Search

Aim. This paper reports a study examining the interrater and intrarater reliability of classifying pressure ulcers according to the European Pressure Ulcer Advisory Panel classification system when using photographs of pressure ulcers and incontinence lesions. Background. Pressure ulcer classification is an essential tool for assessing ulcers and their severity and determining which preventive or therapeutic action is needed. Many classification systems are described in the literature. There are only a limited number of studies that evaluate the interrater reliability of pressure ulcer grading scales. The intrarater reliability is seldom studied. Methods. The study consisted of two phases. In the first phase 56 photographs, together with a random selection of nine photographs from the same set, were presented to 473 nurses. In the second phase, the 56 photographs were presented twice to 86 other nurses with an interval of one month and in a different order. All the nurses were familiar with the European Pressure Ulcer Advisory Panel classification. They did not receive any additional training on classification, and were asked to classify the lesions as normal skin, blanchable erythema, pressure ulcers (four grades, European Pressure Ulcer Advisory Panel classification) or incontinence lesions. Results. In the first phase, the multirater-Kappa for the 473 participating nurses was 0.37 (P < 0.001). Non-blanchable erythema was often confused with blanchable erythema and incontinence lesions. Also incontinence lesions were frequently not correctly classified. The intrarater agreement was low (kappa = 0.38). In the second phase, the interrater agreement was not significantly different in both sessions. The intrarater agreement was 0.52. Conclusion. Both the interrater and intrarater reliability of the European Pressure Ulcer Advisory Panel classification of lesion photographs by nurses was very low. Differentiation between pressure ulcers and incontinence lesions seems to be difficult. [ABSTRACT FROM AUTHOR]

Tomatoes are the main dietary source of lycopene, and the bioavailability of lycopene from tomato paste is higher than that from fresh tomatoes. We investigated systematically the effect of mechanical homogenization and heating on the bioavailability of carotenoids from canned tomatoes. Further, we compared the carotenoid response in triglyceride-rich lipoproteins (TRL) after single consumption with the change in fasting plasma carotenoid concentrations after 4 d of daily consumption. In a split plot design, 17 men and women consumed tomatoes which had received minimal additional heating and 16 others consumed extensively additionally heated tomatoes (1 h at 100 degrees C). These tomatoes were not, mildly or severely homogenized. The tomato products were consumed daily (ca. 22 mg/d lycopene) for 4 d. Eleven participants provided postprandial blood samples on the d 1 and all gave fasting blood samples on d 1 and 4. Homogenization enhanced the lycopene response significantly (P<0.05) both in TRL [mean areas under the curves: 54.9, 72.0 and 88.7 nmol. h/L (SE 11.0) for not, mildly and severely homogenized tomatoes, respectively] and in plasma [mean changes: 0.19, 0.22 and 0.23 micromol/L (SE 0.009), respectively]. Additional heating also tended to enhance the lycopene responses in TRL (P = 0.14) and plasma (P = 0.17). Similar effects to those for lycopene were found for beta-carotene. We conclude that the intactness of the cellular matrix of tomatoes determines the bioavailability of carotenoids and that matrix disruption by mechanical homogenization and/or heat treatment enhances the bioavailability. The carotenoid response in plasma after 4 d intervention can be used to compare the bioavailability of carotenoids from different foods. [ABSTRACT FROM AUTHOR]

Carotenoids are thought to contribute to the beneficial effects of increased vegetable consumption. Various dietary factors have an effect on the bioavailability of carotenoids. The type of food matrix in which carotenoids are located is a major factor. The bioavailability of beta-carotene from vegetables in particular has been shown to be low (14% from mixed vegetables) compared with that of purified beta-carotene added to a simple matrix (e.g., salad dressing), whereas for lutein, the difference is much smaller (relative bioavailability of 67% from mixed vegetables). Processing, such as mechanical homogenization or heat treatment, has the potential to enhance the bioavailability of carotenoids from vegetables (from 18% to a sixfold increase). The amount of dietary fat required to ensure carotenoid absorption seems low (approximately 3-5 g per meal), although it depends on the physicochemical characteristics of the carotenoids ingested. Unabsorbable, fat-soluble compounds reduce carotenoid absorption, and interaction among carotenoids may also result in a reduced carotenoid bioavailability. Research into the functional benefits of carotenoids should consider the fact that the bioavailability of beta-carotene in particular is one order of magnitude higher when provided as a pure compound added to foods than when it is present naturally in foods. [ABSTRACT FROM AUTHOR]

Objective: To investigate the dose-response relationship between cholesterol lowering and three different, relatively low intake levels of plant sterols (0.83, 1.61, 3.24 g/d) from spreads. To investigate the effects on lipid-soluble (pro)vitamins.Design: A randomized double-blind placebo controlled balanced incomplete Latin square design using five spreads and four periods. The five study spreads included butter, a commercially available spread and three experimental spreads fortified with three different concentrations of plant sterols.Subjects: One hundred apparently healthy normocholesterolaemic and mildly hypercholesterolaemic volunteers participated.Interventions: Each subject consumed four spreads, each for a period of 3.5 week.Results: Compared to the control spread, total cholesterol decreased by 0.26 (CI: 0.15-0.36), 0.31 (CI: 0.20-0.41) and 0.35 (CI: 0.25-0.46) mmol/L, for daily consumption of 0.83, 1.61 and 3.24 g plant sterols, respectively. For LDL-cholesterol these decreases were 0.20 (CI: 0.10-0.31), 0.26 (CI: 0.15-0.36) and 0.30 (CI: 0.20-0.41). Decreases in the LDL/HDL ratio were 0.13 (CI: 0.04-0.22), 0.16 (CI: 0.07-0.24) and 0.16 (CI: 0.07-0.24) units, respectively. Differences in cholesterol reductions between the plant sterol doses consumed were not statistically significant. Plasma vitamin K1 and 25-OH-vitamin D and lipid standardized plasma lycopene and alpha-tocopherol were not affected by consumption of plant sterol enriched spreads, but lipid standardized plasma (alpha + beta)-carotene concentrations were decreased by about 11 and 19% by daily consumption of 0.83 and 3.24 g plant sterols in spread, respectively.Conclusions: The three relatively low dosages of plant sterols had a significant cholesterol lowering effect ranging from 4.9-6.8%, 6.7-9.9% and 6.5-7.9%, for total, LDL-cholesterol and the LDL/HDL cholesterol ratio, respectively, without substantially affecting lipid soluble (pro)vitamins. No significant differences in cholesterol lowering effect between the three dosages of plant sterols could be detected. This study would support that consumption of about 1.6 g of plant sterols per day will beneficially affect plasma cholesterol concentrations without seriously affecting plasma carotenoid concentrations. [ABSTRACT FROM AUTHOR]

