Follow-up dietary counseling benefits attainment of intake goals for total fat, saturated fat, and fiber.
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High levels of dietary fat have been shown to promote the development of mammary tumors induced in rats by 7,12-dimethylbenz(alpha)anthracene, and polyunsaturated fats were found to be more effective than saturated fats. In further studies it was found that diets containing 3% sunflowerseed oil (polyunsaturated fat) and 17% beef tallow or coconut oil (saturated fats) enhance tumorigenesis as much as a diet containing 20% sunflowerseed oil. Rats on these diets developed at least twice as many tumors as those fed diets containing either 3% sunflowerseed oil or 20% of the saturated fats alone. These results are in accord with human epidemiological data which show that breast cancer mortality in different countries is positively correlated with total fat intake but not with intake of polyunsaturated fat. Total fat intake varies greatly in different countries, but most human diets probably contain levels of polyunsaturated fat at least equivalent to 3% sunflowerseed oil.
The relationship between the per person supply of fat from dairy products and lard and cause-specific cancer mortality was examined using 1979-1981 FAO data from 36 countries. Significant correlations (P less than 0.01) were found between dairy and lard fat intake and total, breast, prostate, rectal, colon, and lung cancer. Significant relationships between site-specific cancer mortality and ischemic heart disease mortality could also be established. Hormone-dependent cancers significantly correlate with both hormone-dependent and non-hormone-dependent cancers of the opposite sex, pointing toward other than sex-linked factors as an explanation. The level of saturated fat intake provides the most plausible link for the relationship between the cancers considered and ischemic heart disease mortality. Our findings support the concept of the important role saturated fat plays in cancer promotion.
The effects of diets differing in saturated, monounsaturated and polyunsaturated fatty acid composition (SAFA, MUFA and PUFA, respectively) on plasma lipoproteins and factor VIIc were investigated in 28 middle-aged men and women with mild to moderate hyperlipidaemia. The subjects were stabilized on a diet with a total fat content fairly typical of New Zealand, containing approximately 40% energy as fat, before entering a randomized cross-over trial of diets high in PUFA (20% energy; SAFA and MUFA 10% each) or a high MUFA diet (20% energy; SAFA and PUFA 10% each). After 6-week periods on each diet the subjects returned to a high SAFA diet. Body weight and blood pressure remained unchanged during the study. Total and LDL cholesterol, HDL cholesterol and the HDL2 subfraction were significantly lower on both the MUFA and the PUFA diet than on SAFA. However, there were no statistically significant differences in lipoprotein concentrations on the MUFA and PUFA diet. Factor VIIc concentrations were similar on the three diets. The proportion of PUFA in a MUFA diet appears to be a major determinant of the relative lipoprotein response to such a diet. In order to avoid a reduction in HDL-C when replacing SAFA with MUFA it may be necessary to ensure that PUFA does not provide more than about 8% total energy. Thus careful planning is needed to identify the most appropriate foods to replace those rich in SAFA in diets designed to reduce the lipoprotein-mediated risk of coronary heart disease.
The effects of varying the ratio of polyunsaturated/saturated fatty acids (P/S) and omega 3/omega 6 polyunsaturated fatty acids (PUFA) of dietary fats on lipid metabolism were studied in rats using safflower oil (SFO), linseed oil (LSO), palm oil (PLO), and a 1:1 combination of these oils. The hypocholesterolemic and hypotriglyceridemic effects depended on the P/S ratio of dietary fats, LSO (omega 3 PUFA) being more effective than SFO (omega 6 PUFA). A similar pattern of the response was observed on liver cholesterol and triglyceride. The liver cholesterol-lowering effect of LSO, but not SFO, remained even when they were combined with PLO. The activity of liver delta 6-desaturase tended to be higher while that of liver phospholipase A2 was significantly lower in the LSO group than in the SFO or PLO groups. The aortic PGI2 production and the production by platelets of thromboxane A2 were significantly low in rats fed LSO accompanying a distinct reduction of arachidonate in tissue phospholipids. The depressing effect of LSO disappeared when it was combined with SFO but not with PLO. There were no significant differences in enzyme activities and eicosanoid production between SFO and PLO in spite of a large difference in their P/S ratio. Thus, lipid parameters examined were complicatedly regulated by the ratios of omega 3/omega 6 as well as P/S, suggesting an existence of an appropriate ratio for these variables.
