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American Journal of Clinical Nutrition, Vol. 80, No. 5, 1185-1193, November 2004
© 2004 American Society for Clinical Nutrition

ORIGINAL RESEARCH COMMUNICATION

Diets containing barley significantly reduce lipids in mildly hypercholesterolemic men and women1,2,3

Kay M Behall, Daniel J Scholfield and Judith Hallfrisch

1 From the Diet & Human Performance Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD

2 Supported by intramural agricultural research funds. Barley was provided by the National Barley Foods Council, Spokane, WA.

3 Address reprint requests to K Behall, Building 307B, Room 220, Beltsville Human Nutrition Research Center, Beltsville, MD 20705. E-mail: behall{at}bhnrc.arsusda.gov.


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Background: Barley has high amounts of soluble fiber but is not extensively consumed in the US diet.

Objective: This study investigated whether consumption of barley would reduce cardiovascular disease risk factors comparably with that of other sources of soluble fiber.

Design: Mildly hypercholesterolemic subjects (9 postmenopausal women, 9 premenopausal women, and 7 men) consumed controlled American Heart Association Step 1 diets for 17 wk. After a 2-wk adaptation period, whole-grain foods containing 0, 3, or 6 g ß-glucan/d from barley were included in the Step 1 diet menus. Diets were consumed for 5 wk each and were fed in a Latin-square design. Fasting blood samples were collected twice weekly.

Results: Total cholesterol was significantly lower when the diet contained 3 or 6 g ß-glucan/d from barley than when it contained no ß-glucan; the greatest change occurred in the men and postmenopausal women. HDL and triacylglycerol concentrations did not differ with the 3 amounts of dietary ß-glucan. Large LDL and small VLDL fractions and mean LDL particle size significantly decreased when whole grains were incorporated into the 3 diets. Large LDL and large and intermediate HDL fractions were significantly higher, mean LDL particle size was significantly greater, and intermediate VLDL fractions were significantly lower in the postmenopausal women than in the other 2 groups. A group-by-diet interaction effect was observed on LDL fractions and small LDL particle size.

Conclusion: The addition of barley to a healthy diet may be effective in lowering total and LDL cholesterol in both men and women.

Key Words: Barley • ß-glucans • whole grains • cholesterol • triacylglycerols • lipoprotein fractions


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
SUBJECTS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Cardiovascular disease (CVD) continues to be the number one cause of death in the United States despite numerous efforts to reduce its prevalence. Consumption of diets high in whole grains has been reported to have health benefits, such as a reduced risk of CVD (1, 2). These benefits have been attributed to the effects of the fiber content of whole-grain foods on risk factors, primarily on cholesterol concentration (3, 4). Other, more general, physiologic benefits of the consumption of whole grains include reduced transit time for foods, which may reduce the risk of colon cancer (5, 6), and reduced absorption of nutrients (7, 8), which may reduce glucose and insulin responses and thus the risk of obesity (9).

Epidemiologic studies often combined several fiber food sources (mixed grains and cereals, fruit, and vegetables with or without legumes), which made it difficult to determine the specific beneficial dietary component. Many of the studies in humans added either fiber supplements or fiber-containing foods to self-selected diets. Numerous studies showed that whole grains containing a high amount of soluble fiber, such as oats, are more effective in lowering blood cholesterol than are grains containing predominantly insoluble fibers, such as wheat or rice (10-13). The US Food and Drug Administration (14) allows the health claim statement that, depending on the ß-glucan content, consumption of soluble fiber from oats or psyllium in a diet low in saturated fat and cholesterol may reduce the risk of CVD. Most clinical studies evaluating the effects of soluble fibers have used oats or psyllium even though barley contains at least as much ß-glucan as they do (15). The purpose of this study was to examine the effects on CVD risk factors of the consumption of various amounts of ß-glucan from barley, a grain not frequently consumed by Americans, in a controlled whole-grain diet in mildly hypercholesterolemic men and women. Mildly hypercholesterolemic men alone were evaluated in a previous study (16).


   SUBJECTS AND METHODS
TOP
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
RESULTS
 DISCUSSION
 REFERENCES
 
Subjects
Mildly hypercholesterolemic [total cholesterol: 5.18–6.2 mmol/L (200–240 mg/dL)], normotensive men and women who had been weight stable for 6 mo and who were not taking medication known to affect lipid metabolism or blood pressure were recruited for this study. Men were included in this study to confirm previous results because the diet was modified from the previous study. The study design was approved by the Johns Hopkins School of Public Health Institutional Review Board, and it conformed to US Government regulations governing human research. Written informed consent was obtained from each subject after an oral explanation of the study.