Objectives: To compare the effects of free access to reduced fat products or their full fat equivalents on fat and energy intake, body weight, plasma lipids and fat-soluble antioxidants concentrations and haemostasis variables.Design: A multicentre open randomised controlled trial in which intervention and control groups were followed in parallel for six months. Volunteers had free access to 44 different foods either in reduced fat or full fat version, covering between 30 and 40% of energy intake. The remainder of energy intake was covered by foods bought in regular shops.Setting: Zeist, Wageningen and Maastricht, The Netherlands.Subjects: Two hundred and forty-one non-obese healthy volunteers who had no intention to lose weight.Main Outcome Measures: Food intake, body weight, plasma lipid, vitamin E, beta-carotene, lycopene and fibrinogen concentrations, plasma factor VII clotting activity, and plasminogen-activator-inhibitor-I antigen level.Results: One hundred and three volunteers in the full fat group and 117 volunteers in the reduced fat group completed the study. Energy and fat intake from the free access products was lower in the reduced fat group, but no difference in energy and fat intake of other products occurred. Body weight, energy-, fat- and vitamin E intake and percentage of energy derived from fat decreased in the reduced fat group. No other statistical significant intervention effects were observed. Blood lipid concentrations, factor VII activity and plasminogen-inhibitor-activator-1 level were reduced after consumption of reduced fat products.Conclusions: When subjects without intention to lose weight limit fat intake by switching from ad libitum consumption of full fat products to reduced fat products body weight gain is prevented, and fat and energy intake are reduced. Such a switch may have beneficial effects on biochemical cardiovascular risk factors. We concluded that reduced fat products will help in a population strategy aimed at preventing overweight and obesity, they will also be effective in maintaining a lower body weight after slimming. Ad libitum consumption of reduced fat products will be ineffective for those individuals that want to reduce body weight because they are currently overweight or obese. [ABSTRACT FROM AUTHOR]

Objectives: To compare effects on plasma total-, LDL-, and HDL-cholesterol concentrations of margarines enriched with different vegetable oil sterols or sitostanol-ester.Design: A randomized double-blind placebo-controlled balanced incomplete Latin square design with five treatments and four periods of 3.5 weeks. Margarines enriched with sterols from soybean, sheanut or ricebran oil or with sitostanol-ester were compared to a non-enriched control margarine. Sterol intake was between 1.5-3.3 g/d. Two thirds of the soybean oil sterols were esterified to fatty acids.Setting: Unilever Research Laboratory, Vlaardingen, The Netherlands.Subjects: One hundred healthy non-obese normocholesterolaemic and mildly hypercholesterolaemic volunteers aged 45+/-12.8 y, with plasma total cholesterol levels below 8 mmol/L at entry.Main Outcome Measures: Plasma lipid, carotenoid and sterol concentrations, blood clinical chemistry and haematology, fatty acid composition of plasma cholesterylesters and food intake.Results: Ninety-five volunteers completed the study. None of the margarines induced adverse changes in blood clinical chemistry, serum total bile acids or haematology. Plasma total- and LDL-cholesterol concentrations were significantly reduced by 8-13% (0.37-0.44 mmol/L) compared to control for margarines enriched in soybean oil sterol-esters or sitostanol-ester. No effect on HDL-cholesterol concentrations occurred. The LDL- to HDL-cholesterol ratio was reduced by 0.37 and 0.33 units for these margarines, respectively. Effects on blood lipids did not differ between normocholesterolaemic and mildly hypercholesterolaemic subjects. Plasma sitosterol and campesterol levels were significantly higher for the soybean oil sterol margarine and significantly lower for the sitostanol-ester margarine compared to control. Dietary intake was very similar across treatments. The fatty acid composition of plasma cholesterylesters confirmed the good compliance to the treatment. All sterol enriched margarines reduced lipid-standardized plasma alpha- plus beta-carotene levels. Plasma lycopene levels were also reduced but this effect was not significant for all products.Conclusions: A margarine with sterol-esters from soybean oil, mainly esters from sitosterol, campesterol and stigmasterol, is as effective as a margarine with sitostanol-ester in lowering blood total- and LDL-cholesterol levels without affecting HDL-cholesterol concentrations. Incorporation in edible fat containing products of such substances may substantially reduce the risk of cardiovascular disease in the population. [ABSTRACT FROM AUTHOR]

Objectives: In 60 healthy humans, a blend of commonly used edible vegetable fats was compared with the same fat blend after random chemical interesterification, for their effects in terms of nutritional safety on blood lipids, blood enzymes and hemostasis parameters.Design: Both fat blends were supplied double-blind at two energy levels (4 and 8% of energy) in margarine according to a parallel design. At either energy level, the two fat blends were consumed according to a cross-over design for two periods of three weeks, without an intermediate wash-out period.Results: The 30 parameters studied revealed no statistically significant differences between the two fat blends, except for slightly (approximately 10%) lower D-dimers concentrations after consumption of the interesterified fat blend.Conclusions: Increased levels of the fibrin-degradation products D-dimers are positively associated with risk for coronary heart disease. Thus, it was concluded that the inclusion of a chemically interesterified vegetable fat blend in the diet of healthy people does not influence fasting blood lipids, blood enzymes and/or hemostasis parameters in an adverse way, when compared with a non-interesterified fat blend with the same fatty acid composition. [ABSTRACT FROM AUTHOR]

In this study the effect of the positional distribution of stearic acid (18:0) and oleic acid (18:1) in a triacylglycerol on absorption of fat, energy and nutrients was investigated in young rats. In addition the effect of dietary calcium on these variables was studied. Forty rats were fed purified diets containing either a fat blend high in 2-oleoyl-distearate or a fat blend high in 1-oleoyl-distearate. Both diets were given at low (0.3 g/100 g) and high (1.0 g/100 g) dietary calcium concentrations. Total fat absorption, expressed as the percentage of fat intake, was significantly lower in rats fed 2-oleoyl-distearate compared with 1-oleoyl-distearate at both dietary calcium concentrations. When expressed as absolute figures, the lower fat absorption in rats fed 2-oleoyl-distearate compared with 1-oleoyl-distearate only reached statistical significance at the high dietary calcium concentration. The reduced absorption of total fat was mainly caused by the lower absorption of stearic acid. The percentage of, but not absolute, absorption of oleic acid and energy were lower in rats fed 2-oleoyl-distearate. Absolute and percentage of calcium absorption were lower in rats fed 2-oleoyl-distearate compared with 1-oleoyl-distearate. Absolute and percentage of magnesium absorption were not significantly affected by the positional distribution of stearic acid and oleic acid in the triacylglycerol, but were decreased at a high dietary calcium concentration. We concluded that the lowered stearic acid absorption from 2-oleoyl-distearate compared with 1-oleoyl-distearate might have been due to the greater formation of insoluble calcium and magnesium soaps in the intestine. [ABSTRACT FROM AUTHOR]

