We aimed to examine the effect of natto and red yeast rice (NR) supplementation on lipid and lipoprotein profiles, gene expressions of cholesterol metabolism, and the composition of gut microbiota in ApoE^-/- mice. Forty-one male ApoE^-/- mice aged 7–8 wks old were randomly fed a control diet (CD), CD + NR (oral gavage at 0.3 g/kg BW/day), high-fat and high-cholesterol diet (HFD), or HFD + NR for 12 wks. Fasting blood samples, liver and intestine tissues and fecal samples were collected at week 12. Biochemical parameters, gene expressions in cholesterol metabolism and gut microbiota composition and diversity were measured using standard methods. NR supplementation had no significant effect on lipid and lipoprotein profiles. Compared with the HFD group, HFD + NR resulted in higher mRNA expressions of HMGCR and CYP7A1 (both P-NR < 0.05) and ABCA1 (P-diet*NR = 0.0134, P-NR = 0.0407), lower mRNA expression of PCSK9 (P-diet*NR = 0.0002), lower fasting glucose concentrations (P-diet*NR = 0.0011), and lower relative abundance of genera Bacteroides and Lactococcus (both P-NR < 0.01) and Coriobacteriaceae_UCG-002 (P-diet*NR = 0.0007). The relative abundance of Lactococcus was inversely correlated with HMGCR and CYP7A1, and the relative abundance of Coriobacteriaceae_UCG-002 was positively correlated with PCSK9 and inversely correlated with ABCA1 (all P < 0.05). These findings suggest that NR supplementation may regulate gene expressions in cholesterol metabolism via changes in the gut microbiota in HFD-fed ApoE^-/- mice.

Background: Environmental and cardiometabolic impacts of adherence to plant-based dietary patterns with different quality are unclear. Objectives: To investigate the associations between adherence to the overall, healthy, and unhealthy plant-based dietary patterns, as assessed by the plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI), respectively, and risk of myocardial infarction (MI), type 2 diabetes (T2D), stroke, and all-cause mortality and greenhouse gas (GHG) emissions. Methods: Data from adults (N = 14,652 for cardiometabolic diseases and 15,318 for all-cause mortality) in the China Health and Nutrition Survey (1997–2015 wave) were analyzed. PDI, hPDI, and uPDI scores were calculated with dietary intake data. The total GHG emissions were calculated by summing the amount of emissions from all food groups included in the index. Cox proportional hazard regression models and linear regression models were used for statistical analysis. Results: Greater adherence to an unhealthy plant-based dietary pattern, as reflected by higher uPDI scores, was positively associated with risk of MI (Q5 vs. Q1: HR = 5.90; 95% CI: 2.59–13.48), T2D (Q5 vs. Q1: HR = 2.18; 95% CI: 1.75–2.73), stroke (Q5 vs. Q1: HR = 5.96; 95% CI: 2.86–12.42) and all-cause mortality (Q5 vs. Q1: HR = 6.87; 95% CI: 4.70–10.03). PDI scores were inversely associated with the risk of MI, T2D, and all-cause mortality, and hPDI scores were inversely and positively associated with the risk of T2D and stroke, respectively. All scores were inversely associated with GHG emissions (all p-trends < 0.001). Conclusions: Long-term adherence to unhealthy plant-based dietary patterns guided by higher uPDI scores may be a risk factor for new-onset cardiometabolic diseases and all-cause death in Chinese adults. Food-based dietary guidelines, clinicians, and dietitians should consider the quality of plant-based dietary patterns prior to making recommendations for both healthy individuals and those with elevated cardiometabolic disease risk.

Background/Objectives: Data on the effects of low- versus high-glycemic index (GI) meals across various carbohydrate contents on postprandial subjective satiety and gut hormones are unclear. Methods: This study aimed to investigate the effects of low-carbohydrate (45%E) or high-carbohydrate (65%E) breakfasts with low-GI (≤55) versus high-GI (>70) values on postprandial subjective satiety and plasma gut hormone concentrations in healthy adults, and whether sex and the quantity and quality of habitual dietary carbohydrate intake influenced these effects. In this exploratory secondary analysis of an acute randomized crossover controlled-feeding trial, 15 healthy adults (19–25y) were randomly assigned to one of four breakfasts on separate days: high-carbohydrate low-GI, low-carbohydrate low-GI (LCLGI), high-carbohydrate high-GI, and low-carbohydrate high-GI meals. Postprandial subjective satiety scores were measured over 240 min following breakfasts, and area under the curve (AUC240) of fullness, hunger, desire to eat, and prospective eating scores were calculated. Plasma concentrations of ghrelin, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) were measured at fasting and 240 min after breakfast. Results: Both low-GI breakfasts resulted in lower AUC240 (P_GI = 0.0423) of fullness and higher AUC240 (P_GI = 0.0291) compared to high-GI breakfasts. The LCLGI breakfast resulted in the highest AUC240 of hunger (P_Interaction = 0.0178) and prospective eating scores (P_Interaction = 0.0153) compared to the other three breakfasts. The postprandial plasma concentrations of ghrelin, GLP-1, and GIP were similar among the four breakfasts (all p > 0.05). Conclusions: These findings suggested a relatively unfavorable effect of the LCLGI breakfast on postprandial satiety, without influencing postprandial ghrelin, GLP-1, or GIP concentrations.

Cardiometabolic diseases (CMDs) remain major causes of mortality and morbidity globally. Optimal protein intake, both in quantity and quality, is part of healthy dietary patterns aimed at improving cardiometabolic risk factors (CMRFs) and preventing CMDs. This chapter focuses on the long-term associations between animal and plant protein intake and their impact on CMD risk and CMRFs. Despite the heterogeneity in the current literature, evidence suggests that dietary approaches that limit the consumption of animal-derived foods and favor plant-derived foods may more effectively reduce CMD risk and unfavorable CMRFs in healthy individuals or those with elevated cardiometabolic risk. Future studies should investigate the associations between isocaloric substitutions of plant for animal protein with CMD risk and directly compare the differential effects of animal and plant protein consumption on CMRFs in large, diverse populations. These findings will inform dietary guidance on the optimal selection of protein aimed at improving cardiometabolic health. <!----> <!----> <!----> <!---->