The purpose of the research is to assess the impact of co-consuming plant sterols-enriched food product as part of a healthy eating pattern diet on endothelial function (brachial artery FMD, vasodilation-related and vasoconstriction-related biomarkers) and blood pressure management (24-hour ambulatory and classic blood pressure) in Singapore individuals with MetS.
This is a 13-wk double-blinded, randomized, crossover study design. Following a 1-wk pre-intervention baseline period, subjects will be randomly assigned to follow a healthy eating pattern diet either contain 2.0 g free plant sterols equivalent of their palmityl esters (Plant Sterol Diet) or do not contain plant sterols (Control Diet) for 4 weeks. After a 4-week dietary 'washout' period, they will consume the alternative diet for 4 weeks. The random assignment will be done with SAS 9.4 software. Body size measurement, dietary assessment, brachial artery FMD and blood pressure measurements, and fasting-state blood collection will be conducted at week 1, 5, 9, and 13, which correspond to before and during the last 1 week of the two 4-week intervention periods. During study week 1 and weeks 6-9, all subjects will consume their habitual, unrestricted self-chosen diets. During study weeks 2-5 and 10-13, all subject will follow a healthy eating pattern diet, referred to as the "My Healthy Plate" designed by HPB. Each subject's energy requirement will be estimated using sex-specific equations and Recommended Dietary Allowances for healthy Singaporean. One-on-one dietary counselling and written instructions for each subject will be provided by a research dietitian and trained research staff to achieve a healthy eating pattern diet. Compliance with the plant sterols consumption will be promoted by frequent online and in-person contact.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
20
Consumption a healthy eating pattern diet with a plant sterols-enriched food product
Compliance with a healthy diet in accordance to the recommendation by the Singapore Health Promotion Board.
National University of Singapore
Singapore, Singapore
Change in brachial artery flow-mediated dilation (FMD)
Brachial artery FMD will be measured by high-frequency and ultrasonographic imaging.
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
Change in vasodilation and vasoconstriction related biomarkers
Vasodilation and vasoconstriction related biomarkers contains nitric oxide, endothelial nitric oxide synthase, and endothelin-1. They will be measured using the commercially available ELISA assay kits.
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
Change in blood pressure
Classical and 24-hour ambulatory blood pressure: Systolic and diastolic blood pressure and 5-day of 24-hour ambulatory blood pressure will be measured.
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
Change in blood lipid-lipoproteins
Assessing the blood lipid-lipoproteins profile includes the measurements of plasma total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations.
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
Change in skin carotenoid status
Measured using resonance Raman spectroscopy.
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
Height
Height (cm)
Time frame: Pre-intervention only
Change in weight
Weight (kg)
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
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Change in waist circumference
Waist circumference (cm)
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
Change in diet
Dietary assessment, 3-day food record
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)
Change in sleep quality (Pittsburgh sleep quality index questionnaire (PSQI))
Recall based questionnaire assessing sleep habits for the past one month only which includes sleeping timing habits and quality of sleep (Very good, Fairly good, Fairly bad and very bad)
Time frame: Every 4 weeks (Week 1, week 5, week 9, week 13)