A general clinical screening of fasting blood and urine samples was used to select subjects with mildly elevated cholesterol who had no other medical conditions and who were taking no medications that would affect lipid or glucose metabolism. Heights and weights were measured, and duplicate blood pressure readings were obtained. Subjects completed a health history questionnaire. Before subjects were accepted as participants, physicians from Johns Hopkins University School of Public Health evaluated the health history and clinical screening values for underlying disease before subjects were accepted as participants, and the physicians provided medical supervision throughout the study.

Twenty-seven subjects with mildly elevated plasma cholesterol concentrations were selected for the study. Two subjects withdrew during the study for reasons not related to the study. Prestudy characteristics of the 7 men, 9 premenopausal women, and 9 postmenopausal women who completed the study are listed in Table 1Go.


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  		TABLE 1 Prestudy characteristics of study participants1

 
Diets and Procedures
Subjects initially were placed on an American Heart Association Step 1 diet (17) with a 7-d rotating menu for 2 wk as an adaptation period to the study regimen, dietary changes, and fiber content (Table 2Go). Initial estimates of the subjects' energy needs were made during this period. Energy intakes were adjusted proportionately in 300-kcal increments to maintain initial body weights. Breakfast and dinner were consumed Monday through Friday in the Human Study Facility. Lunch and an evening snack were packaged for off-site consumption. Weekend meals were frozen or packed in ice (or both) for home consumption. All foods were weighed to 0.5 g. Subjects were weighed daily Monday through Friday, and body weights were verified by Human Study Facility personnel. Subjects agreed to consume only the study food given to them and to consume all food items given to them. Water, selected spices, noncaloric beverages, and noncaloric sweeteners were allowed ad libitum, and the subjects recorded the consumption of these items daily. No discretionary salt was allowed.


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  		TABLE 2 Nutrient content of diets1

 
After the 2-wk adaptation period, whole-grain foods containing soluble fiber from barley were included in the Step 1 diet. Diets were fed in a Latin-square design for 5 wk each. The 3 diets (low–, medium–, and high–ß-glucan) were designed to contain approximately the same amount of total dietary fiber but different amounts of ß-glucan (0, 3, and 6 g added ß-glucan/2800 kcal, respectively). In the experimental menus, a test food was substituted into the Step 1 menu at breakfast, lunch, dinner, and evening snack (Table 3Go). Wheat and rice test foods (pancakes, spice cookie bar, no-bake cookies, hot cereal, granola, steamed grain, tabbouleh, and muffins) were made with whole-wheat flour, wheat flakes, and brown rice. The basic diet without the test foods and the diet containing wheat and rice test foods were designed to contain little added soluble fiber. Diets including barley flakes, barley flour, or pearled barley in the test foods (replacing the wheat or rice) contained ≥6 g ß-glucan/2800 kcal as part of the total dietary fiber. Diets including test foods made with half barley and half whole wheat or brown rice contained 3 g ß-glucan/2800 kcal in the total dietary fiber (Table 2Go). The ß-glucan content of the barley used to prepare the experimental foods was determined enzymatically by the National Barley Foods Council (16) and the US Department of Agriculture (Western Region, Albany CA) with the use of American Association of Cereal Chemists method 32-23. Total and soluble fiber content of the diets were determined by using the Association of Official Analytical Chemists method 991.43, which was performed at Covance Laboratories Inc (Madison WI). Whole-wheat flour and brown rice were purchased from a local grocery store. Wheat flakes were purchased in one lot from Barry Farm Enterprises (Wapakoneta, OH). Barley flakes, barley flour, and pearled barley were produced from one lot of barley and donated by the National Barley Foods Council (Spokane, WA).


