Abstract P2075: Impact of a Minimally Processed Provegetarian Diet on LDL-cholesterol and Cardiovascular Risk Factors in Adults with Heterozygous Familial Hypercholesterolemia: a Randomized Controlled Feeding Trial
Bibliographic record
Abstract
Introduction: Heterozygous familial hypercholesterolemia (HeFH) is a severe genetic disorder that accelerates atherosclerosis and leads to premature cardiovascular diseases (CVDs). Minimally processed provegetarian diets are recommended in dietary and clinical guidelines worldwide for their cardioprotective properties. However, the impact of such diet on LDL-cholesterol (LDL-C) and other CVD risk factors has not yet been assessed in fully controlled feeding settings among adults with HeFH. Hypothesis: We tested the hypothesis that a minimally processed provegetarian diet (MPVD) induces clinically significant improvements in plasma LDL-C levels (primary outcome) and other CVD risk factors compared to a standard American diet (SAD) among adults with HeFH. Methods: In this randomized, crossover, controlled feeding trial, 50 adults with genetically confirmed HeFH, free of cholesterol-lowering medication, consumed a MPVD and a SAD for 4 weeks each in a random order under fully controlled feeding conditions. Fasting plasma atherogenic lipid levels and other CVD risk factors were measured at the end of each diet. Results: Relative to the SAD, the MPVD induced a clinically significant reduction in LDL-C (−18.6%, 95% confidence interval (CI) −22.1%, −15.2%; P <0.0001). Stratified analyses revealed no evidence of effect modification due to sex, LDL-receptor genotype, and BMI. However, a greater reduction of LDL-C was observed in older participants ( P diet*age =0.02) and in those with lower lipoprotein(a) levels ( P diet*Lp(a) =0.02). The MPVD also reduced apolipoprotein B (−15.2%, 95%CI −18.3%, −12.0%), non-HDL-C (−18.0%, 95%CI −21.0%, −14.8%), triglycerides (−8.6%, 95%CI −14.4%, −2.2%), and systolic (−2 mm Hg, 95%CI −3.3 mm Hg, 0.0 mm Hg) and diastolic (−2 mm Hg, 95%CI −3.4 mm Hg, −0.5 mm Hg) blood pressure. Overall, the MPVD reduced the 10-year risk of CVD by 1.55% ( P =0.03). Moreover, while the two diets were isocaloric and had the same macronutrient composition, the MPVD improved satiety compared to the SAD, with the effect being more important among men ( P diet*gender =0.03). Conclusion: This study demonstrates that, compared to a standard American diet, a minimally processed provegetarian diet induces clinically significant reductions in LDL-C and other CVD risk factors in adults with HeFH. It paves the way for developing precision nutrition strategies that incorporate gender-specific counseling and underscores the critical role of diet modification in HeFH management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".