Effects of short-term high-carbohydrate feeding on serum triglyceride of children with familial hypercholesterolaemia.

In 5 children with familial hypercholesterolaemia, serum triglyceride levels, which were initially normal, rose after three days on a high-carbohydrate diet; a similar response occurred in one child with normal serum lipoproteins. These observations suggest that a rise in serum triglyceride on high-carbohydrate feeding is a normal finding in children and therefore should not be used as a test for the diagnosis of the pathological state of `carbohydrate-induced hypertriglyceridaemia'. The findings in familial hypercholesterolaemia indicate that diets used in the treatment of this condition should not contain an unduly high proportion of carbohydrate. Detailed investigations showed that most of the increase in triglyceride occurred in the very low density lipoproteins, but small increases were also found in the other lipoproteins. The lipid composition of all the lipoproteins changed, the proportion of triglyceride being increased. In all children the fatty acid composition of serum triglyceride (g./100 g. total fatty acids) showed an increase in palmitoleic acid and a decrease in linoleic acid. A raised percentage of palmitoleic acid appears to be the most consistent indicator of accelerated lipogenesis during high-carbohydrate feeding. Changes in triglyceride fatty acid composition were similar in all the lipoproteins. On high-carbohydrate feeding the absolute concentration of all triglyceride fatty acids, including linoleic acid, increase.