Diets high in palmitic acid (16:0), lauric and myristic acids (12:0 + 14:0), or oleic acid (18:1) do not alter postprandial or fasting plasma homocysteine and inflammatory markers in healthy Malaysian adults. Virgin olive oil, palm olein and coconut oil diets do not raise cell adhesion molecules and thrombogenicity indices in healthy Malaysian adults High-monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations. Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women. Consumption of trans fats and estimated effects on coronary heart disease in Iran Epidemiologic studies on dietary fats and coronary heart disease. Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women Reduced bone mineralization in infants fed palm olein-containing formula: a randomized, double-blinded, prospective trial. Behenic acid is a cholesterol-raising saturated fatty acid in humans. Replacement of dietary fat with palm oil: effect on human serum lipids, lipoproteins and apolipoproteins. Replacement of saturated with unsaturated fats had no impact on vascular function but beneficial effects on lipid biomarkers, E-selectin, and blood pressure: results from the randomized, controlled Dietary Intervention and VAScular function (DIVAS) study. Independence of the effects of cholesterol and degree of saturation of the fat in the diet on serum cholesterol in man. Fat high in stearic acid favorably affects blood lipids and factor VII coagulant activity in comparison with fats high in palmitic acid or high in myristic and lauric acids. Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes. Effects of dietary saturated, monounsaturated, and n-3 fatty acids on blood pressure in healthy subjects. Effects of trans- and n-3 unsaturated fatty acids on cardiovascular risk markers in healthy males. An 8 weeks dietary intervention study A randomized study of coconut oil versus sunflower oil on cardiovascular risk factors in patients with stable coronary heart disease Prediction of cardiovascular mortality in middle-aged men by dietary and serum linoleic and polyunsaturated fatty acids. Biomarkers of Dairy Fatty Acids and Risk of Cardiovascular Disease in the Multi‐Ethnic Study of Atherosclerosis Comparison of predictive performance of various fatty acids for the risk of cardiovascular disease events and all-cause deaths in a community-based cohort. Replacement of partially hydrogenated soybean oil by palm oil in margarine without unfavorable effects on serum lipoproteins Palmitic acid in the sn-2 position of dietary triacylglycerols does not affect insulin secretion or glucose homeostasis in healthy men and women Effects of palm olein and olive oil on serum lipids in a Chinese population: a randomized, double-blind, cross-over trial. Fatty acid saturation of the diet and plasma lipid concentrations, lipoprotein particle concentrations, and cholesterol efflux capacity. Rationale and design of the TRANSFACT project phase I: a study to assess the effect of the two different dietary sources of trans fatty acids on cardiovascular risk factors in humans. Ad libitum intake of low-fat diets rich in either starchy foods or sucrose: effects on blood lipids, factor VII coagulant activity, and fibrinogen. A diet rich in high-oleic-acid sunflower oil favorably alters low-density lipoprotein cholesterol, triglycerides, and factor VII coagulant activity. Stearic acid-rich interesterified fat and trans-rich fat raise the LDL/HDL ratio and plasma glucose relative to palm olein in humans Coronary risk factors in schoolchildren. 
Exchanging partially hydrogenated fat
for palmitic acid in the diet increases
LDL-cholesterol and endogenous
cholesterol synthesis in
normocholesterolemic women Soluble fibre (Plantago ovata husk) reduces plasma low-density lipoprotein (LDL) cholesterol, triglycerides, insulin, oxidised LDL and systolic blood pressure in hypercholesterolaemic patients: A randomised trial. Palm Olein and Olive Oil Cause a Higher Increase in Postprandial Lipemia Compared with Lard but Had No Effect on Plasma Glucose, Insulin and Adipocytokines High Fat Diet with a High Monounsaturated Fatty Acid and Polyunsaturated/Saturated Fatty Acid Ratio Suppresses Body Fat Accumulation and Weight Gain in Obese Hamsters Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors Effects of high-fat and low-fat diets rich in monounsaturated fatty acids on serum lipids, LDL size and indices of lipid peroxidation in healthy non-obese men and women when consumed under controlled conditions Fatty acid content of serum lipid fractions and blood lipids in normolipidaemic volunteers fed two types of cheese having different fat compositions: a pilot study Palm olein increases plasma cholesterol moderately compared with olive oil in healthy individuals. Effects on blood pressure of omega 3 fats in subjects at increased risk of cardiovascular disease. The type of oil used for cooking is associated with the risk of nonfatal acute myocardial infarction in costa rica. Epidemiological Evidence of Relationships between Dietary Polyunsaturated Fatty Acids and Mortality in the Multiple Risk Factor Intervention Trial Interactions between dietary fat, fish, and fish oils and their effects on platelet function in men at risk of cardiovascular disease. The Mediterranean diet in secondary prevention of coronary heart disease.
BACKGROUND Dietary fat type is known to modulate the plasma lipid profile , but its effects on plasma homocysteine and inflammatory markers are unclear . OBJECTIVE We investigated the effects of high-protein Malaysian diets prepared with palm olein , coconut oil ( CO ) , or virgin olive oil on plasma homocysteine and selected markers of inflammation and cardiovascular disease ( CVD ) in healthy adults . DESIGN A r and omized-crossover intervention with 3 dietary sequences of 5 wk each was conducted in 45 healthy subjects . The 3 test fats , namely palmitic acid (16:0)-rich palm olein ( PO ) , lauric and myristic acid ( 12:0 + 14:0)-rich CO , and oleic acid (18:1)-rich virgin olive oil ( OO ) , were incorporated at two-thirds of 30 % fat calories into high-protein Malaysian diets . RESULTS No significant differences were observed in the effects of the 3 diets on plasma total homocysteine ( tHcy ) and the inflammatory markers TNF-α , IL-1β , IL-6 , and IL-8 , high-sensitivity C-reactive protein , and interferon-γ . Diets prepared with PO and OO had comparable nonhypercholesterolemic effects ; the postpr and ial total cholesterol for both diets and all fasting lipid indexes for the OO diet were significantly lower ( P < 0.05 ) than for the CO diet . Unlike the PO and OO diets , the CO diet was shown to decrease postpr and ial lipoprotein(a ) . CONCLUSION Diets that were rich in saturated fatty acids prepared with either PO or CO , and an OO diet that was high in oleic acid , did not alter postpr and ial or fasting plasma concentrations of tHcy and selected inflammatory markers . This trial was registered at clinical trials.gov as NCT00941837 Background / objectives : Effects of high-protein diets that are rich in saturated fats on cell adhesion molecules , thrombogenicity and other nonlipid markers of atherosclerosis in humans have not been firmly established . We aim to investigate the effects of high-protein Malaysian diets prepared separately with virgin olive oil ( OO ) , palm olein ( PO ) and coconut oil ( CO ) on cell adhesion molecules , lipid inflammatory mediators and thromobogenicity indices in healthy adults . Methods : A r and omized cross-over intervention with three dietary sequences , using virgin OO , PO and CO as test fats , was carried out for 5 weeks on each group consisting of 45 men and women . These test fats were incorporated separately at two-thirds of 30 % fat calories into high-protein Malaysian diets . Results : For fasting and nonfasting blood sample s , no significant differences were observed on the effects of the three test-fat diets on thrombaxane B2 ( TXB2 ) , TXB2/PGF1α ratios and soluble intracellular and vascular cell adhesion molecules . The OO diet induced significantly lower ( P<0.05 ) plasma leukotriene B4 ( LTB4 ) compared with the other two test diets , whereas PGF1α concentrations were significantly higher ( P<0.05 ) at the end of the PO diet compared with the OO diet . Conclusion : Diets rich in saturated fatty acids from either PO or CO and high in monounsaturated oleic acid from virgin OO do not alter the thrombogenicity indices — cellular adhesion molecules , thromboxane B2 ( TXB2 ) and TXB2/prostacyclin ( PGF1α ) ratios . However , the OO diet lowered plasma proinflammatory LTB4 , whereas the PO diet raised the antiaggregatory plasma PGF1α in healthy Malaysian adults . This trial was registered at clinical trials.gov as NCT 00941837 BACKGROUND Low-fat diets increase plasma triacylglycerol and decrease HDL-cholesterol concentrations , thereby potentially adversely affecting cardiovascular disease ( CVD ) risk . High-monounsaturated fatty acid ( MUFA ) , cholesterol-lowering diets do not raise triacylglycerol or lower HDL cholesterol , but little is known about how peanut products , a rich source of MUFAs , affect CVD risk . OBJECTIVE The present 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 high-MUFA diets [ olive oil ( OO ) , peanut oil ( PO ) , and peanuts and peanut butter ( PPB ) ] . DESIGN A r and omized , double-blind , 5-period crossover study design ( n = 22 ) was used to examine the effects of the diets on serum lipids and lipoproteins  : AAD [ 34 % fat ; 16 % saturated fatty acids ( SFAs ) , 11 % MUFAs ] , Step II ( 25 % fat ; 7 % SFAs , 12 % MUFAs ) , OO ( 34 % fat ; 7 % SFAs , 21 % MUFAs ) , PO ( 34 % fat ; 7 % SFAs , 17 % MUFAs ) , and PPB ( 36 % fat ; 8 % SFAs , 18 % MUFAs ) . RESULTS The high-MUFA diets lowered total cholesterol by 10 % and LDL cholesterol by 14 % . This response was comparable with that observed for the Step II diet . Triacylglycerol concentrations were 13 % lower in subjects consuming the high-MUFA diets and were 11 % higher with the Step II diet than with the AAD . The high-MUFA diets did not lower HDL cholesterol whereas the Step II diet lowered it by 4 % compared with the AAD . 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 % . CONCLUSION A high-MUFA , cholesterol-lowering diet may be preferable to a low-fat diet because of more favorable effects on the CVD risk profile BACKGROUND Metabolic studies suggest that saturated fatty acids differ in their effects on blood lipids . OBJECTIVE The objective was to examine the associations between intakes of individual saturated fatty acids and their food sources in relation to the risk of coronary heart disease ( CHD ) .  