Berglund Lars, Lefevre Michael, Ginsberg Henry N, Kris-Etherton Penny M, Elmer Patricia J, Stewart Paul W, Ershow Abby, Pearson Thomas A, Dennis Barbara H, Roheim Paul S, Ramakrishnan Rajasekhar, Reed Roberta, Stewart Kent, Phillips Katherine M
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Am J Clin Nutr. 2007 Dec;86(6):1611-20. doi: 10.1093/ajcn/86.5.1611.
In subjects with a high prevalence of metabolic risk abnormalities, the preferred replacement for saturated fat is unresolved.
The objective was to study whether carbohydrate or monounsaturated fat is a preferred replacement for saturated fat.
Fifty-two men and 33 women, selected to have any combination of HDL cholesterol < or = 30th percentile, triacylglycerol > or = 70th percentile, or insulin > or = 70th percentile, were enrolled in a 3-period, 7-wk randomized crossover study. The subjects consumed an average American diet (AAD; 36% of energy from fat) and 2 additional diets in which 7% of energy from saturated fat was replaced with either carbohydrate (CHO diet) or monounsaturated fatty acids (MUFA diet).
Relative to the AAD, LDL cholesterol was lower with both the CHO (-7.0%) and MUFA (-6.3%) diets, whereas the difference in HDL cholesterol was smaller during the MUFA diet (-4.3%) than during the CHO diet (-7.2%). Plasma triacylglycerols tended to be lower with the MUFA diet, but were significantly higher with the CHO diet. Although dietary lipid responses varied on the basis of baseline lipid profiles, the response to diet did not differ between subjects with or without the metabolic syndrome or with or without insulin resistance. Postprandial triacylglycerol concentrations did not differ significantly between the diets. Lipoprotein(a) concentrations increased with both the CHO (20%) and MUFA (11%) diets relative to the AAD.
In the study population, who were at increased risk of coronary artery disease, MUFA provided a greater reduction in risk as a replacement for saturated fat than did carbohydrate.
在代谢风险异常高发的人群中，饱和脂肪的首选替代物尚无定论。
研究碳水化合物或单不饱和脂肪是否为饱和脂肪的首选替代物。
选取52名男性和33名女性，入选标准为高密度脂蛋白胆固醇处于≤第30百分位数、甘油三酯处于≥第70百分位数或胰岛素处于≥第70百分位数的任意组合，参与一项为期3个阶段、为期7周的随机交叉研究。受试者食用平均美式饮食（AAD；36%的能量来自脂肪）以及另外两种饮食，其中饱和脂肪提供的7%能量分别被碳水化合物（CHO饮食）或单不饱和脂肪酸（MUFA饮食）替代。
相对于AAD，CHO饮食（-7.0%）和MUFA饮食（-6.3%）的低密度脂蛋白胆固醇均降低，而MUFA饮食期间高密度脂蛋白胆固醇的降幅（-4.3%）小于CHO饮食期间（-7.2%）。MUFA饮食的血浆甘油三酯有降低趋势，但CHO饮食的血浆甘油三酯显著升高。尽管饮食脂质反应因基线脂质谱不同而有所差异，但有或无代谢综合征以及有或无胰岛素抵抗的受试者对饮食的反应并无差异。各饮食之间的餐后甘油三酯浓度无显著差异。相对于AAD，CHO饮食（20%）和MUFA饮食（11%）的脂蛋白(a)浓度均升高。
在该冠心病风险增加的研究人群中，作为饱和脂肪的替代物，MUFA比碳水化合物能更大程度地降低风险。
