Effect of Strawberries in a Cholesterol Lowering Dietary Portfolio Research Proposal

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The Effects of Strawberries on a Cholesterol-Lowering Dietary Portfolio" by Jenkins, D.J.A. Nguyen, T.H. Kendall, C.W.C. Faulkner, D.A. Bashyam, B. Kim, I.J. Ireland, C. Patel, D. Vidgen, E. Josse, a.R. Sessof, H.D. Burton-Freeman, B. Josse, R.G. Leiter, L.A. Singer, W. is available on the database Science Direct and was accessed on December 1, 2008.

This work is peer reviewed and empirical. The research problem or question is the previous inability of anti-oxidant supplements to be proven by more than theoretical means to have a positive effect on risk factors for heart disease and related risk factors for it. The work demonstrates that adding a food item with a high level of palatability not only helps as much as adding other high antioxidant or fiber containing supplements or foods. It is therefore inferred that adding strawberries to a cholesterol-lowering dietary portfolio may improve the utility of cholesterol lowering dietary portfolios in two ways; first by providing a positive change in risk factors for heart disease and by making such a diet more palatable and therefore easier to elicit compliance with. (Jenkins et al. 2008, p. 1636-1637)

The purpose of the research study is to demonstrate, more than theoretically the positive effects of reduction of heart disease risk factors utilizing a high antioxidant food that is easy to add to an already functional long-term low-cholesterol dietary portfolio. (Jenkins et al. 2008, p. 1636-1637)

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The applicability in health sciences is to determine both the effectiveness of a certain food, in this case strawberries with regard to heart disease risk factor reduction in a more than theoretical manner, i.e. through scientific empirical means. The secondary purpose is to compare this additional dietary food, as an alternative in comparison to another food that is high in fiber, in this case high fiber oat bran bread. (Jenkins et al. 2008, p. 1636)

TOPIC: Research Proposal on Effect of Strawberries in a Cholesterol Lowering Dietary Portfolio Assignment

The sample includes a group of 85 previously identified hyperlipidemic individuals, who were willing to commit to a five-year study of particular foods associated with a low-cholesterol diet. 84 participants were recruited by means of a volunteer recruitment method associated with a newspaper classified, while one participant was directed to the research study via direct physician referral. The strawberry challenge was added to the research study after 17 men and 17 post-menopausal women had already been compliant with the dietary study for 2-3 years, and 8 other men and women had been compliant for 1-2 years. 42 of these subjects were asked to be involved in the strawberry study and 30 agreed to participate. No participants had a history of cardiovascular disease, untreated hypertension, diabetes or renal or liver disease but all has raised LDL serum cholesterol levels upon screening for the study, some participants were on long-term statin treatment and all remained at a constant level during the Strawberry substudy. The demographic breakdown of the strawberry substudy sample is as follows: "The participants were largely of European origin (n = 26). There was also 1 Filipino, 1 East Indian, 1 African, and 1 Hispanic participant. Participants." (Jenkins et al. 2008, p. 1637)

Sampling methodology has specific strengths, in that it demonstrates the use of participants seeking to lower clinically high LDL lipid cholesterol (through dietary means in addition to or separate from statin therapy) prior to the development of outward complications associated with heart disease or risk factors such as diabetes or renal or liver disease. Some participants had a history of hypertension, but not untreated hypertension. The work then describes a preventative start time for dietary intervention with regard to high LDL lipid cholesterol. Additionally, all participants had been compliant with the cholesterol-lowering diet of the overall study prior to having the added strawberry substudy standards. The work therefore demonstrates the abilty to provide data regarding the nature of how strawberries might change the LDL lipid profile, in comparison to the standard diet of the study and among a population that is not clinically complicated by other disease processes. The study might also demonstrate a limitation of validity in the fact that looking for the primary incidence, i.e if strawberries create added benefit of greater compliance in population that has already been demonstratively compliant with the dietary requirements of the broader study limits information on how compliant the general population might be with the overall diet or the added strawberry substudy. In other words it would be a challenge to see if the general population of hyperlipidemia would be willing to be compliant within the confines of new cholesterol lowering dietary profile, a major concern in a clinical setting. The study might also be helped with a study group who had not been concurrently following a cholesterol lowering diet and was just subject to the strawberry substudy. It is also important to note that the long-term study employed a self-selection diet of foods included in a low-saturated therapeutic diet associated with the, National Cholesterol Education Program Adult Treatment Panel III. (p. 1637) This protocol could answer for some variation and a limitation of validity as participants were allowed to self select foods that could have potentially been more or less effective in an overall cholesterol lowering dietary profile.