DESIGN This was a prospect i ve cohort study of 80082 women in the Nurses ' Health Study aged 34 - 59 y. Subjects had no known cardiovascular disease , cancer , hypercholesterolemia , or diabetes , and completed vali date d food-frequency question naires in 1980 . RESULTS During 14 y of follow-up , we documented 939 incident cases of major CHD events . In multivariate analyses in which age , smoking , and other covariates were controlled for , intakes of short- to medium-chain saturated fatty acids ( 4:0 - 10:0 ) were not significantly associated with the risk of CHD . In contrast , intakes of longer-chain saturated fatty acids ( 12:0 - 18:0 ) were each separately associated with a small increase in risk . The multivariate RR for a 1 % energy increase from stearic acid was 1.19 ( 95 % CI : 1.02 , 1.37 ) . The ratio of polyunsaturated to saturated fat was strongly and inversely associated with CHD risk ( multivariate RR for a comparison of the highest with the lowest deciles : 0.58 ; 95 % CI : 0.41 , 0.83 ; P for trend < 0.0001 ) . Conversely , higher ratios of red meat to poultry and fish consumption and of high-fat to low-fat dairy consumption were associated with significantly greater risk . CONCLUSION A distinction between stearic acid and other saturated fats does not appear to be important in dietary advice to reduce CHD risk , in part because of the high correlation between stearic acid and other saturated fatty acids in typical diets Objective : To investigate the consumption of industrial trans-fatty acids ( TFAs )  in Iranian homes and the proportion of coronary heart disease ( CHD ) events in Iran attributable to such intake . Design , setting and participants : The consumption of industrial TFAs was determined using ( 1 ) detailed in-home assessment s of dietary intake among 7158 urban and rural households containing 35 924 individuals and ( 2 ) gas chromatography to determine TFA contents of the most commonly consumed partially hydrogenated oils . The population -attributable risk for CHD owing to TFA consumption was calculated on the basis of ( 1 ) documented effects of TFAs on total : high-density lipoprotein ( HDL ) cholesterol in r and omized controlled dietary trials and ( 2 ) relationships of TFA intake with incidence of CHD in prospect i ve observational studies . Results : Partially hydrogenated oils were used extensively for cooking in Iranian homes with average per-person intake of 14 g/1000 kcal .  TFAs  accounted for 33 % of fatty acids in these products , or 4.2 % of all calories consumed ( 12.3 g/day ) . On the basis of total : HDL cholesterol effects alone , 9 % of CHD events would be prevented by replacement of TFA in Iranian homes with cis-unsaturated fats ( 8 % by replacement with saturated fats ) . On the basis of relationships of TFA intake with CHD incidence in prospect i ve studies , 39 % of CHD events would be prevented by replacement of TFA with cis-unsaturated fats ( 31 % by replacement with saturated fats ) . These population -attributable risks may be overestimates owing to competing risks and because not all the fat used for cooking might actually be consumed . If actual TFA consumption were only half as large , the estimated proportion of CHD events prevented by TFA elimination would be 5 % on the basis of total : HDL cholesterol effects and replacement with cis-unsaturated ( 4 % for replacement with saturated fats ) , and 22 % on the basis of prospect i ve studies and replacement with cis-unsaturated fats ( 17 % for replacement with saturated fats ) . These estimates do not include possible additional benefits derived from replacing TFAs with vegetable oils containing n-3 fatty acids . Conclusions : Intake of TFAs is high in Iranian homes and contributes to a sizeable proportion of CHD events . Replacement of partially hydrogenated oils with unhydrogenated oils would likely produce substantial reductions in CHD incidence . Sponsorship : National Heart , Lung and Blood Institute , National Institutes of Health , USA . National Nutrition & Food Technology Research Institute , Tehran , Iran The results of large prospect i ve epidemiologic investigations support the hypothesis that coronary disease risk depends on the quality rather than quantity of dietary fat . Whereas saturated fat and cholesterol appear to increase the risk of coronary heart disease ( CHD ) as predicted by their effects on blood lipids , strong evidence has emerged that the deleterious effects of trans unsaturated fatty acids ( trans fatty acids ) extend beyond those predicted by their well-known adverse influence on the ratio of low-density lipoprotein to high-density lipoprotein cholesterol . On the other h and , increased consumption of the polyunsaturated fats , linoleic acid and linolenic acid , appears to reduce the risk of CHD Introduction High dietary saturated fat intake is associated with higher blood concentrations of low-density lipoprotein cholesterol ( LDL-C ) , an established risk factor for coronary heart disease . However , there is increasing interest in whether various dietary oils or fats with different fatty acid profiles such as extra virgin coconut oil may have different metabolic effects but trials have reported inconsistent results . We aim ed to compare changes in blood lipid profile , weight , fat distribution and metabolic markers after four weeks consumption of 50 g daily of one of three different dietary fats , extra virgin coconut oil , butter or extra virgin olive oil , in healthy men and women in the general population . Design R and omised clinical trial conducted over June and July 2017 . Setting General community in Cambridgeshire , UK . Participants Volunteer adults were recruited by the British Broadcasting Corporation through their websites . Eligibility criteria were men and women aged 50–75 years , with no known history of cancer , cardiovascular disease or diabetes , not on lipid lowering medication , no contraindications to a high-fat diet and willingness to be r and omised to consume one of the three dietary fats for 4 weeks . Of 160 individuals initially expressing an interest and assessed for eligibility , 96 were r and omised to one of three interventions ; 2 individuals subsequently withdrew and 94 men and women attended a baseline assessment . Their mean age was 60 years , 67 % were women and 98 % were European Caucasian . Of these , 91 men and women attended a follow-up assessment 4 weeks later . Intervention Participants were r and omised to extra virgin coconut oil , extra virgin olive oil or unsalted butter and asked to consume 50 g daily of one of these fats for 4 weeks , which they could incorporate into their usual diet or consume as a supplement . Main outcomes and measures The primary outcome was change in serum LDL-C ; secondary outcomes were change in total and high-density lipoprotein cholesterol ( TC and HDL-C ) , TC/HDL-C ratio and non-HDL-C ; change in weight , body mass index ( BMI ) , waist circumference , per cent body fat , systolic and diastolic blood pressure , fasting plasma glucose and C reactive protein . Results LDL-C concentrations were significantly increased on butter compared with coconut oil ( + 0.42 , 95 % CI 0.19 to 0.65 mmol/L , P<0.0001 ) and with olive oil ( + 0.38 , 95 % CI 0.16 to 0.60 mmol/L , P<0.0001 ) , with no differences in change of LDL-C in coconut oil compared with olive oil ( −0.04 , 95 % CI −0.27 to 0.19 mmol/L , P=0.74 ) . Coconut oil significantly increased HDL-C compared with butter ( + 0.18 , 95 % CI 0.06 to 0.30 mmol/L ) or olive oil ( + 0.16 , 95 % CI 0.03 to 0.28 mmol/L ) . Butter significantly increased TC/HDL-C ratio and non-HDL-C compared with coconut oil but coconut oil did not significantly differ from olive oil  for TC/HDL-C and non-HDL-C. There were no significant differences in changes in weight , BMI , central adiposity , fasting blood glucose , systolic or diastolic blood pressure among any of the three intervention groups . Conclusions and relevance Two different dietary fats ( butter and coconut oil ) which are predominantly saturated fats , appear to have different effects on blood lipids compared with olive oil , a predominantly monounsaturated fat with coconut oil more comparable to olive oil with respect to LDL-C. The effects of different dietary fats on lipid profiles , metabolic markers and health outcomes may vary not just according to the general classification of their main component fatty acids as saturated or unsaturated but possibly according to different profiles in individual fatty acids , processing methods as well as the foods in which they are consumed or dietary patterns . These findings do not alter current dietary recommendations to reduce saturated fat intake in general but highlight the need for further elucidation of the more nuanced relationships between different dietary fats and health . Trial registration number NCT03105947 ; Results OBJECTIVE Palm and palm olein ( PO ) oils are used in some infant formula fat blends to match the fatty acid profile of human milk , but their presence has been shown to lower calcium and fat absorption . We aim ed to determine if the reported differences in calcium absorption could affect skeletal development by comparing bone mineral accretion in healthy term infants fed a milk-based formula with ( PMF ) or without PO . METHODS Whole body bone mineralization was evaluated in healthy term infants fed 1 of 2 coded , commercially available , ready-to-feed infant formulas in a r and omized , double-blind , parallel study . Subjects were fed either 1 ) . PMF formula ( Enfamil with iron ; Mead Johnson Division of Bristol Myers , Evansville , IN ; N = 63 ) containing PO/coconut/soy/high-oleic sunflower oils ( 45/20/20/15 % oil ) ; or 2 ) . milk-based formula without PO ( Similac with iron ; Ross Products Division Abbott Laboratories , Columbus , OH ; N = 65 ) , containing high-oleic safflower/coconut/soy oils ( 40/30/30 % oil ) from enrollment by 2 weeks after birth until 6 months . Anthropometrics and formula intake were determined monthly ; total body bone mineral content ( BMC ) and bone mineral density ( BMD ) were measured at baseline , 3 , and 6 months of age using dual energy x-ray absorptiometry . RESULTS Intent-to-treat analyses indicated no significant differences between feeding groups in weight , length , head circumference , or formula intake throughout the study . BMC and BMD were not different at baseline but repeated measures analyses show that infants fed PMF had significantly lower BMC and BMD at 3 and 6 months . CONCLUSIONS Healthy term infants fed a formula containing PO as the predominant oil in the fat blend had significantly lower BMC and BMD than those fed a formula without PO . The inclusion of PO in infant formula at levels needed to provide a fatty acid profile similar to that of human milk leads to lower bone mineralization BACKGROUND Dietary behenic acid ( 22:0 ) is poorly absorbed . Because of its low bioavailability compared with other fatty acids and because of its very long chain length , the effect of dietary behenic acid ( behenate ) on serum lipid concentrations in humans is assumed to be neutral . OBJECTIVE The objective was to establish the cholesterol-raising potential of behenic acid by comparing the effects on lipid and lipoprotein concentrations of a specially formulated fat enriched with behenic acid with those of palm oil ( rich in palmitic acid ; 16:0 ) and high-oleic acid sunflower oil ( rich in cis oleic acid ; 18:1 ) . DESIGN In a r and omized , crossover , metabolic-ward study , 7 mildly hypercholesterolemic men were fed 3 natural-food diets supplemented with behenate oil , palm oil , or high-oleic acid sunflower oil .  