Background:
Hypertriglyceridemia is a common condition in the United States and is often associated with other metabolic disturbances, including
insulin resistance,
metabolic syndrome, and a predominance of small dense
LDL particles.Objective: The objective of this trial was to evaluate the effects of a combination of
egg protein (Epro) and
unsaturated fatty acids (UFAs) substituted for refined starches and added
sugars on
insulin sensitivity (primary outcome) and other cardiometabolic health markers in
overweight or obese adults with elevated
triglyceride (TG) concentrations.Methods: Subjects with elevated TG concentrations were given test foods prepared by using Epro
powder (∼8% of energy) and
vegetable oil (∼8% of energy; Epro and UFA condition) or test foods prepared by using refined
starch and
sugar (∼16% of energy;
carbohydrate condition) in a randomized, double-blind, controlled-feeding, crossover trial (3 wk/condition, 2-wk washout). The Matsuda
insulin sensitivity index (MISI), fasting
lipids, and other cardiometabolic health markers were assessed at baseline and the end of each diet condition. Responses were compared by using repeated-measures ANCOVA.Results: Twenty-five participants [11 men, 14 women; mean ± SEM: age, 46.3 ± 2.4 y; body mass index (in kg/m2), 31.8 ± 1.0] with a median (interquartile range limits) fasting serum TG concentration of 173 mg/dL (159, 228 mg/dL) completed the trial. The MISI value increased 18.1% ± 8.7% from baseline during the Epro and UFA condition and decreased 5.7% ± 6.2% from baseline during the
carbohydrate condition (P < 0.001). The disposition index increased 23.8% ± 20.8% during the Epro and UFA condition compared with a decrease of 16.3% ± 18.8% during
carbohydrate (P = 0.042) and
LDL peak particle size increased 0.12 nm (-0.12, 0.28 nm) with Epro and UFA compared with a decrease of 0.15 nm (-0.33, 0.12 nm) with
carbohydrate (P = 0.019). TG and
VLDL cholesterol concentrations were lowered by 18.5% (-35.7%, -6.9%) and 18.6% (-34.8%, -7.4%), respectively, after the Epro and UFA condition and by 2.5% (-13.4%, 17.0%) and 3.6% (-12.5%, 16.2%), respectively, after the
carbohydrate diet condition (P < 0.002).Conclusions: The replacement of refined
carbohydrates with a combination of Epro and UFA increased the MISI value and altered several markers of cardiometabolic health in
overweight or obese adults with elevated TG concentrations. This trial was registered at clinicaltrials.gov as NCT02924558.