The methodology of the study, including the inclusion of the randomized broader study sampling among participants and their long-term participation in the broader study was to assign 15 of the 30n to a strawberry added regimen, or an added bran bread participant sample for comparison. All data is quantitative in that the determination of change of the two comparison groups was through fasting lipid panel blood tests, scaling of satiety using a 7 day assessment scale and an assessment scale of the whole substudy period by self report on a similar scale of palatability, in a comparison among the two groups was also quantitative to as much a degree as possible for self-report scaling. (p. 1637)

Research methodology demonstrates the effectiveness of judging both the physiological effects of the substudy, as well as the varied acceptance of palatability and satiety of the diet, demonstrating that the results of the substudy where sought in the bi-fold research question, i.e. The effects of the change on the serum cholesterol levels and the effects of the diet on palatability, in comparison between strawberries and oat bran bread. Compliance must be eliminated as a demonstrative factor, as each participant had a mean involvement of 2.5 years in the overall study and had then shown significant ability to follow a cholesterol lowering dietary portfolio, much of which was self-selected. (p. 1637) the validity and reliability of the methodology, barring the previously mentioned weaknesses is essentially effective as a comparison in a situation where individuals had shown considerable ability to comply with a cholesterol lowering diet over a long period of time.

Data analysis included an analysis of Lipid Research Clinics protocol for total cholesterol and high-density lipoprotein cholesterol. Low density lipoprotein oxidation was estimated measuring in the LDL fraction based on a research standard accepted by the broader system. Protien oxidzation was also measured as were sodium, potassium, chloride, urea, creatinin, alanine, aspartate transminases, alkaline phosphate, albumin, globulin and total bilirubin using both blood and urine where applicable. In an attempt to control for self-selected dietary additions the researchers also analyzed diet diaries for macronutrients, micronutrients, fatty acids, cholesterol and fiber using the standards of the U.S. department of Agriculture data, and all was added to the dietary compliance score, expected to be 25% and then added to an additional 75% for a total expected compliance score of 100%. (p. 1639) Added statistical analysis for comparison was applied to determine the overall change of both added strawberries or added oat bran bread over a 1 year period, making the strawberry substudy a long-term addendum to the broader long-term study. (p. 1640)

The data analysis type seems to have accounted for a great deal of variation and challenge to validity and reliability of the study, incorporating a significant data set for each comparison participant and attempting to control for both the self-selected cholesterol lowering regimen as well as overall health. Yet, again compliance cannot be considered a significant aspect of analysis among any but a large population of already compliant individuals.

The results of the study was the determination of the fact that both the oat bran bread added comparison body and the strawberry comparison body showed significant laberatory reduction of damaginf cholesterol levels and therefore an assumed reduced risk of heart disease. The compliance factor challenged the results but indicated that among this particular group of long-term compliant individuals those who participated in the strawberry comparison group found the dietary addition more palatable than those who participated in the added oat bran bread component. Satiety was constant between the two groups and there were no baseline differences between the serum protein thiols or in conjugated dienes, or TBARS in the LDL fraction. (p. 1640)

The results of the study indicate reduction of danger markers in both compared groups and therefore indicate that anti-oxidant… [END OF PREVIEW] . . . READ MORE

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