Katan M B
Department of Human Nutrition, Wageningen Agricultural University, Netherlands.
Am J Clin Nutr. 1997 Oct;66(4 Suppl):974S-979S. doi: 10.1093/ajcn/66.4.974S.
Reducing the intake of saturated fatty acids reduces the risk of coronary disease. This paper reviews the merits of two types of diets reduced in saturated fat. Low-fat, high-carbohydrate diets lower plasma low-density lipoprotein (LDL) but also lower high-density lipoprotein (HDL) concentrations and raise plasma very-low-density lipoprotein. The predicted net effect on coronary risk is zero. Weight loss with low-fat diets is modest and insufficient to offset the fall in HDL. Evidence for other beneficial effects of low-fat diets in incomplete. In contrast, diets low in saturated fat but high in unsaturated oils improve the ratio of HDL to LDL in plasma and thus reduce the predicted coronary risk. Recommendations to reduce total fat intake are therefore too imprecise; guidelines should aim specifically at saturated and probably also at trans fatty acids, whereas recommendations for restriction of cis-unsaturated fatty acids are not supported by firm scientific evidence.
减少饱和脂肪酸的摄入量可降低冠心病风险。本文综述了两种饱和脂肪含量降低的饮食的优点。低脂、高碳水化合物饮食可降低血浆低密度脂蛋白（LDL）水平，但同时也会降低高密度脂蛋白（HDL）浓度，并提高血浆极低密度脂蛋白水平。对冠心病风险的预测净效应为零。低脂饮食导致的体重减轻幅度较小，不足以抵消HDL的下降。关于低脂饮食其他有益作用的证据并不充分。相比之下，饱和脂肪含量低但不饱和油含量高的饮食可改善血浆中HDL与LDL的比例，从而降低预测的冠心病风险。因此，减少总脂肪摄入量的建议过于不精确；指南应特别针对饱和脂肪酸，可能还应针对反式脂肪酸，而限制顺式不饱和脂肪酸的建议尚无确凿科学证据支持。