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  		TABLE 3 Sample menus

 
Statistical analysis
Two blood samples (separated by 1 d) were collected after an overnight fast of ≥12 h before controlled feeding began and weekly during each period. Plasma was separated and stored at –80 °C until all samples were collected. Triacylglycerol and total cholesterol concentrations were measured enzymatically with the use of an automated spectrophotometric system (Baker Instruments Corp, Allentown, PA). HDL-cholesterol concentrations were measured after other fractions were precipitated with the use of dextran sulfate and manganese chloride (18). VLDL and LDL concentrations were calculated (19). Lipid subclass fractions were measured during the last week of each period with the use of nuclear magnetic resonance spectroscopy (LipoScience, Raleigh, NC; 20). Data were statistically analyzed by analysis of variance by using a mixed-model procedure (PC/SAS, version 8.2; SAS Institute, Cary, NC). Subjects acted as their own control subjects. Data were examined for normal distribution. Triacylglycerol concentrations were log transformed for statistical evaluation. Data reported are least-squares means (±SEM). Significance was defined as P < 0.05. When effects were significant, mean comparisons were done with the use of Sidák-adjusted P values so that the experimentwise error was 0.05.


   RESULTS
TOP
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
DISCUSSION
 REFERENCES
 
Some subjects noted some gastrointestinal discomfort during the equilibration period. The major complaints were that there was too much food and that subjects had a very full feeling after eating. Compared with the equilibration period, complaints about bloating and flatulence increased during all experimental diets; the greatest number of complaints occurred during the high–ß-glucan diet.

Average body weights varied by <1 kg from the initial weight (overall average: 85.6 ± 4.5 kg) to the end of the Step 1 equilibration period (85.0 ± 4.5 kg). Subjects' average weight after consuming all 3 whole-grain diets (low–: 84.3 ± 5.1 kg; medium–: 84.2 ± 5.1 kg; high–ß-glucan: 84.2 ± 5.1 kg) was less than initial weights or weights after the Step 1 equilibration diet. The weights of the subjects did not differ significantly during the 3 experimental diets (P = 0.73). Energy intake during the Step 1 diet averaged 2600 kcal/d, and that during the experimental diets averaged 2725 kcal/d; this increase in intake was intended to correct the small weight loss observed during the Step 1 diet and to maintain a constant weight in subjects during the experimental diets.

Total plasma cholesterol concentrations were significantly affected by the diet consumed (P < 0.0001, Table 4Go) and by the length of time (in wk, P < 0.001; Figure 1Go) the diets were consumed. No significant interaction between diet and time was observed (P = 0.92). Cholesterol concentrations on average did not significantly decrease until week 4 of each period. Compared with prestudy concentrations (Table 1Go), overall total cholesterol was 0.5% lower after consumption of the Step 1 diet and 4%, 9%, and 10% lower, respectively, after the low–, medium–, and high–ß-glucan diets. Total cholesterol concentrations after the medium–and high–ß-glucan diets were significantly lower than those after the low–diet. The reductions observed by group (men, premenopausal women, or postmenopausal women) were not significantly different, and no diet-by-group interaction was observed.


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  		TABLE 4 Fasting lipid concentrations determined enzymatically after the equilibration and experimental dietary periods1

 


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  		FIGURE 1. Mean weekly total and LDL cholesterol by diet: low–ß-glucan diet, •; medium–ß-glucan diet, {triangledown}; high–ß-glucan diet, {blacksquare}. Total and LDL cholesterol were significantly different by diet (P < 0.0001) and week within a diet (P < 0.0001), but there was no interaction between diet and week (total cholesterol: P = 0.660; LDL cholesterol: P = 0.402). Mean total and LDL-cholesterol concentrations for weeks 1 and 2 are significantly different from those for weeks 4 and 5, P < 0.05 (Sidák mean separation). Error bars represent SEMs.

 
Calculated LDL-cholesterol concentrations followed the same significant (Table 4Go, diet, P < 0.0001; Figure 1Go, wk, P < 0.001) pattern of reduction as that of total cholesterol. Compared with prestudy concentrations, LDL cholesterol was 3.6% lower after the Step 1 diet and significantly (P < 0.001) lower (8.0%, 13.8%, and 17.4%, respectively) after the low–, medium–, and high–ß-glucan diets. LDL-cholesterol concentrations after the medium–and high–ß-glucan diets were significantly lower than those after the Step 1 or low–ß-glucan diet. No significant difference was observed among men, premenopausal women, or postmenopausal women, and no diet-by-group interaction was observed.

