The effect of diet on plasma lipids, lipoproteins, and coronary heart disease.

The role that diet plays in the management of plasma lipid levels is discussed in this review. It has long been recognized that saturated fatty acids and cholesterol raise the plasma cholesterol level whereas polyunsaturated fatty acids lower it. Recently, the effects of other dietary constituents in the management of plasma lipid levels have been established. In particular, monounsaturated fatty acids, soluble fiber, and vegetarian diets favorably affect plasma lipid levels. Overweight and obesity adversely affect plasma lipid levels. Omega-3 fatty acids are hypotriglyceridemic, and high carbohydrate diets low in saturated fatty acids are hypocholesterolemic. Further work is required to establish the long-term consequences of alcohol and coffee consumption on the plasma lipid response. A variety of alternative dietary strategies can be employed in conjunction with traditional dietary recommendations (i.e., reduce total fat, especially saturated fatty acids and dietary cholesterol) for the management of plasma lipid levels. The expected plasma total cholesterol (specifically low-density-lipoprotein cholesterol) reduction is approximately 10% to 20% when dietary saturated fatty acids and cholesterol are decreased to less than or equal to 7% of calories and less than or equal to 200 mg of cholesterol per day. Further dietary modifications, such as increasing soluble fiber, may lead to additional reductions of 1% to 10% in plasma total cholesterol.