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A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis

BACKGROUND: Endothelial dysfunction is a predictive risk factor for the development of atherosclerosis and is assessed by flow-mediated dilation (FMD). Although it is known that NO-dependent endothelial dysfunction occurs after consuming a high-fat meal, the magnitude of the effect and the factors t...

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Autores principales: Fewkes, Juanita J, Kellow, Nicole J, Cowan, Stephanie F, Williamson, Gary, Dordevic, Aimee L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437993/
https://www.ncbi.nlm.nih.gov/pubmed/35665799
http://dx.doi.org/10.1093/ajcn/nqac153
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author Fewkes, Juanita J
Kellow, Nicole J
Cowan, Stephanie F
Williamson, Gary
Dordevic, Aimee L
author_facet Fewkes, Juanita J
Kellow, Nicole J
Cowan, Stephanie F
Williamson, Gary
Dordevic, Aimee L
author_sort Fewkes, Juanita J
collection PubMed
description BACKGROUND: Endothelial dysfunction is a predictive risk factor for the development of atherosclerosis and is assessed by flow-mediated dilation (FMD). Although it is known that NO-dependent endothelial dysfunction occurs after consuming a high-fat meal, the magnitude of the effect and the factors that affect the response are unquantified. OBJECTIVES: We conducted a systematic review and meta-analysis exploring the quantitative effects of a single high-fat meal on endothelial function and determined the factors that modify the FMD response. METHODS: Six databases were systematically searched for original research published up to January 2022. Eligible studies measured fasting and postprandial FMD following consumption of a high-fat meal. Meta-regression was used to analyze the effect of moderator variables. RESULTS: There were 131 studies included, of which 90 were suitable for quantitative meta-analysis. A high-fat meal challenge transiently caused endothelial dysfunction, decreasing postprandial FMD at 2 hours [−1.02 percentage points (pp); 95% CI: −1.34 to −0.70 pp; P < 0.01; I(2) = 93.3%], 3 hours [−1.04 pp; 95% CI: −1.48 to −0.59 pp; P < 0.001; I(2) = 84.5%], and 4 hours [−1.19 pp; 95% CI: −1.53 to −0.84 pp; P < 0.01; I(2) = 94.6%]. Younger, healthy-weight participants exhibited a greater postprandial reduction in the FMD percentage change than older, heavier, at-risk groups after a high-fat meal ( P < 0.05). The percentage of fat in the meals was inversely associated with the magnitude of postprandial changes in FMD at 3 hours (P < 0.01). CONCLUSIONS: A single, high-fat meal adversely impacts endothelial function, with the magnitude of the impact on postprandial FMD moderated by the fasting FMD, participant age, BMI, and fat content of the meal. Recommendations are made to standardize the design of future postprandial FMD studies and optimize interpretation of results, as high-fat meals are commonly used in clinical studies as a challenge to assess endothelial function and therapeutics. This trial was registered at PROSPERO as CRD42020187244.
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spelling pubmed-94379932022-09-06 A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis Fewkes, Juanita J Kellow, Nicole J Cowan, Stephanie F Williamson, Gary Dordevic, Aimee L Am J Clin Nutr Original Research Communications BACKGROUND: Endothelial dysfunction is a predictive risk factor for the development of atherosclerosis and is assessed by flow-mediated dilation (FMD). Although it is known that NO-dependent endothelial dysfunction occurs after consuming a high-fat meal, the magnitude of the effect and the factors that affect the response are unquantified. OBJECTIVES: We conducted a systematic review and meta-analysis exploring the quantitative effects of a single high-fat meal on endothelial function and determined the factors that modify the FMD response. METHODS: Six databases were systematically searched for original research published up to January 2022. Eligible studies measured fasting and postprandial FMD following consumption of a high-fat meal. Meta-regression was used to analyze the effect of moderator variables. RESULTS: There were 131 studies included, of which 90 were suitable for quantitative meta-analysis. A high-fat meal challenge transiently caused endothelial dysfunction, decreasing postprandial FMD at 2 hours [−1.02 percentage points (pp); 95% CI: −1.34 to −0.70 pp; P < 0.01; I(2) = 93.3%], 3 hours [−1.04 pp; 95% CI: −1.48 to −0.59 pp; P < 0.001; I(2) = 84.5%], and 4 hours [−1.19 pp; 95% CI: −1.53 to −0.84 pp; P < 0.01; I(2) = 94.6%]. Younger, healthy-weight participants exhibited a greater postprandial reduction in the FMD percentage change than older, heavier, at-risk groups after a high-fat meal ( P < 0.05). The percentage of fat in the meals was inversely associated with the magnitude of postprandial changes in FMD at 3 hours (P < 0.01). CONCLUSIONS: A single, high-fat meal adversely impacts endothelial function, with the magnitude of the impact on postprandial FMD moderated by the fasting FMD, participant age, BMI, and fat content of the meal. Recommendations are made to standardize the design of future postprandial FMD studies and optimize interpretation of results, as high-fat meals are commonly used in clinical studies as a challenge to assess endothelial function and therapeutics. This trial was registered at PROSPERO as CRD42020187244. Oxford University Press 2022-06-06 /pmc/articles/PMC9437993/ /pubmed/35665799 http://dx.doi.org/10.1093/ajcn/nqac153 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Research Communications
Fewkes, Juanita J
Kellow, Nicole J
Cowan, Stephanie F
Williamson, Gary
Dordevic, Aimee L
A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis
title A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis
title_full A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis
title_fullStr A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis
title_full_unstemmed A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis
title_short A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis
title_sort single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis
topic Original Research Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437993/
https://www.ncbi.nlm.nih.gov/pubmed/35665799
http://dx.doi.org/10.1093/ajcn/nqac153
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