Comparison of a Standardized High-Fat Meal versus a High-Fat Meal Scaled to Body Mass for Measuring Postprandial Triglycerides: A Randomized Crossover Study

Post-meal triglycerides are an independent cardiovascular disease (CVD) risk factor, but the ideal high-fat meal formulation has yet to be standardized and is one challenge prohibiting widespread clinical adoption of postprandial triglyceride assessment. Two general approaches often used are giving individuals a high-fat meal scaled to body weight or a standardized high-fat meal containing a set fat bolus. A recent expert panel statement has endorsed the latter, specifying 75 g of fat as an appropriate fat dosage. Despite this recommendation, no study to date has tested whether there is a difference in postprandial triglycerides or if risk classification is affected based on these different approaches. We recruited 16 generally healthy individuals with roughly equal distribution among body mass index (BMI)class (n = 5–6/per BMI category) and sex (n = 2–3 M/F) within each BMI class. Each participant underwent two abbreviated fat tolerance tests separated by ~1 week: one with a scaled to body weight high-fat meal (9 kcal/kg; 70% fat) and a standardized meal containing 75 g of fat (70% fat). Fasting, 4 h, and absolute change in triglycerides across the entire sample and within each BMI category were similar regardless of high-fat meal. Only one participant with obesity had discordant postprandial responses between the fat tolerance tests (i.e., different CVD risk classification). These findings suggest that, within a certain range of fat intake, generally healthy individuals will have a similar postprandial triglyceride response. Considering the greater convenience of utilizing standardized high-fat meals, our data suggest that a standardized high-fat meal may be acceptable for large-scale studies and clinical implementation.

Postprandial Triglycerides, Flow-Mediated Dilation, and the Inflammatory Cytokine Milieu in Metabolically Healthy Obesity: A Cross-Sectional Pilot Study

The cardiovascular disease (CVD) risk of metabolically healthy obesity (MHO) remains controversial. We sought to further characterize the CVD risk profile in MHO by evaluating postprandial triglycerides, vascular function, and systemic inflammatory markers. Control individuals that were normal-weight and metabolically healthy (Con), MHO, and metabolic syndrome (MetS) were recruited (n = 10–11/group). Each participant underwent an abbreviated fat tolerance test, fasting and postprandial flow-mediated dilation (FMD), and had a panel of inflammatory cytokines measured. MHO displayed postprandial triglycerides similar to those in Con and both MHO and Con had lower values than those for MetS (p < 0.01). Fasting FMD was lower in MHO and MetS compared to that of Con (p < 0.01), but during the postprandial period the vasodilatory response of MHO was similar to that while fasting (p = 0.39), while FMD in Con and MetS decreased after the high-fat meal (p values < 0.01). MHO displayed a number of inflammatory cytokines greater than those of Con and MetS (all p values < 0.05), while MetS and MHO had higher TNF-α than did Con (p < 0.05). In conclusion, MHO was associated with lower fasting FMD and a greater inflammatory burden but did not suffer the same negative postprandial effects as did MetS.

