Poly is more effective than monounsaturated fat for dietary management in the metabolic syndrome: The muffin study
Open accessAbstract
Background The metabolic syndrome (MetS) is highly prevalent and associated with an increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Lifestyle recommendations to treat MetS often include the replacement of saturated fats (SFAs) and monosaccharides with unsaturated fat. However, it is unclear whether metabolic parameters will improve more when the saturated fat in American Heart Association (AHA) diets is replaced with higher concentrations of monounsaturated or polyunsaturated fatty acids (MUFA or PUFA).Objective To test the hypothesis that an AHA diet enriched in MUFA improves lipoprotein lipids, insulin resistance, inflammation, and endothelial function to a greater extent than a diet enriched in PUFA in middle-aged men and women with MetS.Methods A prospective, open-label, parallel group design with randomization to a hypocaloric MUFA or PUFA-enriched diet after weight stabilization on an AHA step I diet. Participants consumed 3 MUFA-enriched or PUFA-enriched muffins daily with additional supplementation as required to ensure 25%-50% increases in dietary fat intake from these sources at the expense of SFA and the opposing unsaturated fat. Changes in MetS components were measured at baseline and after 6 months of dietary intervention.Results Thirty-nine participants (mean age, 60.8 years; 79% African-American, 60% women) with MetS completed the 6-month study. Compared to baseline, assignment to either MUFA (n = 23) or PUFA (n = 16) both were associated with weight loss (MUFA: -2.3 ± 1 kg, P = .06; PUFA: -4.6 ± 2 kg; P = .002), but PUFA was also associated with reductions in triglycerides (TG) (-30 ± 18 mg/dL, P = .02), systolic blood pressure (BP) (-7 ± 3 mm Hg, P = .01), diastolic BP (DBP) (-4 ± 2 mm Hg, P = .01) and improved flow mediated dilation (FMD) (7.1% ± 1.8% vs 13.6% ± 2%, absolute increase; P = .0001). When compared to MUFA treatment, PUFA intervention was associated with reduced TG (P = .04) and DBP (P = .07) as well as increased FMD (P = .04) even after adjustment for changes in weight. There was no effect on total cholesterol, low-density lipoprotein cholesterol, glucose, high-sensitivity C-reactive protein (hs-CRP), or other inflammatory proteins. Overall, 25% (4 of 16) assigned to PUFA and 13% (3 of 23) to MUFA converted to non-MetS status.Conclusion Substitution of SFA with PUFA in patients with MetS is associated with greater reductions in TG and improvement in endothelial function than MUFA that is independent of weight loss. These preliminary findings raise the possibility that PUFA may be the unsaturated fat of choice to reduce cardiometabolic risk in patients with MetS.
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The prevalence of metabolic syndrome is increasing globally, driven by rising obesity rates and sedentary lifestyles.
“The prevalence of MetS is increasing globally, driven by rising obesity rates and sedentary lifestyles [1].”
