Clarke R, Frost C, Collins R, Appleby P, Peto R
Clinical Trial Service Unit, Radcliffe Infirmary, Oxford.
BMJ. 1997 Jan 11;314(7074):112-7. doi: 10.1136/bmj.314.7074.112.
To determine the quantitative importance of dietary fatty acids and dietary cholesterol to blood concentrations of total, low density lipoprotein, and high density lipoprotein cholesterol.
Meta-analysis of metabolic ward studies of solid food diets in healthy volunteers.
395 dietary experiments (median duration 1 month) among 129 groups of individuals.
Isocaloric replacement of saturated fats by complex carbohydrates for 10% of dietary calories resulted in blood total cholesterol falling by 0.52 (SE 0.03) mmol/l and low density lipoprotein cholesterol falling by 0.36 (0.05) mmol/l. Isocaloric replacement of complex carbohydrates by polyunsaturated fats for 5% of dietary calories resulted in total cholesterol falling by a further 0.13 (0.02) mmol/l and low density lipoprotein cholesterol falling by 0.11 (0.02) mmol/l. Similar replacement of carbohydrates by monounsaturated fats produced no significant effect on total or low density lipoprotein cholesterol. Avoiding 200 mg/day dietary cholesterol further decreased blood total cholesterol by 0.13 (0.02) mmol/l and low density lipoprotein cholesterol by 0.10 (0.02) mmol/l.
In typical British diets replacing 60% of saturated fats by other fats and avoiding 60% of dietary cholesterol would reduce blood total cholesterol by about 0.8 mmol/l (that is, by 10-15%), with four fifths of this reduction being in low density lipoprotein cholesterol.
确定膳食脂肪酸和膳食胆固醇对血液中总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇浓度的定量影响。
对健康志愿者固体食物饮食的代谢病房研究进行荟萃分析。
129组个体中的395项饮食实验（中位持续时间1个月）。
用复合碳水化合物等热量替代10%膳食热量的饱和脂肪，可使血液总胆固醇降低0.52（标准误0.03）mmol/l，低密度脂蛋白胆固醇降低0.36（0.05）mmol/l。用多不饱和脂肪等热量替代5%膳食热量的复合碳水化合物，可使总胆固醇进一步降低0.13（0.02）mmol/l，低密度脂蛋白胆固醇降低0.11（0.02）mmol/l。用单不饱和脂肪类似地替代碳水化合物，对总胆固醇或低密度脂蛋白胆固醇没有显著影响。每天避免摄入200mg膳食胆固醇，可使血液总胆固醇进一步降低0.13（0.02）mmol/l，低密度脂蛋白胆固醇降低0.10（0.02）mmol/l。
在典型的英国饮食中，用其他脂肪替代60%的饱和脂肪并避免60%的膳食胆固醇，可使血液总胆固醇降低约0.8mmol/l（即降低10 - 15%），其中五分之四的降低是低密度脂蛋白胆固醇的降低。
