Lichtenstein A H, Ausman L M, Carrasco W, Jenner J L, Gualtieri L J, Goldin B R, Ordovas J M, Schaefer E J
Lipid Metabolism Laboratory, Tufts University, Boston, Mass. 02111.
Arterioscler Thromb. 1993 Oct;13(10):1533-42. doi: 10.1161/01.atv.13.10.1533.
The most stringent dietary recommendations of the National Cholesterol Education Program (NCEP) are to limit fat intake to < 30% of calories, saturated fat intake to < 7% of calories, and cholesterol intake to < 200 mg/d (Step 2 diet). There is debate as to whether the remaining fat in the diet should be relatively high in monounsaturated or polyunsaturated fatty acids. We examined this issue by testing the effects of diets meeting the aforementioned guidelines that were enriched in three different vegetable oils on plasma lipids in the fasting and postprandial states in a clinically relevant population. Female and male subjects (n = 15, mean age, 61 years) with low-density lipoprotein cholesterol (LDL-C) concentrations > 130 mg/dL were studied under strictly controlled conditions. Subjects were first placed on a diet similar to that currently consumed in the United States to stabilize plasma lipids with respect to identical fat and cholesterol intakes. The subjects then received diets meeting NCEP Step 2 criteria in which two thirds of the fat calories were given either as canola, corn, or olive oil in a randomized, double-blinded fashion for 32 days each. Plasma cholesterol concentrations declined after consumption of diets enriched in all the test oils; however, the declines were significantly greater for the canola (12%) and corn (13%) than for the olive (7%) oil-enriched diet. Mean plasma LDL-C concentrations declined after consumption of diets enriched in all the test oils (16%, 17%, and 13% for canola, corn, and olive oil, respectively), and the magnitude of the declines was statistically indistinguishable among the test oils. Mean plasma high-density lipoprotein cholesterol (HDL-C) concentrations declined after consumption of the baseline diet, and these declines were significant for the canola (7%) and corn (9%) oil-enriched diets. Changes in LDL apolipoprotein (apo)B concentrations paralleled those of LDL-C. Switching from the baseline to the vegetable oil--enriched diets had no significant effect on plasma triglyceride, apoA-I, and lipoprotein(a) concentrations or the total cholesterol to HDL-C ratio. LDL apoB to apoA-I ratios were significantly reduced when the subjects consumed the vegetable oil--enriched diets. Differences similar to those observed in the fasting state were observed in the postprandial state.(ABSTRACT TRUNCATED AT 400 WORDS)
美国国家胆固醇教育计划(NCEP)最严格的饮食建议是将脂肪摄入量限制在热量的30%以下,饱和脂肪摄入量限制在热量的7%以下,胆固醇摄入量限制在200毫克/天以下(第二步饮食)。关于饮食中剩余的脂肪应富含单不饱和脂肪酸还是多不饱和脂肪酸,存在争议。我们通过测试符合上述指南且富含三种不同植物油的饮食对临床相关人群空腹和餐后血脂的影响来研究这个问题。研究了低密度脂蛋白胆固醇(LDL-C)浓度>130毫克/分升的男性和女性受试者(n = 15,平均年龄61岁),研究在严格控制的条件下进行。受试者首先食用与美国目前饮食相似的饮食,以在相同脂肪和胆固醇摄入量的情况下稳定血脂。然后,受试者接受符合NCEP第二步标准的饮食,其中三分之二的脂肪热量以随机、双盲的方式分别由菜籽油、玉米油或橄榄油提供,每种饮食持续32天。食用富含所有测试油的饮食后,血浆胆固醇浓度下降;然而,菜籽油(12%)和玉米油(13%)导致的下降幅度明显大于橄榄油(7%)丰富的饮食。食用富含所有测试油的饮食后,平均血浆LDL-C浓度下降(菜籽油、玉米油和橄榄油分别下降16%、17%和13%),且下降幅度在各测试油之间无统计学差异。食用基线饮食后,平均血浆高密度脂蛋白胆固醇(HDL-C)浓度下降,菜籽油(7%)和玉米油(9%)丰富的饮食下降显著。LDL载脂蛋白(apo)B浓度的变化与LDL-C的变化平行。从基线饮食转换为富含植物油的饮食对血浆甘油三酯、apoA-I和脂蛋白(a)浓度或总胆固醇与HDL-C的比值没有显著影响。当受试者食用富含植物油的饮食时,LDL apoB与apoA-I的比值显著降低。在餐后状态观察到与空腹状态类似的差异。(摘要截选至400字)