Journal Name:
Circulation
Article Title:
Monounsaturated Fatty Acids and Risk of cardiovascular disease
Date Written:
1999
Volume:
100
Number:
Page:
1253
Author(s):
Kris-Etherton, P.
Article:
Recent attention has been directed to the role that diets higher in total fat comprised in large part by MUFA instead of carbohydrates or SFAs may play in lowering CVD risk. A high-MUFA diet has been shown not to increase TAGs nor lower HDL-C. Typical sources of MUFAs assessed included olive oil (OO) and canola oil (CO). In this study, the hypocholesterolemic effects of peanut oil, which contains lower levels of MUFAs than OO or CO, was assessed in order to increase food options available in planning high MUFA, cholesterol-lowering diets.
The study compared the CVD risk profile of an Average American diet (AAD) with those of 4 cholesterol-lowering diets: an American Heart Association/National Cholesterol Education Program Step II diet and 3 diets high in MUFAs and including OO, peanut oil (PO), or peanuts and peanut butter (PPB). A randomized, double-blind, 5-period crossover study design with males and females (n = 22) was used.
The results of the study showed that the high-MUFA diets reduced TC by 10% and LDL-C by 14%. This was comparable to the Step II diet. However, TAG concentrations were 13% lower in subjects on the high MUFA diets and 11% higher with Step II diets compared to the AAD. The Step II diet also resulted in 4% lower HDL-C levels. The high MUFA diets did not yield any decrease in HDL-C. The OO, PO, and PPB diets decreased CVD risk by an estimated 25%, 16%, and 21%, respectively, whereas the Step II diet lowered CVD risk by 12%. This study clearly showed that more favorable effects on blood lipids and CVD risk profile are achieved with diets containing high levels of MUFAs in comparison with diets characterized by low-fat and high-carbohydrate. The incorporation of CO in the diet in order to reduce CVD risk is supported by the results of this research.
This publication also reviews current understanding of how monounsaturated fatty acids (MUFAs) affect risk for cardiovascular disease (CVD). This is a topic that has attracted considerable scientific interest, in large part because of uncertainty regarding whether MUFA or carbohydrate should be substituted for saturated fatty acids (SFAs) and the desirable quantity of MUFA to include in the diet. In the mid-1980s, investigators began to debate the question of the ideal substitute for SFA calories: carbohydrate or unsaturated fatty acids, specifically MUFAs under stable weight conditions. The results of a number of studies conducted to date indicate that although both diets lower total and low-density lipoprotein (LDL) cholesterol, the high-MUFA diet do not lower high-density lipoprotein (HDL) cholesterol or increase triglycerides, as do low-fat/carbohydrate-rich diet. Thus, a consensus has arisen to support the observations that HDL cholesterol levels are higher and triglycerides are lower on a high-MUFA than low-fat/carbohydrate-rich, blood cholesterol-lowering diet.
Several studies are reviewed including a meta-analysis of results of 14 studies published between 1983 and 1994. In this research, diets high in oils enriched in MUFA versus PUFA elicited similar effects on total, LDL, and HDL cholesterol, whereas the PUFA-enriched oil had a slight triglyceride-lowering effect. On the basis of existing evidence that compared the relative cholesterolemic effects of MUFA versus PUFA, for practical purposes, it seems to matter little which unsaturated fatty acid class replaces SFA in the diet. Thus, the cholesterolemic effects of MUFA versus PUFA substitution for dietary SFA are comparable. Studies have also shown that enrichment of the diet with MUFA at the expense of PUFA led to LDLs that were less susceptible to oxidation. It has not been established, however, whether in vitro oxidative susceptibility of LDL is related to atherogenesis or CHD risk.
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