Comparative Effects of Two Popular Diets in Veterans with the Metabolic Syndrome

描述(由申请人提供)： 代谢综合征(METS)是退伍军人中的常见问题，与心血管疾病(CVD)的可能性更大相关。地中海饮食是唯一被证明可以降低心血管事件发生率的流行饮食，但单不饱和脂肪酸(MUFA)或多不饱和脂肪酸(PUFA)的丰富在多大程度上改善了蛋氨酸的参数尚不清楚。同样，虽然低强度运动改善了心血管疾病风险因素的概况，但还没有比较MUFA和PUFA丰富的饮食和运动对持续1年以上的MET患者的比较研究。最近，退伍军人事务部成立了这一举措！这是一项旨在帮助退伍军人减肥的全国性体重管理计划。使用VA Promoted计划，我们将使用MOVE！对膳食脂肪组成[富MUFA和PUFA强化饮食之间的比较]的影响进行系统评估。我们推测，在改善与蛋氨酸相关的心脏代谢参数方面，富含多不饱和脂肪酸的饮食包括抗氧化剂、降脂和胰岛素增敏特性，将优于不那么可口的多不饱和脂肪酸丰富的饮食。具体地说，就是曼联的举动！该计划有望带来比PUFA举措更大的改善！这些项目包括身体成分和有氧健身(特定目标1)、内皮依赖血流介导的血管扩张和餐后脂肪对饮食负荷的反应(特定目标2)以及导致这些影响的机制(特定目标3)(脂解和脂质转移蛋白活性、稳态模型评估-估计的胰岛素抵抗)。总而言之，这些研究将促进我们对MUFA和PUFA强化饮食方案对心脏代谢健康的不同影响的潜在机制的理解，以及当与MOVE结合时！该计划将为退伍军人(和普通公众)提供新的有用信息，这些信息有兴趣优化他们的饮食以预防心血管疾病和改善血管健康。 公共卫生相关性： 对退伍军人医疗保健的潜在影响：根据退伍军人管理局2006年2月27日发布的一份新闻稿，在领取医疗福利的750万退伍军人中，超过70%的人患有肥胖症，20%的人患有糖尿病，这一比例远远高于美国总人口的糖尿病患病率约为7%。鉴于这些关切，退伍军人事务部和卫生与公众服务部(HHS)开展了一项协调一致的活动，教育退伍军人和家庭成员实现更健康的饮食和生活方式的重要性。除了旨在减肥和改善蛋氨酸的生化和生理参数的饮食调整外，这项建议还将利用这一举措！这是一项由退伍军人管理局设计的全国性体重管理计划，旨在将饮食与日常步行相结合，以减轻体重并改善心血管健康。因此，这项建议与退伍军人管理局的医疗保健任务有直接关系。

DESCRIPTION (provided by applicant): The Metabolic Syndrome (MetS) is a common problem among Veterans and is associated with a greater likelihood of cardiovascular disease (CVD). The Mediterranean diet is the only popular diet that has been shown to reduce CVD event rates but the extent to which monounsaturated fatty acid (MUFA) or polyunsaturated fatty acid (PUFA) enrichment results in improvement in parameters of MetS is unresolved. Similarly, while low intensity exercise improves the CVD risk factor profile, there have been no comparative investigations comparing MUFA and PUFA enriched diets and exercise in patients with MetS that have extended beyond 1 year. Recently, the VA established the MOVE! program, a national weight management program designed to help Veterans lose weight. Using the VA promoted program, we will perform a systematic evaluation of the effects of dietary fat composition [comparison between MUFA-enriched and PUFA enriched diet] with MOVE!. We hypothesize that a MUFA-enriched diet consisting of antioxidant, lipid reducing and insulin sensitizing properties will be superior to the less palatable PUFA- enriched diet on improving cardiometabolic parameters associated with MetS. Specifically, the MUFA MOVE! program is expected to lead to greater improvements than the PUFA MOVE! program in body composition and aerobic fitness (Specific Aim 1), endothelial dependent flow mediated vasodilation and the postprandial lipid response to a meal load (Specific Aim 2) and the mechanisms (lipolytic and lipid transfer protein activity, homeostasis model assessment-estimated insulin resistance) responsible for these effects (Specific Aim 3). Collectively, these studies will advance our understanding of mechanisms underlying the differential effects of MUFA and PUFA-enriched dietary regimens on cardiometabolic health and when combined with the MOVE! program, will provide new and useful information to Veterans (and the general public) interested in optimizing their diets for CVD disease prevention and improved vascular health. PUBLIC HEALTH RELEVANCE: Potential Impact on Veterans Health Care: According to a VA news release dated February 27, 2006, of the 7.5 million veterans receiving health benefits, more than 70% are obese and 20% are diabetic, which is considerably higher compared to the general U.S. population where the prevalence of DM approximates 7%. In view of these concerns, the VA and Department of Health and Human Services (HHS) have embarked on a coordinated campaign to educate veterans and family members about the importance of attaining a healthier diet and lifestyle. In addition to dietary modification aimed at weight loss and improving biochemical and physiologic parameters of MetS, this proposal will also utilize the MOVE! program, a national weight management program designed by the VA in an effort to coordinate diet with daily walking to reduce body weight and improve cardiovascular health. Therefore, this proposal has direct relevance to the VA health care mission.