Dietary fat and serum lipids: an evaluation of the experimental data

Hegsted, D. M.; Ausman, Lynne M.; Johnson, Julia A.; Dallal, Gerard E.

doi:10.1093/ajcn/57.6.875

Cited by 458 publications

(235 citation statements)

References 86 publications

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“…The in¯uences of dietary fat on serum cholesterol have been studied extensively, and there is universal agreement that a reduction in dietary saturated fat will lower serum total and low density lipoprotein (LDL) cholesterol (Grundy & Denke, 1990;La Rosa et al, 1990;Mensink & Katan, 1992;Hegsted et al, 1993;NCEP Expert Panel, 1993;Katan et al, 1994). There is, however, no agreement as to which nutrients should replace saturated fatty acids.…”

Section: Introductionmentioning

confidence: 99%

The effect of a low-fat, high-carbohydrate diet on serum high density lipoprotein cholesterol and triglyceride

et al. 1998

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Objective: To determine whether substituting carbohydrate for saturated fat has any adverse effects on serum high density lipoprotein (HDL) cholesterol and triglycerides in free-living individuals. Design: Randomised crossover trial. Setting: General community. Subjects: Volunteer sample of 38 healthy free-living men with mean (s.d.) age 37 (7) y, moderately elevated serum total cholesterol 5.51 (0.93) mmolal and body mass index 26.0 (3.6) kgam 2 . Interventions: Participants completed two six week experimental periods during which they consumed either a traditional Western diet (36%, 18%, and 43% energy from total, saturated, and carbohydrate, respectively) or a low-saturated fat high-carbohydrate diet (22%, 6% and 59% energy from total, saturated, and carbohydrate, respectively). Dietary principles were reinforced regularly, but food choices were self-selected during each experimental period. Main outcome measures: Serum lipids, body weight and plasma fatty acids. Results: Reported energy and nutrient intakes, plasma fatty acids, and a drop in weight from 79.1 (12.5) kg on the Western diet to 77.6 (12.0) kg on the high-carbohydrate diet (P`0.001) con®rmed a high level of compliance with experimental diets. Total and low density lipoprotein (LDL) cholesterol fell from 5.52 (1.04) mmolal and 3.64 (0.88) mmolal, respectively on the Western diet to 4.76 (1.10) mmolal and 2.97 (0.94) mmolal on the high-carbohydrate diet (P`0.001). HDL cholesterol fell from 1.21 (0.27) mmolal on the Western diet to 1.07 (0.23) mmolal on the high-carbohydrate diet (P 0.057), but the LDL:HDL cholesterol ratio improved from 3.17 (1.05) on the Western diet to 2.88 (0.97) on the high-carbohydrate diet (P 0.004). Fasting triglyceride levels were unchanged throughout the study. Conclusions: Replacement of saturated fat with carbohydrate from grains, vegetables, legumes, and fruit reduces total and LDL cholesterol with only a minor effect on HDL cholesterol and triglyceride. It seems that when free living individuals change to a ®bre rich high-carbohydrate diet appropriate food choices lead to a modest weight reduction. This may explain why the marked elevation of triglyceride and reduction of HDL cholesterol observed on strictly controlled high-carbohydrate diets may not occur when such diets are followed in practice.

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Section: Introductionmentioning

confidence: 99%

The effect of a low-fat, high-carbohydrate diet on serum high density lipoprotein cholesterol and triglyceride

et al. 1998

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“…By the 1960s, it was clear that several dietary components had sizable effects: higher intake of cholesterol and saturated fatty acids (SFA) raises serum cholesterol on average; calorie imbalance (on 'Western' fare) with weight gain also raises serum cholesterol; in contrast, higher intake of polyunsaturated fatty acids (PFA) and watersoluble fibre have moderate cholesterol-lowering effects, as does weight loss by obese people consuming fat-modified fare. [7][8][9][10][11] Extensive evidence demonstrating these dietary influences has been from the early 1960s on the scientific foundation for repeated recommendations by expert groups that the general population improve eating patterns to lower serum cholesterol. [12][13][14][15][16][17][18][19] More recently, data on adverse effects of dietary trans fatty acids on serum cholesterol led to expansion of recommendations to encompass avoidance of foods with these components.…”