Male hamsters (30 per group) were fed five different semi-purified diets ad libitum. The diets, containing 30% of energy (en%) as fat, differed in their dietary fat composition (specified fatty acids exchanged at 10 en%) and were fed for 4 weeks. The five fatty acids compared in mixed triglycerides were elaidic acid (C18:1 9t), vaccenic acid (C18:1 11t), their cis-counterpart oleic acid (C18:1 9c), medium-chain fatty acids (MCFA; C8:0 and C10:0), and palmitic acid (C16:0). Compared with oleic acid, dietary MCFA and palmitic acid tended to increase blood cholesterol levels in the hamsters. The effect of elaidic and vaccenic acid on blood cholesterol did not differ from that of oleic acid. When elaidic acid and vaccenic acids were compared directly, the ratio of LDL/HDL-cholesterol in plasma was significantly higher in hamsters fed vaccenic acid than in those fed elaidic acid, and elaidic acid was incorporated at low levels, but more efficiently than vaccenic acid at the sn-2 position of platelet phospholipids. Biological consequences of this low incorporation are considered unlikely as levels of arachidonic acid (C20:4 n-6) and docosohexaenoic acid (C22:6 n-3) in the platelet phospholipids of all dietary groups did not differ. With respect to the effect on the LDL/HDL-cholesterol ratio, elaidic acid may be preferable to vaccenic acid. We conclude that this animal study does not provide evidence for the suggestion, based on epidemiological observations, that elaidic acid would be more detrimental to cardiovascular risk than vaccenic acid.

Background: Fat-soluble vitamin E and carotenoids are regarded as being protective against chronic diseases. Little is known about the effect of dietary fat on the bioavailability of these compounds., Objective: The objective of this study was to assess the effect of the amount of dietary fat on plasma concentrations of vitamin E and carotenoids after supplementation with these compounds., Design: During two 7-d periods, 4 groups of 14-15 volunteers received daily, with a low-fat hot meal, 1 of 4 different supplements: vitamin E (50 mg), alpha- plus beta-carotene (8 mg), lutein esters (8 mg lutein), or placebo. The supplements were provided in a low- or high-fat spread supplied in random sequence during either of the 2 experimental periods., Results: As anticipated, plasma concentrations of vitamin E, alpha- and beta-carotene, and lutein were significantly higher in the supplemented groups than in the placebo group. The amount of dietary fat consumed with the hot meal (3 or 36 g) did not affect the increases in plasma concentrations of vitamin E (20% increase with the low-fat spread and 23% increase with the high-fat spread) or alpha- and beta-carotene (315% and 139% with the low-fat spread and 226% and 108% with the high-fat spread). The plasma lutein response was higher when lutein esters were consumed with the high-fat spread (207% increase) than with the low-fat spread (88% increase)., Conclusion: Optimal uptake of vitamin E and alpha- and beta-carotene requires a limited amount of fat whereas the amount of fat required for optimal intestinal uptake of lutein esters is higher. 2000;71:-93.

A study was conducted in 12 healthy males and 12 healthy females (mean age 36 years, mean body mass index 24 kg/m2), to determine the effect of a margarine enriched with phytosterol esters on faecal short-chain fatty acids (SCFAs) and faecal bacterial enzyme activities, viable faecal microflora count, female sex hormones and serum cholesterol concentrations. The study design was a two-period, parallel dosing, randomized, placebo-controlled dietary study. Under controlled dietary conditions, participants consumed 40 g of the control margarine for 21 and 28 consecutive days for males and females, respectively. This was followed immediately by the second part of the study where subjects were equally and randomly allocated to consume daily 40 g of either the control or the test margarine, containing 8.6 g vegetable oil phytosterols (a mixture of beta-sitosterol, campesterol and stigmasterol), also for 21 or 28 days. All females were shown to have a regular menstrual cycle and were on an established method of contraception not involving oral contraceptives. When compared with the control group values, the test group showed a significant reduction in serum total and LDL cholesterol concentrations of 18 and 23% (P < 0.001; P < 0.001) respectively, in faecal lactic acid concentration (P = 0.039) and in serum progesterone levels (P = 0.021). There were no other significant treatment effects. Within each group a number of significant changes occurred compared to baseline. In the test group, faecal lactic acid concentration and the ratio of acetic acid:total SCFA; and the ratio of butyric acid:total SCFA, in the control group were both significantly reduced (P = 0.016). Compared to baseline, azo-reductase activity was significantly reduced in the control group (P = 0.047). Total faecal aerobes (P = 0.028), lactobacilli (P = 0.003) and staphylococci (P = 0.025) content was also significantly reduced in the control group, while in the test group only lactobacilli content was reduced (P = 0.019). Of the significant findings reported in this study, none was considered to be of biological importance except the beneficial reduction in serum total and LDL-cholesterol concentrations. The daily consumption of a margarine enriched with 8.6 g vegetable oil phytosterols did not affect the bacterial profile or the metabolic activities of the gut microflora, nor did it result in biologically relevant effects on serum female sex hormone levels. The margarine enriched with the vegetable oil phytosterols was well tolerated by both male and female volunteers.

