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Dietary fat: assessing the evidence in support of a moderate-fat diet; the benchmark based on lipoprotein metabolism

Published online by Cambridge University Press:  27 March 2009

P. M. Kris-Etherton ,
A. E. Binkoski ,
G. Zhao ,
S. M. Coval ,
K. F. Clemmer ,
H. D. Hecker ,
H. Jacques  and
T. D. Etherton
P. M. Kris-Etherton*
Affiliation:
Nutrition Department, The Pennsylvania State University, University Park, PA, USA
A. E. Binkoski
Affiliation:
Nutrition Department, The Pennsylvania State University, University Park, PA, USA
G. Zhao
Affiliation:
Nutrition Department, The Pennsylvania State University, University Park, PA, USA
S. M. Coval
Affiliation:
Nutrition Department, The Pennsylvania State University, University Park, PA, USA
K. F. Clemmer
Affiliation:
Nutrition Department, The Pennsylvania State University, University Park, PA, USA
H. D. Hecker
Affiliation:
Nutrition Department, The Pennsylvania State University, University Park, PA, USA
H. Jacques
Affiliation:
Department des Sciences des Aliments et de Nutrition, Universite Laval, Sainte-Foy, Quebec, Canada
T. D. Etherton
Affiliation:
Department of Dairy and Animal Science, The Pennsylvania State University, University Park, PA, USA
*
*Dr Penny Kris-Etherton, fax +1 814 863 6026, email [email protected]
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Abstract

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There is a growing database that has evaluated the effects of varying amounts of total fat on risk factors for cardiovascular disease, diabetes and overweight and obesity. The evidence clearly suggests that extremes in dietary fat should be avoided, and instead a diet moderate in total fat (25–35 % energy) is preferable for the majority of individuals. Moreover, we now appreciate the importance of individualizing dietary fat recommendations within this range of total fat. With respect to cardiovascular disease, a diet higher in total fat (30–35 % energy) affects the lipid and lipoprotein risk profile more favourably than a lower-fat diet; this is also the case for individuals with diabetes, with the added benefit of better glycaemic control. Dietary fibre (≧25g/d) attenuates and even prevents the potentially adverse lipid and lipoprotein effects of a lower-fat diet. With respect to weight control, a moderate-fat diet can be as, or even more, effective than a lower-fat diet, because of advantages with long-term adherence and potentially favourable effects on lipids and lipoproteins. Thus, there is now a convincing scientific basis to advocate a diet moderate in total fat for the majority of individuals. Implicit to this position is that unsaturated fat has numerous beneficial health effects. However, because fat is energy dense, moderation in fat intake is essential for weight control. Consequently, a simple message to convey is to avoid diets that are very low and very high in fat. Moreover, within the range of a moderate-fat diet it is still important to individualize the total fat prescription. Nonetheless, the guiding principle is that moderation in total fat is the defining benchmark for a contemporary diet that reduces risk of chronic disease.

Type
Macronutrient Metabolism Group Symposium on ‘Dietary fat: how low should we go?’