Mean serum lipid and lipoprotein concentrations and plasma triacylglycerol fatty acid composition were determined from fasting blood drawn during the final 4 d of each 3-wk diet period . RESULTS Behenate oil produced mean concentrations of total cholesterol ( 5.87+/-0.8 mmol/L ) and LDL cholesterol ( 4.40+/-0.8 mmol/L ) not significantly different from those produced by palm oil ( 5.84+/-0.7 and 4.42+/-0.7 mmol/L , respectively ) but significantly higher than those produced by high-oleic acid sunflower oil ( 5.12+/-0.5 and 3.70+/-0.6 mmol/L , respectively ) . There were no significant differences in triacylglycerol or HDL-cholesterol concentrations . CONCLUSIONS Despite its low bioavailability compared with oleic acid , behenic acid is a cholesterol-raising fatty acid in humans and is therefore not a suitable substitute for palmitic acid in manufactured triacylglycerols Thirty-eight male volunteers participated in a double-blind cross-over trial evaluating the effect of replacing the usual sources of saturated fat in the Dutch diet ( animal fats and hydrogenated oils ) by palm oil , which is virtually free of cholesterol and trans-fatty acids , on serum lipids , lipoproteins and apolipoproteins . Maximum ( about 70 % ) replacement had no significant effect on serum total cholesterol or most lipoprotein fractions , but result ed in an 11 % increase in serum high-density-lipoprotein (HDL)2-cholesterol relative to the control ( P2 = 0.01 ) . The palm-oil diet also caused an 8 % decrease in low-density-lipoprotein (LDL):HDL2 + HDL3-cholesterol ratio ( P2 = 0.02 ) as well as a 9 % decrease in triacylglycerols in the low-density-lipoprotein fractions ( P2 = 0.01 ) . Palm oil consumption result ed in a 4 % increase in serum apolipoprotein AI ( P2 = 0.008 ) and a 4 % decrease in apolipoprotein B ( P2 = 0.01 ) relative to the control diet ; the B : AI apolipoprotein ratio was decreased by 8 % ( P2 < 0.0001 ) . These results were not significantly affected by the different lipoprotein E phenotypes of the volunteers . Although the observed differences were relatively modest , the present study , nonetheless , indicates that dietary palm oil , when replacing a major part of the normal fat content in a Dutch diet , may slightly reduce the lipoprotein- and apolipoprotein-associated cardiovascular risk profiles BACKGROUND Public health strategies to lower cardiovascular disease ( CVD ) risk involve reducing dietary saturated fatty acid ( SFA ) intake to ≤10 % of total energy ( % TE ) . However , the optimal type of replacement fat is unclear . OBJECTIVE We investigated the substitution of 9.5 - 9.6%TE dietary SFAs with either monounsaturated fatty acids ( MUFAs ) or n-6 ( ω-6 ) polyunsaturated fatty acids ( PUFAs ) on vascular function and other CVD risk factors . DESIGN In a r and omized , controlled , single-blind , parallel-group dietary intervention , 195 men and women aged 21 - 60 y from the United Kingdom with moderate CVD risk ( ≥50 % above the population mean ) followed one of three 16-wk isoenergetic diets ( % TE target compositions , total fat : SFA : MUFA : n-6 PUFA ) that were rich in SFAs ( 36:17:11:4 , n = 65 ) , MUFAs ( 36:9:19:4 , n = 64 ) , or n-6 PUFAs ( 36:9:13:10 , n = 66 ) . The primary outcome measure was flow-mediated dilatation ; secondary outcome measures included fasting serum lipids , microvascular reactivity , arterial stiffness , ambulatory blood pressure , and markers of insulin resistance , inflammation , and endothelial activation . RESULTS Replacing SFAs with MUFAs or n-6 PUFAs did not affect the percentage of flow-mediated dilatation ( primary endpoint ) or other measures of vascular reactivity . Of the secondary outcome measures , substitution of SFAs with MUFAs attenuated the increase in night systolic blood pressure ( -4.9 mm Hg , P = 0.019 ) and reduced E-selectin ( -7.8 % , P = 0.012 ) . Replacement with MUFAs or n-6 PUFAs lowered fasting serum total cholesterol ( -8.4 % and -9.2 % , respectively ) , low-density lipoprotein cholesterol ( -11.3 % and -13.6 % ) , and total cholesterol to high-density lipoprotein cholesterol ratio ( -5.6 % and -8.5 % ) ( P ≤ 0.001 ) . These changes in low-density lipoprotein cholesterol equate to an estimated 17 - 20 % reduction in CVD mortality . CONCLUSIONS Substitution of 9.5 - 9.6%TE dietary SFAs with either MUFAs or n-6 PUFAs did not significantly affect the percentage of flow-mediated dilatation or other measures of vascular function . However , the beneficial effects on serum lipid biomarkers , blood pressure , and E-selectin offer a potential public health strategy for CVD risk reduction . This trial was registered at www . clinical trials.gov as NCT01478958 The effect on the fasting serum lipid levels of adding daily 291 mg of cholesterol to diets containing 3 mg of cholesterol and equal fat content , but different fatty acid composition , was tested on 12 young men . The saturated diet provided 97 g/day of a staurated oil made up of 2 parts of palm oil and 1 part of coconut oil . The polyunsatured diet provided 97 g/day of safflower oil . The cholesterol was dissolved in 40 g of either oil incorporated into a spread . A similar spread , devoid of cholesterol , was fed during the cholesterol free periods . Duration of dietary periods was 14 days . Addition of cholesterol produced a mean elevation of serum cholesterol of 9 mg/dl ( SE + /- 2.1 ) in the presence of the saturated diet , and of 8 mg/dl ( SE + /- 1.6 ) in the presence of the polyunsaturated diet . Both cholesterol elevations were significant ( P less than 0.01 ) but not significantly different from each other . Substitution of the saturated diet for the polyunsatured diet caused a significant elevation of serum cholesterol which was the same when the substitution was made in the presence or in the absence of added dietary cholesterol The effect of fats high in individual , prevalent saturated dietary fatty acids on lipoproteins and hemostatic variables in young healthy subjects was evaluated in a r and omized strictly controlled metabolic feeding study . Three experimental diets : shea butter ( S ; 42 % stearic acid ) , palm oil ( P ; 43 % palmitic palmitic acid ) , and palm-kernel oil with high-oleic sunflower oil ( ML ; 10 % myristic acid , 30 % lauric acid ) were served to 15 men for 3 wk each , separated by washout periods . Diet S compared with diet P result ed in significant reduction in plasma cholesterol ( 22 % ) LDL cholesterol ( 26 % ) , apolipoprotein B ( 18 % ) , HDL cholesterol ( 12 % ) , apolipoprotein A-I ( 13 % ) , and a 13 % lower factor VII coagulant activity ( P = 0.001 ) . Similar differences were observed between diets S and ML . In conclusion , intake of shea butter high in stearic acid favorably affects blood lipids and factor VII coagulant activity in young men , compared with fats high in saturated fatty acids with 12 - 16 carbons BACKGROUND Nutritional therapy is a cornerstone of diabetes management , but no epidemiologic studies have investigated the relation between specific dietary fatty acids and cholesterol and cardiovascular disease ( CVD ) risk  among diabetic patients . OBJECTIVE This study assessed the relation between specific dietary fatty acids and cholesterol and CVD risk among women with type 2 diabetes . DESIGN Among 5672 women with type 2 diabetes from the Nurses ' Health Study , diet was assessed prospect ively and up date d periodically .  Relative risks of CVD were estimated from Cox proportional hazards analysis after adjustment for potential confounders . RESULTS Between 1980 and 1998 , we identified 619 new cases of CVD ( nonfatal myocardial infa rct ion , fatal coronary heart disease , and stroke ) . The relative risk ( RR ) of CVD for an increase of 200 mg cholesterol/1000 kcal was 1.37 ( 95 % CI : 1.12 , 1.68 ; P = 0.003 ) . Each 5 % of energy intake from saturated fat , as compared with equivalent energy from carbohydrates , was associated with a 29 % greater risk of CVD ( RR : 1.29 ; 95 % CI : 1.02 , 1.63 ; P = 0.04 ) . The ratio of polyunsaturated to saturated fat ( P : S ) was inversely associated with the risk of fatal CVD . We estimated that replacement of 5 % of energy from saturated fat with equivalent energy from carbohydrates or monounsaturated fat was associated with a 22 % or 37 % lower risk of CVD , respectively . CONCLUSIONS A higher intake of cholesterol and saturated fat and a low P : S were related to increased CVD risk among women with type 2 diabetes . Among diabetic persons , replacement of saturated fat with monounsaturated fat may be more effective in lowering CVD risk than is replacement with carbohydrates BACKGROUND The quantity and quality of fats consumed in the diet influence the risk of cardiovascular disease ( CVD ) . Although the effect of diet on plasma lipids and lipoproteins is well documented , less information exists on the role of fats on blood pressure ( BP ) . OBJECTIVE The objective was to evaluate the effects of different types of dietary fat on BP in healthy subjects . DESIGN Healthy subjects ( n = 162 ) were r and omly assigned for 3 mo to follow 1 of 2 isoenergetic diets : 1 rich in monounsaturated fatty acids ( MUFA diet ) and the other rich in saturated fatty acids ( SFA diet ) . Each group was further r and omly assigned to receive supplementation with fish oil ( 3.6 g n-3 fatty acids/d ) or placebo . RESULTS Systolic BP ( SBP ) and diastolic BP ( DBP ) decreased with the MUFA diet [ -2.2 % ( P = 0.009 ) and -3.8 % ( P = 0.0001 ) , respectively ] but did not change with the SFA diet [ -1.0 % ( P = 0.2084 ) and -1.1 % ( P = 0.2116 ) ] . The MUFA diet caused a significantly lower DBP than did the SFA diet ( P = 0.0475 ) . Interestingly , the favorable effects of MUFA on DBP disappeared at a total fat intake above the median ( > 37 % of energy ) . The addition of n-3 fatty acids influenced neither SBP nor DBP . CONCLUSIONS Changing the proportions of dietary fat by decreasing SFAs and increasing MUFAs decreased diastolic BP . Interestingly , the beneficial effect on BP induced by fat quality was negated by the consumption of a high total fat intake . The addition of n-3 fatty acids to the diet had no significant effect on BP Background : Studies of long-term intake of industrially produced trans fatty acids ( TFA ) and n-3 polyunsaturated fatty acids ( PUFA ) suggest opposite effects on cardiovascular disease risk . Common mechanisms of action are probable . Objective : To examine the effects on cardiovascular risk markers of dietary enrichment with TFA or n-3 PUFA . Design : R and omized , double-blind , parallel intervention trial . Setting : Department of Human Nutrition , The Royal Veterinary and Agricultural University . Subjects : In all , 87 healthy males included , 79 completed . Intervention : Subjects were r and omly assigned to 8 weeks of a daily intake of 33 g of experimental fats from either partially hydrogenated soy oil containing 20 g of TFA , 12 g of fish oil with approximately 4 g of n-3 PUFA and 21 g of control fat , or 33 g of control fat . The experimental fats were incorporated into bakery products .  