From Marine-Based Omega-3 Fatty Acids and Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (2025) · cites this paper as [1]
The Abstract Background calls metabolic syndrome “highly prevalent,” and the Introduction describes it as common. Neither passage says its prevalence is increasing globally or attributes an increase to rising obesity rates and sedentary lifestyles. (LLM, conf=0.84)
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Cites
Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944 · see citing works
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011 · see citing works
Corretti, M. C., Anderson, T. J., Benjamin, E. J., Celermajer, D. S., Charbonneau, F., Creager, M. A., Deanfield, J. E., Drexler, H., Gerhard‐Herman, M. D., Herrington, D. M., et al. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01746-6 · Cited by 4,606 · see citing works
de Lorgeril, M., Salen, P., Martin, J.-L., Monjaud, I., Delaye, J., & Mamelle, N. (1999) · Circulation · doi:10.1161/01.cir.99.6.779 · Cited by 2,910 · see citing works
Esposito, K., Marfella, R., Ciotola, M., Di Palo, C., Giugliano, F., Giugliano, G., D'Armiento, M., D'Andrea, F., & Giugliano, D. (2004) · JAMA · doi:10.1001/jama.292.12.1440 · Cited by 2,126 · see citing works
Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association
Miller, M., Stone, N. J., Ballantyne, C., Bittner, V., Criqui, M. H., Ginsberg, H. N., Goldberg, A. C., Howard, W. J., Jacobson, M. S., Kris-Etherton, P. M., et al. (2011) · Circulation · doi:10.1161/cir.0b013e3182160726 · Cited by 1,871 · see citing works
Self-citationTHE DIET AND 15-YEAR DEATH RATE IN THE SEVEN COUNTRIES STUDY
KEYS, A., MIENOTTI, A., KARVONEN, M. J., ARAVANIS, C., BLACKBURN, H., BUZINA, R., DJORDJEVIC, B. S., DONTAS, A. S., FIDANZA, F., KEYS, M. H., et al. (1986) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114480 · Cited by 1,790 · see citing works
Dietary Fat Intake and the Risk of Coronary Heart Disease in Women
Hu, F. B., Stampfer, M. J., Manson, J. E., Rimm, E. B., Colditz, G. A., ROSNER, B. A., Hennekens, C. H., & Willett, W. C. (1997) · New England Journal of Medicine · doi:10.1056/nejm199711203372102 · Cited by 1,774 · see citing works
Jakobsen, M. U., O’Reilly, E. J., Heitmann, B. L., Pereira, M. A., Bälter, K., Fraser, G. E., Goldbourt, U., Hallmans, G., Knekt, P., Liu, S., et al. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.27124 · Cited by 1,026 · see citing works
Benefits of the Mediterranean Diet: Insights From the PREDIMED Study
Martínez‐González, M. Á., Salas‐Salvadó, J., Estruch, R., Corella, D., Fitó, M., & Ros, E. (2015) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2015.04.003 · Cited by 785 · see citing works
Exercise stress testing in evaluation of patients with ischemic heart disease
Bruce, R. A., & Hornsten, T. R. (1969) · Progress in Cardiovascular Diseases · doi:10.1016/0033-0620(69)90027-9 · Cited by 646 · see citing works
Suppression by diets rich in fish oil of very low density lipoprotein production in man.
Nestel, P. J., CONNOR, W. E., Reardon, M., Connor, S. L., Wong, S., & Boston, R. C. (1984) · Journal of Clinical Investigation · doi:10.1172/jci111422 · Cited by 616 · see citing works
Omega-3 fatty acids and coronary heart disease risk: clinical and mechanistic perspectives
Harris, W. S., Miller, M., Tighe, A. P., Davidson, M. H., & Schaefer, E. J. (2008) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2007.11.008 · Cited by 552 · see citing works
Self-citationde Oliveira Otto, M. C., Mozaffarian, D., Kromhout, D., Bertoni, A. G., Sibley, C. T., Jacobs, D. R., & Nettleton, J. A. (2012) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.037770 · Cited by 364 · see citing works
MASSIVE THROMBOSIS PRODUCED BY FATTY ACID INFUSION*
Connor, W. E., Hoak, J. C., & WARNER, E. D. (1963) · Journal of Clinical Investigation · doi:10.1172/jci104778 · Cited by 298 · see citing works
Katzel, L. I. (1995) · JAMA · doi:10.1001/jama.1995.03530240025035 · Cited by 297 · see citing works
Gardener, H. E., Wright, C. B., Gu, Y., Demmer, R. T., Boden-Albala, B. M., Elkind, M. S. V., Sacco, R. L., & Scarmeas, N. (2011) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.012799 · Cited by 237 · see citing works
