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Provident Perspective Volume 2, Issue 2 Provident NewsProvident is proud to welcome new team members to our staff:
New Locations Provident now has 4 offices, 3 of which are in Bloomington, IN and one in Glen Ellyn, IL (as of January 2, 2007), a western suburb of Chicago.
Administrative Offices
Accounting, Data Management and Statistics
1st Street Clinical Research Center
2nd Street Clinical Research Center Recent and Upcoming Publications and PresentationsJournal ArticlesMaki KC, Davidson MH, Witchger MS, Dicklin MR, Subbaiah PV. Effects of high-fiber oat and wheat cereals on postprandial glucose and lipid responses. Int J Vitam Nutr Res. 2006;(in press). Maki KC, Rains TM, Kaden VN, Raneri KR, Davidson MH. Effects of a reduced glycemic load diet on body weight, body composition and cardiovascular risk markers in overweight and obese men and women. Am J Clin Nutr. 2007;(in press). Davidson MH, Bays HE, Stein E, Maki KC, Shalwitz RA, Doyle R. Effects of fenofibrate on atherogenic dyslipidemia in hypertriglyceridemic subjects. Clin Cardiol. 2006;29:268-293. Ansell BJ, Fonarow GC, Maki KC, Dicklin MR, Bell M, Davidson MH. Reduced treatment success in lipid management among women with coronary heart disease or risk equivalents: results of a national survey. Am Heart J. 2006;152:976-981. Deedwania PC, Maki KC, Dicklin MR, Stone NJ, Ballantyne CM, Davidson MH. Application of recent definitions of the metabolic syndrome to survey data from the National Cholesterol Education Program Evaluation Project Utilizing Novel E-technology. J Cardiometabolic Syndrome. 2006;(in press). Maki KC, Galant R, Samuel P, Tesser J, Witchger MS, Ribaya-Mercado J, Blumberg J, Geohas, J. Effects of consuming foods containing oat beta-glucan on blood pressure, carbohydrate metabolism and biomarkers of oxidative stress in men and women with elevated blood pressure. Eur J Clin Nutr. 2006;(advance e-pub):1-10. Davidson MH, Dittakavi V, Bandari A, Davidson DJ, Maki KC, Subbaiah P. Colesevelam HCI decreases atherosclerosis and may activate reverse cholesterol transport in cholesterol-fed rabbits. Journal of Applied Research. 2006;6:4-13. Clark LT, Maki KC, Galant R, Maron DJ, Pearson TA, Davidson MH. Ethnic differences in achievement of cholesterol treatment goals: results from the National Cholesterol Education Program Evaluation Project Utilizing Novel E-technology (NEPTUNE) II. Can J Cardiol. 2006;22:315-322. AbstractsMaki KC, Davidson MH, Bays HE, Shalwitz RA, Doyle R. Effects of omega-3 acid ethyl esters on LDL particle size on subjects with hypertriglyceridemia despite statin therapy. FASEB J. 2007;(in press) Izumi R, Hurt J, Maki KC, Bell M, Zavras A, McCamish M. Clinical predictors of glycosylated hemoglobin responses to thiazolidinedione therapy. Circulation. 2007;(in press). Maki KC. High-viscosity hydroxypropylmethylcellulose: A promising agent for metabolic risk factor management. Am Chem Soc. 2007;(in press). Davidson MH, Bays H, Stein E, Maki KC, Doyle R, Shalwitz RA. COMBOS – The combination of prescription omega-3s with simvastatin: A randomized, double-blind, placebo-controlled study to assess the efficacy and safety of prescription omega-3 (Omacor®) added to stable statin therapy in hypertriglyceridemic patients. Proceedings of the Midwest Lipid Association 3rd Annual Scientific Forum. 2006. Maki KC, Carson ML, Miller MP, Turowski M, Wilder D, Bell M, Ratcliff N, Reeves MS. High-viscosity hydroxypropylmethylcellulose blunts postprandial glucose and insulin responses. J Am Coll Nutr. 2006;25:464. In the LiteratureMcLaughlin T, Carter S, Lamendola C, et al. Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults. Am J Clin Nutr. 2006;84:813-821. Methods: This randomized clinical trial was designed to determine the effects of moderate variations in the carbohydrate and fat content of calorie-restricted diets on weight loss and cardiovascular disease risk markers in obese (body mass index between 29 and 36 kg/m2), insulin-resistant individuals. Insulin resistance was determined according to steady-state plasma insulin and glucose [SSPG] concentrations, a direct measure of the ability to mediate the disposal of an infused glucose load. For 16 weeks, subjects followed either a calorie-restricted 60% energy as carbohydrate diet (n = 30; 15% protein, 25% fat) or a calorie-restricted 40% carbohydrate diet (n = 27; 15% protein, 45% fat). Results: Subjects in both the 60% and 40% carbohydrate diet groups lost significant amounts of weight (-5.7 ± 0.7 kg and -6.9 ± 0.7 kg, respectively, p < 0.0001 for both groups combined) and experienced significant declines in SSPG concentration (p < 0.0001) and systolic and diastolic blood pressures (p < 0.0001 and p < 0.02). These changes did not differ significantly between diet groups. Irrespective of diet, the more weight lost, the greater the magnitude of decrease in SSPG concentration (r = 0.50, p < 0.001). Subjects following the 40% carbohydrate diet compared with the 60% carbohydrate diet had greater reductions in daylong insulin concentration (-32% vs. -13%, p < 0.01) and daylong triglyceride (TG) concentration (-25% vs. -7%, p = 0.02). Fasting TG concentration was reduced to a larger extent with the 40% carbohydrate diet compared with the 60% carbohydrate diet (-47 mg/dL difference between groups, p = 0.04) and high-density lipoprotein (HDL) cholesterol was increased to a larger extent with 40% compared with 60% carbohydrate diets (5 mg/dL difference between groups, p < 0.01). The percentage of subjects with low-density lipoprotein (LDL) phenotype pattern B changed from 61% to 39% in the lower carbohydrate diet group, compared with a change from 50% to 45% in the higher carbohydrate diet group (p = 0.04). Mean LDL particle size also increased more in the lower carbohydrate group (p = 0.04). Conclusions: The results of this study indicate that among obese, insulin-resistant individuals, a calorie-restricted, moderately low carbohydrate diet is as efficacious as a calorie-restricted, higher carbohydrate, low fat diet for producing weight loss. Furthermore, the moderately low carbohydrate diet may be more beneficial for improving the cardiovascular risk profile. Dr. Maki’s Commentary: This study adds to the growing body of evidence suggesting that moderate carbohydrate restriction may be beneficial for those with insulin resistance and hyperinsulinemia. Among such individuals, “atherogenic dyslipidemia” is commonly present, which is characterized by elevated TGs, depressed HDL cholesterol and a predominance of small, dense LDL particles. It is not widely appreciated that conversion from LDL pattern A (large, buoyant LDL) to pattern B (small, dense LDL) is a threshold phenomenon. Above a threshold level for fasting TG, the LDL subclass distribution shifts from pattern A to pattern B. The threshold varies from person to person, but appears to be in the range of 100 to 200 mg/dL in most people. For individuals with TGs above 100 mg/dL, moderate carbohydrate restriction may help to maintain a lower average daylong insulin level, resulting in a reduced fasting TG concentration and an increase in HDL cholesterol. If the fasting TG level crosses the individual’s threshold, a shift from LDL pattern B to pattern A will also occur, increasing the mean LDL particle size. All of these changes would be expected to lower cardiovascular disease risk. About ProvidentProvident has a team of research professionals with extensive experience in the design and conduct of clinical trials to evaluate pharmaceuticals, medical and functional foods, dietary supplements and medical devices. For more information, visit our web site: http://www.providentcrc.com. Or, contact us directly: Tia Rains: trains@providentcrc.com, Director of Medical Writing / Principal Scientist |
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