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Low Glycemic Food-Based Approaches to Manage Postprandial Hyperglycemia-Mediated Impairments in Vascular Endothelial Function In Adults With Prediabetes
McDonald, Joshua David

2018, Doctor of Philosophy, Ohio State University, Human Ecology: Human Nutrition.
Cardiovascular disease (CVD) is the leading cause of mortality in the US, afflicting over 800,000 adults per year. Postprandial hyperglycemia (PPH) increases CVD risk by transiently impairing vascular endothelial function (VEF) in an oxidative stress-dependent manner by reducing nitric oxide (NO•) bioavailability. Eggs and dairy milk are low-glycemic foods that attenuate PPH, suggesting these foods may attenuate oxidative stress-mediated impairments in VEF. Thus, the central hypothesis of this dissertation was that co-ingestion of egg- and dairy milk-based meals would attenuate glucose-induced oxidative stress that decreases NO• biosynthesis and bioavailability to impair VEF. To test this hypothesis, 3 separate randomized, controlled, cross-over trials were conducted in adults with prediabetes. In all studies, prior to and at 30-min intervals for 180-min postprandially, we assessed brachial artery flow-mediated dilation (FMD) and measured circulating biomarkers of glycemic control, oxidative stress, and NO• homeostasis. In the first study, subjects (n = 20) ingested isocaloric meals (400 kcal) containing 100 g glucose (GLU) or 75 g glucose with 1.5 whole eggs (EGG), 7 egg whites (WHITE), or two egg yolks (YOLK). Compared with GLU, EGG and WHITE attenuated PPH and oxidative stress responses. This was accompanied by improvements in arginine (ARG) metabolism, NO• metabolites, and FMD responses. While YOLK improved ARG metabolism, it failed to attenuate GLU-mediated PPH, oxidative stress, and declines in NO• metabolites and FMD. In the second study, subjects (n = 23) ingested glucose dissolved in 473 mL of water (75 g, GLU) or non-fat dairy milk (MILK) or an isonitrogenous (16.5 g) amount of whey (WHEY) or casein (CASEIN) dissolved in 473 mL of water. Compared with GLU, all dairy-based treatments similarly attenuated PPH, oxidative stress, and impairments in FMD; dairy-mediated protection was accompanied by improvements in ARG metabolism and NO• metabolites. In the third study, subjects (n = 22) ingested glucose (75 g) dissolved in 473 mL of water (GLU), non-fat dairy milk (NFM), or full-fat dairy milk (FFM). Compared with GLU, NFM and FFM similarly protected against PPH, oxidative stress and declines in FMD. This was accompanied by improvements in ARG metabolism and greater levels of NO• metabolites. In conclusion, this dissertation demonstrates that co-ingestion of eggs, as whole eggs or egg whites and dairy milk, regardless of fat content, with a glucose challenge protects against PPH-mediated impairments in VEF by improving NO• biosynthesis and bioavailability. Thus, dietary modification of carbohydrate-based meals with eggs and dairy milk are likely effective food-based approaches to mitigate PPH-mediated CVD risk. This is of public health importance as CVD remains the leading cause of the death in the US and is expected to afflict ~50% of the population by 2035.
Richard Bruno (Advisor)
Carolyn Gunther (Committee Member)
Frederick Villamena (Committee Member)
Jeff Volek (Committee Member)
320 p.

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McDonald, J. (2018). Low Glycemic Food-Based Approaches to Manage Postprandial Hyperglycemia-Mediated Impairments in Vascular Endothelial Function In Adults With Prediabetes. (Electronic Thesis or Dissertation). Retrieved from https://etd.ohiolink.edu/

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McDonald, Joshua. "Low Glycemic Food-Based Approaches to Manage Postprandial Hyperglycemia-Mediated Impairments in Vascular Endothelial Function In Adults With Prediabetes." Electronic Thesis or Dissertation. Ohio State University, 2018. OhioLINK Electronic Theses and Dissertations Center. 19 Oct 2018.

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McDonald, Joshua "Low Glycemic Food-Based Approaches to Manage Postprandial Hyperglycemia-Mediated Impairments in Vascular Endothelial Function In Adults With Prediabetes." Electronic Thesis or Dissertation. Ohio State University, 2018. https://etd.ohiolink.edu/

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