Information
Proceedings of the Nutrition Society , Volume 61 , Issue 2 , May 2002 , pp. 287 - 298
Copyright
Copyright © The Nutrition Society 2002

References

Abbott, WG Boyce, VL Grundy, SM & Howard, BV (1989) Effects of replacing saturated fat with complex carbohydrate in diets of subjects with NIDDM. Diabetes Care 12, 102–107.CrossRefGoogle ScholarPubMed
Agren, JJ Hanninen, O Julkunen, A Fogelholm, L Vidgren, H Schwab, U Pynnonen, O & Uusitupa, M (1996) Fish diet, fish oil, and docosahexaenoic acid rich oil lower fasting and postprandial plasma lipid levels. European Journal of Clinical Nutrition 50, 765–771.Google ScholarPubMed
American Diabetes Association (2002) Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 25, Suppl., S50–S60.CrossRefGoogle Scholar
Anderson, JW (2000) Dietary fiber prevents carbohydrateinduced hypertriglyceridemia. Current Atherosclerosis Reports 2, 536–541.CrossRefGoogle ScholarPubMed
Anderson, JW Chen, WJ & Sieling, B (1980) Hypolipidemic effects of high–carbohydrate, high–fiber diets. Metabolism 29, 551–558.CrossRefGoogle ScholarPubMed
Anderson, JW Johnstone, BM & Cook-Newell, ME (1995) Meta-analysis of the effects of soy protein intake on serum lipids. New England Journal of Medicine 333, 276–282.CrossRefGoogle ScholarPubMed
Asztalos, B Lefevre, M Wong, L Foster, TA Tulley, R Windhauser, M Zhang, W & Roheim, PS (2000) Differential response to low-fat diet between low and normal HDL-cholesterol subjects. Journal of Lipid Research 41, 321–328.CrossRefGoogle ScholarPubMed
Austin, MA (1999) Epidemiology of hypertriglyceridemia and cardiovascular disease. American Journal of Cardiology 83, 13F–16F.CrossRefGoogle ScholarPubMed
Berglund, L Oliver, EH Fontanez, N Holleran, S Matthews, K Reheim, PS Ginsberg, HN Ramakrishnan, R & Levfevre, M (1999) HDL-subpopulation patterns in response to reductions in dietary total and saturated fat intakes in healthy subjects. American Journal of Clinical Nutrition 70, 992–1000.CrossRefGoogle ScholarPubMed
Bonanome, A Visona, A Lusiani, L Beltramello, G Confortin, L Biffanti, S Sorgato, F Costa, F & Pagnan, A (1991) Carbohydrate and lipid metabolism in patients with non-insulin-dependent diabetes mellitus: effects of a low-fat, high-carbohydrate diet vs a diet high in monounsaturated fatty acids. American Journal of Clinical Nutrition 54, 586–590.CrossRefGoogle Scholar
Borkman, M Campbell, LV Chisholm, DJ & Storlien, LH (1991) Comparison of the effects on insulin sensitivity of high carbohydrate and high fat diets in normal subjects. Journal of Clinical Endocrinology and Metabolism 72, 432–437.CrossRefGoogle ScholarPubMed
Brown, L Rosner, B Willett, WW & Sacks, FM (1999) Cholesterollowering effects of dietary fiber; a meta-analysis. American Journal of Clinical Nutrition 69, 30–42.CrossRefGoogle ScholarPubMed
Campbell, LV Marmot, PE Dyer, JA Borkman, M & Storlien, LH (1994) The high-monounsaturated fat diet as a practical alternative for NIDDM. Diabetes Care 17, 177–182.CrossRefGoogle ScholarPubMed
Chandalia, M Garg, A Lutjohann, D von Bergmann, K Grundy, SM & Brinkley, J (2000) Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. New England Journal of Medicine 342, 1392–1398.CrossRefGoogle ScholarPubMed
Coulston, AM Hollenbeck, CB Swislocki, AL Chen, YD & Reaven, GM (1987) Deleterious metabolic effects of highcarbohydrate, sucrose-containing diets in patients with noninsulin- dependent diabetes mellitus. American Journal of Medicine 82, 213–220.CrossRefGoogle Scholar
Coulston, AM Hollenbeck, CB Swislocki, AL & Reaven, GM (1989) Persistence of hypertriglyceridemic effect of low-fat highcarbohydrate diets in NIDDM patients. Diabetes Care 12, 94–101.CrossRefGoogle ScholarPubMed