Dietary fat saturation has been shown to affect hepatic apoB/E receptor expression and to modify low density lipoprotein (LDL) composition and density in guinea pigs. The current studies were designed to investigate the independent and interactive effects of dietary fat saturation alterations in apoB/E receptor expression and LDL composition on in vivo LDL turnover kinetics, both receptor-mediated and receptor-independent. Guinea pigs were fed semi-purified diets containing 15% fat, either polyunsaturated corn oil (CO), monounsaturated olive oil (OL), or saturated lard, and injected with radioiodinated LDL isolated from animals fed the homologous diet. Blood samples were obtained over 33 h to determine apoLDL fractional catabolic rates (FCR) and flux rates. Compared to animals fed OL- or lard-based diets, intake of the CO-based diet resulted in a 50% decrease in LDL apoB pool size associated with a twofold increase in receptor-mediated FCR (P less than 0.001) and a 28% decrease in flux rate (P less than 0.05). Maximal LDL binding capacity of hepatic apoB/E receptors, determined in vitro, was twofold higher for animals fed the CO-based diet compared to guinea pigs fed the OL- and lard-based diets (P less than 0.01). There was a significant correlation between hepatic apoB/E receptor number and in vivo receptor-mediated LDL FCR (r = 0.987). Significant differences in LDL turnover were related to the source of LDL. When injected into animals fed a nonpurified commercial diet, the smaller, cholesteryl ester-depleted LDL isolated from animals fed the CO-based diet had a twofold higher FCR compared to larger LDLs from guinea pigs fed the OL- and lard-based diets, which had similar turnover rates. When LDL from animals fed the commercial diet was radiolabeled and injected into animals fed the three types of dietary fat, significant differences in LDL turnover were observed in the order CO greater than lard greater than OL, suggesting that intravascular processing and tissue uptake of the smaller LDL from animals fed the commercial diet varies depending on the dietary fat saturation fed to the recipient animals. These studies demonstrate that guinea pigs fed polyunsaturated fat diets lower plasma LDL levels in part by an increase in apoB/E receptor-mediated fractional LDL turnover and a decrease in apoLDL flux. In addition, fat saturation alters LDL composition and size which independently affect LDL turnover rates in vivo.
Ninety nude mice were inoculated subcutaneously with 1 x 10(7) cells of the human colonic cancer cell lines, SW-620 and LS174T. Tumour growth was assessed weekly for three weeks whilst the animals were receiving one of three diets: control (4.6% fat), coconut (20% fat, saturated fatty acids) and Maxepa (20% fat; n-3 fatty acids). At the end of the study SW-620 tumour weights (mean +/- SD, gm) were: control = 0.38 +/- 0.22, coconut = 0.43 +/- 0.31, Maxepa 0.20 +/- 0.16; the LS174T tumour weights were control = 1.33 +/- 1.27, coconut = 0.47 +/- 0.74, Maxepa = 0.38 +/- 0.56 (p less than 0.001, analysis of covariance). The Maxepa diet produced significant retardation in tumour growth (p less than 0.001). This was associated with reduced levels of linoleic acid and arachidonic acid in adipose tissue and tumour lipids with incorporation of n-3 fatty acids (all p less than 0.01 at least, analysis of variance). Moreover, the Maxepa diet produced significant reductions of plasma cholesterol, phospholipids and triglycerides (all p less than 0.01).
The substitution of saturated fat by complex carbohydrate, according to current dietary recommendations, results in a decrease of plasma and low-density lipoprotein (LDL) cholesterol levels. To determine whether this decrease might result from structural and thus functional changes in LDL particles, the binding internalization and degradation of 125I-LDL were measured using TR715-19 cells, a mutant CHO line into which has been transfected the human LDL receptor, and in which measurements of binding are highly reproducible. Eleven nondiabetic subjects (35 +/- 4 years, 27% +/- 3% body fat) were studied after they had 15% protein, and 560 mg cholesterol/d and the other containing 21% fat (6% saturated), 65% carbohydrate, 14% protein, and 524 mg cholesterol/d.LDL cholesterol levels decreased form 125 +/- 6 to 108 +/- 5 mg/dl (P < .01) on the high-carbohydrate diet. There was an increase in the binding affinity of LDL (Kd 6.6 +/- 2.6 v 7.3 +/- 2.7 micrograms/mL +/- SD; P < .02), and internalization (P < .10), and degradation (P < .05) were also higher. The data suggest that decreasing dietary saturated fat may cause alterations in LDL composition that result in increased receptor clearance; this may partially explain the LDL-decreasing effect of this dietary change.
