Modification of high-density lipoprotein functions by diet and other lifestyle changes : A systematic review of randomized controlled trials
(2021) In Journal of Clinical Medicine 10(24).- Abstract
High-density lipoprotein (HDL) functional traits have emerged as relevant elements that may explain HDL antiatherogenic capacity better than HDL cholesterol levels. These properties have been improved in several lifestyle intervention trials. The aim of this systematic review is to summarize the results of such trials of the most commonly used dietary modifications (fatty acids, cholesterol, antioxidants, alcohol, and calorie restriction) and physical activity. Articles were screened from the Medline database until March 2021, and 118 randomized controlled trials were selected. Results from HDL functions and associated functional components were extracted, including cholesterol efflux capacity, cholesteryl ester transfer protein,... (More)
High-density lipoprotein (HDL) functional traits have emerged as relevant elements that may explain HDL antiatherogenic capacity better than HDL cholesterol levels. These properties have been improved in several lifestyle intervention trials. The aim of this systematic review is to summarize the results of such trials of the most commonly used dietary modifications (fatty acids, cholesterol, antioxidants, alcohol, and calorie restriction) and physical activity. Articles were screened from the Medline database until March 2021, and 118 randomized controlled trials were selected. Results from HDL functions and associated functional components were extracted, including cholesterol efflux capacity, cholesteryl ester transfer protein, lecithin-cholesterol acyltransferase, HDL antioxidant capacity, HDL oxidation status, paraoxonase-1 activity, HDL anti-inflammatory and endothelial protection capacity, HDL-associated phospholipase A2, HDL-associated serum amyloid A, and HDL-alpha-1-antitrypsin. In mainly short-term clinical trials, the consumption of monounsaturated and polyunsaturated fatty acids (particularly omega-3 in fish), and dietary antioxidants showed benefits to HDL functionality, especially in subjects with cardiovascular risk factors. In this regard, antioxidant-rich dietary patterns were able to improve HDL function in both healthy individuals and subjects at high cardiovascular risk. In addition, in randomized trial assays performed mainly in healthy individuals, reverse cholesterol transport with ethanol in moderate quantities enhanced HDL function. Nevertheless, the evidence summarized was of unclear quality and short-term nature and presented heterogeneity in lifestyle modifications, trial designs, and biochemical techniques for the assessment of HDL functions. Such findings should therefore be interpreted with caution. Large-scale, long-term, randomized, controlled trials in different populations and individuals with diverse pathologies are warranted.
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- author
- Sanllorente, Albert ; Lassale, Camille ; Soria-florido, Maria Trinidad LU ; Castañer, Olga ; Fitó, Montserrat and Hernáez, Álvaro
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Antioxidants, Ethanol, Fatty acids, High-density lipoprotein, Physical activity, Trials
- in
- Journal of Clinical Medicine
- volume
- 10
- issue
- 24
- article number
- 5897
- publisher
- MDPI AG
- external identifiers
-
- scopus:85121113088
- pmid:34945193
- ISSN
- 2077-0383
- DOI
- 10.3390/jcm10245897
- language
- English
- LU publication?
- yes
- id
- a8163441-ff98-417e-8d0a-8bf52f47258d
- date added to LUP
- 2022-01-27 12:16:39
- date last changed
- 2024-07-15 04:45:39
@article{a8163441-ff98-417e-8d0a-8bf52f47258d,
abstract = {{<p>High-density lipoprotein (HDL) functional traits have emerged as relevant elements that may explain HDL antiatherogenic capacity better than HDL cholesterol levels. These properties have been improved in several lifestyle intervention trials. The aim of this systematic review is to summarize the results of such trials of the most commonly used dietary modifications (fatty acids, cholesterol, antioxidants, alcohol, and calorie restriction) and physical activity. Articles were screened from the Medline database until March 2021, and 118 randomized controlled trials were selected. Results from HDL functions and associated functional components were extracted, including cholesterol efflux capacity, cholesteryl ester transfer protein, lecithin-cholesterol acyltransferase, HDL antioxidant capacity, HDL oxidation status, paraoxonase-1 activity, HDL anti-inflammatory and endothelial protection capacity, HDL-associated phospholipase A2, HDL-associated serum amyloid A, and HDL-alpha-1-antitrypsin. In mainly short-term clinical trials, the consumption of monounsaturated and polyunsaturated fatty acids (particularly omega-3 in fish), and dietary antioxidants showed benefits to HDL functionality, especially in subjects with cardiovascular risk factors. In this regard, antioxidant-rich dietary patterns were able to improve HDL function in both healthy individuals and subjects at high cardiovascular risk. In addition, in randomized trial assays performed mainly in healthy individuals, reverse cholesterol transport with ethanol in moderate quantities enhanced HDL function. Nevertheless, the evidence summarized was of unclear quality and short-term nature and presented heterogeneity in lifestyle modifications, trial designs, and biochemical techniques for the assessment of HDL functions. Such findings should therefore be interpreted with caution. Large-scale, long-term, randomized, controlled trials in different populations and individuals with diverse pathologies are warranted.</p>}},
author = {{Sanllorente, Albert and Lassale, Camille and Soria-florido, Maria Trinidad and Castañer, Olga and Fitó, Montserrat and Hernáez, Álvaro}},
issn = {{2077-0383}},
keywords = {{Antioxidants; Ethanol; Fatty acids; High-density lipoprotein; Physical activity; Trials}},
language = {{eng}},
number = {{24}},
publisher = {{MDPI AG}},
series = {{Journal of Clinical Medicine}},
title = {{Modification of high-density lipoprotein functions by diet and other lifestyle changes : A systematic review of randomized controlled trials}},
url = {{http://dx.doi.org/10.3390/jcm10245897}},
doi = {{10.3390/jcm10245897}},
volume = {{10}},
year = {{2021}},
}