Coulston, A Liu, GC & Reaven, GM (1983) Plasma glucose, insulin and lipid responses to high-carbohydrate low-fat diets in normal humans. Metabolism 32, 52–56.CrossRefGoogle ScholarPubMed
Crouse, JR Morgan, T Terry, JG Ellis, J Vitolins, M & Burke, GL (1999) A randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins. Archives of Internal Medicine 159, 2070–2076.CrossRefGoogle ScholarPubMed
Cuevas, AM Guasch, V Castillo, O Irribarra, V Mizon, C San Martin, A Strobel, P Perez, D Germain, AM & Leighton, F (2000) A high-fat diet induces and red wine counteracts endothelial ysfunction in human volunteers. Lipids 35, 143–148.CrossRefGoogle ScholarPubMed
Cullen, P (2000) Evidence that triglycerides are an independent coronary heart disease risk factor. American Journal of Cardiology 86, 943–949.CrossRefGoogle ScholarPubMed
Dayton, S Pearce, ML Hashimoto, S Dixon, WJ & Tomiyasu, U (1969) A controlled clinical trial of a diet high in unsaturated fat preventing complications in atherosclerosis. Circulation 39–40, Suppl. II, 63–98.Google Scholar
DeCaterina, R Liao, JK-names & Libby, P (2000) Fatty acid modulation of endothelial activation. American Journal of Clinical Nutrition 71, 213S–223S.CrossRefGoogle Scholar
de Lorgeril, M, Salen, P, Martin, JL, Monjaud, I, Delaye, J & Mamelle, N (1999) Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 99, 779–785.CrossRefGoogle ScholarPubMed
Diabetes Prevention Program Website: www.niddk.nih.gov/welcome/releases/8_8_01.htm/2.Google Scholar
Elmer, P (1996) Effects of a Step 1 diet and a high monounsaturated (MUFA) fat diet on Hemostatic Factors in Individuals with Markers for Insulin Resistance. FASEB Journal 10, A262.Google Scholar
Elmer, PJ (1995) Dietary effects on lipoproteins and thrombogenic activity: Effects of reducing dietary total and saturated fats on hemostatic factors. FASEB Journal 9, A289.Google Scholar
Endres, S, Georgilis, K, Lonnemann, G, Van der Meer, JW et al. (1989) The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. New England Journal of Medicine 320, 265–271.CrossRefGoogle ScholarPubMed
Food and Agriculture Organization (2001) FAO food balance sheets. http://apps.fao.org/lim500/nph-wrap.pl FoodBalanceSheet&Domain=FoodBalanceSheet.Google Scholar
Fickova, M, Hubert, P, Cremel, G & Leray, C (1998) Dietary (n-3) and (n-6) polyunsaturated fatty acids rapidly modify fatty acid composition and insulin effects in rat adipocytes. Journal of Nutrition 128, 512–519.CrossRefGoogle ScholarPubMed
Garg, A (1998) High-monounsaturated-fat diets for patients with diabetes mellitus: a meta-analysis. American Journal of Clinical Nutrition 67, Suppl., 577S–582S.CrossRefGoogle ScholarPubMed
Garg, A, Bantle, JP, Henry, RR, Coulston, AM, Griver, KA, Raatz, SK, Huet, BA & Reaven, GM (1994) Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. Journal of the American Medical Association 271, 1421–1428.CrossRefGoogle ScholarPubMed
Garg, A, Bonanome, A, Grundy, SM, Zhang, ZJ & Unger, RH (1988) Comparison of a high-carbohydrate diet with a high-monounsaturated fat diet in patients with non-insulin-dependent diabetes mellitus. New England Journal of Medicine 319, 829–834.CrossRefGoogle ScholarPubMed
Garg, A, Grundy, SM& Unger, RH (1992) Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM. Diabetes 41, 1278–1285.CrossRefGoogle ScholarPubMed
Gascon, A, Jacques, H, Moorjani, S, Deshaies, Y, Brun, L-D & Julien, P (1996) Plasma lipoprotein profile and lipolytic activities in response to the substitution of lean white fish for other animal protein sources in premenopausal women. American Journal of Clinical Nutrition 63, 315–321.CrossRefGoogle Scholar
