A randomised controlled trial of increasing fruit and vegetable intake and how this influences the carotenoid concentration and activities of PON-1 and LCAT in HDL from subjects with type 2 diabetes

BACKGROUND: High density lipoproteins (HDL) have many cardioprotective roles; however, in subjects with type 2 diabetes (T2D) these cardioprotective properties are diminished. Conversely, increased fruit and vegetable (F&V) intake may reduce cardiovascular disease risk, although direct trial evidence of a mechanism by which this occurs in subjects with T2D is lacking. Therefore, the aim of this study was to examine if increased F&V consumption influenced the carotenoid content and enzymes associated with the antioxidant properties of HDL in subjects with T2D. METHODS: Eighty obese subjects with T2D were randomised to a 1- or ≥6-portion/day F&V diet for 8-weeks. Fasting serum was collected pre- and post-intervention. HDL was subfractionated into HDL(2) and HDL(3) by rapid ultracentrifugation. Carotenoids were measured in serum, HDL(2) and HDL(3) by high performance liquid chromatography. The activity of paraoxonase-1 (PON-1) was measured in serum, HDL(2) and HDL(3) by a spectrophotometric assay, while the activity of lecithin cholesterol acyltransferase (LCAT) was measured in serum, HDL(2) and HDL(3) by a fluorometric assay. RESULTS: In the ≥6- vs. 1-portion post-intervention comparisons, carotenoids increased in serum, HDL(2) and particularly HDL(3), (α-carotene, p = 0.008; β-cryptoxanthin, p = 0.042; lutein, p = 0.012; lycopene, p = 0.016), as did the activities of PON-1 and LCAT in HDL(3) (p = 0.006 and 0.044, respectively). CONCLUSION: To our knowledge, this is the first study in subjects with T2D to demonstrate that increased F&V intake augmented the carotenoid content and influenced enzymes associated with the antioxidant properties of HDL. We suggest that these changes would enhance the cardioprotective properties of this lipoprotein. CLINICAL TRIAL REGISTRATION: ISRCTN21676269