Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: studies in the fasting and postprandial states.

Pubmed ID: 18065577

Journal: The American journal of clinical nutrition

Publication Date: Dec. 1, 2007

Affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA. lars.berglund@ucdmc.ucdavis.edu

MeSH Terms: Humans, Male, Adult, Female, Middle Aged, Double-Blind Method, Uric Acid, Blood Glucose, Cholesterol, Triglycerides, Dietary Carbohydrates, Dietary Fats, Unsaturated, Insulin, Apolipoprotein A-I, Apolipoproteins B, Lipoprotein(a), Dietary Fats, Cross-Over Studies, Postprandial Period

Grants: 5 U01 HL049644, HL049648, HL049649, HL049651, HL049659, M01 RR00645

Authors: Ginsberg HN, Ramakrishnan R, Reed R, Kris-Etherton PM, Berglund L, Lefevre M, Elmer PJ, Stewart PW, Ershow A, Pearson TA, Dennis BH, Roheim PS, Stewart K, Phillips KM

Cite As: Berglund L, Lefevre M, Ginsberg HN, Kris-Etherton PM, Elmer PJ, Stewart PW, Ershow A, Pearson TA, Dennis BH, Roheim PS, Ramakrishnan R, Reed R, Stewart K, Phillips KM, DELTA Investigators. Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: studies in the fasting and postprandial states. Am J Clin Nutr 2007 Dec;86(6):1611-20.

Studies:

Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA)

Abstract

BACKGROUND: In subjects with a high prevalence of metabolic risk abnormalities, the preferred replacement for saturated fat is unresolved. OBJECTIVE: The objective was to study whether carbohydrate or monounsaturated fat is a preferred replacement for saturated fat. DESIGN: Fifty-two men and 33 women, selected to have any combination of HDL cholesterol < or = 30th percentile, triacylglycerol > or = 70th percentile, or insulin > or = 70th percentile, were enrolled in a 3-period, 7-wk randomized crossover study. The subjects consumed an average American diet (AAD; 36% of energy from fat) and 2 additional diets in which 7% of energy from saturated fat was replaced with either carbohydrate (CHO diet) or monounsaturated fatty acids (MUFA diet). RESULTS: Relative to the AAD, LDL cholesterol was lower with both the CHO (-7.0%) and MUFA (-6.3%) diets, whereas the difference in HDL cholesterol was smaller during the MUFA diet (-4.3%) than during the CHO diet (-7.2%). Plasma triacylglycerols tended to be lower with the MUFA diet, but were significantly higher with the CHO diet. Although dietary lipid responses varied on the basis of baseline lipid profiles, the response to diet did not differ between subjects with or without the metabolic syndrome or with or without insulin resistance. Postprandial triacylglycerol concentrations did not differ significantly between the diets. Lipoprotein(a) concentrations increased with both the CHO (20%) and MUFA (11%) diets relative to the AAD. CONCLUSIONS: In the study population, who were at increased risk of coronary artery disease, MUFA provided a greater reduction in risk as a replacement for saturated fat than did carbohydrate.