Gillman, MW, Cupples, LA, Millen, BE, Ellison, RC & Wolf, PA (1997) Inverse association of dietary fat with development of ischemic stroke in men. Journal of the American Medical Association 278, 2145–2150.CrossRefGoogle ScholarPubMed
Ginsberg, HN, Kris-Etherton, P, Dennis, B, Elmer, PJ, Ershow, A, Lefevre, M, Pearson, T, Roheim, P, Ramakrishnan, R, Reed, R, Stewart, K, Stewart, P, Phillips, K & Anderson, N (1998) Effects of reducing dietary saturated fatty acids on plasma lipids and lipoproteins in healthy subjects. Arteriosclerosis Thrombosis and Vascular Biology 18, 441–449.CrossRefGoogle ScholarPubMed
Goodfellow, J, Bellamy, MF, Ramsey, MW, Jones, CJ & Lewis, MJ (2000) Dietary supplements with marine omega-3 fatty acids improve systemic large artery endothelial dysfunction in subjects with hypercholesterolemia. Journal of the American College of Cardiology 35, 265–270.CrossRefGoogle Scholar
Grundleger, ML & Thenen, SW (1982) Decreased insulin binding, glucose transport, and glucose metabolism in soleus muscle of rats fed a high fat diet. Diabetes 31, 232–237.CrossRefGoogle ScholarPubMed
Grundleger, ML & Thenen, SW (1982) Decreased insulin binding, glucose transport, and glucose metabolism in soleus muscle of rats fed a high fat diet. Diabetes 31, 232–237.CrossRefGoogle ScholarPubMed
Higashi, K Ishikawa, T Shige, H, Tomiyasu, K, Yoshida, H, Ito, T, Nakajima, K, Yonemura, A, Sawada, S & Nakamura, H (1997) Olive oil increased the magnitude of postprandial chylomicron remnants compared to milk fat and safflower oil. Journal of the American College of Nutrition 16, 429–434.CrossRefGoogle ScholarPubMed
Holme, I (1990) An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence. Circulation 82, 1916–1924.CrossRefGoogle ScholarPubMed
Hu, FB, Manson, JE, Stampfer, MJ, Colditz, G, Liu, S, Solomon, CG & Willet, WC (2001) Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England Journal of Medicine 345, 790–797.CrossRefGoogle ScholarPubMed
Hu, FB, Stampfer, MJ Manson, JAE, Rimm, E, Colditz, GA, Rosner, BA, Hennekens, CH & Willet, WC (1997) Dietary fat intake and the risk of coronary heart disease in women. New England Journal of Medicine 337, 1491–1499.CrossRefGoogle ScholarPubMed
Hu, FB Stampfer, MJ Manson, JE Rimm, E Colditz, GA Speizer, FE Hennekens, CH & Willett, WC (1999) Dietary protein and risk of ischemic heart disease in women. American Journal of Clinical Nutrition 70, 221–227.CrossRefGoogle ScholarPubMed
Jacques, H Noreau, L & Moorjani, S (1992) Effects of plasma lipoproteins and endogenous sex hormones of substituting lean white fish for other animal-protein sources in diets of postmenopausal women. American Journal of Clinical Nutrition 55, 896–901.CrossRefGoogle ScholarPubMed
Jucker, BM Cline, GW Barucci, N & Shulman, GI (1999) Differential effects of safflower oil versus fish oil feeding on insulin-stimulated glycogen synthesis, glycolysis, and pyruvate dehydrogenase flux in skeletal muscle: a 13C nuclear magnetic resonance study. Diabetes 48, 134–140.CrossRefGoogle ScholarPubMed
Keys, A (1970) Coronary heart disease in seven countries. American Heart Association Monograph no. 29. New York: American Heart Association.Google Scholar
Keys, A Menotti, A Karvonen, MJ Aravanis, C Blackburn, H Buzina, R Djordjevic, BS Dontas, AS Fibanza, F Keys, MH Kromhout, D Nedeljkovic, S Punsar, S Seccareccia, F & Toshima, H (1986) The diet and 15-year death rate in the Seven Countries Study. American Journal of Epidemiology 124, 903–915.CrossRefGoogle ScholarPubMed