Plasma lipids , blood pressure , heart rate variability ( HRV ) , arterial dilatory capacity , compliance , and distensibility were recorded before and after intervention and at follow-up 12 weeks after the intervention . Results : High-density lipoprotein cholesterol ( HDL-C ) decreased in the TFA group and triglycerides and mean arterial blood pressure decreased in the n-3 PUFA group compared to the control group . HRV , arterial dilatory capacity , compliance , and distensibility were unchanged . Conclusion : The results indicate that the association between coronary heart disease risk and intake of TFA and n-3 PUFA relates only modestly to changes in traditional risk markers . Sponsorship : Danish Medical Research Council ( Grant no. 22 - 01 - 0390 ) , Center of Advanced Food Research ( Copenhagen , Denmark ) ( Grant no. KVL-R-2001 - 107 ) , the Danish Heart Association ( Grant no. 99 - 2 - 3 - 45 - 22748 ) , Novozymes ( Bagsvaerd , Denmark ) , Aarhus Olie ( Aarhus , Denmark ) , and from private sources . The experimental fats were provided by Pronova Biocare ( Aalesund , Norway ) and Aarhus Olie ( Aarhus , Denmark ) Background and rationale Coronary artery disease ( CAD ) and its pathological atherosclerotic process are closely related to lipids . Lipids levels are in turn influenced by dietary oils and fats . Saturated fatty acids increase the risk for atherosclerosis by increasing the cholesterol level . This study was conducted to investigate the impact of cooking oil media ( coconut oil and sunflower oil ) on lipid profile , antioxidant mechanism , and endothelial function in patients with established CAD . Design and methods In a single center r and omized study in India , patients with stable CAD on st and ard medical care were assigned to receive coconut oil ( Group I ) or sunflower oil ( Group II ) as cooking media for 2 years . Anthropometric measurements , serum , lipids , Lipoprotein a , apo B/A-1 ratio , antioxidants , flow-mediated vasodilation , and cardiovascular events were assessed at 3 months , 6 months , 1 year , and 2 years . Results Hundred patients in each arm completed 2 years with 98 % follow-up . There was no statistically significant difference in the anthropometric , biochemical , vascular function , and in cardiovascular events after 2 years . Conclusion Coconut oil even though rich in saturated fatty acids in comparison to sunflower oil when used as cooking oil media over a period of 2 years did not change the lipid-related cardiovascular risk factors and events in those receiving st and ard medical care BACKGROUND Substitution of dietary polyunsaturated for saturated fat has long been recommended for the primary prevention of cardiovascular disease ( CVD ) , but only a few prospect i ve cohort studies have provided support for this advice . METHODS We assessed the association of dietary linoleic and total polyunsaturated fatty acid ( PUFA ) intake with cardiovascular and overall mortality in a population -based cohort of 1551 middle-aged men . Dietary fat composition was estimated with a 4-day food record and serum fatty acid composition . RESULTS During the 15-year follow-up , 78 men died of CVD and 225 of any cause . Total fat intake was not related to CVD or overall mortality . Men with an energy-adjusted dietary intake of linoleic acid ( relative risk [ RR ] 0.39 ; 95 % confidence interval [ CI ] , 0.21 - 0.71 ) and PUFA ( RR , 0.38 ; 95 % CI , 0.20 - 0.70 ) in the upper third were less likely to die of CVD than men with intake in the lower third after adjustment for age . Multivariate adjustment weakened the association somewhat . Mortality from CVD was also lower for men with proportions of serum esterified linoleic acid ( RR , 0.42 ; 95 % CI , 0.21 - 0.80 ) and PUFA ( RR , 0.25 ; 95 % CI , 0.12 - 0.50 ) in the upper vs lower third , with some attenuation in multivariate analyses . Serum and to a lesser extent dietary linoleic acid and PUFA were also inversely associated with overall mortality . CONCLUSIONS Dietary polyunsaturated and more specifically linoleic fatty acid intake may have a substantial cardioprotective benefit that is also reflected in overall mortality . Dietary fat quality seems more important than fat quantity in the reduction of cardiovascular mortality in men Background Evidence regarding the role of dairy fat intake in  cardiovascular disease (  CVD ) has been mixed and inconclusive . Most earlier studies have used self‐reported measures of dietary intake and focused on relatively racially homogeneous population s. Circulating biomarkers of dairy fat in a multiethnic cohort provide objective measures of dairy fat intake and facilitate conclusions relevant to population s with different diets and susceptibility to CVD . Methods and Results In a multiethnic cohort of 2837 US adults aged 45 to 84 years at baseline ( 2000–2002 ) , phospholipid fatty acids including 15:0 , 14:0 , and trans‐16:1n7 were measured using st and ardized methods , and the incidence of CVD prospect ively adjudicated . Self‐reported whole‐fat dairy and butter intakes had strongest associations with 15:0 , rather than 14:0 or trans‐16:1n7 . In multivariate models including demographics and lifestyle and dietary habits , each SD‐unit of 15:0 was associated with 19 % lower CVD risk ( hazard ratio [ 95 % CI ] 0.81 [ 0.68 to 0.98 ] ) and 26 % lower coronary heart disease ( CHD ) risk ( 0.74 [ 0.60 to 0.92 ] ) . Associations were strengthened after mutual adjustment for 14:0 and trans‐16:1n‐7 and were similar after adjustment for potential mediators . Plasma phospholipid 14:0 and trans‐16:1n‐7 were not significantly associated with incident CVD or CHD . All findings were similar in white , black , Hispanic , and Chinese American participants .  Conclusion Plasma phospholipid 15:0 , a biomarker of dairy fat , was inversely associated with incident CVD and CHD , while no association was found with phospholipid 14:0 and trans‐16:1n‐7 . These findings support the need for further investigation of CVD effects of dairy fat , dairy‐specific fatty acids , and dairy products in general BACKGROUND The issue of whether saturated fats and trans fats are superior predictors of all-cause death and cardiovascular disease than n-3 polyunsaturated fatty acids , such as eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) , remains a matter of contention . Furthermore , few studies have examined the relationship between fatty acids and the outcomes of cardiovascular disease ( CVD ) in Asian population s. The aim of this study was to compare the effectiveness of various plasma fatty acids as predictors for all-cause death and CVD events in an ethnic Chinese population . METHODS This study assembled a community-based prospect i ve cohort , comprising 1833 participants ( 60.6 ± 10.5 yrs , 44.5 % women ) who underwent a comprehensive evaluation of fatty acids in blood using gas chromatography . None of the subjects had a history of CVD at the time of recruitment . RESULTS A total of 568 individuals died and 275 individuals developed CVD during the follow-up period ( median of 9.6 years ; interquartile range of 8.9 - 10.5 years ) . Following adjustment for established cardiovascular risk factors , the relative risk of all-cause death in the highest quartile , compared with the lowest quartile , was 1.33 for saturated fats ( 95 % confidence interval [ CI ] , 1.01 - 1.75 , test for trend , P = 0.015 ) , 1.71 for trans fats ( 95 % CI , 1.27 - 2.31 , test for trend , P = 0.0003 ) , 0.77 for EPA ( 95 % CI , 0.59 - 1.00 , test for trend , P = 0.048 ) , and 0.89 for DHA ( 95 % CI , 0.68 - 1.18 , test for trend , P = 0.354 ) . Similar patterns were observed for CVD events  . Trans fats presented the largest area under the receiver operator characteristic curve ( 0.740 , 95 % CI , 0.716 - 0.766 ) for the prediction of all-cause death . A mutually adjusted two-marker model indicated that saturated fats and trans fats were significant predictors of all-cause death and CVD ; however , the other fatty acids were not . In addition , trans fats presented the greatest improvement in net reclassification for all-cause death ( 7.7 % , P = 0.003 ) , followed by EPA ( 3.8 % , P = 0.033 ) . Saturated fats presented the greatest improvement in net reclassification for CVD events ( 5.6 % , P = 0.039 ) . CONCLUSIONS Our data provides strong evidence to support that plasma saturated fats and trans fats can predict all-cause death and CVD more effectively than other fatty acid markers We have compared the effects of three different margarines , one based on palm oil ( PALM-margarine ) , one based on partially hydrogenated soybean oil ( TRANS-margarine ) and one with a high content of polyunsaturated fatty acids ( PUFA-margarine ) , on serum lipids in 27 young women . The main purpose of the study was to test if replacement of trans fatty acids in margarine by palmitic acid results in unfavorable effects on serum lipids . The sum of saturated fatty acids ( 12∶0 , 14∶0 , 16∶0 ) was 36.3 % of total fatty acids in the PALM-diet , the same as the sum of saturated ( 12∶0 , 14∶0 , 16∶0 ) ( 12.5 % ) and trans ( 23.1 % ) fatty acids in the TRANS-diet . This sum was 20.7 % in the PUFA-diet . The content of oleic acid was 37.9 , 35.2 , and 38.6 % , respectively , in the three diets , whereas linoleic acid amounted to 16 , 13.5 , and 27.3 % , respectively . Total fat provided 30–31 % and the test margarines 26 % of total energy in all three diets . The subjects consumed each of the diets for 17 d in a Latin-square crossover design . There were no significant differences in total cholesterol , low density lipoprotein (LDL)-cholesterol and apolipoprotein B ( apoB ) between the TRANS- and the PALM-diets . High density lipoprotein (HDL)-cholesterol and apoA-I were significantly higher on the PALM-diet compared to the TRANS-diet whereas the ratio of LDL-cholesterol to HDL-cholesterol was lower , although not significantly ( P=0.077 ) on the PALM-diet . Total cholesterol , LDL-cholesterol , and apoB were significantly lower on the PUFA-diet compared to the two other diets . HDL-cholesterol was not different on the PALM- and the PUFA-diets but it was significantly lower on the TRANS-diet compared to the PUFA diet . Compared to the PUFA-diet  the ratio of LDL-to HDL-cholesterol was higher on both the PALM- and the TRANS-diets whereas apoA-I was not different . Triglycerides and lipoprotein ( a ) were not significantly different among the three diets . We concluded that nutritionally , palmitic acid from palm oil may be a reasonable alternative to trans fatty acids from partially hydrogenated soybean oil in margarine if the aim is to avoid trans fatty acids . A palm oil-based margarine is , however , less favorable than one based on a more polyunsaturated vegetable oil Background / objectives : Dietary triacylglycerols containing palmitic acid in the sn-2 position might impair insulin release and increase plasma glucose . Subjects/ Methods : We used a cross-over design ed feeding trial in 53 healthy Asian men and women ( 20–50 years ) to test this hypothesis by exchanging 20 % energy of palm olein ( PO ; control ) with r and omly interesterified PO ( IPO ) or high oleic acid sunflower oil ( HOS ) . After a 2-week run-in period on PO , participants were fed PO , IPO and HOS for 6 week consecutively in r and omly allocated sequences . Fasting ( midpoint and endpoint ) and postpr and ial blood at the endpoint following a test meal ( 3.54 MJ , 14 g protein , 85 g carbohydrate and 50 g fat as PO ) were collected for the measurement of C-peptide , insulin , glucose , plasma glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 , lipids and apolipoproteins ; pre-specified primary