A study was conducted in 12 healthy males and 12 females (mean age 36 years) to assess the impact of a margarine enriched with phytosterol esters on faecal concentrations of bile acids and sterols. During the run-in period, volunteers consumed 40 g of a control margarine for 21 consecutive days if male, and for 28 days if female. Half of the volunteers were then randomly allocated to consume the control margarine for another 21 or 28 days, respectively. The remaining subjects consumed 40 g of a margarine containing 8.6 g vegetable oil phytosterol (46% (w/w) beta-sitosterol, 26% campesterol, 20% stigmasterol). Throughout the total study subjects consumed the same diet adjusted for individual energy requirements. The phytosterol ester-enriched spread significantly enhanced faecal neutral sterol concentrations from about 40 mg/g to 190 mg/g dry weight faeces. Faecal neutral sterol metabolites increased from about 30 mg/g to about 50 mg/g. The major parent sterols excreted were cholesterol, sitosterol, campesterol and stigmasterol. Sitosterol, campesterol and stigmasterol comprised 28%, 15% and 12% of the total faecal neutral sterols, reflecting the composition of the sterol enriched margarine. The major sterol metabolites excreted were metabolites formed by, predominantly, oxidation at the 3-position and metabolites saturated at the 5,6 position in a beta-configuration. Faecal secondary bile acid concentration was reduced by vegetable oil sterols from 7.6 mg/g dry faeces to 6.0 mg/g. Consumption of vegetable oil phytosterols slightly but significantly increased the faecal concentration of 4-cholesten-3-one. However, 4-cholesten-3-one concentration remained very low (< 2 mg/g) and in line with values reported in the literature for subjects fed high or low fat diets. No sterol oxides could be detected in the faeces. We conclude that in healthy adult males and females a high intake of vegetable oil phytosterol esters does increase the amount of neutral sterols in the faeces, as expected, but does not result in the increased formation of bile acids or sterol metabolites.

In a 9-week study seventy-six healthy adult volunteers with an average age of 44 (SD 11) years, with baseline plasma total cholesterol levels below 8 mmol/l, received in a balanced, double-blind, crossover design, a total of three different table spreads for personal use. Two spreads were fortified either with free (non-esterified) vegetable-oil sterols, mainly from soyabean oil (31 g sterol equivalents/kg; 0.8 g/d) or sheanut-oil sterols (133 g sterol equivalents/kg; 3.3 g/d). One spread was not fortified (control). Average intake of spread was 25 g/d for 3 weeks. None of the spreads induced changes in blood clinical chemistry or haematology. Plasma total- and LDL-cholesterol concentrations were statistically significantly reduced by 3.8% and 6% (both 0.19 mmol/l) respectively, for the spread enriched with free soyabean-oil sterols compared with the control spread. The spread enriched with sheanut-oil sterols did not lower plasma total- and LDL-cholesterol levels. None of the plant-sterol-enriched spreads affected plasma HDL-cholesterol concentrations. Plasma-lipid-standardized concentrations of alpha- plus beta-carotene were not statistically significantly affected by the soyabean-oil sterol spread in contrast to lipid-standardized plasma lycopene levels which showed a statistically significant decrease (9.5%). These findings indicate that a daily intake of free soyabean-oil sterols as low as 0.8 g added to a spread is effective in lowering blood total- and LDL-cholesterol levels with limited effects on blood carotenoid levels. The lowering in total- and LDL-cholesterol blood levels due to consumption of the vegetable-oil-sterol-enriched spread may be helpful in reducing the risk of CHD for the population.

Carotenoids, folate and vitamin C may contribute to the observed beneficial effects of increased vegetable intake. Currently, knowledge on the bioavailability of these compounds from vegetables is limited. We compared the efficacy of different vegetables, at the same level of intake (i.e. 300 g/d), in increasing plasma levels of carotenoids, folate and vitamin C and we investigated if disruption of the vegetable matrix would enhance the bioavailability of these micronutrients. In an incomplete block design, sixty-nine volunteers consumed a control meal without vegetables and three out of four vegetable meals (i.e. broccoli, green peas, whole leaf spinach, chopped spinach; containing between 1.7 and 24.6 mg beta-carotene, 3.8 and 26 mg lutein, 0.22 and 0.60 mg folate and 26 and 93 mg vitamin C) or a meal supplemented with synthetic beta-carotene (33.3 mg). Meals were consumed for 4 d and fasting blood samples were taken at the end of each period. Consumption of the spinach-supplemented meal did not affect plasma levels of beta-carotene, although the beta-carotene content was 10-fold those of broccoli and green peas, which induced significant increases in plasma beta-carotene levels (28 (95% CI 6.4, 55)% and 26 (95% CI 2.6, 54)% respectively). The beta-carotene-supplemented meal increased plasma concentrations of beta-carotene effectively (517 (95% CI 409, 648)%). All vegetable meals increased the plasma concentrations of lutein and vitamin C significantly. Broccoli and green peas were, when expressed per mg carotenoid consumed, also more effective sources of lutein than spinach. A significant increase in plasma folate concentration was found only after consumption of the spinach-supplemented meal, which provided the highest level of folate. Disruption of the spinach matrix increased the plasma responses to both lutein (14 (95% CI 3.7, 25)%) and folate (10 (95% CI 2.2, 18)%), whereas it did not affect the response to beta-carotene. We conclude that the bioavailabilities of beta-carotene and lutein vary substantially among different vegetables and that the bioavailabilities of lutein and folate from spinach can be improved by disruption of the vegetable matrix.

Background: To gain more insight into the relation between vegetable consumption and the risk of chronic diseases, it is important to determine the bioavailability of carotenoids from vegetables and the effect of vegetable consumption on selected biomarkers of chronic diseases., Objective: To assess the bioavailability of beta-carotene and lutein from vegetables and the effect of increased vegetable consumption on the ex vivo oxidizability of LDL., Design: Over 4 wk, 22 healthy adult subjects consumed a high-vegetable diet (490 g/d), 22 consumed a low-vegetable diet (130 g/d), and 10 consumed a low-vegetable diet supplemented with pure beta-carotene (6 mg/d) and lutein (9 mg/d)., Results: Plasma concentrations of vitamin C and carotenoids (ie, alpha-carotene, beta-carotene, lutein, zeaxanthin, and beta-cryptoxanthin) were significantly higher after the high-vegetable diet than after the low-vegetable diet. In addition to an increase in plasma beta-carotene and lutein, the pure carotenoid-supplemented diet induced a significant decrease in plasma lycopene concentration of -0.11 micromol/L (95% CI: -0.21, -0.0061). The responses of plasma beta-carotene and lutein to the high-vegetable diet were 14% and 67%, respectively, of those to the pure carotenoid- supplemented diet. Conversion of beta-carotene to retinol may have attenuated its plasma response compared with that of lutein. There was no significant effect on the resistance of LDL to oxidation ex vivo., Conclusions: Increased vegetable consumption enhances plasma vitamin C and carotenoid concentrations, but not resistance of LDL to oxidation. The relative bioavailability of lutein from vegetables is higher than that of beta-carotene.

