Although the hypocholesteremic effect of unsaturated dietary fats has been repeatedly demonstrated, the mechanism underlying this effect is by no means clear. Four possibilities exist: 1) decreased cholesterol synthesis, 2) increased excretion of cholesterol or its metabolites, or both, 3) shift of plasma cholesterol to some other tissue(s), or 4) some combination of these factors.In a previous study of a single patient in this hospital (2) significantly increased excretion of neutral but not acidic fecal sterols was demonstrated when unsaturated fat replaced saturated fat in the diet. The present study extends that single experience to five studies in four other patients and utilizes a different and more generally useful methodology.An adequate evaluation of steroid 1 excretion depends first on devising a satisfactory procedure for quantitative isolation of fecal neutral steroids and simultaneously of other metabolic end products, notably the fecal bile acids; and second, on measuring accurately these excretion products by means that take into account the numerous chemical forms of these excretion products, some of which are still not identified.