Key result
A low-fat, high-carbohydrate diet reduced total triglycerides and cholesterol similarly regardless of polyunsaturated to saturated fat ratio, though a lower ratio increased HDL cholesterol.
Why the study?
Does a low-fat, high-carbohydrate diet with a low P/S ratio compared to a high P/S ratio improve plasma lipids in patients with familial endogenous hypertriglyceridemia?
Does a low-fat, high-carbohydrate diet with a low P/S ratio compared to a high P/S ratio improve plasma lipids in patients with familial endogenous hypertriglyceridemia?
In patients with familial endogenous hypertriglyceridemia, reducing dietary fat intake lowers triglycerides and cholesterol regardless of the polyunsaturated to saturated fat ratio, but a lower P/S ratio may uniquely increase HDL cholesterol.
May support low-fat diets in hypertriglyceridemia regardless of P/S ratio; leaves open HDL effects pending randomized trials.
In this study we compared the effects of a low-fat, high-carbohydrate (LFHC) diet at two levels of polyunsaturated fatty acids on plasma lipids of 20 patients affected by familial endogenous hypertriglyceridemia. During the intervention period the proportion of dietary energy derived from fat was reduced from about 45% to 20% in all the subjects. Ten patients (group I) consumed a LFHC diet with a polyunsaturated to saturated fat (P/S) ratio of 0.4, while the other 10 patients (group II) had a diet with a P/S ratio of 1–7. During the intervention period we observed a significant decrease of total plasma triglycerides and cholesterol in both groups. In spite of the different P/S ratio, the decrease of total triglycerides and cholesterol was superimposable in the two groups. The fall in plasma triglycerides and cholesterol was due only to the decrease in very low density lipoproteins (VLDL). On the contrary, low density lipoproteins (LDL) cholesterol was unchanged in both groups. Finally, during the intervention period we observed an increase of high density lipoproteins (HDL) cholesterol only in group I while it did not vary in group II. During the intervention period the HDL to LDL cholesterol ratio increased significantly only in group I while it did not vary in group II. The increase of HDL cholesterol levels observed in group I was due mainly to the rise of HDL2 cholesterol concentrations. The results show that when the intake of fat, and in particular, of saturates is reduced the effect of different amounts of polyunsaturates or monounsaturates on plasma triglycerides and cholesterol subfraction levels seems to be variable.
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Cominacini et al. (1990) studied Familial endogenous hypertriglyceridemia (n=20). Low-fat, high-carbohydrate diet with P/S ratio of 0.4 vs. Low-fat, high-carbohydrate diet with P/S ratio of 1-7 was evaluated on Plasma lipids (total triglycerides and cholesterol). A low-fat, high-carbohydrate diet reduced total triglycerides and cholesterol similarly regardless of polyunsaturated to saturated fat ratio, though a lower ratio increased HDL cholesterol.
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