Mediterranean Diet Inversely Associated With the Incidence of Metabolic Syndrome
Tortosa, A., Bes‐Rastrollo, M., Sánchez‐Villegas, A., Basterra-Gortari, F. J., Núñez-Córdoba, J. M., & Martínez‐González, M. Á. (2007) · Diabetes Care · doi:10.2337/dc07-1231 · Cited by 235 · see citing works
Straznicky, N. E., Lambert, E. A., Lambert, G. W., Masuo, K., Esler, M. D., & Nestel, P. J. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0961 · Cited by 227 · see citing works
Souza, S. C., Palmer, H. J., Kang, Y., Yamamoto, M. T., Muliro, K. V., Paulson, K. E., & Greenberg, A. S. (2003) · Journal of Cellular Biochemistry · doi:10.1002/jcb.10565 · Cited by 184 · see citing works
Vafeiadou, K., Weech, M., Altowaijri, H., Todd, S., Yaqoob, P., Jackson, K. G., & Lovegrove, J. A. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.097089 · Cited by 178 · see citing works
Wang, Q., Afshin, A., Yakoob, M. Y., Singh, G. M., Rehm, C. D., Khatibzadeh, S., Micha, R., Shi, P., Mozaffarian, D., the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE), et al. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.002891 · Cited by 166 · see citing works
Sato, F., Tamura, Y., Watada, H., Kumashiro, N., Igarashi, Y., Uchino, H., Maehara, T., Kyogoku, S., Sunayama, S., Sato, H., et al. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-2384 · Cited by 132 · see citing works
Mata, P., Varela, O., Rodrigo Alonso, K., Lahoz, C., de Oya, M., & Badimón, L. (1997) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.17.10.2088 · Cited by 116 · see citing works
A hypothesis on the development of acute myocardial infarction in Greenlanders
Dyerberg, J., & Bang, H. O. (1982) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.3109/00365518209168395 · Cited by 116 · see citing works
Is drop-out from obesity treatment a predictable and preventable event?
Colombo, O., Ferretti, V. V., Ferraris, C., Trentani, C., Vinai, P., Villani, S., & Tagliabue, A. (2014) · Nutrition Journal · doi:10.1186/1475-2891-13-13 · Cited by 110 · see citing works
Mediterranean diet and metabolic syndrome: a cross-sectional study in the Canary Islands
León, E. E. Á., Henríquez, P., & Serra‐Majem, L. (2006) · Public Health Nutrition · doi:10.1017/s1368980007668487 · Cited by 104 · see citing works
A hypothesis on the development of acute myocardial infarction in Greenlanders
Dyerberg, J., & Bang, H. O. (1982) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365518209168395 · Cited by 100 · see citing works
Nicklas, B. J., Dennis, K. E., Berman, D. M., Sorkin, J. D., Ryan, A. S., & Goldberg, A. P. (2003) · The Journals of Gerontology Series A · doi:10.1093/gerona/58.2.m181 · Cited by 95 · see citing works
Self-citationThe Relationship of Dietary Fat and Cholesterol to Mortality in 10 Years: The Honolulu Heart Program
McGee, D., REED, D. M., Stemmerman, G. N., Rhoads, G., Yano, K., & Feinleib, M. (1985) · International Journal of Epidemiology · doi:10.1093/ije/14.1.97 · Cited by 76 · see citing works
Miller, M. J., Beach, V., Sorkin, J. D., Mangano, C., Dobmeier, C., Novacic, D., Rhyne, J., & Vogel, R. A. (2009) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2008.12.023 · Cited by 74 · see citing works
Self-citationHalverstadt, A., Phares, D. A., Ferrell, R. E., Wilund, K. R., Goldberg, A. P., & Hagberg, J. M. (2003) · Metabolism · doi:10.1016/s0026-0495(03)00284-1 · Cited by 74 · see citing works
Self-citationLong-term monounsaturated fatty acid diets reduce platelet aggregation in healthy young subjects
Smith, R. D., Kelly, C. N. M., Fielding, B. A., et al. (2003) · British Journal Of Nutrition · doi:10.1079/bjn2003953 · Cited by 72 · see citing works
Nigam, A., Bourassa, M. G., Fortier, A., Guertin, M., & Tardif, J. (2006) · American Heart Journal · doi:10.1016/j.ahj.2005.03.050 · Cited by 71 · see citing works
Dietary Intake of Fatty Acids and Serum C-reactive Protein in Japanese
Yoneyama, S., Miura, K., Sasaki, S., Yoshita, K., Morikawa, Y., Ishizaki, M., Kido, T., Naruse, Y., & Nakagawa, H. (2007) · Journal of Epidemiology · doi:10.2188/jea.17.86 · Cited by 66 · see citing works
Stevenson, J. L., Clevenger, H. C., & Cooper, J. A. (2015) · Obesity · doi:10.1002/oby.21202 · Cited by 62 · see citing works
Dietary Therapy in Diabetes Mellitus: Is There a Single Best Diet?
