Beef in an Optimal Lean Diet (BOLD) Effects on Metabolic Syndrome
Beef in an Optimal Lean Diet (BOLD) Effects on Metabolic Syndrome
The proposed research will provide important information about the role of 2 intervention
 diets that provide different amounts of lean beef and meet current nutrient recommendations
 for the treatment of Metabolic Syndrome (MetSyn), a chronic disease that is still increasing
 in prevalence at alarming rates. The experimental and diet designs will enable us to evaluate
 lifestyle interventions for MetSyn for persons who maintain weight, lose weight and maintain
 their weight loss, as is currently recommended in clinical practice. Importantly, the
 investigators will compare a diet high in lean beef (5 oz/day) which is compositionally
 similar (i.e., energy and nutrients) to the modified-DASH diet, a low beef diet which has
 become the Gold Standard for the management of cardiovascular disease (CVD) risk factors,
 including MetSyn. In addition, the investigators also will evaluate a moderate-high protein
 diet (BOLD+) that is higher in total protein (from mixed sources including lean beef,
 7oz/day) than the BOLD diet, on CVD risk factors in persons with MetSyn. A follow-up study
 was conducted to assess dietary compliance in a sub-sample of the population at 12-months;
 participants were not informed of this end-point and additional consent was obtained.

 Hypotheses:

 1. Healthful isocaloric diets that include lean beef as the primary source of protein (BOLD
 diet) with average (18%; BOLD) or moderate-high (28%; BOLD+) total protein intake will
 show similar or greater reductions in CVD risk, respectively when compared to a
 modified-DASH diet.

 2. A healthful weight-loss diet, including lean beef as the primary source of protein in a
 high-moderate protein diet (BOLD+ diet), plus regular exercise (BOLD+ + ex) will reduce
 body weight equal to that of a BOLD + ex and DASH + ex intervention, but may improve CV
 risk factors (such as BP and TG), and therefore reduce the prevalence of MetSyn more
 than a BOLD + ex and DASH + ex intervention.

 3. The BOLD diet will be more effective than the modified-DASH diet, and the BOLD+ diet
 more effective than the BOLD diet in maintaining the CVD benefits attained during phases
 1 and 2. Dietary adherence will be better on the BOLD and BOLD + diets compared with the
 modified DASH diet.
Inclusion Criteria:

 -  (BMI 27-42 kg/m2)

 -  Three or more of the following risk factors (defined as having MetSyn):

 -  abdominal obesity [waist circumference > 102 cm (40 inches) in men and > 88 cm
 (35 inches) in women],

 -  elevated blood glucose [> 110mg/dl (6.1 mmol/L)]

 -  elevated TG [>150 mg/dl (1.7 mmol/L)]

 -  low HDL-C [<40 mg/dl (1.03 mmol/L) in men and <50 mg/dL (1.29 mmol/l) in women]

 -  hypertension (Systolic Blood Pressure > 130 mmHg or Diastolic Blood Pressure > 85
 mmHg)*

 -  BP medication accepted if BP stable and less than 160/100mm Hg

 Exclusion Criteria:

 -  A history of myocardial infarction, stroke, diabetes mellitus, liver disease, kidney
 disease, and thyroid disease (unless controlled on medication)

 -  Lactation, pregnancy, or desire to become pregnant during the study

 -  Intake of putative cholesterol-lowering supplements (psyllium, fish oil capsules, soy
 lecithin, niacin, fiber, flax, and phytoestrogens, stanol/sterol supplemented foods)

 -  High alcohol consumption (≥ 14 drinks/week)

 -  Participation in regular physical activity (> 1 formal session/week)

 -  Lipid or glucose lowering medication