Effects of dietary fatty acid composition on plasma cholesterol. 1996

P Khosla, and K Sundram
Foster Biomedical Research Laboratory, Brandeis University, Waltham, MA, USA.

It should be clear from the preceding sections that the effects of dietary fatty acids on plasma lipids get more complicated the more we try to simplify them! We have presented one argument as to how different fatty acids may interact to impact human plasma lipids. This is by no means an endorsement that ours is the only argument. Nevertheless, a strong case can be made for 14:0 and 18:2 as being the key players in this scenario. The role of palmitic acid seems to be the most controversial. While clearly certain studies do indeed reveal 16:0 to be hypercholesterolemic relative to 18:1, the data from studies suggesting that it behaves similarly to 18:1 are equally compelling. What is certain is that it is erroneous to assume that 16:0 is the major cholesterol-raising SFA simply because it is the most abundant SFA in the diet. Clearly, 18:0 cannot be considered cholesterol-elevating. One is therefore left with the 12-16C SFA. However, 12:0 and 14:0 are only of concern if diets contain palm-kernel, coconut oil or dairy products as major dietary constituents. Accordingly one is left with 16:0 and its response is highly dependent on the metabolic status as well as the age of the subjects being used. While "elderly" hypercholesterolemic humans clearly benefit from decreased 16:0 (and all SFA) consumption, "younger" normocholesterolemic subjects fail to show such clear-cut effects. Additionally, the concomitant levels of dietary cholesterol and 18:2 also have a major bearing on the cholesterolemic response of 16:0 As far as guidelines for the general public are concerned, clearly for people with TC > 225 and LDL-C > 130 mg/dl and/or those who are overweight (i.e. those percieved to be at high risk), the primary emphasis should clearly be on reducing total fat consumption. Decreasing saturated fat consumption will invariably also lower dietary cholesterol consumption. The latter manouver will generally lower TC and LDL-C. Whether the reduction occurs because of the removal of 14:0, or 16:0 and/or dietary cholesterol is a mute point, since most dietary guidelines advocate curtailing intake of animal and dairy products, which will result in reductions of all the SFA. It remains to be established whether life-long adherence to the above dietary guidelines in those subjects with normal cholesterol levels and an absence of the other conventional risk factors for CHD, will result in a subsequent decrease in CHD risk. In the latest NCEP report 39 million Americans were targeted as those who would benefit from reductions in LDL-C, principally by dietary means. This is indeed a very high number. But that leaves almost 220 million Americans! For them the age old recommendation to consume a moderate fat load, maintain ideal body weight and eat a varied and balanced diet would still appear to be the most powerful advice.

UI MeSH Term Description Entries
D002318 Cardiovascular Diseases Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM. Adverse Cardiac Event,Cardiac Events,Major Adverse Cardiac Events,Adverse Cardiac Events,Cardiac Event,Cardiac Event, Adverse,Cardiac Events, Adverse,Cardiovascular Disease,Disease, Cardiovascular,Event, Cardiac
D002784 Cholesterol The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Epicholesterol
D004041 Dietary Fats Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. Fats, Dietary,Dietary Fat,Fat, Dietary
D005227 Fatty Acids Organic, monobasic acids derived from hydrocarbons by the equivalent of oxidation of a methyl group to an alcohol, aldehyde, and then acid. Fatty acids are saturated and unsaturated (FATTY ACIDS, UNSATURATED). (Grant & Hackh's Chemical Dictionary, 5th ed) Aliphatic Acid,Esterified Fatty Acid,Fatty Acid,Fatty Acids, Esterified,Fatty Acids, Saturated,Saturated Fatty Acid,Aliphatic Acids,Acid, Aliphatic,Acid, Esterified Fatty,Acid, Saturated Fatty,Esterified Fatty Acids,Fatty Acid, Esterified,Fatty Acid, Saturated,Saturated Fatty Acids
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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