title: Role of a prudent breakfast in improving cardiometabolic risk factors in subjects with hypercholesterolemia: a randomized controlled trial.
abstract: OBJECTIVE
  It is unclear whether advising a prudent breakfast alone is sufficient to improve blood lipids and cardiometabolic risk factors in overweight hypercholesterolemic subjects. The aim of this study was to investigate whether a prudent low-fat breakfast (PB) rich in dietary fiber lowers low-density lipoprotein cholesterol (LDL-C) and other cardiometabolic risk factors in subjects with elevated LDL-cholesterol levels.
  
  
  METHODS
  In a parallel, controlled, 12-week study, 79 healthy overweight subjects (all regular breakfast eaters) were randomly allocated to a group that received a PB based on Nordic foods provided ad libitum or a control group that consumed their usual breakfast. The primary outcome was plasma LDL-C. Secondary outcomes were other blood lipids, body weight, sagittal abdominal diameter (SAD), glucose tolerance, insulin sensitivity and inflammation markers (C-reactive protein [CRP] and tumor necrosis factor receptor-2 [TNF-R2]), and blood pressure. The PB was in accordance with national and Nordic nutrition recommendations and included oat bran porridge with low-fat milk or yogurt, bilberry or lingonberry jam, whole grain bread, low-fat spread, poultry or fatty fish, and fruit.
  
  
  RESULTS
  No differences were found in LDL-C, other blood lipids, body weight, or glucose metabolism, but SAD, plasma CRP, and TNF-R2 decreased more during PB compared with controls (p < 0.05). In the overall diet, PB increased dietary fiber and β-glucan compared with controls (p < 0.05).
  
  
  CONCLUSIONS
  Advising a prudent breakfast for 3 months did not influence blood lipids, body weight, or glucose metabolism but reduced markers of visceral fat and inflammation. The trial was registered in the Current Controlled Trials database (http://www.controlled-trials.com); International Standard Randomized Controlled Trial Number (ISRCTN): 84550872.
authors.affiliation: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, SE-751 85 Uppsala, Sweden.
authors.forename: Viola
authors.initials: V
authors.lastname: Adamsson
authors.affiliation: Lantmännen R&D, St Göransgatan 160 A, SE-104 25 Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Reumark
authors.affiliation: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, SE-751 85 Uppsala, Sweden.
authors.forename: Matti
authors.initials: M
authors.lastname: Marklund
authors.affiliation: Department of Medical Sciences, Uppsala University, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Larsson
authors.affiliation: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, SE-751 85 Uppsala, Sweden. Electronic address: ulf.riserus@pubcare.uu.se.
authors.forename: Ulf
authors.initials: U
authors.lastname: Risérus
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D062408:Breakfast; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood*; D018752:Diet, Fat-Restricted; D004043:Dietary Fiber / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy*; D007249:Inflammation; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat; D008055:Lipids / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000517:prevention & control*; D008875:Middle Aged; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL; D004043:Dietary Fiber; D008055:Lipids; D047889:Receptors, Tumor Necrosis Factor, Type II; D002097:C-Reactive Protein
keywords: Cardiometabolic risk factors; Inflammation; LDL-cholesterol; Nordic diet; Prudent breakfast; Visceral fat