HDL-cholesterol concentrations were significantly affected by the diet consumed (P < 0.001; Table 4Go). Compared with prestudy concentrations, HDL-cholesterol concentrations were significantly lower (P < 0.05) after all 3 test diets but did not differ significantly among the 3 diets. Postmenopausal women had significantly (P < 0.01) higher HDL cholesterol (1.56 ± 0.10) than did men (1.00 ± 0.11) or premenopausal women (1.17 ± 0.10). Total:HDL cholesterol was significantly (P < 0.001) affected by the diet consumed. The ratio was highest after the low–ß-glucan diet. The postmenopausal women had significantly lower total:HDL cholesterol (3.74 ± 0.38) than did the men (5.36 ± 0.43; P < 0.05) or the premenopausal women (4.69 ± 0.38; P < 0.26). No group-by-diet interaction was observed for either the HDL-cholesterol concentrations or total:HDL cholesterol.

Overall triacylglycerol concentrations increased from the prestudy concentrations (Tables 1Go and 4Go), but the differences were not significant. No differences were observed between the experimental diets. No significant difference was observed among men, premenopausal women, or postmenopausal women, and no diet-by-group interaction was observed. Log transformation of the triacylglycerol data did not change the results of the statistical comparisons.

Lipid fraction concentrations by diet are shown in Table 5Go. Concentrations of intermediate and large particle fractions of VLDL cholesterol; small and intermediate fractions of LDL cholesterol; and small, intermediate, and large fractions of HDL cholesterol after the Step 1 diet and the 3 experimental diets did not differ significantly. Large fractions of LDL cholesterol after the low–, medium–, and high–ß-glucan diets were significantly lower than those after the Step 1 diet, and there were no significant differences between the 3 experimental diets.


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  		TABLE 5 Fasting lipid fractions and particle number by diet, determined by nuclear magnetic resonance spectroscopy at the end of each controlled dietary period1

 
Lipid fraction concentrations by group are presented in Table 6Go. The concentration of intermediate VLDL cholesterol fractions and small LDL cholesterol fractions was significantly lower and the concentrations of large LDL cholesterol fractions and large and intermediate HDL cholesterol fractions were significantly higher in the postmenopausal women than in the men or the premenopausal women. The numbers of VLDL, LDL, and HDL particles did not significantly vary with diet, group, or diet-by-group interaction.


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  		TABLE 6 Fasting lipid fractions by group determined by nuclear magnetic resonance spectroscopy1

 
Mean VLDL particle size (Table 7Go) showed a significant diet by group interaction. However, few a priori comparisons were significant, and no consistent pattern was evident by group or diet in the significant pairs. Mean LDL particle size was smaller after all 3 test diets than after the Step 1 diet. Mean LDL particle size was significantly larger in the postmenopausal women than in the other groups. A significant diet-by-group interaction was observed (Table 7Go), which appeared to be driven by the higher values after the Step 1 diet. Concentrations of LDL particle size in the men were lowest on the high–ß-glucan diet; the premenopausal and postmenopausal women had no significant differences between the experimental diets.


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  		TABLE 7 Mean particle size in 7 men and 9 premenopausal and 9 postmenopausal women determined by nuclear magnetic resonance spectroscopy1

 

   DISCUSSION
TOP
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 DISCUSSION
REFERENCES
 
Most research studies using food as the soluble fiber source have fed oats or oat products (1, 7, 11, 12, 21-28). Significantly lower total cholesterol (1, 21-23) and LDL-cholesterol (1, 21-23) concentrations were reported after the consumption of oat bran than after that of wheat bran or rice bran added to the self-selected diets of hypercholesterolemic subjects. Generally, no significant change was reported in triacylglycerol (1, 21, 24) or HDL-cholesterol (1, 22-24) concentrations in these subjects when oatmeal or oat bran was included in the diet. The lipids of normolipemic subjects usually do not decrease with the addition of soluble fiber to their diet (1, 25, 29, 30).

Total and LDL cholesterol were significantly reduced in mildly hypercholesterolemic women after consumption of a modified Step 1 diet containing oats, but not wheat, for 6 wk (31). Mildly hypercholesterolemic men and women consuming a self-selected American Heart Association Step 2 diet averaging 8 g more soluble fiber per day than the control diet had significantly lower total cholesterol, total:HDL cholesterol, and LDL:HDL cholesterol (10). Our results with the use of a controlled Step 1 diet with 3 or 6 g ß-glucan/d were similar, even though different soluble fibers were used.

