title: Effects of whole grain, fish and bilberries on serum metabolic profile and lipid transfer protein activities: a randomized trial (Sysdimet).
abstract: OBJECTIVE
  We studied the combined effects of wholegrain, fish and bilberries on serum metabolic profile and lipid transfer protein activities in subjects with the metabolic syndrome.
  
  
  METHODS
  Altogether 131 subjects (40-70 y, BMI 26-39 kg/m(2)) with impaired glucose metabolism and features of the metabolic syndrome were randomized into three groups with 12-week periods according to a parallel study design. They consumed either: a) wholegrain and low postprandial insulin response grain products, fatty fish 3 times a week, and bilberries 3 portions per day (HealthyDiet), b) wholegrain and low postprandial insulin response grain products (WGED), or c) refined wheat breads as cereal products (Control). Altogether 106 subjects completed the study. Serum metabolic profile was studied using an NMR-based platform providing information on lipoprotein subclasses and lipids as well as low-molecular-weight metabolites.
  
  
  RESULTS
  There were no significant differences in clinical characteristics between the groups at baseline or at the end of the intervention. Mixed model analyses revealed significant changes in lipid metabolites in the HealthyDiet group during the intervention compared to the Control group. All changes reflected increased polyunsaturation in plasma fatty acids, especially in n-3 PUFAs, while n-6 and n-7 fatty acids decreased. According to tertiles of changes in fish intake, a greater increase of fish intake was associated with increased concentration of large HDL particles, larger average diameter of HDL particles, and increased concentrations of large HDL lipid components, even though total levels of HDL cholesterol remained stable.
  
  
  CONCLUSIONS
  The results suggest that consumption of diet rich in whole grain, bilberries and especially fatty fish causes changes in HDL particles shifting their subclass distribution toward larger particles. These changes may be related to known protective functions of HDL such as reverse cholesterol transport and could partly explain the known protective effects of fish consumption against atherosclerosis.
  
  
  BACKGROUND
  The study was registered at ClinicalTrials.gov NCT00573781.
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
authors.forename: Maria
authors.initials: M
authors.lastname: Lankinen
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland ; VTT, Technical Research Centre of Finland, Kuopio, Finland.
authors.forename: Marjukka
authors.initials: M
authors.lastname: Kolehmainen
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Jääskeläinen
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Paananen
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Joukamo
authors.affiliation: Computational Medicine, Institute of Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
authors.forename: Antti J
authors.initials: AJ
authors.lastname: Kangas
authors.affiliation: Computational Medicine, Institute of Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland ; NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Pasi
authors.initials: P
authors.lastname: Soininen
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland ; VTT, Technical Research Centre of Finland, Espoo, Finland.
authors.forename: Kaisa
authors.initials: K
authors.lastname: Poutanen
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Mykkänen
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland ; Division of Internal Medicine, Department of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Gylling
authors.affiliation: VTT, Technical Research Centre of Finland, Espoo, Finland.
authors.forename: Matej
authors.initials: M
authors.lastname: Orešič
authors.affiliation: National Institute for Health and Welfare, Public Health Genomics Research Unit, Biomedicum, Helsinki, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Jauhiainen
authors.affiliation: Computational Medicine, Institute of Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland ; NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland ; Computational Medicine, School of Social and Community Medicine and the Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom ; Oulu University Hospital, Oulu, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Ala-Korpela
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland ; Research Unit, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Uusitupa
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland ; Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Ursula
authors.initials: U
authors.lastname: Schwab
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001053:Apolipoproteins / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D004032:Diet; D002523:Edible Grain / Q000737:chemistry*; D015525:Fatty Acids, Omega-3 / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000097:blood; D005260:Female; D005396:Fish Products; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000178:diet therapy*; D055442:Metabolome; D008875:Middle Aged; D010316:Particle Size; D029800:Vaccinium myrtillus / Q000737:chemistry*
chemical_list: D001053:Apolipoproteins; D008076:Cholesterol, HDL; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6