Many dietary factors affect plasma triglycerides. Those which decrease the triglyceride level include n-3 fatty acids from fish oil, weight loss, alcohol restriction, and a higher fat (unsaturated fat) diet, whereas a high-carbohydrate, low-fat diet increases triglycerides. The individual responses and the associated magnitude of change in triglycerides as a result of these different dietary factors will vary. For patients with hypertriglyceridemia, fish oil supplements will usually elicit the most potent effects. However, some patients can normalize their triglyceride level with weight loss plus exercise, by avoiding or limiting their alcohol intake, and by increasing the total fat content of their diet. In addition, fish oil supplements can help further to reduce plasma triglycerides. Thus, the combined effects of multiple dietary interventions provide the most potent means of maximally lowering the plasma triglyceride level.
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This study compared the effects of three diets – the AAD, a Step-I, and low-saturated fat (6.1%) diet – on lipids and lipoproteins in various population groups. A stepwise reduction in saturated fat resulted in a parallel reduction in total and LDL-cholesterol. HDLs fell 7% on the Step-I diet and 11% on the low-saturated fat diet. Compared with the AAD, triglycerides increased by 9% with both low-fat diets.
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Kris-EthertonPMPearsonTAWanYHargroveRLMoriartyKFishellVHigh-monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations. Am J Clin Nutr1999; 70: 1009–1015.
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This study compared the CVD risk profile of an AAD with that of four cholesterol-lowering diets: an American Heart Association/National Cholesterol Education Program Step-II diet and three high-MUFA diets (olive oil, peanut oil, and peanuts and peanut butter). Results showed that a high-MUFA, cholesterol-lowering diet has a more favorable effect on the CVD risk profile compared with a low-fat, Step-II diet.
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Kris-EthertonPMZhaoGPelkmanCLFishellVKCovalS.Beneficial effects of a diet high in monounsaturated fatty acids on risk factors for cardiovascular disease. The role of peanuts and peanut products. Nutr Clin Care2000; 3: 153–158.
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This meta-analysis of 70 studies showed that weight reduction was associated with a significant decrease in total cholesterol, LDL-cholesterol, and triglycerides. For every kilogram decrease in body weight, a 0.009 mmol/l increase in HDL level occurred for subjects at a stable, reduced weight.
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Yu-PothSZhaoGEthertonTNaglakMJonnalagaddaSKris-EthertonPM.Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta analysis. Am J Clin Nutr1999; 69: 632–646.
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This meta-analysis of 37 dietary intervention studies in free-living individuals assessed the impact of Step-I and Step-II diets on CVD risk factors. The Step-I and Step-II diets lowered the total cholesterol, LDL cholesterol, and triglyceride levels. HDL-cholesterol decreased in response to Step-II, but not Step-I, diets. Step-I/Step-II diets combined with weight loss and/or exercise decreased the triglyceride and raised the HDL-cholesterol level.
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Kris-EthertonPM.for the DELTA Investigators. Effects of replacing saturate fat (SFA) with monounsaturated fat (MUFA) or carbohydrate (CHO) on plasma lipids and lipoproteins in individuals with insulin resistance [abstract]. FASEB J1996; 10: 2666.
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The benefits of fish oil on CVD appear to be mediated in part through lipid modification –increased HDL-cholesterol level, reduced triglycerides, reduced postprandial lipemia, and reduced remnant concentrations. LDL-cholesterol concentration and oxidation may, however, increase with fish oil intake. Additional cardiovascular health benefits of fish oil include improved endotheial function and better arterial elasticity.
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This study evaluated the effects of n-3 fatty acids from fish oil (EPA and DHA) and plant oils (Alpha-linolenic acid) on lipids and lipoproteins in both crossover (n = 36) and parallel (n = 29) designed studies providing less than 7 g n-3 fatty acids/day with a treatment period of ≥ 2 weeks duration. The serum triglyceride level decreased by 25–30%, and that of HDL-cholesterol increased by 1–3%. The LDL-cholesterol tended to rise by 5–10%.
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RambjorGSWalenAIWindsorSLHarrisWS.Eicosapentaenoic acid is primarily responsible for hypotriglyceridemic effect of fish oil in humans. Lipids1996; 31: S45–S49.
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