Grundy, S. M. (1991) · Diabetes Care · doi:10.2337/diacare.14.9.796 · Cited by 48 · see citing works
Diet and cardiovascular disease prevention: What works?
van Horn, L. V., & Kavey, R. (1997) · Annals of Behavioral Medicine · doi:10.1007/bf02892285 · Cited by 47 · see citing works
Secondary Prevention Strategy of Cardiovascular Disease Using Endothelial Function Testing
Matsuzawa, Y., Guddeti, R. R., Kwon, T., Lerman, L. O., & Lerman, A. (2015) · Circulation Journal · doi:10.1253/circj.cj-15-0068 · Cited by 45 · see citing works
Individual versus group therapy for obesity: Comparison of dropout rate and treatment outcome
Minniti, A., Bissoli, L., Francesco, V. D., Fantin, F., Mandragona, R., Olivieri, M., Fontana, G., Rinaldi, C. A., Bosello, O., & Zamboni, M. M. (2007) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/bf03327593 · Cited by 44 · see citing works
Joseph, L. J., Prigeon, R. L., Blumenthal, J. B., Ryan, A. S., & Goldberg, A. P. (2011) · The Journals of Gerontology Series A · doi:10.1093/gerona/glr093 · Cited by 42 · see citing works
Self-citationParticipant Retention in the Veterans Health Administration's MOVE! Weight Management Program, 2010
Locatelli, S. M., Sohn, M.-W., Spring, B. J., Hadi, S., & Weaver, F. M. (2012) · Preventing Chronic Disease · doi:10.5888/pcd9.120056 · Cited by 20 · see citing works
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- [29]Jakobsen MU O'Reilly EJ Heitmann BL Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 2009 89 1425 1432 19211817 PMC2676998
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Grosso, G., Laudisio, D., Frias-Toral, E., Barrea, L., Muscogiuri, G., Savastano, S., & Colao, A. (2022) · Nutrients · doi:10.3390/nu14061137 · Cited by 255 · see citing works
Miller, M., Bhatt, D. L., Brinton, E. A., Jacobson, T. A., Steg, P. G., Pineda, A. L., Ketchum, S. B., Doyle, R. T., Tardif, J.-C., & Ballantyne, C. M. (2023) · European Heart Journal Open · doi:10.1093/ehjopen/oead114 · Cited by 11 · see citing works
Self-citationBasirat, A., & Merino-Torres, J. F. (2025) · Nutrients · doi:10.3390/nu17203279 · Cited by 9 · see citing works
- Authors
- Miller, M., Sorkin, J. D., Mastella, L., Sutherland, A., Rhyne, J., Donnelly, P., Simpson, K., & Goldberg, A. P.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Miller, Michael
- Venue
- Journal of clinical lipidology
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 10
- Issue
- 4
- Pages
- 996-1003
- ISSN
- 1876-4789 (ISSN-L)
- 1933-2874
- PMC
- PMC5010036
- OpenAlex
- W2346312442
- Cited by
- 41
- References
- 43
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 7 · 2018: 4 · 2017: 5
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of clinical lipidology (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- VA Merit (I01CX000147)
- Baltimore VA Geriatric Research, Education and Clinical Center
- NHLBI
- Nutrition Obesity Research Center (NORC) (DK072488-4)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- metabolic syndrome, polyunsaturated fatty acids, monounsaturated fatty acids, fat replacement, saturated fat, weight loss, triglycerides, blood pressure, flow-mediated dilation, endothelial function, insulin resistance, inflammation, lipoprotein lipids, type 2 diabetes risk, cardiovascular risk, middle-aged adults, African Americans
- MeSH terms
- Adult, Aged, Dietary Fats, Unsaturated, Endothelium, Vascular, Fatty Acids, Monounsaturated, Fatty Acids, Unsaturated, Female, Humans, Insulin Resistance, Lipoproteins, Male, Middle Aged, Metabolic Syndrome, Overweight
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