Mendis S, Samarajeewa U, Thattil R O
Room 4034, World Health Organization, 20 Ave Appia, 1211 Geneva 27, Switzerland.
Br J Nutr. 2001 May;85(5):583-9. doi: 10.1079/bjn2001331.
The aim of the present study was to examine the effect of reducing saturated fat in the diet, or partly replacing it with unsaturated fat, on the serum lipoprotein profile of human subjects. The study had two intervention periods, 8 weeks (phase 1) and 52 weeks (phase 2). In phase 1, total fat was reduced from 31 to 25% energy (polyunsaturated fatty acids (PUFA):saturated fatty acids (SFA) ratio increased from 0.2 to 0.4) by reducing the quantity of coconut fat (CF) in the diet from 17.8 to 9.3% energy intake. In phase 2, subjects were randomised to groups A and B. In group A total fat was reduced from 25 to 20% energy (PUFA:SFA ratio increased from 0.4 to 0.7) by reducing the quantity of CF in the diet from 9.3 to 4.7% total energy intake. In group B, the saturated fat content in the diet was similar to group A. In addition a test fat (a mixture of soyabean oil and sesame oil, PUFA:monosaturated fatty acids ratio 2) contributed 3.3% total energy intake and total fat contributed 24% energy intake (PUFA:SFA ratio increased from 0.7 to 1.1). At the end of phase 1, there was a 7.7% reduction in cholesterol (95% CI -3.6, -12.2) and 10.8% reduction in LDL (95% CI -4.9, -16.5) and no significant change in HDL and triacylglycerol. At the end of phase 2, the reduction in cholesterol in both groups was only about 4% (95% CI -12, 3.2) partly due the concomitant rise in HDL. The reduction in LDL at 52 weeks was significantly higher in group B (group A mean reduction 11%, 95% CI -20.1, -2.0 and group B mean reduction 16.2% 95% CI -23.5, -8.9). In phase 2, triacylglycerol levels showed a mean reduction of 6.5% in group 2A and a mean increase of 8.2% in group 2B. The reduction of saturated fat in the diet is associated with a lipoprotein profile that would be expected to reduce cardiovascular risk. The reduction of dietary saturated fat with partial replacement of unsaturated fat brings about changes in total cholesterol, HDL- and LDL-cholesterol that are associated with a lower cardiovascular risk.
本研究的目的是检验减少饮食中饱和脂肪含量或部分用不饱和脂肪替代饱和脂肪,对人体受试者血清脂蛋白谱的影响。该研究有两个干预期,分别为8周(第1阶段)和52周(第2阶段)。在第1阶段,通过将饮食中椰子油(CF)的量从能量摄入的17.8%降至9.3%,使总脂肪从能量的31%降至25%(多不饱和脂肪酸(PUFA):饱和脂肪酸(SFA)的比例从0.2增至0.4)。在第2阶段,受试者被随机分为A组和B组。在A组中,通过将饮食中CF的量从总能量摄入的9.3%降至4.7%,使总脂肪从能量的25%降至20%(PUFA:SFA比例从0.4增至0.7)。在B组中,饮食中的饱和脂肪含量与A组相似。此外,一种试验脂肪(大豆油和芝麻油的混合物,PUFA:单不饱和脂肪酸比例为2)提供3.3%的总能量摄入,总脂肪提供24%的能量摄入(PUFA:SFA比例从0.7增至1.1)。在第1阶段结束时,胆固醇降低了7.7%(95%置信区间 -3.6,-12.2),低密度脂蛋白(LDL)降低了10.8%(95%置信区间 -4.9,-16.5),而高密度脂蛋白(HDL)和三酰甘油无显著变化。在第2阶段结束时,两组胆固醇的降低幅度仅约为4%(95%置信区间 -12,3.2),部分原因是HDL同时升高。在52周时,B组LDL的降低幅度显著高于A组(A组平均降低11%,95%置信区间 -20.1,-2.0;B组平均降低16.2%,95%置信区间 -23.5,-8.9)。在第2阶段,2A组三酰甘油水平平均降低6.5%,2B组平均升高8.2%。饮食中饱和脂肪的减少与一种预期会降低心血管风险的脂蛋白谱相关。用不饱和脂肪部分替代饮食中的饱和脂肪会导致总胆固醇、HDL胆固醇和LDL胆固醇发生变化,这些变化与较低的心血管风险相关。