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）是退伍军人中常见的问题，与心血管疾病（CVD）的可能性更大有关。地中海饮食是唯一一种已被证明可降低CVD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）富集导致MetS参数改善的程度尚未解决。同样，虽然低强度运动改善了CVD风险因素，但没有比较研究比较了超过1年的MetS患者的MUFA和PUFA强化饮食和运动。最近，该公司成立了MOVE！该计划是一项旨在帮助退伍军人减肥的国家体重管理计划。使用VA促进计划，我们将使用MOVE！对膳食脂肪组成的影响[富含MUFA和富含PUFA的饮食之间的比较]进行系统评价。我们假设，富含MUFA的饮食具有抗氧化、降脂和胰岛素增敏特性，在改善与MetS相关的心脏代谢参数方面，其上级效果优于不太可口的富含PUFA的饮食。具体来说，MUFA MOVE！预计该计划将比PUFA MOVE带来更大的改进！计划在身体组成和有氧健身（具体目标1），内皮依赖性血流介导的血管舒张和餐后脂质反应的膳食负荷（具体目标2）和机制（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）负责这些影响（具体目标3）。总的来说，这些研究将促进我们对MUFA和PUFA富集饮食方案对心脏代谢健康的差异效应的机制的理解，以及与MOVE！计划，将提供新的和有用的信息，退伍军人（和公众）有兴趣优化他们的饮食，心血管疾病的预防和改善血管健康。 公共卫生相关性： 对退伍军人医疗保健的潜在影响：根据VA 2006年2月27日的新闻稿，在750万接受医疗福利的退伍军人中，超过70%是肥胖症，20%是糖尿病患者，这与糖尿病患病率接近7%的美国普通人群相比要高得多。鉴于这些问题，退伍军人事务部和卫生与公众服务部（HHS）已经开始了一项协调运动，教育退伍军人和家庭成员了解获得更健康饮食和生活方式的重要性。除了旨在减轻体重和改善MetS的生化和生理参数的饮食调整外，该提案还将利用MOVE！该计划是由VA设计的全国体重管理计划，旨在协调饮食与日常步行，以减轻体重并改善心血管健康。因此，这项建议与退伍军人事务部的医疗保健使命直接相关。

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.