Determinants of Postprandial Triglycerides Across the Spectrum of Aging

Objectives Elevated postprandial triglycerides (TG) are a risk factor for cardiovascular disease, and older adults exhibit greater postprandial lipemia (PPL) compared to younger adults. However, determinants of PPL, especially in older populations, remain poorly defined. This cross-sectional study examined the influence of body composition, lifestyle behaviors, and metabolic risk factors for PPL across the aging spectrum. Methods We recruited individuals evenly distributed between the ages of 50–89 years (50% male; 50% female). Participants completed diet and physical activity questionnaires and wore an accelerometer for 5 days. Body composition was measured via bioelectrical impedance. Following an overnight fast, participants also completed an abbreviated fat tolerance test: a blood draw was performed before and 4 hours after consumption of a high-fat meal (9 kcal/kg; 73% fat) to determine fasting and peak postprandial metabolic responses. Results 56 participants (age groups: 50s, n = 15; 60s, n = 15; 70s, n = 15; 80s, n = 11) completed the study. Fasting TG did not differ across age groups (50s: 99.7 ± 50.1 mg/dL; 60s: 114.3 ± 71.1 mg/dL; 70s: 102.9 ± 45.0 mg/dL; 80s: 86.9 ± 39.5 mg/dL; P = 0.63). There was also no difference in 4-hour TG across age groups (50s: 162.9 ± 76.9 mg/dL; 60s: 181.9 ± 99.9 mg/dL; 70s: 130.8 ± 82.0 mg/dL; 80s: 130.8 ± 60.6 mg/dL; P = 0.40). Across age groups, variables significantly correlated (p's &lt; 0.05) with 4-hour TG included BMI (r = 0.29), visceral adiposity (r = 0.31), ALT (r = 0.37), fasting glucose (r = 0.27), 4-hour glucose (r = 0.34) and alcohol intake (r = 0.33). In a backward elimination regression (R2 = 0.31), the most predictive variables of 4-hour TG were 4-hour glucose (β = 0.31; P = 0.01), ALT (β = 0.33; P = 0.007), and alcohol intake (β = 0.25; P = 0.04). Conclusions In older adults aged 50–89, we identified ALT, postprandial glucose, and alcohol intake as key determinants of postprandial TG. Future studies should aim to explore the relationship between liver health, insulin resistance, alcohol intake, and PPL across the aging spectrum. Funding Sources Donna Cadwalader Research and Development Grant, College of Education and Human Sciences and Oklahoma State University Foundation.

Fasting, non-fasting and postprandial triglycerides for screening cardiometabolic risk

Fasting triacylglycerols have long been associated with cardiovascular disease (CVD) and other cardiometabolic conditions. Evidence suggests that non-fasting triglycerides (i.e. measured within 8 h of eating) better predict CVD than fasting triglycerides, which has led several organisations to recommend non-fasting lipid panels as the new clinical standard. However, unstandardised assessment protocols associated with non-fasting triglyceride measurement may lead to misclassification, with at-risk individuals being overlooked. A third type of triglyceride assessment, postprandial testing, is more controlled, yet historically has been difficult to implement due to the time and effort required to execute it. Here, we review differences in assessment, the underlying physiology and the pathophysiological relevance of elevated fasting, non-fasting and postprandial triglycerides. We also present data suggesting that there may be a distinct advantage of postprandial triglycerides, even over non-fasting triglycerides, for early detection of CVD risk and offer suggestions to make postprandial protocols more clinically feasible.

Acute Epigallocatechin-3-Gallate Supplementation Alters Postprandial Lipids after a Fast-Food Meal in Healthy Young Women: A Randomized, Double-Blind, Placebo-Controlled Crossover Study

A high-fat fast-food meal negatively impacts postprandial metabolism even in healthy young people. In experimental studies, epigallocatechin-3-gallate (EGCG), a bioactive compound present in green tea, has been described as a potent natural inhibitor of fatty acid synthase. Thus, we sought to evaluate the effects of acute EGCG supplementation on postprandial lipid profile, glucose, and insulin levels following a high-fat fast-food meal. Fourteen healthy young women 21 ± 1 years and body mass index 21.4 ± 0.41 kg/m2 were enrolled in a randomized, double-blind, placebo-controlled crossover study. Participants ingested capsules containing 800 mg EGCG or placebo immediately before a typical fast-food meal rich in saturated fatty acids. Blood samples were collected at baseline and then at 90 and 120 min after the meal. The EGCG treatment attenuated postprandial triglycerides (p = 0.029) and decreased high-density lipoprotein cholesterol (HDL-c) (p = 0.016) at 120 min. No treatment × time interaction was found for total cholesterol, low-density lipoprotein (LDL-c), and glucose or insulin levels. The incremental area under the curve (iAUC) for glucose was decreased by EGCG treatment (p < 0.05). No difference was observed in the iAUC for triglycerides and HDL-c. In healthy young women, acute EGCG supplementation attenuated postprandial triglycerides and glucose but negatively impacted HDL-c following a fast-food meal.