Klem, ML Wing, RR McGuire, MT Seagle, HM & Hill, JO (1997) A descriptive study of individuals successful at long-term maintenance of substantial weight loss. American Journal of Clinical Nutrition 66, 239–246.CrossRefGoogle ScholarPubMed
Krauss, RM (2001) Dietary and genetic effects on low-density lipoprotein heterogeneity. Annual Reviews in Nutrition 21, 283–295.CrossRefGoogle ScholarPubMed
Krauss, RM & Dreon, DM (1995) Low-density-lipoprotein subclasses and response to a low-fat diet in healthy men. American Journal of Clinical Nutrition 62, 478S–487S.CrossRefGoogle ScholarPubMed
Krauss, RM Eckel, RH Howard, B Appel, LJ Daniels, SR Deckelbaum, RJ Erdman, JW Jr Kris-Etherton, P Goldberg, LJ Kotchen, TA Lichtenstein, AH Mitch, WE Mullis, R Robinson, K Wylie-Rosett, J St Jeor, S Suttie, J Tribble, DL & Bazzarre, TL (2000) AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation 102, 2284–2299.CrossRefGoogle ScholarPubMed
Kris-Etherton, PM (1996) Effects of replacing saturated fat (SFA) with monounsaturated fat (MUFA) or carbohydrates (CHO) on plasma lipids and lipoproteins in individuals with markers for insulin resistance. FASEB Journal 10, A262.Google Scholar
Kris-Etherton, PM Zhao, G Pelkman, CL Fishell, VK & Coval, SM (1999) Beneficial effects of a diet high in monounsaturated fatty acids on risk factors for cardiovascular disease. Nutrition in Clinical Care 3, 153–162.CrossRefGoogle Scholar
Kromhout, D & Coulander, CDL (1984) Diet, prevalence and 10-year mortality from coronary heart disease in 871 middleaged men. American Journal of Epidemiology 119, 733–741.CrossRefGoogle Scholar
Lacaille, B Julien, P Deshaies, Y Lavigne, C Brun, LD & Jacques, H (2000) Responses of plasma lipoproteins and sex hormones to the consumption of lean fish incorporated in a prudent-type diet in normolipidemic men. Journal of the American College of Nutrition 19, 745–753.CrossRefGoogle Scholar
Leren, P (1970) The Oslo diet-Heart Study; eleven year report. Circulation 42, 936–942.CrossRefGoogle ScholarPubMed
Lefevre, M, Champagne, C, Harsha, D, Tulley, R & Rood, J (2001) Comparison of step 1 versus high-monounsaturated fat diet therapies for CVD risk reductions in free-living subjects with elevated cholesterol. Circulation 104, Suppl. II, 372.Google Scholar
Lerman-Garber, I, Ichazo-Cerro, S, Zamora-Gonzalez, J, Cardoso-Saldana, G & Posadas-Romero, C (1994) Effect of a highmonounsaturated fat diet enriched with avocado in NIDDM patients. Diabetes Care 17, 311–315.CrossRefGoogle ScholarPubMed
Lichtenstein, AH (2001) Got soy? American Journal of Clinical Nutrition 73, 667–668.CrossRefGoogle ScholarPubMed
Lichtenstein, AH, Ausman, LM, Carrasco, W, Jenner, JL, Ordovas, JM & Schaefer, EJ (1994) Short-term consumption of a low-fat diet beneficially affects plasma lipid concentrations only when accompanied by weight loss. Arteriosclerosis and Thrombosis 14, 1751–1760.CrossRefGoogle ScholarPubMed
Lictenstein, AH & Schwab, US (2000) Relationship of dietary fat to glucose metabolism. Atherosclerosis 150, 227–243.CrossRefGoogle Scholar
McCarron, DA, Oparil, S, Chait, A, Haynes, RB, Kris-Efherton, P, Stern, JS, Resnick, LM, Clark, S, Morris, CD, Hatton, DC, Metz, JA, McMahon, M, Holcomb, S, Snyder, GW & Pi-Sunyer, FX (1997) Nutritional management of cardiovascular risk factors. A randomized clinical trial. Archives of Internal Medicine 157, 169–177.CrossRefGoogle ScholarPubMed
McGee, D, Reed, D, Stemmerman, G, Rhoads, G, Yano, K & Feinleib, M (1985) The relationship of dietary fat and cholesterol to mortality in 10 years: the Honolulu Heart Program. International Journal of Epidemiology 14, 97–105.CrossRefGoogle ScholarPubMed
