Lanigan, JA; (2013) Diet and endothelial function in healthy young people. Doctoral thesis , UCL (University College London).

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Abstract

Cardiovascular disease (CVD) is the most common cause of death globally; yet, its pathogenesis and early development are poorly understood. Atherosclerosis begins early in life and is associated with CVD risk factors including diet. This thesis investigated associations between diet and atherosclerosis development. Participants in an RCT investigating effects of supplementation with DHA – an n- 3 fatty acid – provided a convenience sample for this epidemiological dietary study. The primary RCT outcome was brachial artery endothelial function measured using vascular ultrasound (FMD). Secondary outcomes were conventional CVD risk factors. A food frequency questionnaire (FFQ) was used to derive dietary patterns and relationships between dietary patterns and outcomes were investigated. A FFQ for assessment of n-3 LC PUFA was designed. Red cell fatty acids were used to validate the FFQ and investigate relationships of n-3 fatty acids with atherosclerosis development. A healthy dietary pattern was associated with lower carotid artery intima media thickness in women in the highest compared with the lowest quintile for this dietary pattern score (mean difference: -0.07mm, 95% CI: 07 -0.1, -0.03, P = 0.002). This pattern was also associated with lower CVD risk. Dietary patterns were not directly related to FMD. Higher DHA status was associated with lower FMD in women (mean difference in absolute amounts: -0.08 mm, 95% CI: -0.1, 0.03; P = 0.001). FMD was lower in DHA supplemented compared to control groups (mean difference in absolute amounts: -0.03 mm; 95% CI: -0.005 to -0.06 mm; P = 0.02). In secondary analysis this effect was confined to men. Triglyceride (mean difference: -28%, 95% CI: -40% to -15%; P<0.0001) and VLDL concentration were significantly lower in DHA supplemented individuals compared to controls. Findings suggest that diet protects against atherosclerosis development via reductions in conventional CVD risk factors.

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