and secondary outcomes were postpr and ial changes in C-peptide and plasma glucose . Results : Low density lipoprotein cholesterol was 0.3 mmol/l ( 95 % confidence interval ( 95 % CI ) ) 0.1 , 0.5 ; P<0.001 ) lower on HOS than on PO or IPO as predicted , indicating good compliance to the dietary intervention . There were no significant differences ( P=0.58 ) between diets among the 10 male and 31 female completers in the incremental area under the curve ( 0–2 h ) for C-peptide in nmol.120 min/l : GM ( 95 % CI ) were PO 220 ( 196 , 245 ) , IPO 212 ( 190 , 235 ) and HOS 224 ( 204 , 244 ) . Plasma glucose was 8 % lower at 2 h on IPO vs PO and HOS ( both P<0.05 ) . Conclusion : Palmitic acid in the sn-2 position does not adversely impair insulin secretion and glucose homeostasis BACKGROUND AND OBJECTIVES As the most widely produced edible vegetable oil , palm oil is known as to contain a high level of saturated fatty acid , which was thought to adversely affect serum lipid profiles . However , recent studies have shown no influence or benefits of palm oil on serum lipids . The potential nutritional value of palm oil is attributed to the high mono-unsaturation at the crucial sn2-position of the oil 's triacylglycerols , as with the so-called ' healthy ' olive oil ( OO ) . The aim of this study was to further test this hypothesis and evaluate the effects of consuming palm olein versus olive oil on serum lipid profiles in a Chinese population . METHODS AND STUDY DESIGN In total , 120 participants were recruited from a spinnery in Yixing city and r and omly divided into two groups ( palm olein or olive oil ) to conduct a 2 × 2 crossover trial for 2 months ' intervention with 2-week washout periods . Each participant was provided 48 g of test oil per day . At the end of each period , anthropometry , and blood lipid indices were measured to determine the effects of palm olein and olive oil . RESULTS Palm olein and olive oil consumption had no significantly different effect on BMI , on serum total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triacylglycerol ( TG ) , Apo B , fasting glucose , or insulin concentrations ( all p>0.05 ) . CONCLUSIONS In a dietary crossover trial , palm olein and olive oil had no recognisably different effects on body fatness or blood lipids in a healthy Chinese population BACKGROUND The fatty acid content and saturation degree of the diet can modulate HDL composition and cholesterol efflux . OBJECTIVE We studied the modifications in plasma lipoprotein particles and serum capacity to stimulate cholesterol efflux induced by different fatty acids . DESIGN Seventeen women and 24 men followed in the same sequence 4 diets containing 35 % of total energy as fat . The saturated fat diet contained 17 % palm oil ; the monounsaturated fat diet , 20.9 % olive oil ; the n-6 polyunsaturated fat diet , 12.5 % sunflower oil ; and the n-3 polyunsaturated fat diet , sunflower oil supplemented with 4 - 4.5 g fish oil/d . Each phase lasted 4 - 5 wk . RESULTS In both sexes , apolipoprotein ( apo ) A-I concentrations were significantly lower with unsaturated fat diets than with the saturated fat diet , but concentrations of lipoproteins containing only apo A-I ( Lp A-I ) were lower only in the men . Concentrations of lipoproteins containing both apo A-I and apo A-II ( Lp A-I : A-II ) were lower with both polyunsaturated fat diets in the women but significantly higher in the men . Lp E concentrations were significantly higher with the 2 polyunsaturated fat diets . Lp E non-B particle concentrations were not modified in the men but were significantly higher in the women in both polyunsaturated fat phases . Lp C-III concentrations were higher with the saturated fat diet only in the men . The serum sample s taken after the n-3 polyunsaturated fat phase were the most efficient for extracting cellular cholesterol in both sexes . CONCLUSIONS The monounsaturated and polyunsaturated fat diets were healthier , producing a better lipid profile . The n-3 polyunsaturated fat diet increased the capacity of serum to promote the efflux of cholesterol from cells in culture BACKGROUND Detrimental effects of consumption of industrial trans fatty acids ( TFA ) from partially hydrogenated vegetable oils ( PHVO ) on cardiovascular disease ( CVD ) risk factors are well documented . However , very little information is available on the effect of natural sources of TFA coming from milk fat , dairy products and ruminant meat . In fact , due to the naturally low level of TFA in milk fat , it is almost impossible to conduct a clinical trial with a limited number of subjects ( < 200 ) . METHODOLOGY To compare the effects of industrial and natural dietary sources of TFA , two specific test fats have been design ed and produced . A substantial amount of milk fat ( 130 kg ) enriched in TFA has been produced by modification of the cow 's diet and selection of cows with the highest TFA content . The level obtained was approximately 4- to 7-fold higher than typically present in milk fat ( approximately 20 instead of 3 - 6 g/100 g of total fatty acids ) . The control fat is composed of PHVO balanced in saturated fatty acids ( lauric , myristic and palmitic ) . Both experimental fats contain about 20 - 22 % of monounsaturated TFA and the volunteers ' daily experimental fat intake ( 54 g ) , will represent about 12.0 g/day of TFA or 5.4 % of the daily energy ( based on 2000 kcal/day ) . These two test fats have been incorporated into food items and will be provided to 46 healthy subjects under a r and omised , double blind , controlled , cross-over design . The primary outcome is high-density lipoprotein cholesterol ( HDL-C ) , which is an independent risk factor for CVD . Other parameters such as low-density lipoprotein cholesterol ( LDL-C ) , very low-density lipoprotein cholesterol ( VLDL-C ) , and HDL-C level and subclasses will be also to be evaluated . CONCLUSION We have shown that it is technically feasible to perform a clinical trial on the comparative effects of natural and industrial sources of TFA isomers on CVD risk factors . Results are expected by mid-2006 People are advised to reduce their intake of saturated fat and replace it by carbohydrate to avoid coronary heart disease . It is unknown whether sucrose and starchy foods , two major sources of carbohydrates , have similar effects on cardiovascular risk markers if incorporated as a replacement for saturated fat into diets eaten ad libitum . We served 20 healthy , normal-weight women aged 21 to 52 years three strictly controlled diets ad libitum : FAT , high in total fat ( 46 % of total energy [ E% ] ) and saturated fat ( 21 E% ) ; STARCH , high in total carbohydrates ( 59 E% ) and low in sucrose ( 2.5 E% ) ; and SUCROSE , high in total carbohydrates ( 59 E% ) and sucrose ( 23.2 E% ) . The diets were eaten in r and omized order for a period of 2 weeks . Blood lipids , factor VII coagulant activity ( FVIIc ) , and fibrinogen concentrations were measured with subjects in the fasted state ( 9:45 AM ) and the postabsorptive state ( 6:00 PM ) . STARCH was associated with lower total cholesterol ( mean difference , 0.34 mmol/L ; 95 % confidence interval [ CI ] , 0.18 to 0.50 ) , low-density lipoprotein ( LDL ) cholesterol ( 0.25 mmol/L ; 95 % CI , 0.13 to 0.37 ) , fasting triglycerides ( 0.15 mmol/L ; 95 % CI , 0.07 to 0.23 ) , nonfasting triglycerides ( 0.44 mmol/L ; 95 % CI , 0.30 to 0.58 ) , and nonfasting FVIIc ( 9.8 % ; 95 % CI , 3.8 to 15.8 ) than SUCROSE . Compared with FAT , STARCH result ed in a desirable decrease of LDL cholesterol and nonfasting FVIIc .  STARCH was also associated with a minor weight loss ( 0.7 kg ) that was not found on the other 2 diets . We conclude that starchy foods with a natural content of dietary fiber can be recommended as substitutes for saturated fat in the dietary prevention of coronary heart disease . According to the present short-term findings in healthy females , substitution with sucrose is not advisable OBJECTIVE To compare concentrations of factor VII coagulant activity ( factor VIIc ) , fibrinogen , plasminogen activator inhibitor-1 , and blood lipids on a saturated fat-rich diet with one rich in monounsaturated fat . DESIGN Subjects were r and omly allocated to two groups . The study design was an ABB/BAA extra-period crossover . One group consumed a diet rich in saturated fatty acid ( SFA ) with fat making up 20.8 % of total energy , for 5 weeks and then one rich in monounsaturated fatty acid ( MUFA ) , with fat making up 20.3 % of total energy for 10 weeks . The other group consumed the MUFA diet for 5 weeks followed by the SFA diet for 10 weeks . SUBJECTS/ SETTING Men and women aged 35 to 69 years who were nonsmokers with no chronic illness and not on any medication were recruited to participate . Eighteen subjects were recruited and 15 ( 5 men , 10 women ) completed the community-based study . INTERVENTION Blood was sample d at the beginning and end point of each 5-week diet period for analysis of coagulation and fibrinolysis factors and blood lipids . Subjects kept 3-day food diaries twice during each of the three diet periods and were weighed on each visit for blood collection . Analysis of plasma fatty acids was used to indicate dietary compliance . MAIN OUTCOME MEASURES Differences in fasting factor VIIc , fibrinogen , plasminogen activator inhibitor-1 , insulin , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , apolipoproteins A-1 and B , and plasma oleic acid levels while receiving the SFA diet vs MUFA diet . STATISTICAL ANALYSIS A general linear model allowing for the ABB/BAA extra-period crossover , was used for each of the outcome measures . RESULTS Factor VIIc was lower on the MUFA diet ( P < .05 ) but fibrinogen and insulin concentrations and plasminogen activator inhibitor-1 activity did not differ between diets . Low-density lipoprotein cholesterol ( P < .001 ) and triglyceride ( P < .01 ) levels were lower on the MUFA diet compared with the SFA diet . A significant increase in both plasma phospholipid and neutral lipid oleic acid ( P < .0001 ) occurred on the MUFA diet . CONCLUSIONS Substitution of foods rich in saturated fat with foods rich in high-oleic-acid sunflower oil and margarine has favorable outcomes on blood lipids and factor VIIc . This oil presents another useful source of MUFA for diets aim ed at prevention of heart disease Background Dietary trans-rich and interesterified fats were compared to an unmodified saturated fat for their relative impact on blood lipids and plasma glucose . Each fat had melting characteristics , plasticity and solids fat content suitable for use as hardstock in margarine and other solid fat formulations . Methods Thirty human volunteers were fed complete , whole food diets during 4 wk periods , where total fat ( ~31 % daily energy , > 70 % from the test fats ) and fatty acid composition were tightly controlled . A crossover design was used with 3 r and omly-assigned diet rotations and repeated- measures analysis . One test fat rotation was based on palm olein ( POL ) and provided 12.0 percent of energy ( % en ) as palmitic acid ( 16:0 ) ; a second contained trans-rich partially hydrogenated soybean oil ( PHSO ) and provided 3.2 % en as trans fatty acids plus 6.5 % en as 16:0 , while the third used an interesterified fat ( IE ) and provided 12.5 % en as stearic acid ( 18:0 ) . After 4 wk the plasma lipoproteins , fatty acid profile , as well as fasting glucose and insulin were assessed . In addition , after 2 wk into each period an 8 h postpr and ial challenge was initiated in a subset of 19 subjects who consumed a meal containing 53 g of test fat . Results After 4 wk , both PHSO and IE fats significantly elevated both the LDL/HDL ratio and fasting blood glucose , the latter almost 20 % in the IE group relative to POL . Fasting 4 wk insulin was 10 % lower after PHSO ( p > 0.05 ) and 22 % lower after IE ( p < 0.001 ) compared to POL . For the postpr and ial study the glucose incremental area under the curve ( IAUC ) following the IE meal was 40 % greater than after either other meal ( p < 0.001 ) , and was linked to relatively depressed insulin and C-peptide ( p < 0.05 ) . Conclusion Both PHSO and IE fats altered the metabolism of lipoproteins and glucose relative to an unmodified saturated fat when fed to humans under identical circumstances Death rates from coronary heart disease ( CHD ) in Northern Irel and are among the highest in the world . However , no data have been available to test the hypothesis that the high prevalence of CHD is reflected by the risk status of the childhood population . A r and omly selected 2 % population sample of 1015 children aged 12 and 15 years was studied to obtain baseline information on  blood pressure , lipid profile , cigarette smoking , family history , physical activity , cardiorespiratory fitness , and dietary fat intake .  