Does perceived caloric and nutrient intake influence the acute effect of beverage consumption on cardiovascular function?

Objective: To explore whether consuming the same high-fat/sugar beverage affects endothelial function differently depending on whether it is presented as 'unhealthy' vs. 'healthy'. Methods: Twenty-five young (21±2 years), healthy women completed three conditions: milkshake consumption (540kcal, 80g sugar, 14g fat) where correct 'unhealthy' information was given (milkshake condition), consumption of same milkshake with incorrect, 'healthy' information given (100kcal, 3g sugar, 4g fat; sham-nutrishake condition), and water consumption (control). Pre- and post-beverage we assessed: 1) Endothelial function via standard brachial artery flow-mediated dilation (FMD); 2) Perceived shame, stress, beverage healthiness and harm; 3) Blood glucose, insulin, triglycerides and cortisol and tumor necrosis factor alpha (TNFα) receptor binding. Results: Glucose, triglycerides, and insulin increased in the milkshake and sham-nutrishake conditions (p<.05). The milkshake was perceived as less healthy ( p <.001) and more harmful ( p <.001) than the sham-nutrishake. Shame, stress, and cortisol and TNFα receptor binding did not increase post-consumption. FMD decreased after the milkshake condition (pre: 7.4±3.3%; post-60min: 4.9±2.9%; post-90 min: 4.5±3.1%, p< .001) but not the sham-nutrishake (pre: 5.7±2.2%; post-60min: 5.5±2.6%; post-90min: 5.0±2.4%, p= .43) or control conditions (pre: 7.0±2.6%; post-60min: 6.6±4.1%; post-90min: 6.0±3.2%, p= .29). Shear rate stimulus covariation did not alter FMD results. Lower perceived beverage healthiness was significantly associated with a greater reduction in FMD ( ρ= .36, p= .002). Conclusions: A high-fat/sugar milkshake reduced FMD only when presented as high in fat, sugar, and Calories. This suggests that perceptions about nutritional information contribute to the impact of food intake on endothelial function, and that nocebo effects could be involved in cardiovascular disease etiology.