Forty-two healthy men and women were subjected to four consecutive dietary periods differing in the fat content of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (n-6) [PUFA(n-6)] and (n-3) [PUFA(n-3)]. Plasma lipids, vitamin E, and in vitro LDL oxidation were examined during each period. Adhesion of human monocytes to cultured human endothelial cells was used as a functional test to identify differences in the biological properties of LDL from each dietary period. Consumption of an SFA-rich diet resulted in higher LDL cholesterol (4.06 +/- 0.85 mmol/L, P < .05) than did consumption of MUFA- (3.59 +/- 0.75 mmol/L), PUFA(n-6)- (3.44 +/- 0.77 mmol/L), or PUFA(n-3)- (3.31 +/- 0.8 mmol/L) rich diets. HDL cholesterol was lower during both PUFA-rich diets (1.24 +/- 0.28 and 1.27 +/- 0.28 mmol/L for n-6 and n-3, respectively) than during the SFA-(1.32 +/- 0.36 mmol/L) and MUFA- (1.32 +/- 0.34 mmol/L) rich diets. LDL resistance to copper-induced oxidation, expressed as lag time, was highest during the MUFA-rich diet (55.1 +/- 7.3 minutes) and lowest during the PUFA(n-3)- (45.3 +/- 7 minutes) and SFA- (45.3 +/- 6.4 minutes) rich diets. LDL induction of monocyte adhesion to endothelial cells was lower during the MUFA-rich diet than the other periods. The highest monocyte adhesion was obtained during the PUFA(n-3) and SFA dietary periods. In conclusion, an MUFA-rich diet benefits plasma lipid levels compared with an SFA-rich diet. Furthermore, this diet results in an increased resistance of LDL to oxidation and a lower rate of monocyte adhesion to endothelial cells than the other dietary fats examined.

To determine the effects of dietary fat saturation on plasma lipoproteins, we studied 21 free-living normolipidemic women (13 pre- and 8 postmenopausal) on three consecutive diet periods. During the first 4 wk they consumed a saturated diet rich in palm oil and butter [19% saturated fatty acids (S), 14% monounsaturated fatty acids (M), and 3.5% polyunsaturated fatty acids (P)], followed by 6 wk of a monounsaturated diet rich in olive oil (11% S, 22% M, and 3.6% P), and 6 wk of a polyunsaturated diet rich in sunflower oil (10.7% S, 12.5% M, and 12.8% P). Compared with the diet rich in saturated fatty acids, both diets rich in unsaturated fatty acids had similar lowering effects on total and low-density-lipoprotein cholesterol. High-density lipoprotein cholesterol and apolipoprotein A-I were higher in the monounsaturated-rich period than in the polyunsaturated-rich (10.5% and 12.7% respectively, P less than 0.001) and the saturated-rich period (5.3%, and 7.9%, respectively, P less than 0.05). These effects were independent of menopause status. Our data show that at this level of fat intake (36% as calories), a monounsaturated-rich diet results in a less atherogenic lipid profile than either polyunsaturated- or saturated-rich diets.

The purpose of this study was to investigate the effects of an intensive diet and exercise program on the quantity and quality of LDL as well as its susceptibility to in vitro oxidation. The diet was low in fat (< 10% kcal) and cholesterol (< 100 mg/d), while high in complex, unrefined carbohydrates (> 70% kcal) and fiber (35 g/1000 kcal). The study was composed of 80 participants in a 3-week residential program where food was provided ad libitum and there was daily aerobic exercise, primarily walking. In each subject, preparticipation and postparticipation fasting blood samples were drawn and LDL was isolated via density gradient ultracentrifugation. LDL particle diameter was determined by gradient gel electrophoresis of serum (n = 23). Isolated LDL was either separated into 6 subfractions by saline gradient equilibrium ultracentrifugation (n = 26) or subjected to in vitro copper oxidation (n = 32). Significant reductions (P < .01) in serum levels of cholesterol (20%). LDL-cholesterol (20%), HDL-cholesterol (17%), triglycerides (26%), and glucose (16%) as well as in body weight (4%) were noted for the total population. The mean particle diameter of the LDL increased (24.2 +/- 0.2 to 25.1 +/- 0.14 nm, P < .01) and was correlated with the reduction in serum triglycerides (r = .58, P < .01). Six of 22 subjects changed in LDL phenotype from B (< or = 25.5 nm) to A (> 25.5 nm). The percentage of LDL-cholesterol carried in the more dense subfractions fell significantly, while that carried by the less dense fractions increased. Initial oxidation levels fell (21%), while the lag time before copper-induced oxidation increased (13%). Reductions were observed in both the rate of oxidation (16%) and peak oxidation (20%). All of these changes should result in a dramatic reduction in the risk for atherosclerosis and its clinical sequelae.