Using available criteria thresholds , 15 - 23 % displayed increased blood pressure , 12 - 25 % had unfavourable lipid profiles , and 18 - 34 % were overfat . In 15 year old children , 16 - 21 % admitted being regular smokers , 26 - 34 % displayed poor cardiorespiratory fitness , and 24 - 29 % reported little physical activity in the previous week . Dietary analysis revealed relatively low polyunsaturated to saturated fatty acid ratios and high mean fat intakes , accounting for approximately 40 % total daily energy . Despite the exclusion of family history from the analysis , 16 % of the older children exhibited three or more risk factors . These results justify major concern about the level of potential coronary risk in Northern Irel and schoolchildren . Broadly based primary prevention strategies aim ed at children are essential if future adult CHD mortality is to be reduced Summary . Partial hydrogenation of oil results in fats containing unusual isomeric fatty acids characterized by cis and trans configurations . Hydrogenated fats containing trans fatty acids increase plasma total cholesterol ( TC ) and LDL-cholesterol while depressing HDL-cholesterol levels . Identifying the content of trans fatty acids by food labeling is overshadowed by a reluctance of health authorities to label saturates and trans fatty acids separately . Thus , it is pertinent to compare the effects of trans to saturated fatty acids using stable isotope methodology to establish if the mechanism of increase in TC and LDL-cholesterol is due to the increase in the rate of endogenous synthesis of cholesterol . Ten healthy normocholesterolemic female subjects consumed each of two diets containing approximately 30 % of energy as fat for a fourweek period . One diet was high in palmitic acid ( 10.6 % of energy ) from palm olein and the other diet exchanged 5.6 % of energy as partially hydrogenated fat for palmitic acid . This fat blend result ed in monounsaturated fatty acids decreasing by 4.9 % and polyunsaturated fats increasing by 2.7 % . The hydrogenated fat diet treatment provided 3.1 % of energy as elaidic acid . For each dietary treatment , the fractional synthesis rates for cholesterol were measured using deuterium-labeling procedures and blood sample s were obtained for blood lipid and lipoprotein measurements . Subjects exhibited a higher total cholesterol and LDL-cholesterol level when consuming the diet containing trans fatty acids while also depressing the HDL-cholesterol level . Consuming the partially hydrogenated fat diet treatment increased the fractional synthesis rate of free cholesterol . Consumption of hydrogenated fats containing trans fatty acids in comparison to a mixtur e of palmitic and oleic acids increase plasma cholesterol levels apparently by increasing endogenous synthesis of cholesterol UNLABELLED The objective was to evaluate whether the soluble fibre Plantago ovata (Po)-husk improves cardiovascular disease ( CVD ) risk biomarkers including low-density lipoprotein cholesterol ( LDL-C ) . METHODS In a multi-centred , double-blind , placebo-controlled , parallel , r and omised trial conducted in primary care-clinics in Spain , France and Holl and , mild-moderate hypercholesterolaemic patients ( age range : 43 - 67 years ) received 14 g/d of Po-husk ( n=126 ) or placebo ( microcrystalline-cellulose 14 g/d ; n=128 ) in a low saturated fat diet for 8 weeks . Subsequently , if LDL-C remained > or = 3.35 mmol/L [ 130 mg/dL ] , participants proceeded with the fibre plus simvastatin ( 20mg/d ) for further 8 weeks . Lipid profile , blood pressure ( BP ) , insulin , oxidised LDL and some gene polymorphisms involved in CVD risk were measured . RESULTS Relative to placebo , Po-husk reduced plasma LDL-C by -6 % ( P<0.0002 ) , total cholesterol ( TC ) by -6 % , triglycerides ( TG ) by -21.6 % , apolipoprotein ( Apo ) B-100 by -6.7 % , oxidised LDL by a mean of -6.82 U/L ( 95%CI : 3.15 - 10.48 ) , insulin by -4.68 pmol/L ( 95%CI : 0.68 - 8.67 ) and systolic BP by -4.0 mm Hg ( 95%CI ; 1.2 - 6.7 ) ( P<0.05 ) . The TG-lowering effect in the Po-husk group was magnified by variants in plasminogen-activator-inhibitor ( PAI-1 ; rs1799768 ) and fatty acid-binding protein ( FABP-2 ; rs1799883 ) genes . At 16 weeks , the intra-group action of simvastatin ( 20mg/d ) added to Po-husk or placebo was a similar LDL-C reduction . CONCLUSIONS Po-husk , apart from lowering LDL-C , also reduced TG , TG related to certain gene variants , TC , Apo B-100 , oxLDL , insulin-resistance and systolic BP in mild-moderate hypercholesterolaemic individuals . Thus , the target patients to receive Po-husk would be those who present a cluster of various CVD risk factors , such as metabolic syndrome Postpr and ial lipemia impairs insulin sensitivity and triggers the pro-inflammatory state which may lead to the progression of cardiovascular diseases . A r and omized , crossover single-blind study ( n = 10 healthy men ) was design ed to compare the effects of a high-fat load ( 50 g fat ) , rich in palmitic acid from both plant ( palm olein ) or animal source ( lard ) versus an oleic acid-rich fat ( virgin olive oil ) on lipemia , plasma glucose , insulin and adipocytokines . Serum triacylglycerol ( TAG ) concentrations were significantly lower after the lard meal than after the olive oil and palm olein meals ( meal effect P = 0.003 ; time effect P < 0.001 ) . The greater reduction in the plasma non-esterified free fatty acids levels in the lard group compared to the olive oil meal was mirrored by the changes observed for serum TAG levels ( P < 0.05 ) . The magnitude of response for plasma glucose , insulin and adipocytokines [ interleukin-6 ( IL-6 ) , tumor necrosis factor-α ( TNF-α ) , interleukin-1β ( IL-1β ) and leptin ] were not altered by the type of dietary fats . A significant difference in plasma IL-1β was found over time following the three high fat loads ( time effect P = 0.036 ) . The physical characteristics and changes in TAG structure of lard may contribute to the smaller increase in postpr and ial lipemia compared with palm olein . A high fat load but not the type of fats influences concentrations of plasma IL-1β over time but had no effect on other pro-inflammatory markers tested in the postpr and ial state The aim of this study was to investigate the effect of a high fat diet with experimental oil consisting of 60 % MUFAs ( monounsaturated fatty acids ) with a P/S ratio of 5 on fat deposition and lipid metabolism in obese hamsters . Hamsters were r and omly assigned to a control group and a diet-induced obesity group for nine weeks . Then an additional eight-week experimental period began , during which obese hamsters were r and omly divided into three groups and fed different amounts of the experimental oil mixture in their diets as follows : 5 % , 15 % , and 20 % w/w ( OB-M5 , OB-M15 , and OB-M20 groups , respectively ) . The results showed that the OB-M15 and OB-M20 groups had significantly lower blood cholesterol and higher insulin levels . Compared to the control group , the three obese groups exhibited higher hepatic fatty acid synthase activity ; however , the acyl-CoA oxidase activities were also enhanced . Although dietary fat content differed , there were no differences in energy intake , final body weights , and epididymal fat weights among the four groups . These results suggest that regardless of whether the specimens had a high fat intake or not , dietary fat containing high MUFAs with a high P/S ratio had beneficial effects on maintaining blood lipid profiles and may not result in body fat accumulation in obese hamsters , possibly by promoting lipolytic enzyme activities Context Some experts attribute a low incidence of heart disease in Mediterranean countries to dietary habits . Contribution In this multicenter , 3-group trial , investigators r and omly assigned 772 adults at high risk for cardiovascular disease to a low-fat diet or to a Mediterranean diet supplemented with either virgin olive oil ( 1 L per week ) or nuts ( 30 g per day ) . After 3 months , the Mediterranean diet groups had lower mean plasma glucose level , systolic blood pressure , and total cholesterolhigh-density lipoprotein cholesterol ratio than the low-fat diet group . Caution s The Mediterranean diet groups received more nutritional education than the low-fat diet group . Implication s Mediterranean diets supplemented with olive oil or nuts may improve cardiovascular risk factors . The Editors Cardiovascular disease is the main cause of death in industrialized countries , but incidence rates have marked geographic differences . The low incidence of coronary heart disease ( CHD ) in Mediterranean countries has been partly ascribed to dietary habits ( 1 - 3 ) . Recent findings from large European cohort studies ( 4 - 6 ) suggest that a high degree of adherence to the Mediterranean diet is associated with a reduction in mortality . In small clinical studies , the Mediterranean diet or some of its components have reduced blood pressure ( 7 ) and have improved lipid profiles ( 8 , 9 ) and endothelial function ( 10 ) . Moreover , a recent cross-sectional study ( 11 ) and a 2-year feeding trial ( 12 ) have shown that adherence to the Mediterranean diet is associated with reduced markers of vascular inflammation . These beneficial effects on surrogate markers of cardiovascular risk add biological plausibility to the epidemiologic evidence that supports a protective effect of the Mediterranean diet . Olive oil , a rich source of monounsaturated fatty acids , is a main component of the Mediterranean diet . Virgin olive oil retains all the lipophilic components of the fruit , -tocopherol , and phenolic