Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: Studies in the fasting and postprandial states

Lars Berglund, Michael Lefevre, Henry N. Ginsberg, Penny M. Kris-Etherton, Patricia J. Elmer, Paul W. Stewart, Abby Ershow, Thomas A. Pearson, Barbara H. Dennis, Paul S. Roheim, Rajasekhar Ramakrishnan, Roberta Reed, Kent Stewart, Katherine M. Phillips

Research output: Contribution to journalArticle

106 Scopus citations

Abstract

Background: In subjects with a high prevalence of metabolic risk abnormalities, the preferred replacement for saturated fat is unresolved. Objective: The objective was to study whether carbohydrate or monounsaturated fat is a preferred replacement for saturated fat. Design: Fifty-two men and 33 women, selected to have any combination of HDL cholesterol ≤ 30th percentile, triacylglycerol ≥ 70th percentile, or insulin ≥ 70th percentile, were enrolled in a 3-period, 7-wk randomized crossover study. The subjects consumed an average American diet (AAD; 36% of energy from fat) and 2 additional diets in which 7% of energy from saturated fat was replaced with either carbohydrate (CHO diet) or monounsaturated fatty acids (MUFA diet). Results: Relative to the AAD, LDL cholesterol was lower with both the CHO (-7.0%) and MUFA (-6.3%) diets, whereas the difference in HDL cholesterol was smaller during the MUFA diet (-4.3%) than during the CHO diet (-7.2%). Plasma triacylglycerols tended to be lower with the MUFA diet, but were significantly higher with the CHO diet. Although dietary lipid responses varied on the basis of baseline lipid profiles, the response to diet did not differ between subjects with or without the metabolic syndrome or with or without insulin resistance. Postprandial triacylglycerol concentrations did not differ significantly between the diets. Lipoprotein(a) concentrations increased with both the CHO (20%) and MUFA (11%) diets relative to the AAD. Conclusions: In the study population, who were at increased risk of coronary artery disease, MUFA provided a greater reduction in risk as a replacement for saturated fat than did carbohydrate.

Original languageEnglish (US)
Pages (from-to)1611-1620
Number of pages10
JournalAmerican Journal of Clinical Nutrition
Volume86
Issue number6
DOIs
StatePublished - Dec 1 2007

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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