Comparative Effects of 2 Diets in Veterans With the Metabolic Syndrome
Condition: Metabolic Syndrome
MeSH terms: Metabolic Syndrome; Syndrome
Study type: Interventional

Summary: 
      The purpose of the study is to examine the effects of 2 commonly used diets, a Mediterranean
      monounsaturated fatty acid enriched (MUFA) or AHA polyunsaturated (PUFA) enriched diet
      combined with the VA Managing Overweight/Obesity for Veterans Everywhere (MOVE!) program so
      as to determine which one is superior in reducing cardiometabolic risk factors associated
      with Metabolic Syndrome. The risk factors considered include lipids and lipoproteins,
      inflammatory markers such as CRP and adiponectin, endothelium-dependent flow-mediated
      vasodilatation (FMD) and the postprandial lipid responses to a meal.

      Cardiometabolic risk factors will be determined by measuring several cardiovascular risk
      associated parameters including:

      Biochemical measurements of lipids and inflammatory markers, body composition and VO2max
      (Specific Objective 1, Descriptive).

      Postprandial response to a meal challenge and endothelial vasoreactivity (FMD) assessed by
      BART (Specific Objective 2, Physiological).

      Determination of the effects on postheparin lipases and transfer protein activity, visceral
      adipose tissue (VAT) and homeostasis model assessment-estimated insulin resistance (HOMA-IR)
      (Specific Objective 3, Mechanistic)
    

Detailed description: 
      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 vasodilatation 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.
    

Intervention name(s): MUFA MOVE! (Monounsaturated fatty enriched diet); PUFA MOVE! (Polyunsaturated fatty acid enriched diet)
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): MUFA MOVE!diet and exercise program; PUFA MOVE! diet and exercise program
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: MUFA; PUFA; MOVE! program