We investigated the relative effects of different dietary saturated fats on the size distribution, apolipoprotein (apo) and chemical composition of HDL in fasted rats. Male Sprague-Dawley rats (174 +/- 2 g) were fed diets containing 0.035% cholesterol and 16% fat (wt/wt) from corn oil (CO diet) or from 2% CO plus 14% butterfat (BF diet), beef tallow (BT diet), palm oil (PO diet) or coconut oil (CN diet) for 6 wk. Apparent lipid digestibility was significantly lower with the PO and BT diets vs. the CO, BF and CN diets. Plasma total cholesterol levels were significantly higher in rats fed the PO and BT diets than in rats fed the BF and CN diets but were not different among the PO-, BT- and CO-fed groups. Nondenaturing gradient gel electrophoresis immunoblot analysis indicated that HDL apo A-I and E resided on particles with significantly smaller modal diameters in rats fed all saturated fats compared with those fed the CO diet. Chemical analyses indicated that HDL generally contained proportionately less protein and more triglyceride, free cholesterol and apo E with saturated fat feeding than with CO diet feeding. Significantly higher plasma and VLDL triglyceride levels were noted with ingestion of the BT, PO or CN diet than with the CO diet. Butterfat feeding resulted in lower plasma triglycerides and HDL-esterified cholesterol than did feeding the other saturated fats. Very low density lipoprotein triglyceride concentrations were inversely correlated with HDL modal diameter of apo E containing lipoproteins (P less than 0.005). These data provide further evidence of the interrelationship of triglyceride and HDL metabolism and suggest that mechanisms independent of cholesterol ester transfer protein may mediate this response in rats.
Numerous functional risk factors are associated with the occurrence of secondary amenorrhea in young women. Less is known regarding factors associated with the more prevalent problem of oligomenorrhea. We have evaluated nutrient intake, body composition, perceived psychological stress, 24-hour urinary cortisol, and urinary C peptide (UCP) in 35 eumenorrheic, 11 mildly oligomenorrheic, and 10 oligomenorrheic nonathletic undergraduate women. Nutrient intake was evaluated by a validated food frequency questionnaire. Oligomenorrheic women were found to consume significantly more dietary fiber, crude fiber, and polyunsaturated fat, and significantly less saturated fat than their eumenorrheic classmates. Oligomenorrheic women had significantly lower 24-hour UCP excretion than mildly oligomenorrheic women. The groups did not differ in any aspect of body composition, body weight, age of menarche, perceived psychological stress, or urinary cortisol excretion. The data suggest that higher intake of fiber and lower intake of saturated fat may be associated with oligomenorrhea among otherwise healthy undergraduate nonathletic women.
Mesenteric lymph chylomicrons were characterized during and after the establishment of steady-state triglyceride transport. Chylomicrons were isolated from lymph at 0, 2, 4, 6, 8 and 12 h after the start of an 8-h infusion of triglyceride emulsion (prepared using either corn or butter oil) at 160 mumol/(kg.h). Lymph flow was not influenced by triglyceride source. Output of triglyceride, measured both in whole lymph and in the chylomicron fraction, was not significantly affected by triglyceride source. Butter oil infusion produced a higher output of chylomicron phospholipid and unesterified cholesterol than was observed in response to corn oil emulsion. Ratios of transported phospholipid to triglyceride for butter oil chylomicrons were higher (1.3- to 1.7-fold) than those for corn oil chylomicrons at every time point examined after the start of lipid infusion. No other compositional differences in chylomicrons due to triglyceride source were observed. These results support the hypothesis that differences in efficiency of absorption and transport between saturated and unsaturated fat are sufficient to explain size differences in secreted chylomicrons in response to corn and butter oil infusions, and suggest that chylomicron number may be influenced by dietary fat saturation.
The dietary data from case-control studies of breast, prostate, and lung cancer in Hawaii revealed that saturated fat was a risk factor for these malignancies. The dietary intakes from the three studies were used to calculate the attributable risk (AR) due to saturated fat. For all ethnic groups combined, the ARs for the highest quartiles of intake were 14.9 percent for female breast cancer, 13.0 percent for prostate cancer, and 23.1 percent for male lung cancer. Our results suggested that a reduction of saturated fat to the lowest quartiles of intake could result in a 10 to 20 percent decrease in risk for these three cancers in Hawaii. We also examined the ethnic-specific risks associated with saturated fat consumption among the Japanese and the Caucasians in the three studies. The ARs for the highest quartiles of intake were notably higher among the Caucasians than the Japanese, primarily due to the difference in their dietary patterns. Although the calculated AR due to saturated fat was higher among the Caucasians than among the Japanese, all persons in the population would derive considerable benefit by reducing their intake of this nutrient.
BACKGROUND: Recent recommendations for Americans aged 2 and older call for a reduction in the average saturated fat intake to less than 10% of calories. METHODS: Using 24-hour dietary recalls collected from mothers of 4- to 7-year-old urban Latino children, we identified foods and dietary behavior patterns that distinguish children with higher and lower mean daily percentages of calories from saturated fat. RESULTS: Compared with children in the lowest quintile of intake, children in the highest quintile consumed more than twice as much saturated fat per day from high-fat milk products (18.5 g vs 7.8 g), mostly from whole milk. They did not consume different kinds of milk or different amounts of milk per eating occasion, but on average they consumed milk more frequently (2.8 vs 1.6 eating occasions per day). Even children in the lowest quintile, on average, exceeded the 10% of calories from saturated fat currently recommended. If low-fat (1% fat) milk had been substituted without other dietary changes, all but the highest two quintiles would have been within the recommended level. CONCLUSIONS: The substitution of low-fat for whole milk appears to be a key strategy for preschool children for achieving recommended levels of saturated fat intake.