compounds with strong antioxidant and anti-inflammatory properties ( 13 , 14 ) . Tree nuts , which are also typical in the Mediterranean diet , have a favorable fatty acid profile and are a rich source of nutrients and other bioactive compounds that may beneficially influence the risk for CHD , such as fiber , phytosterols , folic acid , and antioxidants ( 15 ) . Frequent nut intake has been associated with decreased CHD rates in prospect i ve studies ( 15 ) . Walnuts differ from all other nuts through their high content of polyunsaturated fatty acids , particularly -linolenic acid , a plant n-3 fatty acid ( 16 ) , which may confer additional antiatherogenic properties ( 17 ) . Therefore , we design ed a large-scale feeding trial in high-risk participants to assess the effects of 2 Mediterranean diets , one supplemented with virgin olive oil and the other supplemented with mixed nuts , compared with a low-fat diet on cardiovascular outcomes . We report the results of a 3-month intervention on intermediate markers of cardiovascular risk in the first 772 participants who were recruited into the trial . Supplement . Original Version ( PDF ) Methods Study Design The Prevencin con Dieta Mediterrnea ( PREDIMED ) Study is a large , parallel-group , multicenter , r and omized , controlled , 4-year clinical trial that aims to assess the effects of the Mediterranean diet on the primary prevention of cardiovascular disease ( www.predimed.org ) . An estimated 9000 high-risk participants ( > 5000 participants are already recruited ) will be assigned to 3 interventions : Mediterranean diet with virgin olive oil , Mediterranean diet with mixed nuts , or low-fat diet . The main outcome is an aggregate of cardiovascular events ( cardiovascular death , nonfatal myocardial infa rct ion , or nonfatal stroke ) . The anticipated completion date of the trial is December 2010 . We design ed our present study to assess the 3-month effects of the dietary interventions on surrogate markers of cardiovascular risk in participants entering the study during the first 6 months of recruitment . The institutional review boards of the 10 participating centers approved the study protocol . Participants and Recruitment From October 2003 to March 2004 , we selected 930 potential participants in primary care centers affiliated with 10 teaching hospitals across Spain . Eligible participants were community-dwelling men , 55 to 80 years of age , and women , 60 to 80 years of age , who fulfilled at least 1 of 2 criteria : type 2 diabetes or 3 or more CHD risk factors ( current smoking , hypertension [ blood pressure > 140/90 mm Hg or treatment with antihypertensive drugs ] , low-density lipoprotein [ LDL ] cholesterol level 4.14 mmol/L [ 160 mg/dL ] [ or treatment with hypolipidemic drugs ] , high-density lipoprotein [ HDL ] cholesterol level 1.04 mmol/L [ 40 mg/dL ] , body mass index [ BMI ] 25 kg/m2 , or a family history of premature CHD ) . Exclusion criteria were history of cardiovascular disease , any severe chronic illness , drug or alcohol addiction , history of allergy or intolerance to olive oil or nuts , or low predicted likelihood of changing dietary habits according to the stages-of-change model ( 18 ) . The primary care physicians based participants ' eligibility on review of clinical records and a screening visit . They obtained a list of c and i date s from computer-based records of patients who attended each participating center and review ed their clinical records to exclude those who did not meet eligibility criteria . They then invited suitable c and i date s by telephone to attend a screening visit . The visit included an interview with administration of a 26-item question naire to inquire about medical conditions and risk factors related to eligibility . Of the eligible c and i date s who met entry requirements , 95 % agreed to participate and provided informed consent . R and omization and Intervention After the screening visit , each center r and omly assigned eligible participants to 1 of 3 diet groups by using a computer-generated r and om-number sequence . The coordinating center constructed the r and omization table , and participants were r and omly assigned into blocks of 50 participants balanced by center , sex , and age group ( < 70 years and 70 years ) . We concealed allocation into the intervention groups by using closed envelopes with correlative numbers by prespecified subgroups of sex and age . The baseline examination included the administration of a 14-item question naire , an extension of a previously vali date d question naire ( 19 ) , that assessed the degree of adherence to the traditional Mediterranean diet . We assigned values of 0 or 1 to each item ( Appendix Table 1 ) . We also administered a 137-item vali date d food frequency question naire ( 20 ) ; the vali date d Spanish version ( 21 ) of the Minnesota Leisure Time Physical Activity Question naire ; and a 47-item question naire about education , lifestyle , history of illnesses , and medication use . We performed anthropometric and blood pressure measurements and obtained sample s of fasting blood and spot urine . We repeated all examinations at 3 months . The same dietitian delivered the interventions to the 3 r and omized groups in each center . On the basis of the assessment of individual Mediterranean diet scores , the dietitian gave personalized dietary advice during a 30-minute session to each participant , with recommendations on the desired frequency of intake of specific foods . We advised participants who were allocated to the low-fat diet to reduce intake of all types of fat , and we gave them a leaflet with written recommendations according to the American Heart Association guidelines ( 22 ) . For total fat intake , these recommendations were opposite to those given to participants in the 2 Mediterranean diet groups , who received instructions intended to increase the 14-item Mediterranean diet score , including increased consumption of vegetable fats and oils . We did not suggest any energy restriction . While the participants who were allocated to the low-fat diet did not receive further intervention , those assigned the 2 Mediterranean diet groups had access to more intense intervention in 2 ways . First , they were given a free provision of typical Mediterranean fatty foods ( olive oil or nuts ) . Depending on group assignment , participants were given either free virgin olive oil ( 15 L [ 1 L/wk ] for 3 months ) or free sachets of walnuts , hazelnuts , and almonds ( 1350 g of walnuts [ 15 g/d ] , 675 g of hazelnuts [ 7.5 g/d ] , and 675 g of almonds [ 7.5 g/d ] for 3 months ) . To improve adherence and account for family needs , participants in the corresponding Mediterranean diet groups were given excess olive oil or additional 1000-g packets of nuts . We analyzed the nutrient composition of the olive oil and nuts used in the study by st and ard methods in a reference laboratory ( Appendix Table 2 ) ) . Second , 1 week after inclusion , the dietitian delivered a 1-hour group session with up to 20 participants , with separate sessions for each Mediterranean diet group . Each group session consisted of informative talks and provision of written material s with elaborate descriptions of typical Mediterranean foods and seasonal shopping lists , meal plans , and cooking recipes . Throughout the study , all participants had free and continuous access to their center dietitian for advice and consultation . Measurements Trained personnel measured weight and height by using calibrated scales and a wall-mounted stadiometer , respectively ; waist circumference midway between the lowest rib and the iliac crest by using an anthropometric tape ; and blood pressure in triplicate with a vali date d semiautomatic oscillometer ( Omron HEM-705CP , Hoofddorp , the Netherl and s ) . We calculated energy and nutrient intake from Spanish food composition tables ( 23 ) . At the 3-month visit and when consulted by participants , dietitians assessed any adverse effects from the interventions by administering a checklist of symptoms and gave advice on how to remedy them . The checklist included mouth symptoms ; bloating , fullness , or indigestion ; altered bowel Objective To study the effects of the dietary fat content on cardiovascular disease risk factors in humans when the fatty acid composition and types of carbohydrates are kept constant . Methods A controlled dietary study in healthy volunteers with 2 dietary groups and a parallel design consisting of 2 dietary periods was conducted . First , participants received a 2-week wash-in diet rich in saturated fatty acids ( SFA ; 47 % of total fatty acids ) and were then r and omly assigned to either a high-fat ( 40 % of energy ) or a low-fat diet ( 29 % of energy ) for 4 weeks . Both diets were isocaloric , rich in monounsaturated fatty acids ( MUFA ; 51 % of total fatty acids ) and had similar fatty acid and carbohydrate compositions . Results Compared to the wash-in diet , the high-fat and low-fat diets significantly lowered LDL-cholesterol ( −0.34 and −0.41 mmol/l , respectively ; P < 0.001 for time effect in RM-ANOVA ) , and HDL-cholesterol ( −0.13 and −0.18 mmol/l , respectively ; P < 0.001 for time ) , without any differences between the high-fat and low-fat diets ( P = 0.112 and P = 0.085 for time × group interaction in RM-ANOVA , respectively ) . The size of the major LDL fraction , the LDL susceptibility to oxidation and the plasma concentrations of oxidized LDL ( ox-LDL ) were significantly reduced by both the high-fat and low-fat diet , again without significant differences between the diets . The ratio of ox-LDL/LDL-cholesterol , serum triacylglycerols and urinary F2-isoprostanes were not significantly affected by the diets . Conclusion A high-fat and a low-fat diet , both rich in MUFA , had similar effects on lipid-related cardiovascular disease risk factors in metabolically healthy men and women The aim of this r and omised , double-blind , crossover study in normolipidaemic volunteers was to investigate the effect of consumption of an experimental cheese ( from cows fed a grass and maize silage-based diet with 5 % of linseed oil added ) or a control cheese ( without linseed oil ) on both plasma lipids and fatty acid content of serum lipid fractions . A lower content of medium-chain saturated fatty acids as well as a higher content of stearic acid and polyunsaturated fatty acids were found in the experimental cheese ; its consumption was successful in limiting the enhanced blood concentration of atherogenic fatty acids , without affecting fatty acid content of serum lipid fractions . These results indicate that dairy products could be considered as key foods for fat modifications with the objective of optimizing their nutritional quality BACKGROUND Despite the high content of palmitic acid , palm olein has been shown to have a neutral effect on plasma cholesterol concentrations when compared with olive oil , which is suggested to be attributable to palmitic acid in the sn-1 and sn-3 position . In contrast , palmitic acid is in the sn-2 position in lard . OBJECTIVE The objective was to investigate the effects of a diet rich in palm olein , fractionated palm oil , olive oil , and lard on plasma blood lipids , inflammatory