A High-Carbohydrate, High-Fiber Meal Improves Endothelial Function in Adults With the Metabolic Syndrome
- David W. Brock, PHD12,
- Christopher K. Davis, MD, PHD13,
- Brian A. Irving, PHD12,
- Jessica Rodriguez, RD, CNSD4,
- Eugene J. Barrett, MD, PHD45,
- Arthur Weltman, PHD145,
- Ann Gill Taylor, RN, EDD2 and
- Glenn A. Gaesser, PHD1
- 1Department of Human Services, University of Virginia, Charlottesville, Virginia
- 2Center for the Study of Complementary and Alternative Therapies, University of Virginia, Charlottesville, Virginia
- 3Department of Pediatric Cardiology, University of Virginia, Charlottesville, Virginia
- 4General Clinical Research Center, University of Virginia, Charlottesville, Virginia
- 5Department of Endocrinology and Metabolism, University of Virginia, Charlottesville, Virginia
- Address correspondence and reprint requests to Glenn A. Gaesser, PhD, University of Virginia, 210 Emmet St. S., P.O. Box 400407, Charlottesville, VA 22904-4407. E-mail: gag2q{at}virginia.edu
Brachial artery flow-mediated dilation (FMD) using high-resolution ultrasound is a well-accepted, noninvasive bioassay for in vivo endothelium-generated nitric oxide (NO) in humans (1). Impaired NO generation characterizes the endothelial phenotype prone to the development of atherosclerosis and is linked to acute cardiovascular events. In several studies (2,3), endothelial dysfunction is an independent predictor of future cardiovascular morbidity and mortality. The postprandial state may be critical in the development of atherosclerosis (4). A single high-fat meal can induce endothelial dysfunction, whereas low-fat meals generally neither improve nor worsen FMD (5–8). The lack of a reported effect of low-fat meals on FMD may be attributable in part to insufficient dietary fiber in the meal. In particular, increased cereal fiber consumption is associated with reduced cardiovascular disease incidence and mortality (9–11) and lower prevalence of the metabolic syndrome (12) and may reduce systemic inflammation (13). We examined whether a high-carbohydrate meal, rich in cereal fiber, would improve brachial artery FMD in adults with the metabolic syndrome. For comparison, we also examined the impact of a low-carbohydrate, low-fiber meal.
RESEARCH DESIGN AND METHODS
Twelve (9 women and 3 men: 44.7 ± 7.9 years of age, 98.9 ± 16.6 kg, 1.70 ± 0.07 m) nonsmoking, nondiabetic adults who met the International Diabetes Federation criteria for the metabolic syndrome participated in the study (14). Subjects were not taking medications to control blood lipids, blood …