Dietary recommendations for diabetic patients now generally include the reduction of total and saturated fat and an increase in complex carbohydrates. We conducted two series of studies on individuals with obesity and/or non-insulin-dependent diabetes mellitus (NIDDM) to assess the effects of this dietary recommendation on both lipoproteins and their metabolism as well as on insulin secretion and action and energy expenditure. Both series compared a diet high in saturated fat with a diet high in complex carbohydrates and fiber. Calories and proportion of protein were constant. In the first set of studies, we sought to examine the effect of replacement of saturated fat with complex carbohydrate in a regimen with conventional foods that would closely approximate foods expected to be used and recommended to diabetic patients. In the second regimen, we examined a more extreme difference between carbohydrate content and fat content using a dietary change that would approximate the contrasts between traditional diets of Native Americans or other cultures and a modern westernized diet. The effects on lipoproteins included consistent decreases in total and low-density lipoprotein (LDL) cholesterol (av 10%), minimum to no change in high-density lipoprotein cholesterol, and insignificant changes in total or very-low-density lipoprotein (VLDL) triglycerides or 24-h triglyceride profiles. Changes in total and LDL cholesterol required 3-4 wk to reach equilibrium. Metabolic studies used to elucidate the reasons for the decrease in LDL cholesterol confirmed no stimulation of VLDL triglyceride or apolipoprotein B (apoB) production on the high-carbohydrate diet. The decrease in LDL appeared to be due to decreases in mechanisms that convert VLDL to LDL and increased activity of LDL apoB clearance. There were no changes in fasting and 2- or 24-h glucose profiles or in fasting and 2-h insulin concentrations in individuals consuming a diet of 30% fat and 55% carbohydrate. However, in the study with traditional foods, where dietary carbohydrate was 70% and fat only 15%, there was an improvement in glucose tolerance. It was accompanied by an improvement in glucose-mediated glucose disposal and insulin secretion. Finally, with a whole-body calorimeter, we found no difference between the high-fat and high-carbohydrate diets in terms of 24-h energy expenditure. In individuals having a wide range of obesity and glucose tolerance, substitution of complex carbohydrates for saturated fat has beneficial effects of lowering LDL cholesterol and possibly improving glucose tolerance and insulin secretion but without having any adverse effects on lipoprotein metabolism or energy expenditure.
The potential of a food or a diet to raise the plasma level of total and low-density-lipoprotein cholesterol and to promote atherosclerosis is directly related to its cholesterol and saturated fat content. A new formula that indicates the concentrations of cholesterol and saturated fat in foods, termed the cholesterol-saturated fat index (CSI), has been devised. A low CSI indicates low saturated fat and/or cholesterol content and thus hypocholesterolemic and low atherogenic potential. Guidelines are provided for using the CSI to evaluate or plan low-fat diets, for comparing a food or a mixed dish with others, and for evaluating a day's food intake. A comprehensive table of foods is presented.
This article reviews seven community-based programs for prevention of cardiovascular disease and their effects on blood cholesterol levels and saturated fat intake. In two programs, cholesterol levels were reduced more in the intervention area than in the reference area. In two other programs, cholesterol increased less in the intervention area than in the reference area. In one program, cholesterol levels initially fell in the intervention group and increased in the reference group; after the first 4 years, the levels also started to increase in the intervention group. The final two programs reduced cholesterol equally in both groups. Only two programs reported on the intake of saturated fats; in both, intake of saturated fat was reduced more in the intervention area than in the reference populations. In one program area, total intake of fat was reduced more than in the reference area. Published data do not allow us to draw conclusions regarding which components of the programs were most important. These studies show that the average blood cholesterol level can be affected in a general population.
1. The effects of saturated fat and cholesterol on lipoprotein fluidity were tested in New Zealand white rabbits fed diets containing corn oil (CO) or cocoa butter (CB) with and without added 0.2% cholesterol. 2. Saturated fats had little effect on fluidity in any lipoprotein fraction. 3. Cholesterol feeding dramatically reduced fluidity in VLDL and LDL, but minimal change was noted in HDL. 4. Cholesterol-fed rabbits were hypercholesteroloemic throughout the 10-month study. 5. The rabbits became adapted to cholesterol feeding as VLDL became more fluid with time.