Palm oil carotenoids are a mixture of alpha- and beta-carotenes, which are used as food colorants. They may also be applied as a functional food ingredient because of the provitamin A activity of alpha- and beta-carotenes and their proposed beneficial roles in the prevention of chronic diseases. This paper discusses the results of an incomplete balanced crossover study with 69 healthy adult volunteers to compare palm oil carotenoids with synthetic beta-carotene in their efficacies to increase plasma levels of carotenoids. Four days of supplementation with natural palm oil carotenoids (7.6 mg/day of alpha-carotene, 11.9 mg/day of all-trans-beta-carotene, 7.5 mg/day of cis-beta-carotene) or synthetic beta-carotene (23.8 mg/day of all-trans-beta-carotene, 4.4 mg/day of cis-beta-carotene), added to a mixed meal, resulted in significant increases in plasma levels of the supplied carotenoids as compared to consumption of a low-carotenoid meal (i.e., 7.2-fold increase in alpha-carotene and 3.5-fold increase in all-trans-beta-carotene following palm oil carotenoids; 6.9-fold increase in all-trans beta-carotene following synthetic beta-carotene). As the carotenoid content differed between the treatments, the relative plasma responses were calculated per milligram of beta-carotene intake. These were similar for the two supplements, suggesting that the presence of alpha-carotene does not affect the bioavailability of beta-carotene from palm oil. It was concluded that 4 days of supplementation with palm oil carotenoids or synthetic beta-carotene improves the plasma beta-carotene status substantially, whereas alpha-carotene is additionally delivered by the palm oil supplement.

Effects of butter and 2 types of margarine on blood lipid and lipoprotein concentrations were compared in a controlled diet study with 23 men and 23 women. Table spreads, added to a common basal diet, provided 8.3% of energy as fat. Diets averaged 34.6% of energy as fat and 15.5% as protein. Each diet was fed for 5 wk in a 3 x 3 Latin-square design. One margarine (TFA-M) approximated the average trans monoene content of trans fatty acid-containing margarines in the United States (17% trans fatty acids by dry wt). The other margarine (PUFA-M) was free of trans unsaturated fatty acids; it contained approximately twice the polyunsaturated fatty acid content of TFA-M (49% compared with 27% polyunsaturated fatty acids). The tub-type margarines had similar physical properties at ambient temperature. Fasting blood lipids and lipoproteins were determined in 2 samples taken from the subjects during the fifth week of each dietary treatment. Compared with butter, total cholesterol was 3.5% lower (P=0.009) after consumption of TFA-M and 5.4% lower (P< 0.001) after consumption of PUFA-M. Similarly, LDL cholesterol was 4.9% lower (P=0.005) and 6.7% lower (P< 0.001) after consumption of TFA-M and PUFA-M, respectively. Neither margarine differed from butter in its effect on HDL cholesterol or triacylglycerols. Thus, consumption of TFA-M or PUFA-M improved blood lipid profiles for the major lipoproteins associated with cardiovascular risk when compared with butter, with a greater improvement with PUFA-M than with TFA-M.

The long-term effects of consumption of marine long-chain n-3 polyunsaturated fatty acids (PUFA) on atherosclerosis in the rabbit were examined. Female Dutch rabbits were fed purified diets, containing 40 energy% total fat, for a period of 2.5 years. To study the dose response relationship between fish oil intake and atherosclerosis, four diets were formulated with fish oil levels being 0, 1, 10 and 20 energy%. A fifth and sixth group were fed an alpha-linolenic acid-(C18:3, n-3) and linoleic acid-(C18:2, n-6) rich diet, respectively. Every 6 weeks, blood samples were taken for determination of clinical chemical parameters, triacylglycerol and total cholesterol levels. Feeding 10 and 20 energy% fish oil containing diets, resulted in an increase of liver enzymes (AST, ALT and ALP). Histological evaluation of the liver also revealed adverse effects of fish oil containing diets. Triacylglycerol blood levels were similar in all groups, and remained constant throughout the study. Total cholesterol levels in blood was significantly lower in the animals fed a linoleic acid-rich diet, as compared with the other five groups. An n-3 long-chain PUFA concentration dependent increase in aorta plaque surface area was observed in the fish oil groups. A significant positive relationship was found between the group mean score for severity of liver pathology and the aorta plaque surface area. These results indicate that the long-chain n-3 polyunsaturated fatty acids in fish oil may be hepatotoxic to the herbivorous rabbit, which may interfere with the outcome of atherosclerosis studies. This finding necessitates the exclusion of liver pathology in experimental studies on atherosclerosis in animal models.

Objectives: To assess the blood concentration of catechins following green or black tea ingestion and the effect of addition of milk to black tea., Design: Twelve volunteers received a single dose of green tea, black tea and black tea with milk in a randomized cross-over design with one-week intervals. Blood samples were drawn before and up to eight hours after tea consumption., Setting: The study was performed at the Unilever Research Vlaardingen in The Netherlands., Subjects: Twelve healthy adult volunteers (7 females, 5 males) participated in the study. They were recruited among employees of Unilever Research Vlaardingen., Interventions: Green tea, black tea and black tea with semi-skimmed milk (3 g tea solids each)., Results: Consumption of green tea (0.9 g total catechins) or black tea (0.3 g total catechins) resulted in a rapid increase of catechin levels in blood with an average maximum change from baseline (CVM) of 0.46 micromol/l (13%) after ingestion of green tea and 0.10 micromol/l (13%) in case of black tea. These maximum changes were reached after (mean (s.e.m.)) t=2.3 h (0.2) and t=2.2 h (0.2) for green and black tea respectively. Blood levels rapidly declined with an elimination rate (mean (CVM)) of t1/2=4.8 h (5%) for green tea and t1/2=6.9 h (8%) for black tea. Addition of milk to black tea (100 ml in 600 ml) did not significantly affect the blood catechin levels (areas under the curves (mean (CVM) of 0.53 h. micromol/l (11%) vs 0.60 h. micromol/l (9%) for black tea and black tea with milk respectively., Conclusion: Catechins from green tea and black tea are rapidly absorbed and milk does not impair the bioavailability of tea catechins.