Some studies reported the ß-glucan (primarily from oats) content of the diets fed to the subjects (1, 3, 10, 11, 26-28, 32, 33). Similar to our results with barley, total and LDL cholesterol of hypercholesterolemic subjects decreased significantly after consumption of 3–11 g oat ß-glucan/d for ≥4 wk, whereas it did not decrease after consumption of the placebo diet (3, 11, 26, 32, 33). The greatest percentage decrease in total and LDL cholesterol occurred after the higher ß-glucan intake (14.5%). Uusitupa et al (33) reported that the significant reductions in LDL cholesterol observed after 4 wk were not sustained; after 8 wk, LDL-cholesterol concentrations had increased and were only 4% lower than initial concentrations. No significant decreases in total (27, 28, 34) or LDL (27, 28, 34) cholesterol after diets containing 1.9, 3.0, or 11.2 g ß-glucan/d were reported. Törrönen et al (28) suggested that the lack of effect in their study could have been due to poor solubility of the ß-glucan that resulted in low viscosity in the intestine. The food matrix (liquid or baked) used to incorporate the oat ß-glucan into the diet also affects total:LDL and total:HDL cholesterol; both ratios were significantly lower after consumption of orange juice but not of bread and cookies containing {approx}5.9 g ß-glucan/d than after consumption of the control wheat fiber (35). Brown et al (36) performed a meta-analysis of 67 controlled dietary studies and calculated that, for each gram of soluble fiber from oats, psyllium, or pectin, total cholesterol and LDL-cholesterol concentrations decreased by {approx}1.55 mg/dL (0.04 mmol/L). The meta-analysis showed no significant change in triacylglycerols and HDL cholesterol. The observed changes appeared to be independent of study design, treatment length, and dietary fat content.

A few studies reported barley as the source of ß-glucan in the diet. Similar to our results, the addition of ß-glucan from barley to the diet of mildly hypercholesterolemic men and women resulted in total and LDL-cholesterol concentrations lower than those before the study or after consumption of a control grain (15, 16, 29, 30, 37). Blood lipid concentrations of the men and women who began the study with normal cholesterol concentrations did not change (29, 30). No significant difference between oats and barley was observed, which is an indication that ß-glucan and not the source was critical in lipid reduction (37). Similar to our results, the addition of the barley bran flour and barley oil (13) or whole-grain barley (16) to a Step 1 diet of hypercholesterolemic subjects resulted in a significant decrease in total and LDL cholesterol; the greatest decrease occurred after the diet containing 6 g added ß-glucan/d (16). The men and the postmenopausal women reported here had lower blood lipids that resembled the pattern previously reported for men (16); premenopausal women were the most resistant to changes in blood lipids with a change in diet. Li et al (38), however, reported significant decreases in total, LDL-cholesterol, and triacylglycerol concentrations in women (average age: 20 y) after they consumed {approx}3.6 g ß-glucan/d extracted from barley. In contrast to other studies feeding barley, Keogh et al (39) reported no significant change in total, LDL, or HDL cholesterol or triacylglycerol concentrations after mildly hyperlipidemic men consumed 8–11.9 g ß-glucan/d extracted from barley. The authors concluded that structural changes might have occurred in the ß-glucan during extraction or handling.

The increased risk for coronary artery disease has been associated with a predominance of small, dense LDL particles. This is characterized by elevated triagylglycerol and lower HDL cholesterol concentrations (subclass pattern B). Sex differences were reported in lipoprotein subclass distribution patterns (40-43). Women generally have higher HDL cholesterol concentrations, larger LDL and HDL particle sizes, and lower triacylglycerol concentrations. Postmenopausal women were reported to have significantly higher total, VLDL, and LDL cholesterol and triacylglycerol concentrations; lower HDL cholesterol concentrations; smaller HDL particle size; and a strong correlation between LDL and HDL particle size (41). In contrast to the observation by Li et al (41), the postmenopausal women in the current study had the highest HDL concentrations and mean HDL particle size but no difference in triacylglycerol concentrations from those of the men. Mildly hypercholesterolemic men who consumed up to 6 g barley-derived ß-glucan/d (16) and overweight men who consumed 5.5 g oats-derived ß-glucan/d (44) were reported to have significantly lower LDL-cholesterol concentrations and significantly fewer LDL particle numbers than they had before the study. Although the amount of ß-glucan consumed in the current study was similar to the amounts in those other studies, the change in LDL particle numbers in the current study was not significant. Davy et al (44) suggested that the decrease in small LDL-cholesterol concentrations and LDL particle numbers might contribute to the beneficial effect of oat fiber on CVD. Freedman et al (45) reported that men with relatively high concentrations of either small HDL or large VLDL particles were 3–4 times more likely to have extensive coronary artery disease than were men with concentrations below average. The postmenopausal women in our study had the highest concentrations of large LDL particles, the largest mean LDL particle size, and the smallest concentration of small LDL particles, which suggests that the men or the premenopausal women were at greater risk of CVD. However; the LDL particle size of all of our subjects remained <25 nm regardless of the diet consumed, which indicated their continued risk of coronary artery disease.

