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Dietary Fats and Oils: Relation to Blood Cholesterol. Frank M. Sacks, MD Professor, Nutrition Department, Harvard School of Public Health; Professor of Medicine, Harvard Medical School Senior Physician, Brigham & Women ’ s Hospital. LDL-cholesterol. The “bad” cholesterol

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dietary fats and oils relation to blood cholesterol

Dietary Fats and Oils: Relation to Blood Cholesterol

Frank M. Sacks, MD

Professor, Nutrition Department,

Harvard School of Public Health;

Professor of Medicine, Harvard Medical School

Senior Physician, Brigham & Women’s Hospital

ldl cholesterol
LDL-cholesterol
  • The “bad” cholesterol
  • Goes into the arterial wall
  • Causes atherosclerosis
  • Lowering blood LDL-cholesterol by diet or by most drugs reverses atherosclerosis, prevents heart attacks
  • In trials of dietary polyunsaturated fats, the decrease in LDL-cholesterol matches the decrease in heart disease.
slide3

Acid group

Methyl group

Monounsaturated (Oleic acid)

Saturated

w

Polyunsaturated (Essential fatty acids)

N-3

N-6

Linolenic acid

Linoleic acid

Types of fatty acids

slide4

Saturated

=0.032*

Change in

LDL-C

(mmol/L)

=-0.009*

Mono- unsaturated

=-0.019*

Poly-unsaturated

percentage of calories vs. carbohydrate

Effects of Dietary Fats on LDL-Cholesterol

Based on Mensink & Katan 2003. Figure from Micha & Mozaffarian, Lipids 2010

slide5

Effects of Individual Saturated Fatty Acids on LDL cholesterol

12:0 (lauric)

=0.052*

LDL cholesterol

14:0 (myristic)

=0.048*

16:0 (palmitic)

=0.039*

Change in

LDL-C

(mmol/L)

18:0 (stearic)

=-0.004

percentage of calories vs. carbohydrate

Figure from Micha & Mozaffarian, Lipids 2010. Based on Mensink & Katan 2003.

slide6

Palm oil and Lard Increase LDL-Cholesterol Compared to Olive Oil: 3 weeks each oil, 17% energy

Palm

Lard

Olive

Tholstrup T. AJCN 2011

slide7

Acid group

Methyl group

Oleic acid

Stearic acid

w

Linolenic acid

Linoleic acid

Oleic acid trans

18-carbon fatty acids

slide8

Meta-analysis of 60 controlled trials on dietary fats and blood lipids: effect of replacing carbohydrate with cis- or trans-fat

Mensink..Katan. Am J ClinNutr 2003;77:1146

the omniheart study diets lower carbohydrate modifications of dash diet
The OmniHeart Study Diets: Lower Carbohydrate Modifications of DASH Diet

Emphasize:

Fruits, Vegetables; High-protein foods including beans, whole grains, nuts, low-fat dairy, fish and poultry; Unsaturated Cooking Oils

Reduced in:

Carbohydrates, Saturated Fats, Red Meat, Sweets, and Sugar-containing Beverages.

Higher unsaturated fat, higher protein lowered BP and improved lipid risk factors more than the original high-carbohydrate DASH diet.

omniheart ldl cholesterol mg dl all diets low in saturated fat healthful dash type dietary patterns
OmniHeart: LDL-cholesterol (mg/dL)All diets low in saturated fat, healthful DASH-type dietary patterns

Appel L, Sacks F, et al. JAMA 2007

dietary fats oils to lower ldl cholesterol and prevent heart disease
Dietary Fats, Oils to Lower LDL-cholesterol and Prevent Heart Disease
  • Best Choice:
    • Polyunsaturated vegetable oils
      • Peanut, Soybean, Corn, Rapeseed, sesame
  • Next Best
    • Monounsaturated vegetable oils
      • Olive* (more benefits when polyphenols high)
      • High-oleic sunflower, safflower
  • Unhealthful Choices:
    • Trans unsaturated oils
    • Animal fats, high in saturated fatty acids
    • Palm oil
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