Objective: To assess the effect of supplementation with an antioxidant fortified margarine on the body's antioxidant status and on parameters of oxidative damage to lipids., Design: Single blind, placebo controlled trial, two treatment groups balanced for sex, age and Quetelet Index., Setting: Unilever Research Laboratorium, The Netherlands., Subjects: Thirty-one healthy adult volunteers accomplished the study. Volunteers were recruited among inhabitants of the surrounding area of the research laboratory., Interventions: Volunteers consumed during the four weeks either 15 g/d of an antioxidant fortified margarine (providing 121 mg vitamin C, 31 mg vitamin E, 2.7 mg alpha-carotene and 5.3 mg beta-carotene) or an ordinary margarine. Fasting blood samples were taken before and at the end of the study., Results: Consumption of the antioxidant fortified margarine significantly increased the levels of the supplied antioxidants in plasma and LDL as compared to the changes found after consumption of the control margarine, with the largest increases found in LDL levels of alpha-carotene (15.5-fold increase, 95% CI: 8.4-27.8-fold) and beta-carotene (4.3-fold increase, 95% CI: 2.2-7.9-fold). This increased antioxidant status in the antioxidant fortified margarine group resulted in a significantly increased total antioxidant activity of LDL and resistance of LDL to oxidation (lag time and rate of oxidation) as compared to baseline but not in comparison to the changes found in the control group., Conclusion: Consumption of moderate doses of vitamin E, vitamin C, alpha-carotene and beta-carotene, supplied in a full-fat margarine and consumed as part of a normal diet, effectively increases the blood levels of these antioxidants.

The objective of this study was to investigate the behavioral response to the long term realistic consumption of reduced fat products. During six months, a control group of 103 subjects had free access to about 45 commercially available full-fat products, and a reduced-fat group of 117 subjects had access to the reduced fat equivalents. These experimental products covered about 37% of total energy intake in the control group and 30% of energy intake in the reduced fat group. Other non-experimental food products were bought in regular shops. The results showed that, compared to a baseline measurement before the start of the study, energy intake increased from 10.4 MJ/day to 11.2 MJ/d in the control group, whereas it remained constant at 10.2 MJ/d in the reduced fat group. Fat intake in the control group increased from 99 g/d (35.6en%) to 123g/d (40.6en%), whereas fat intake in the reduced fat group decreased from 95 g/d (34.en%) to 90 g/d (32.7en%). The energy and fat intake from experimental products was lower in the reduced fat group (3.1 MJ/d, 37 g fat/d) than in the control group (4.2 MJ/d, 71 g fat/d). There was some compensatory response in the consumption of experimental products: the ingested amount of experimental products was about 10% higher in the reduced fat group (447 g/d) than in the control group (399 g/d)[t = 2.6; p < 0.01]. There was no compensatory response in the consumption of non-experimental products. Both the control and reduced fat group consumed about 7.1 MJ/d and 53 g fat/d from non-experimental products. It is concluded that long term consumption of reduced fat products leads to a lower energy and fat intake, compared to the consumption of full-fat products.

The hypothesis that tea or dietary lipid-soluble antioxidants reduce atherogenesis by lowering the oxidizability of low-density lipoprotein (LDL) was investigated. Five groups of 20 female New Zealand white rabbits were fed a restricted amount of a high-fat (30 en%) semipurified diet supplemented with cholesterol (0.15%, w/w) for 21 weeks. The vitamin E content of the control diet was 40 mg/kg diet. The animals received either green tea or black tea in their drinking water or vitamin E (200 mg/kg diet) or beta-carotene (20 mg/kg). The serum cholesterol concentrations (in the order of 18-23 mmol/l) were not significantly different between the groups. Vitamin E was substantially increased as compared to controls in vitamin E supplemented animals (3-fold within 8 weeks in plasma and LDL; P < 0.01) and weakly (1.2-fold) by green and black tea (P < 0.05). Green tea consumption tended to reduce aortic lesion formation by 31% (24 +/- 3.2% versus 35 +/- 5.7% for control animals P = 0.11), while black tea, vitamin E and beta-carotene had no effect. This was in contrast to the resistance of isolated LDL to oxidation induced at high copper concentration. Green and black tea induced a 13% and 15% (P < 0.05) prolongation of the lag phase, respectively, with a correspondingly lower oxidation rate, while vitamin E increased the lag phase by 63% (P < 0.01) with a concomitant diminution of the oxidation rate and beta-carotene had no effect. Regression analysis showed that there was no relationship between the extent of atherosclerosis and LDL oxidizability or plasma malondialdehyde as marker of in vivo lipid peroxidation. The results of the present study raise the question whether LDL oxidizability (at least when tested at high induction rate ex vivo) is a primary causal mechanism in atherosclerosis in the cholesterol-fed rabbit. The suitability of the cholesterol-fed rabbit with extreme hypercholesterolaemia as a model to study antiatherosclerotic properties of dietary antioxidants, such as the tested polyphenols, is discussed.

The effect of replacement of fat by nonabsorbable fat on energy intake and on feelings of hunger and satiety was assessed, in normal-weight dietary-restrained (n = 11), dietary-unrestrained (n = 13) and in postobese dietary-restrained women (n = 12), using 2 experimental designs. First, during breakfast and lunch on 2 sequential weekdays, 23 g of dietary fat was replaced by 23 g of a nonabsorbable fat. Second, dietary fat was replaced by a nonabsorbable fat in snacks consumed ad lib during a different week. Fat replacement in meals or in snacks did not result in changes in hunger and satiety ratings throughout the day. Replacement in meals yielded an energy intake reduction of 0.5 MJ/day (not significant) in dietary-unrestrained and in postobese dietary-restrained subjects; this reduction included 44% energy intake compensation. In normal-weight dietary-restrained subjects, energy intake reduction of 0.7 (p < 0.05) MJ/day was observed; this reduction included 22% energy intake compensation. Moreover, fat replacement in meals showed a shift in macronutrient composition from 35-40% energy from fat to 31-32% energy from fat. Replacement in snacks yielded an energy intake reduction of 0.4-0.5 MJ/day (not significant) in normal-weight dietary-restrained subjects and a reduction of 0.6-0.7 (p < 0.05) MJ/day in dietary-unrestrained and in postobese dietary-restrained subjects. In this situation, energy intake from snacks consisted of 48-78% energy from reduced-fat reduced-energy snacks, which implied a replacement of 10-15 g fat by 10-15 g SPE (sucrose polyester) and a shift in macronutrient composition from 35-40 percentage energy from fat to 33-36 percentage energy from fat. These results suggest short-term beneficial effects of fat replacement on energy and fat intake.