A combination of factors and mechanisms appears to contribute to the reduction in lipids observed after the consumption of barley. Mechanisms suggested for the reduction in cholesterol after increased consumption of soluble fiber include increased excretion of bile acids or neutral sterols, increased catabolism of LDL cholesterol, and reduced absorption of fat (46-48). Increased viscosity of the gastric and intestinal contents can delay gastric emptying, decrease nutrient absorption, and interfere with micelle formation. Soluble fibers were shown to be fermented in the colon (46-48) and thus to give rise to short-chain fatty acids that can be absorbed and may inhibit hepatic cholesterol synthesis. In addition to the soluble fiber, barley contains a wide range of phytochemicals, some of which are being investigated for their effect on metabolism.

Consumption of barley-containing foods and the associated soluble fiber significantly improved several CVD risk factors. These results show the potential to moderate several health risk factors through changes in food and nutrient intake without changing energy intake. The highest ß-glucan intake resulted in the greatest reduction in total and LDL-cholesterol concentrations and total:HDL cholesterol, especially in postmenopausal women and men. These results indicate that dietary changes including greater consumption of whole grains including barley, higher ß-glucan intake, and lower fat intake can reduce risk factors associated with CVD.


   ACKNOWLEDGMENTS
 
We are grateful to the Beltsville Human Study Facility and to the volunteers for their participation and commitment to the study.

KMB was responsible for the conception and design of the study, data interpretation, and manuscript preparation. DS was responsible for data analysis and interpretation and assisted in study design and manuscript preparation. JH was responsible for the conception and design of the study and for data interpretation and assisted in manuscript preparation. All of the authors were employed by the US Department of Agriculture at the time this research was carried out.