McManus, K, Antinoro, L & Sacks, F (2001) A randomized controlled trial of a moderate-fat, low-energy diet compared with a low-fat, low-energy diet for weight loss in overweight adults. International Journal of Obesity and Related Metabolic Disorders 25, 1503–1511.CrossRefGoogle ScholarPubMed
McGuire, MT, Wing, RR, Klem, ML, Lang, W & Hill, JO (1999) What predicts weight regain in a group of successful weight losers? Journal of Consulting and Clinical Psychology 67, 177–185.CrossRefGoogle Scholar
Menotti, A, Kromhout, D, Blackhorn, H, Fidanza, F, Buzina, R & Nissinen, A (1999) Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the Seven Countries Study. The Seven Countries Study Research Group. European Journal of Epidemiology 15, 507–515.CrossRefGoogle Scholar
Mori, TA, Watts, GF, Burke, V, Hilme, E, Puddey, IB & Beilin, LJ (2000) Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men. Circulation 102, 1264–1269.CrossRefGoogle ScholarPubMed
National Cholesterol Education Program Expert Panel (2001) Executive summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on detection evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Journal of the American Medical Association 285, 2486–2497.CrossRefGoogle Scholar
National Institutes of Health/National Heart, Lung, and Blood Institute/Obesity Education Initiative Expert Panel (1998) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. The Evidence Report. Bethesda, MD: NIH.Google Scholar
Obarzanek, E, Sacks, FM, Vollmer, WM, Bray, GA, Miller, ER, Lin, PH, Karanja, NM, Most-Windhauser, MM, Moore, TJ, Swain, JF, Bales, CW & Proschan, MA for the DASH Research Group (2001) Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. American Journal of Clinical Nutrition 74, 80–89.CrossRefGoogle ScholarPubMed
Ornish, D Scherwitz, LW Billings, JH Brown, SE Gould, KL Merritt, TA Sparler, S Armstrong, WT Ports, TA Kirkeeide, RL Hogeboom, C & Brand, RJ (1998) Intensive lifestyle changes for reversal of coronary heart disease. Journal of the American Medical Association 280, 2001–2007.CrossRefGoogle ScholarPubMed
Parillo, M Rivellese, AA Ciardullo, AV Capaldo, B Giacco, A Genovese, S & Riccardi, G (1992) A high-monounsaturatedfat/low-carbohydrate diet improves peripheral insulin sensitivity in non-insulin-dependent diabetic patients. Metabolism 41, 1373–1378.CrossRefGoogle ScholarPubMed
Parillo, M Giacco, R Ciardullo, AV Rivellese, AA & Riccardi, G (1996) Does a high-carbohydrate diet have different effects in NIDDM patients treated with diet alone or hypoglycemic drugs Diabetes Care 19, 498–500.CrossRefGoogle ScholarPubMed
Parks, E & Hellerstein, M (2000) Carbohydrate-induced hypertriacylglycerolemia: historical perspective and review of biological mechanisms. American Journal of Clinical Nutrition 71, 412–433.CrossRefGoogle ScholarPubMed
Pelkman, C Pearson, TA Maddox, D Fishell, V Juturu, V & Kris-Etherton, PM (2000) Effects of peanut-rich (high-MUFA) diet vs. a low-fat diet on plasma lipids and lipoproteins during weight loss and weight maintenance. FASEB Journal 14, 293.Google Scholar
Posner, BM Cobb, JL Belanger, AJ, Cupples, LA, D'Agostino, RB & Stokes, J III (1991) Dietary lipid predictors of coronary heart disease in men. The Framingham Study. Archives of Internal Medicine 151, 1181–1187.CrossRefGoogle ScholarPubMed
Rasmussen, OW Thomsen, C Hansen, KW, Vesterlund, M, Winther, E & Hermansen, K (1993) Effects on blood pressure, glucose, and lipid levels of a high-monounsaturated fat diet compared with a high-carbohydrate diet in NIDDM subjects. Diabetes Care 16, 1565–1571.CrossRefGoogle ScholarPubMed