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confidence: 99%

INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary)

et al. 2003

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Blood pressure (BP) above optimal (p120/p80 mmHg) is established as a major cardiovascular disease (CVD) risk factor. Prevalence of adverse BP is high in most adult populations; until recently research has been sparse on reasons for this. Since the 1980s, epidemiologic studies confirmed that salt, alcohol intake, and body mass relate directly to BP; dietary potassium, inversely. Several other nutrients also probably influence BP. The DASH feeding trials demonstrated that with the multiple modifications in the DASH combination diet, SBP/DBP (SBP: systolic blood pressure, DBP: diastolic blood pressure) was sizably reduced, independent of calorie balance, alcohol intake, and BP reduction with decreased dietary salt. A key challenge for research is to elucidate specific nutrients accounting for this effect. The general aim of the study was to clarify influences of multiple nutrients on SBP/DBP of individuals over and above effects of Na, K, alcohol, and body mass. Specific aims were, in a cross-sectional epidemiologic study of 4680 men and women aged 40-59 years from 17 diverse population samples in China, Japan, UK, and USA, test 10 prior hypotheses on relations of macronutrients to SBP/DBP and on role of dietary factors in inverse associations of education with BP; test four related subgroup hypotheses; explore associations with SBP/DBP of multiple other nutrients, urinary metabolites, and foods. For these purposes, for all 4680 participants, with standardized high-quality methods, assess individual intake of 76 nutrients from four 24-h dietary recalls/person; measure in two timed 24-h urine collections/person 24-h excretion of Na, K, Ca, Mg, creatinine, amino acids; microalbuminuria; multiple nutrients and metabolites by nuclear magnetic resonance and high-pressure liquid chromatography. Based on eight SBP/DBP measurements/person, and data on multiple possible confounders, utilize mainly multiple linear regression and quantile analyses to test prior hypotheses and explore relations of multiple dietary and urinary variables to SBP/DBP of individuals. The 4680 INTERMAP participants are equally divided across four age/gender strata: diverse in ethnicity, education, occupation, physical activity; use of cigarettes, alcohol; diagnosed high BP, CVD, diabetes; CVD family history; women vary in parity, use of contraceptive medication and hormone replacement therapy.

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“…The regression equation for LDL cholesterol showed a signi®cant negative (namely, lowering) coef®cient for polyunsaturates, not for MUFA (Table 1). Hegsted et al (1993) included the whole literature, including early papers that only reported total cholesterol, with a few exceptions: formula diets or very short experimental periods. They separately analysed 50 papers reporting metabolic ward experiments and 37 ®eld study experiments, and focused on serum total cholesterol.…”

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confidence: 99%

“…A possibility mentioned in discussion by a few authors (Hegsted et al, 1993;Gardner & Kraemer, 1995) is that average samples of speci®c plant oils rich in MUFA might differ somewhat in their effect on plasma cholesterol. While investigating the possibility that palmitic acid (16:0), and hence palmolein, may be less cholesterolraising than myristic and lauric acids and oils rich in these (Hayes et al, 1991) we happened to compare in turn, in three separate sets of human experiments (21± 42 subjects per experiment) plasma total, LDL and HDL cholesterol on palmolein against three MUFA rich oils: canola, olive and high-oleic sun¯ower oils.…”

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confidence: 99%

Monounsaturated oils do not all have the same effect on plasma cholesterol

Choudhury

1998

Eur J Clin Nutr

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Evidence assembled here indicates that when olive oil forms a major part of dietary fat in controlled human experiments, total and LDL-cholesterols are somewhat higher than when the same amount of fat is one of the modern predominantly monounsaturated oils: low erucic rapeseed or high oleic sun¯ower oil. Oils rich in monounsaturated fatty acids thus do not all have the same effect on plasma cholesterol. This phenomenon is explicable by consideration of the content of other fatty acids and the non-saponi®able fractions of the different monounsaturated oils. It helps to explain the discrepancy that has existed between the classic experiments (using olive oil), which found monounsaturated oils`neutral', and some of the more recent experiments which found them more cholesterol-lowering than carbohydrates. Four published meta-analyses are reviewed. The three which included most of the published experiments show that monounsaturated fatty acids (MUFA) have less plasma cholesterol-lowering effect than polyunsaturated fatty acids.

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Dietary fat and serum lipids: an evaluation of the experimental data

Cited by 458 publications

References 86 publications

The effect of a low-fat, high-carbohydrate diet on serum high density lipoprotein cholesterol and triglyceride

The effect of a low-fat, high-carbohydrate diet on serum high density lipoprotein cholesterol and triglyceride

INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary)

Monounsaturated oils do not all have the same effect on plasma cholesterol

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