   REFERENCES
TOP
 ABSTRACT
 INTRODUCTION
 SUBJECTS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 

  1. Truswell AS. Cereal grains and coronary heart disease. Eur J Clin Nutr 2002;56:1-14.[Medline]
  2. Rimm EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. Vegetable, fruit and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996;275:447-51.[Abstract]
  3. Behall KM, Scholfield DJ, Hallfrisch J. Effect of beta-glucan level in oat fiber extracts on blood lipids in men and women. J Am Coll Nutr 1997;16:46-51.[Abstract]
  4. Leinonen KS, Poutanen KS, Mykkanen HM. Rye bread decreases serum total and LDL cholesterol in men with moderately elevated serum cholesterol. J Nutr 2000;130:164-70.[Abstract/Free Full Text]
  5. Bruce B, Spiller GA, Klevay LM, Gallagher SK. A diet in whole and unrefined foods favorably alters lipids, antioxidant defenses, and colon function. J Am Coll Nutr 2000;19:61-7.[Abstract/Free Full Text]
  6. Lupton JR, Morin JL, Robinson MC. Barley bran flour accelerates gastrointestinal transit time. J Am Diet Assoc 1993;93:881-5.[Medline]
  7. Bridges SR, Anderson JW, Deakins DA, Dillon DW, Wood CL. Oat bran increases serum acetate of hypercholesterolemic men. Am J Clin Nutr 1992;56:455-9.[Abstract/Free Full Text]
  8. Wolever TMS, Vuksan V, Eshuis H, et al. Effect of method of administration of psyllium on glycemic response and carbohydrate digestibility. J Am Coll Nutr 1991;10:364-71.[Abstract]
  9. Wisker E, Godau A, Daniel M, Peschutter G, Feldheim W. Contribution of barley fiber to the metabolizable energy of human diets. Nutr Res 1992;12:1315-23.
  10. Jenkins DJ, Kendall CW, Vuksan V, et al. Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial. Am J Clin Nutr 2002;75:834-9.[Abstract/Free Full Text]
  11. Önning G, Wallmark A, Persson M, Åkesson B, Elmståhl S, Öste R. Consumption of oat milk for 5 weeks lowers serum cholesterol and LDL cholesterol in free-living men with moderate hypercholesterolemia. Ann Nutr Metab 1999;43:301-9.[Medline]
  12. Dubois C, Armand M, Senft M, et al. Chronic oat bran intake alters postprandial lipemia and lipoproteins in healthy adults. Am J Clin Nutr 1995;61:325-33.[Abstract/Free Full Text]
  13. Lupton JR, Robinson MC, Morin JL. Cholesterol-lowering effect of barley bran flour and oil. J Am Diet Assoc 1994;94:65-70.[Medline]
  14. US Food and Drug Administration, Center for Food Safety and Applied Nutrition, Office of Nutritional Products, Labeling, and Dietary Supplements. Claims that can be made for conventional foods and dietary supplements. CFR 101.81. Appendix C. September 2003. Internet: http://www.cfsan.fda.gov/~dms/hclaims.html (accessed 16 December 2003).
  15. McIntosh GH, Whyte J, McArthur R, Nestel PJ. Barley and wheat foods: influence on plasma cholesterol concentrations in hypercholesterolemic men. Am J Clin Nutr 1991;53:1205-9.[Abstract/Free Full Text]
  16. Behall KM, Scholfield DJ, Hallfrisch J. Lipids significantly reduced by diets containing barley in moderately hypercholesterolemic men. J Am Coll Nutr 2004;23:55-62.[Abstract/Free Full Text]
  17. Dietary guidelines for healthy American adults. A statement for physicians and health professional by the Nutrition Committee, American Heart Association. Circulation 1988;77:721A-4A.
  18. Cloey TA, Bachorik PS. Use of a dual precipitation procedure for measuring high-density lipoprotein 3 (HDL3) in normolipidemic serum. Clin Chem 1989;35:1390-3.[Abstract/Free Full Text]
  19. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge. Clin Chem 1972;18:499-502.[Abstract]
  20. Otvos JD. Measurement of lipoprotein subclass profiles by nuclear magnetic resonance spectroscopy. In: Rifai N, Warnick GR, Dominiczak MH, eds. Handbook of lipoprotein testing. Washington, DC: American Association for Clinical Chemisty, 2000:609-23.
  21. Kestin M, Moss R, Clifton PM, Nestel PJ. Comparative effects of three cereal brans on plasma lipids, blood pressure, and glucose metabolism in mildly hypercholesterolemic men. Am J Clin Nutr 1990;52:661-6.[Abstract/Free Full Text]
  22. Anderson JW, Gilinsky NH, Deakins DA, et al. Lipid responses of hypercholesterolemic men to oat-bran and wheat-bran intake. Am J Clin Nutr 1991;54:678-83.[Abstract/Free Full Text]
  23. Zhang JX, Hallmans G, Andersson H, et al. Effect of oat bran on plasma cholesterol and bile acid excretion in nine subjects with ileostomies. Am J Clin Nutr 1992;56:99-105.[Abstract/Free Full Text]
  24. Kirby RW, Anderson JW, Sieling B, et al. Oat-bran intake selectively lowers serum low-density lipoprotein cholesterol concentrations of hypercholesterolemic men. Am J Clin Nutr 1981;34:824-9.[Abstract/Free Full Text]
