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.

Description

The DELTA investigators published the results of a three-period, seven-week randomized crossover study that compared the effect of replacing 7% of energy intake from saturated fatty acids with either monounsaturated fatty acids or carbohydrates on lipoprotein-lipid profile parameters and on indices of plasma glucose-insulin homeostasis. Most of study subjects were characterized by features of the metabolic syndrome. The investigators found that both the monounsaturated fatty acid and carbohydrate substitutions improved plasma levels of total, LDL, and HDL cholesterol as well as apolipoprotein B and apolipoprotein AI levels. No effect was reported on fasting glucose and insulin levels. The greatest variations in HDL cholesterol were observed in subjects with either normal HDL cholesterol or triglyceride levels who were placed on the carbohydrate diet. The greatest improvements to triglyceride levels were observed in subjects with either high triglyceride or low HDL cholesterol levels who received the monounsaturated fatty acid diet. However, both interventions increased plasma levels of Lp(a). These results lend weight to the notion that, in cardiovascular disease risk prevention, individual dietary recommendations are required and should be based on underlying metabolic abnormalities.