A Dietitian-Led Vegan Program May Improve GlycA, and Other Novel and Traditional Cardiometabolic Risk Factors in Patients With Dyslipidemia: A Pilot Study

Tina H T Chiu, Yun-Chun Kao, Ling-Yi Wang, Huai-Ren Chang, Chin-Lon Lin, Tina H T Chiu, Yun-Chun Kao, Ling-Yi Wang, Huai-Ren Chang, Chin-Lon Lin

Abstract

Background: Systematic inflammation and lipid profiles are two major therapeutic targets for cardiovascular diseases. The effect of a nutritionally balanced vegan diet on systematic inflammation and lipoprotein subclass awaits further examination.

Objective: To investigate the change in novel and traditional cardiometabolic risk factors before and after a dietitian-led vegan program, and to test the bioavailability of vitamin B12 in Taiwanese purple laver as part of a vegan diet.

Design: A one-arm pilot intervention study.

Participants/setting: Nine patients with dyslipidemia participated in this 12-week vegan program.

Main outcome measures: Nuclear Magnetic Resonance (NMR) detected GlycA signals (systematic inflammation) and lipoprotein subclass (atherogenicity); trimethylamine N-oxide (TMAO); and other cardiometabolic risk factors.

Statistical analyses performed: Wilcoxon signed-rank test.

Results: In this 12-week vegan intervention emphasizing whole foods, systematic inflammation improved as indicated by a reduction in GlycA (median: -23 μmol/L, p = 0.01). LDL-c (low-density lipoprotein cholesterol) (median -24 mg/dl, p = 0.04) and LDL-p (low-density lipoprotein particles) (median -75 nmol/L, p = 0.02) both decreased significantly. VLDL (very-low-density lipoprotein) and chylomicron particles showed a decreasing trend (-23.6 nmol/L, p = 0.05). Without caloric restriction, body mass index (BMI) (-0.7 kg/m2, p = 0.03), waist circumferences (-2.0 cm, p < 0.001), HbA1c (-0.2%, p = 0.02), and (HOMA-IR) homeostatic model assessment for insulin resistance (-0.7, p = 0.04) have all improved. The change in the TMAO and vitamin B12 status as measured by holo-transcobalamin appeared to depend on baseline diets, TMAO, and vitamin B12 status.

Conclusions: A dietitian-led vegan program may improve systematic inflammation and other novel and traditional cardiometabolic risk factors in high-risk individuals.

Keywords: GlycA; TMAO; cardiometabolic risk factors; lipoprotein particles; vegan.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Chiu, Kao, Wang, Chang and Lin.

Figures

Figure 1
Figure 1
Study design and timeline overview. Participants received three group sessions and three individual nutrition counseling sessions with a dietitian. Health examination (including anthropometrics and blood examination) were performed at baseline and end of week 12.
Figure 2
Figure 2
Changes in (A) GlycA and HDL-particles and (B) LDL-particles, IDL-particles, and VLDL and chylomicron particles after 12 weeks of dietary intervention, with stratification by use of Statin Therapy. HDL-p, high density lipoprotein particles; LDL-p, low-density lipoprotein particles; IDL, intermediate-density lipoprotein particles; VLDL & chylomicron-p, very-low-density lipoprotein and chylomicron particles.
Figure 3
Figure 3
Trimethylamine N-Oxide (TMAO) before and after the 12-week diet intervention. Green lines represent participants who were vegetarians at baseline. Orange lines represent participants who were nonvegetarians at baseline.
Figure 4
Figure 4
Holotranscobalamine before and after the 12-week diet intervention. Green lines represent participants who were vegetarians at baseline. Orange lines represent participants who were nonvegetarians at baseline.

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