  25. Swain JF, Rouse IL, Curley CB, Sacks FM. Comparison of the effects of oat bran and low-fiber wheat on serum lipoprotein levels and blood pressure. N Engl J Med 1990;322:147-52.[Abstract]
  26. Davidson MH, Dugan LD, Burns JH, Bova J, Story K, Drennan KB. The hypocholesterolemic effects of ß-glucan in oatmeal and oat bran. JAMA 1991;265:1833-9.[Abstract]
  27. Mackay S, Ball MJ. Do beans and oat bran add to the effectiveness of a low-fat diet? Eur J Clin Nutr 1992;46:641-8.[Medline]
  28. Törrönen R, Kansanen L, Uusitupa M, et al. Effects of an oat bran concentrate on serum lipids in free-living men with mild to moderate hypercholesterolaemia. Eur J Clin Nutr 1992;46:621-7.[Medline]
  29. Ikegami S, Tomita M, Honda S, et al. Effect of boiled barley-rice feeding in hypercholesterolemic and normolipemic subjects. Plant Foods Hum Nutr 1996;49:317-28.[Medline]
  30. Newman RK, Lewis SE, Newman CW, Bioik RJ, Ramage RT. Hypocholesterolemic effect of barley foods on healthy men. Nutr Rep Int 1989;39:749-60.
  31. Van Horn L, Liu K, Gerber J, et al. Oats and soy in lipid-lowering diets for women with hypercholesterolemia: is there synergy? J Am Diet Assoc 2001;101:1319-25.[Medline]
  32. Braaten JT, Wood PJ, Scott FW, et al. Oat ß-glucan reduces serum cholesterol concentration in hypercholesterolemic subjects. Eur J Clin Nutr 1994;48:465-74.[Medline]
  33. Uusitupa MI, Ruuskanen E, Mäkinen E, et al. A controlled study on the effect of ß-glucan -rich oat bran on serum lipids in hypercholesterolemic subjects: relation to apolipoprotein E phenotype. J Am Coll Nutr 1992;11:651-9.[Abstract]
  34. Lovegrove JA, Clohessy A, Milon H, Williams CM. Modest doses of ß-glucan do not reduce concentrations of potentially atherogenic lipoproteins. Am J Clin Nutr 2000;72:49-55.[Abstract/Free Full Text]
  35. Kerchkhoffs DAJM, Hornstra G, Mensink RP. Cholesterol-lowering effects of ß-glucan from oat bran in mildly hypercholesterolemic subjects may decrease when ß-glucan is incorporated into bread and cookies. Am J Clin Nutr 2003;78:221-7.[Abstract/Free Full Text]
  36. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999;69:30-42.[Abstract/Free Full Text]
  37. Newman RK, Newman CW, Graham H. The hypocholesterolemic function of barley ß-glucans. Cereal Foods World 1989;34:883.
  38. Li J, Kaneko T, Li-Qiang Q, Wang J, Wang Y. Effects of barley intake on glucose tolerance, lipid metabolism and bowel function in women. Nutrition 2003;19:926-9.[Medline]
  39. Keogh GF, Cooper GJS, Mulvey TB, et al. Randomized controlled crossover study of the effects of a highly ß-glucan-enriched barley on cardiovascular disease risk factors in mildly hypercholesterolemic men. Am J Clin Nutr 2003;78:711-8.[Abstract/Free Full Text]
  40. Dumesnil JG, Turgeon J, Tremblay A, et al. Effect of a low-glycaemic index-low-fat-high protein diet on the atherogenic metabolic risk profile of abdominally obese men. Br J Nutr 2003;86:557-68.
  41. Li Z, McNamara JR, Fruchart JC, et al. Effects of gender and menopausal status on plasma lipoprotein subspecies and particle sizes. J Lipid Res 1996;37:1886-96.[Abstract]
  42. Pascot A, Lemieux I, Bergeron J, et al. HDL particle size: a marker of the gender differences in the metabolic risk profile. Atherosclerosis 2002;160:399-406.[Medline]
  43. Maki KC, Davidson MH, Cyrowski MS, Maki AC, Marx P. Low-density lipoprotein subcalss distribution pattern and adiposity-associated dyslipidemia in postmenopausal women. J Am Coll Nutr 2000;19:23-30.[Abstract/Free Full Text]
  44. Davy BM, Davy KP, Ho RC, Beske SD, Davrath LR, Melby CL. High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men. Am J Clin Nutr 2002;76:351-8.[Abstract/Free Full Text]
  45. Freedman DS, Otvos JD, Jeyarajah EJ, Darboriak JJ, Anderson AJ, Walker JA. Relation of lipoprotein subclasses as measured by proton nuclear magnetic resonance spectroscopy to coronary artery disease. Arterioscler Thromb Vasc Biol 1998;18:1046-53.[Abstract/Free Full Text]
  46. Jenkins DJA, Spadafora PJ, Jenkins AL, Rainey-Macdonald CG. Fiber in the treatment of hyperlipidemia. In: Spiller GA, ed. CRC handbook of dietary fiber in human nutrition. Ann Arbor, MI: CRC Press, 1993:419-38.
  47. Marlett JA. Sites and mechanisms for the hypocholesterolemic actions of soluble dietary fiber sources. Adv Exp Med Biol 1997;427:109-21.[Medline]
  48. Andersson M, Ellegård L, Andersson H. Oat bran stimulates bile acid synthesis within 8 h as measured by 7{alpha}-hydroxy-4-cholesten-3-one. Am J Clin Nutr 2002;76:1111-6.[Abstract/Free Full Text]
Received for publication December 29, 2003. Accepted for publication June 11, 2004.




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