Diet-induced thermogenesis was measured during and after a full-fat lunch, an identical but reduced-fat, reduced-energy lunch, and an iso-energetic reduced-fat lunch in 32 normal-weight men and women, age 35-55. Hunger and satiety were scored during and after the lunches, and their relationship to diet-induced thermogenesis was assessed. Diet-induced thermogenesis was relatively higher after the reduced-fat, reduced-energy lunch compared to the full-fat lunch (6.7% vs. 5.2%; p < 0.05). The respiratory quotients were significantly lower after the full-fat lunch than after the 2 reduced-fat lunches (p < 0.05). After the iso-energetic reduced-fat lunch, hunger scores were significantly reduced and satiety scores significantly increased (p < 0.05) until 1800 h. compared to the other 2 lunches. Satiety scores were positively related to the magnitude of diet-induced thermogenesis expressed as an absolute increase in metabolic rate during and after the meal. We conclude that hunger and satiety scores, substrate utilization, and diet-induced thermogenesis showed clear and different short-term responses to diets that differed with respect to the percentage energy from fat and/or the energy content of the meal.

Vitamin E is the major lipid-soluble antioxidant in human subjects and is crucial in protecting polyunsaturated fatty acids (PUFA) against lipid peroxidation. Dietary PUFA have been suggested to inhibit the absorption of vitamin E. The present study in young male rats was designed to investigate the effect of increasing concentrations of dietary linoleic acid on the faecal excretion of vitamin E. The rats were fed on semi-synthetic diets containing two concentrations of fat (59 g/kg diet, 15 energy % (en%) or 131 g/kg, 30 en%) for 3 weeks. Triacylglycerol rich in linoleic acid was added at the expense of triacylglycerol rich in saturated fatty acids to obtain dietary concentrations of 13, 39 or 66 g linoleic acid/kg diet for the high-fat diet (131 g fat/kg) and 12, 24 or 36 g linoleic acid/kg diet for the reduced-fat diet (59 g fat/kg). The results from the present study demonstrate that the faecal excretion of vitamin E was significantly lower in rats fed on diets with high levels of linoleic acid compared with rats fed on lower levels of linoleic acid irrespective of the dietary fat content. The concentration of vitamin E in liver and plasma was significantly lower in animals fed on the highest concentration of linoleic acid compared with those fed on the lowest level. Results from the present study also demonstrate that at the same concentration of linoleic acid, the faecal excretion of vitamin E in rats fed on reduced-fat diets was significantly lower than in rats fed on high-fat diets. Our findings indicate that the apparent absorption of vitamin E is not inhibited by dietary PUFA. Results from the present study also demonstrate that a reduction of dietary fat content from 30 en% to 15 en% does not lower the apparent absorption of vitamin E.

The growing public concern with the adverse effects on health of a high fat intake has led to a proliferation on the market of reduced fat products. However, no consensus exists on the effectivity of reduced fat products to decrease energy intake. The studies that have investigated this topic have included small numbers of subjects, studied under laboratory conditions and over a relatively short period of time. Therefore, we have executed a long-term study in which volunteers had free access to both reduced fat, commercially available products in the laboratory as well as to products obtained from regular shops. We here report the feasibility of such a type of study and the effects of consumption of reduced fat products on blood levels of cholesterol, haemostasis variables, antioxidants and parameters of the immune system. The study was a multicentre parallel comparison trial of six months (so-called MSFAT-study). 241 volunteers received either reduced fat products or full-fat products and the products were clearly labelled as such. Two months before the start of the study, a 1 month adaptation period was executed to optimize the experimental procedures. Food intake was recorded before the start of the adaptation period and 2-4 weeks, 3 months and 6 months after the start of the study. Blood samples were taken before, after 2, 4 and 6 months of the study. In addition, a selection of the reduced fat and full-fat products was sensorically evaluated three times during the study by a subgroup of the volunteers. 220 volunteers completed the study. The reduced fat group consumed on average 46% less fat from the so-called MSFAT-products obtained from the shop at the laboratory than the control group and consumption of these MSFAT-products did not decrease in either of the groups during the time course of the study. The palatability of the reduced fat and full-fat products was similar and as expected, the perceived fattiness of the full-fat products was higher than that of the reduced fat products. No effects were found on blood levels of cholesterol, haemostasis variables, parameters of antioxidant status and immune system characteristics. In conclusion, the experimental manipulation of the fat content of the diet that was achieved and that remained stable throughout the 6 months of the study indicates that this type of set-up is feasible to assess the effects of long-term nutritional intervention in large groups of volunteers under semi-controlled conditions. The regular use of reduced fat products did not positively but also not adversely affect blood cholesterol levels, antioxidant status, haemostasis factors and the body's immune system.

It has been suggested that energy expenditure is higher in subjects consuming reduced-fat, high-carbohydrate diets than in subjects consuming full-fat, low-carbohydrate diets. In a 6-month randomized, controlled trial, seventeen women and twenty men (age 20-35 years; BMI 22-28 kg/m2) had free access either to a range of about forty-five reduced-fat products or the full-fat equivalents. At the end of the 6 months, energy intake, sleeping metabolic rate (SMR), average daily metabolic rate (ADMR), and physical activity (AO) were measured. The intervention resulted in a mean difference of the change of the fat content of the diet of 6% of energy (P < 0.01) between the two groups. SMR. ADMR and AO were virtually the same in both groups. The results suggest that the change in fat content of the diet has no effect on physical activity and energy expenditure. However, subjects with a higher activity level consumed more carbohydrate (ADMR/SMR: r = 0.49, P < 0.01: AO: r = 0.57, P < 0.001).

Objective: Assessment of body composition in relation to the habitual diet and after a six month dietary intervention., Design: After a baseline measurement subjects were randomly assigned to either a group consuming reduced-fat products or a group consuming full-fat products for six months., Subjects: 108 women and 109 men, equally distributed over the age range 19-35 with BMI between 21 and 28, and the age range 36-55 with BMI between 24 and 30., Measurements: Food intake was measured by three day dietary record, body composition by deuterium dilution., Results: At baseline, explained variance of %body fat on age and fat-carbohydrate ratio in the diet together were 17% (P < 0.0001) and 36% (P < 0.0001) for women and men, respectively, and on diet alone 7-8% (P < 0.01) independent of gender. The diet intervention caused on average a change in fat intake and body fat mass in subjects of the reduced-fat group of -5 +/- 29 g/d (P < 0.05) and -0.1 +/- 2.1 kg (ns), respectively, and of +23 +/- 31 g/d (P < 0.0001) and +0.5 +/- 2.3 kg (P < 0.05) in subjects of the full-fat group. The change in the fat content of the diet was positively related to a change in energy intake (fat-carbohydrate ratio: R2 = 0.15, P < 0.0001; g fat: R2 = 0.70, P < 0.0001), the latter explaining 5% of the variation in the change in body fat mass (P < 0.001). Subjects changing the fat content of the diet showed a consequent change in body fat mass only when energy intake changed as well., Conclusion: The fat content of the diet has an effect on body fat as a function of the effect of dietary fat on energy intake.