markers , glucose , and insulin . DESIGN A controlled double-blinded , r and omized 3 × 3 wk crossover dietary intervention study included 32 healthy men who daily replaced part of their habitual dietary fat intake with ~ 17 % of energy from palm olein , olive oil , or lard , respectively . RESULTS Compared with intake of olive oil , palm olein and lard  increased total cholesterol and LDL cholesterol ( P < 0.0001 ) . Palm olein result ed in a lower plasma triacylglycerol concentration than did olive oil ( P < 0.01 ) . No difference in effects was observed in plasma HDL-cholesterol , high-sensitivity C-reactive protein , plasminogen activator-1 , insulin , and glucose concentrations . CONCLUSIONS The current study did not support the previous finding that the effect of palm olein on total plasma cholesterol and LDL cholesterol in healthy individuals with normal plasma cholesterol concentrations is neutral compared with that of olive oil . Thus , sn-positioning was not confirmed to be important with regard to the effect on plasma cholesterol . The relatively lower plasma triacylglycerol concentration  after the palm olein diet than after the olive oil diet was unexpected . This trial is registered at clinical trials.gov as NCT00743301 This study was conducted to compare the effects of omega 3 fatty acids , taken as fish or fish-oil supplements in the setting of a high- or low-fat dietary background , on blood pressure and heart rate in men with moderate cardiovascular risks . One hundred twenty men were r and omly allocated to five high-fat ( 40 % of daily energy ) and two low-fat ( 30 % of energy ) groups to undertaken a 12-week dietary intervention period involving fish , fish oil , or a combination of these . Sodium intake was restricted to less than 90 mmol/d . The five high-fat groups were assigned to take either 6 or 12 fish-oil capsules daily , fish or a combination of fish oil and fish , or placebo capsules . The two low-fat groups took either fish or placebo capsules . Fish meals were devised to provide 1.3 g of eicosapentaenoic acid daily , equivalent to that contained in 6 fish-oil capsules . Subjects were instructed to eat a selection of fish that provided an average of 3.65 g/d ( range , 3.2 to 4.1 g/d ) of total omega 3 fatty acids . Subjects were seen at regular intervals during the baseline and dietary intervention periods for measurement of weight , blood pressure , heart rate , dietary compliance , urinary electrolyte excretion , platelet phospholipid fatty acids , blood glucose , and insulin concentration . There was a greater fall in both systolic and diastolic blood pressures in subjects allocated fish or fish oil , particularly in the low-fat groups , compared with control subjects . However , there was no significant group effect . ( ABSTRACT TRUNCATED AT 250 WORDS Palm oil and soybean oil are the 2 most widely used cooking oils in the world . Palm oil is consumed mainly in developing countries , where morbidity and mortality due to cardiovascular disease ( CVD ) are on the rise . Although cl aims about adverse or protective effects of these oils are commonly made , there are no epidemiologic studies assessing the association between these oils and cardiovascular disease endpoints . We examined whether consumption of palm oil relative to soybean oil and other unsaturated oils ( predominantly sunflower ) is associated with  myocardial infa rct ion ( MI ) in Costa Rica . The cases ( n = 2111 ) were survivors of a first acute MI and were matched to r and omly selected population controls ( n = 2111 ) .  Dietary intake was assessed with a vali date d semiquantitative FFQ . Adipose tissue profiles of essential fatty acids were assessed to vali date cooking oil intake and found to be consistent with self-reported major oils used for cooking . The data were analyzed using conditional logistic regression . Palm oil users were more likely to have an MI than users of soybean oil [ odds ratio ( OR ) = 1.33 ; 95 % CI : 1.08 - 1.63 ] or other cooking oils ( OR = 1.23 ; CI : 0.99 - 1.52 ) , but they did not differ from users of soybean oil with a high trans-fatty acid content ( OR = 1.14 ; CI : 0.84 - 1.56 ) . These data suggest that as currently used in Costa Rica , and most likely in many other developing countries , the replacement of palm oil with a polyunsaturated nonhydrogenated vegetable oil would reduce the risk of MI Abstract This evaluation of the Multiple Risk Factor Intervention Trial data base investigated the effects of dietary PUFA on disease outcomes that may relate to polyunsaturated fatty acid ( PUFA ) biochemistry . The Multiple Risk Factor Intervention Trial was a r and omized clinical trial in coronary heart disease ( CHD ) primary prevention involving 12,866 middle-aged men determined to be at high risk of CHD . They were assigned to either a special intervention group or a usual care group and returned to clinics on an annual basis for assessment of risk factor status . Only data on the usual care men ( n = 6,250 ) are presented , since the multi-intervention effects on the special intervention group introduce considerable analytic complexities . Mean PUFA intake estimates were calculated from four dietary recall interviews at baseline and follow-up Years 1 , 2 , and 3 and estimates for PUFA were established using absolute grams , percentage of total kilocalories , and ratios . Proportional hazards regression analysis controlling for age , race and baseline diastolic blood pressure , smoking , high and low density lipoprotein cholesterol levels , and alcohol was used to analyze dietary PUFA intakes on 10.5-year mortality rates . Results were more significant when PUFA were expressed as percentage of total kilocalories . No significant associations with mortality were detected for linoleic acid ( 18:2n-6 ) , the predominant dietary PUFA . Significant inverse associations were observed for linolenic acid ( 18:3n-3 ) on mortality from CHD ( P < 0.04 ) , all cardiovascular diseases ( CVD ) ( P < 0.03 ) , and all cause mortality ( P < 0.02 ) ; the sum of fatty acids primarily derived from fish oils ( 20:5n-3 + 22:5n-3 + 22:6n-3 ) on CHD ( P < 0.02 ) , CVD ( P < 0.006 ) , and all cause ( P < 0.02 ) mortality ; and , the ratio of 18:3n-3 to 18:2n-6 on cancer mortality ( P < 0.05 ) . Analysis using the total n-3 ( 18:3 + 20:5 + 22:5 + 22:6 ) to total n-6 ( 18:2 + 18:4 + 20:4 ) ratio was also significant on cancer mortality ( P < 0.04 ) . These findings support reports that n-3 fatty acids are protective against CVD and suggest that composition of dietary PUFA may influence CVD and cancer rates Recent studies have suggested that omega 3-fats of marine origin may have a protective role in heart disease . This study aim ed to compare the effects of fish or fish oil , in the setting of a high- or low-fat diet , on platelet aggregation and platelet thromboxane in men with increased risk of cardiovascular disease . One hundred twenty men who were nonsmokers , 30 to 60 years old , with mildly elevated blood pressure and cholesterol were r and omly allocated to one of five high-fat ( 40 % of daily energy ) or two low-fat ( 30 % ) groups for 12 weeks . The five high-fat groups took either 6 or 12 fish oil capsules daily ; fish ; a combination of fish and fish oil ; or placebo capsules . The two low-fat groups took either fish or placebo capsules . Fish meals provided 1.3 g of eicosapentaenoic acid daily , equivalent to 6 fish oil capsules , and contained an average of 3.65 g/d of omega 3-fatty acids . Multiple regression analysis of the combined groups showed that all groups taking omega 3-fatty acids reduced platelet aggregation to both collagen ( P < .0001 ) and platelet-activating factor ( PAF ) ( P < .05 ) and platelet thromboxane B2 responses ( P < .05 ) to collagen-induced aggregation . The low-fat diet alone had no effect on PAF-induced platelet aggregation and only a small effect on platelet responses to collagen ( P < .05 ) . Platelet aggregation responses to PAF were reduced more by fish oil than fish in a high-fat diet , whereas fish had a greater effect when part of a low-fat rather than a high-fat diet . There was no significant difference in collagen-induced platelet aggregation or platelet thromboxane between fish and fish oils on a high or low fat intake . In conjunction with our previous findings of improvements in lipoproteins , blood pressure , and heart rate in this population , these results on platelet function suggest that dietary omega 3-fatty acids incorporated into a low- rather than a high-fat diet have a wider spectrum of more favorable effects on cardiovascular risk factors Epidemiological studies as well as r and omised dietary trials suggest that Mediterranean diet may be important in relation to the pathogenesis and prevention of  coronary heart disease ( CHD ) . A striking protective effect of a Mediterranean diet rich in alpha-linolenic acid ( ALA ) was reported in the Lyon Diet Heart Study with a 50 to 70 % reduction of the risk of recurrence after four years of follow-up in CHD patients . According to current knowledge , dietary ALA should represent about 0.6 to 1 % of total daily energy or about 2 g per day in patients who follow a traditional Mediterranean diet . Supplementation with very long chain omega-3 fatty acids ( c.1 g per day ) in patients following a Mediterranean type of diet  was shown to decrease the risk of cardiac death by 30 % and of sudden cardiac death by 45 % in the GISSI trial . Thus , in the context of a diet rich in oleic acid , poor in saturated fats and not high in omega-6 fatty acids ( a dietary pattern characterizing the traditional Mediterranean diet ) , even a small dose of very long chain omega-3 fatty acids ( one gram under the form of capsules ) might be very protective . These data underline the importance of the accompanying diet in any dietary strategy using fatty acid complements
Comparison of PO diets with diets rich in stearic acid , monounsaturated fatty acids ( MUFAs ) , and polyunsaturated fatty acids ( PUFAs ) showed significantly higher TC , LDL cholesterol , apolipoprotein B , HDL cholesterol , and apolipoprotein A-I , whereas most of the same biomarkers were significantly lower when compared with diets rich in myristic/lauric acid .
Comparison of PO-rich diets with diets rich in trans fatty acids showed significantly higher concentrations of HDL cholesterol and apolipoprotein A-I and significantly lower apolipoprotein B , triacylglycerols , and TC/HDL cholesterol .
Stratified and meta-regression analyses showed that the higher concentrations of TC and LDL cholesterol , when PO was substituted for MUFAs and PUFAs , were not significant in young people and in subjects with diets with a lower percentage of energy from fat .
Both favorable and unfavorable changes in CHD/CVD risk markers occurred when PO was substituted for the primary dietary fats , whereas only favorable changes occurred when PO was substituted for trans fatty acids .
BACKGROUND Palm oil ( PO ) may be an unhealthy fat because of its high saturated fatty acid content .
OBJECTIVE The objective was to assess the effect of substituting PO for other primary dietary fats on blood lipid-related markers of coronary heart disease ( CHD ) and cardiovascular disease ( CVD ) .