < 0.005 ) . Of six experimental group subjects on oral hypoglycemic agents , medication use was discontinued in one and reduced in three . Insulin was reduced in both experimental group patients on insulin . No patient in the control group reduced medication use . Differences between the diet groups in the reductions of serum cholesterol and 24-h microalbuminuria did not reach statistical significance ; however , high-density lipoprotein concentration fell more sharply ( 0.20 mmol/L ) in the experimental group than in the control group ( 0.02 mmol/L ) ( P < 0.05 ) . CONCLUSION The use of a low-fat , vegetarian diet in patients with NIDDM was associated with significant reductions in fasting serum glucose concentration and body weight in the absence of recommendations for exercise . A larger study is needed for confirmation OBJECTIVE To investigate the relative efficacy of four popular weight-loss programmes on plasma lipids and lipoproteins as measures of CVD risk . DESIGN A multi-centred , r and omised , controlled trial of four diets - Dr Atkins ' New Diet Revolution , The Slim-Fast Plan , Weight Watchers Pure Points programme and Rosemary Conley 's ' Eat yourself Slim ' Diet and Fitness Plan - against a control diet , in parallel for 6 months . SETTING AND SUBJECTS The trial was conducted at five universities across the UK ( Surrey , Nottingham , Ulster ( Coleraine ) , Bristol and Edinburgh ( Queen Margaret University College ) ) and involved the participation of 300 overweight and obese males and females aged 21 - 60 years in a community setting . RESULTS Significant weight loss was achieved by all dieting groups ( 5 - 9 kg at 6 months ) but no significant difference was observed between diets at 6 months . The Weight Watchers and Rosemary Conley ( low-fat ) diets were followed by significant reductions in plasma LDL cholesterol ( both -12.2 % after 6 months , P < 0.01 ) , whereas the Atkins ( low-carbohydrate ) and Weight Watchers diets were followed by marked reductions in plasma TAG ( -38.2 % and -22.6 % at 6 months respectively , P < 0.01 ) . These latter two diets were associated with an increase in LDL particle size , a change that has been linked to reduced CVD risk . CONCLUSIONS Overall , these results demonstrate the favourable effects of weight loss on lipid-mediated CVD risk factors that can be achieved through commercially available weight-loss programmes . No detrimental effects on lipid-based CVD risk factors were observed in participants consuming a low-carbohydrate diet Objective : To assess the mechanisms of the blood pressure-lowering effect of a vegetarian diet in the early and later stages of dietary intervention Design : After 2 weeks without intervention ( baseline ) , 20 normotensive men were matched for age and body mass index and r and omly allocated to an omnivorous ( control ) or a lacto-ovovegetarian diet for 6 weeks in a parallel trial Methods : Ambulatory blood pressures were recorded between 0800 and 1700 h on alternate days during the first week of intervention , twice in the second week and weekly thereafter . Blood sample s collected after a st and ard breakfast were analysed for plasma noradrenaline , adrenaline , atrial natriuretic peptide ( ANP ) , renin , aldosterone , glucose and insulin . Factor and multiple regression analyses were used to assess the association among neurohormonal factors , blood pressures and diet . Results were analysed for the first week of the diet and for the entire 6 weeks Results : Ambulatory blood pressures at work were lower on the vegetarian diet than in the controls . This blood pressure decrease was associated with a factor representing lower plasma catecholamine and renin activity levels throughout the study , and a factor representing reduced plasma glucose and insulin levels in week 1 of intervention only . Plasma ANP levels were significantly higher during week 1 of the vegetarian diet Conclusions : A blood pressure lowering effect of a vegetarian diet during normal working activity was shown . Using factors derived from the biochemical variables , results were in keeping with the hypothesis that these effects may be mediated by reduced sympatho-adrenal activity consequent to altered glucose and insulin h and ling . An early increase in plasma ANP may contribute to the blood pressure Aim : To examine cardiovascular health benefits of foods containing a whole soybean extract . Methods : The study design was a r and omized , placebo-controlled crossover trial of consuming soy-based milk and yoghurt ( treatment ) or equivalent dairy products ( control ) for 5 weeks each . Twenty-six mildly hypercholesterolaemic and /or hypertensive volunteers were recruited from the community as study volunteers , of which 23 completed . Main outcome measures included clinic and ambulatory blood pressure , arterial compliance , lipids , fatty acids and isoflavones in fasted blood and 24-hour urinary isoflavone excretion . Nutrient intakes  were assessed initially and after each 5-week period . Multiple regression analyses were used to determine predictor variables in statistical models ; order effects were tested by repeated measures ANOVA . Changes in Lp(a ) were determined by Wilcoxon signed ranks tests ; other differences between treatment and control were assessed by t tests . Results : Plasma and urinary isoflavones were markedly increased by whole soy supplementation but there were no overall differences in plasma lipids , blood pressure or arterial compliance between the soy and dairy diets . However , in 8 equol-positive subjects ( equol detected in either plasma or urine ) , retrospective analysis revealed significant reductions in total cholesterol ( 8.5 % ) , LDL cholesterol ( 10 % ) , LDL : HDL ratio ( 13.5 % ) , plasma triglycerides ( 21 % ) and lipoprotein(a ) ( 11 % ) with the soy diet . These reductions were independent of changes in polyunsaturated fat and other macronutrient intakes . Conclusions : Regular consumption of whole soybean milk and yogurt products had no effect on plasma lipids , blood pressure or arterial compliance in at-risk subjects , despite substantially increasing isoflavone levels in blood and urine . Retrospective analysis suggests that improvement of plasma lipids may have been limited to equol-positive subjects The long-term clinical effects of soy protein containing various amounts of isoflavones on lipoproteins , mononuclear cell LDL receptor messenger RNA concentrations , and other selected cardiovascular risk factors are not well known . Sixty-six hypercholesterolemic , free-living , postmenopausal women were investigated during a 6-mo parallel-group , double-blind trial with 3 interventions . After a control period of 14 d , all subjects were r and omly assigned to 1 of 3 dietary groups ( all with 40 g protein ) : a National Cholesterol Education Program ( NCEP ) Step 1 diet with protein from casein and nonfat dry milk ( control ) , an NCEP Step 1 diet with protein from isolated soy protein containing moderate amounts of isoflavones ( ISP56 ) , or an NCEP Step 1 diet with protein from isolated soy protein containing high amounts of isoflavones ( ISP90 ) . Non-HDL cholesterol in both the ISP56 and ISP90 groups was reduced compared with the control group ( P < 0.05 ) , whereas total cholesterol was not changed . HDL cholesterol increased in both the ISP56 and ISP90 groups ( P < 0.05 ) , whereas the ratio of total to HDL cholesterol decreased significantly in both groups compared with the control ( P < 0.05 ) . Mononuclear cell LDL receptor messenger RNA concentrations increased in subjects consuming ISP56 or ISP90 compared with the control ( P < 0.05 ) . These results indicate that soy protein , with different amounts of isoflavones , may decrease the risk of cardiovascular disease via improved blood lipid profiles , and that the mechanism by which apolipoprotein B-containing lipoproteins were depressed may be via alterations in LDL receptor quantity or activity Background : Lipid metabolites may partially explain the inverse association between the  Mediterranean diet ( MedDiet ) and cardiovascular disease ( CVD ) . Objective : We evaluated the associations between 1 ) lipid species and the risk of CVD ( myocardial infa rct ion , stroke , or cardiovascular death ) ; 2 ) a MedDiet intervention [ supplemented with extra virgin olive oil ( EVOO ) or nuts ] and 1-y changes in these molecules ; and 3 ) 1-y changes in lipid species and subsequent CVD . Design : With the use of a case-cohort design , we profiled 202 lipid species at baseline and after 1 y of intervention in the PREDIMED  ( PREvención con DIeta MEDiterránea ) trial in 983 participants [ 230 cases and a r and om subcohort of 790 participants ( 37 overlapping cases ) ] . Results : Baseline concentrations of cholesterol esters ( CEs ) were inversely associated with CVD . A shorter chain length and higher saturation of some lipids were directly associated with CVD . After adjusting for multiple testing , direct associations remained significant for 20 lipids , and inverse associations remained significant for 6 lipids . When lipid species were weighted by the number of carbon atoms and double bonds , the strongest inverse association was found for CEs [ HR : 0.39 ( 95 % CI : 0.22 , 0.68 ) ] between extreme quintiles ( P-trend = 0.002 ) . Participants in the MedDiet + EVOO and MedDiet + nut groups experienced significant ( P < 0.05 ) 1-y changes in 20 and 17 lipids , respectively , compared with the control group . Of these changes , only those in CE(20:3 ) in the MedDiet + nuts group remained significant after correcting for multiple testing . None of the 1-y changes was significantly associated with CVD risk after correcting for multiple comparisons . Conclusions : Although the MedDiet interventions induced some significant 1-y changes in the lipidome , they were not significantly associated with subsequent CVD risk . Lipid metabolites with a longer acyl chain and higher number of double bonds at baseline were significantly and inversely associated with the risk of CVD 1 . The effect of an ovo‐lacto‐vegetarian ( OLV ) diet on blood pressure was assessed in a r and omized , controlled , crossover trial in 58 mild untreated hypertensive subjects recruited from the Perth Centre for the 1983 NHF Risk Factor Prevalence Survey Recent research suggests that traditional grain-based heart-healthy diet recommendations , which replace dietary saturated fat with carbohydrate and reduce total fat intake , may result in unfavorable plasma lipid ratios , with reduced high-density lipoprotein ( HDL ) and an elevation of low-density lipoprotein ( LDL ) and triacylglycerols ( TG ) . The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol , HDL , LDL , and TG concentrations in nondiabetic adults with hyperlipidemia to a greater extent than a grain-based heart-healthy diet , based on the recommendations of the American Heart Association . Twenty volunteers ( 10 male and 10 female ) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia . Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart-healthy diet for 4 months , followed by a Paleolithic diet for 4 months . Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations . Differences in dietary intakes and plasma lipid measures were assessed using repeated- measures analysis of variance . Four months of Paleolithic nutrition significantly lowered ( P < .001 ) mean total cholesterol , LDL , and TG and increased ( P < .001 ) HDL , independent of changes in body weight , relative to both baseline and the traditional heart-healthy diet . Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart-healthy dietary recommendations Introduction The purpose of this study was to investigate the effects of vegan diet in patients with rheumatoid arthritis ( RA ) on blood lipids oxidized low-density lipoprotein ( oxLDL ) and natural atheroprotective antibodies against phosphorylcholine ( anti-PCs ) . Methods Sixty-six patients with active RA were r and omly assigned to either a vegan diet free of gluten ( 38 patients ) or a well-balanced non-vegan diet ( 28 patients ) for 1 year . Thirty patients in the vegan group completed more than 3 months on the diet regimen . Blood lipids were analyzed by routine methods , and oxLDL and anti-PCs were analyzed by enzyme-linked immunosorbent assay . Data and serum sample s were obtained at baseline and after 3 and 12 months . Results Mean ages were 50.0 years for the vegan group and 50.8 years for controls .  Gluten-free vegan diet induced lower body mass index ( BMI ) and low-density lipoprotein ( LDL ) and higher anti-PC IgM than control diet ( p < 0.005 ) . In the vegan group , BMI , LDL , and cholesterol decreased after both 3 and 12 months ( p < 0.01 ) and oxLDL after 3 months ( p = 0.021 ) and trendwise after 12 months ( p = 0.090 ) . Triglycerides and high-density lipoprotein did not change . IgA anti-PC levels increased after 3 months ( p = 0.027 ) and IgM anti-PC levels increased trendwise after 12 months ( p = 0.057 ) . There was no difference in IgG anti-PC levels . In the control diet group , IgM anti-PC levels decreased both after 3 and 12 months ( p < 0.01 ) . When separating vegan patients into clinical responders and non-responders at 12 months , the effects on oxLDL and anti-PC IgA were seen only in responders ( p < 0.05 ) . Conclusion A gluten-free vegan diet in RA induces changes that are potentially atheroprotective and anti-inflammatory , including decreased LDL and oxLDL levels and raised anti-PC IgM and IgA levels
Conclusions Plant-based diets are associated with decreased total cholesterol , low-density lipoprotein cholesterol , and high-density lipoprotein cholesterol , but not with decreased triglycerides .
Context Although a recent meta- analysis of r and omized controlled trials showed that adoption of a vegetarian diet reduces plasma lipids , the association between vegetarian diets and long-term effects on plasma lipids has not been subjected to meta- analysis .
Objective The aim was to conduct a systematic review and meta- analysis of observational studies and clinical trials that have examined associations between plant-based diets and plasma lipids .