A study was performed to evaluate long-term (6-month) effects of consumption of full-fat products or reduced-fat products on energy and substrate metabolism. Subjects (age, 19 to 35 years; body mass index [BMI], 21 to 28 kg. m-2) were studied during a 36-hour stay in a respiration chamber, before (16 men) and in the third month (16 men) and sixth month (19 men and 17 women) of the study. The diet intervention caused, on average, a change in fat intake of (mean +/- SE) +23 +/- 31 g/d (P < .001) in the full-fat group and of -5 +/- 29 g/d (P .05) in the reduced-fat group. Twenty-four-hour energy expenditure (EE), sleeping metabolic rate (SMR), diet-induced thermogenesis (DIT), and EE for physical activity (ACT) were not different between the groups. Fat oxidation was significantly (P < .05) increased in the full-fat group and was not different from fat intake. During the 6 months of the study, body mass and fat mass were significantly increased in subjects of the full-fat group, whereas there were no changes in body mass or body composition in subjects of the reduced-fat group. It is concluded that in the long run, avoidance of a diet with full-fat products will promote body weight and fast stability.

In previous experiments using the fat substitute sucrose polyester (SPE, or olestra), no compensatory response was observed on day 2 after experimental manipulations, which reduced the percentage of energy from fat to approximately equal to 30% from 40% on day 1. In the present study a more severe manipulation was made; the amount of energy from fat was reduced from 32% to 20% to determine whether such a reduction would provoke any physiologic or behavioral response. Subjects came to the unit for two, 2-d test sessions. Intake on day 1 was fixed: subjects were given meals containing either control fat (11319 kJ, 32% of energy as fat) or SPE (9561 kJ, 20% of energy as fat). On day 2, intake was ad libitum. On day 1 subjects rated themselves as more hungry while consuming the fat-substituted meals than when consuming the control meals and they disclosed greater hunger in the end-of-day questionnaires. The effect of the manipulation was carried over into day 2. By the end of day 2, subjects had compensated for 74% of the energy (fat) deficit caused by the previous day's manipulation. These results differ from those obtained when fat was reduced from 40% to 30% of energy; this more severe reduction reveals that a reduction in fat of this size can lead to a biobehavioral response. Together, these data suggest that people could change their diet to meet dietary guidelines; however, if a more severe reduction is attempted, adherence may be made more difficult by the strength of the compensatory response.

A substantial number of people have difficulties in controlling their body weight and energy/fat intake. Fat substitutes may be helpful in solving these problems. We here report the first study on the longer-term effects of the nonabsorbable fat sucrose polyester (SPE) on energy intake in normal-weight subjects. We studied the longer-term (12 days) effects of the consumption of warm meals with normal dietary fat (5.0 MJ, 1,195 kcal) or meals in which 52 g of fat were replaced by the fat replacer SPE (3.1 MJ, 740 kcal) on spontaneous food intake (measured by dietary records), body weight, and gastrointestinal complaints in healthy volunteers in two studies. In the first study the 48 subjects were unaware of the treatment, whereas in the second study the 47 subjects were informed of what they received. In both studies men and women consumed less energy per day during the SPE (11.2 MJ) compared with the fat treatment (12.7 MJ) (P values < 0.0001) for the whole 12-day period. This was accompanied by equivalent changes in body weight. The percentage of energy from fat decreased from 43% during the fat treatment to 32% during the SPE treatment. During the SPE treatment, more gastrointestinal complaints and a higher frequency of defecation were reported. Information about the treatment did not affect. the outcomes. It is concluded that the use of a fat replacer such as SPE helps in reducing fat and energy intake in normal-weight people.

Objective: Dietary fat intake is higher than recommended in most western countries and is associated with the prevalence of cardiovascular diseases, obesity and cancer. The growing public concern about the adverse effects of a high fat intake has led to an increased availability of ¿reduced-fat' products. Consumption of reduced-fat products might be a convenient way to reduce the energy intake. Besides the potential of reduced-fat products to reduce the energy intake, it might change dietary fat intake, both qualitatively and quantitatively, which in turn might also affect oxidative stress, i.e. the anti-oxidant/pro-oxidant ratio. In this paper we present the effects of 6-month consumption of reduced-fat products on body weight, energy, macronutrient and vitamin E intake, concentration of the plasma lipid peroxidation product malondialdehyde (MDA), erythrocyte free radical scavenging enzymes activities (glutathione peroxidase activity (GSH-Px); superoxide dismutase (SOD) and catalase) as well as plasma fat-soluble anti-oxidative vitamin concentrations (beta-carotene, lycopene and alpha-tocopherol)., Design: A randomized semi-controlled parallel comparison trial of six months, preceded by a one-month adaptation period., Setting: The reduced-fat and full fat products were provided through a realistic shop in order to mimic a ¿free-living' situation., Subjects: Subjects were recruited from respondents on advertisements. Eighty healthy, normal weight (BMI: range 20-30 kg/m2) subjects, aged between 20 and 55y, were selected to participate in this study; 76 subjects completed the study., Interventions: 6 months consumption of either reduced-fat or full-fat products., Results: During the intervention period, consumption of reduced fat products resulted in significantly lower energy intake, in a lower percentage of energy derived from saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids as well as in lower vitamin E intake, when compared to the control group. Body weight, the ratio polyunsaturated fatty acids/saturated fatty acids, plasma MDA, vitamin concentrations (beta-carotene, lycopene and alpha-tocopherol), and erythrocyte free radical scavenging enzyme activities (SOD, GSH-Px and catalase) were not affected by the intervention., Conclusion: Neither the difference in energy intake, nor the change in dietary fat composition seems to affect the integrity of the antioxidant scavenging capacity, assessed by measuring plasma MDA and antioxidative vitamins (lycopene, beta-carotene and alpha-tocopherol) and erythrocyte free radical scavenging enzymes (SOD, GSH-Px and catalase).