Research Committee to the Medical Research Council (1968) Controlled trial of soya-bean oil in myocardial infarction. Lancet ii, 693–700.Google Scholar
Rimm, EB Ascherio, A Giovannucci, E, Spiegelman, D, Stampfer, MJ & Willett, WC (1996) Vegetable, fruit, and cereal fiber intake and coronary heart disease among men. Journal of the American Medical Association 275, 447–451.CrossRefGoogle ScholarPubMed
Ryan, M McInerney, D Owens, D, Collins, P, Johnson, A & Tomkin, GH (2000) Diabetes and the Mediterranean diet: a beneficial effect of oleic acid on insulin sensitivity, adipocyte glucose transport and endothelium-dependent vasoreactivity. Quarterly Journal of Medicine 93, 85–91.CrossRefGoogle ScholarPubMed
Schaefer, EJ, Lichtenstein, AH, Lamon-Fava, S, McNamara, JR, Schaefer, MM, Rasmussen, H & Ordovas, JM (1995) Body weight and low-density lipoprotein cholesterol changes after consumption of a low-fat ad libitum diet. Journal of the merican Medical Association 274, 1450–1455.CrossRefGoogle ScholarPubMed
Slattery, ML, Jacobs, DR, Hilner, JE, Caan, BJ, Van Horn, L, Bragg, C, Manolio, TA, Kushi, LH & Liu, KA (1991) Meat consumption and its associations with other diet and health factors in young adults: the CARDIA study. American Journal of Clinical Nutrition 54, 930–935.CrossRefGoogle ScholarPubMed
Smith, MD (1997) Fat facts & fiction, http://www.healthwell.comGoogle Scholar
Stamler, J (1979) Population studies. In Nutrition, Lipids, and Coronary Heart Disease, pp. 25–88 [Levy, RI, Rifkind, BM, Dennis, SC, and Ernst, N, editor]. New York: Raven Press.Google Scholar
Storlien, LH, James, DE, Burleigh, KM, Chisholm, DJ & Kraegen, EW (1986) Fat feeding causes widespread in vivo insulin resistance, decreased energy expenditure, and obesity in rats. American Journal of Physiology 251, E576–E583.Google ScholarPubMed
Suh, I, Oh, KW, Lee, KH, Psaty, BM, Nam, CM, Kim, SI, Kang, HG, Cho, SY & Shim, WH (2001) Moderate dietary fat consumption as a risk factor for ischemic heart disease in a population with a low fat intake: a case-control study in Korean men. American Journal of Clinical Nutrition 73, 722–727.CrossRefGoogle Scholar
Thomsen, C, Rasmussen, O, Lousen, T, Holst, JJ, Fenselau, S, Schrezenmeir, J & Hermansen, K (1999) Differential effects of saturated and monounsaturated fatty acids on postprandial lipemia and incretin responses in healthy subjects. American Journal of Clinical Nutrition 69 1135–1143.CrossRefGoogle ScholarPubMed
Turpeinen, O, Karvonen, MJ, Pekkarinen, M, Miettinen, M, Elosuo, R, & Paavilainen, E (1979) Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study. International Journal of Epidemiology 8 99–118.CrossRefGoogle ScholarPubMed
Tuomilehto, J, Lindstrom, J, Eriksson, JG, Valle, TT, Hamalainen, H, IIanne-Parikka, P, Keinanen-Kiukaanniemi, S, Laakso, M, Louheranta, A, Rastas, M, Salminen, V & Uusitupa, Mfor the Finnish Diabetes Prevention Study Group (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine 344 1343–1350.CrossRefGoogle ScholarPubMed
US Department of Agriculture/US Department of Health and Human Services (2000) Nutrition and Your Health: Dietary Guidelines for Americans, 5th ed. http://xxx.lanl.gov/pdf/math/0010292 http://xxx.lanl.gov/pdf/math/0010292 http://xxx.lanl.gov/pdf/math/0010292 http://www.health.gov/dietaryguidelines/dga2000/document/frontcover.htmGoogle Scholar
Williams, CM, Moore, F, Morgan, L, & Wright, J (1992) Effects of n -3 alty acids on postprandial triacylglycerol and hormone concentrations in normal subjects. British Journal of Nutrition 68 655–666.CrossRefGoogle Scholar
Wolfe, BM & Giovannetti, PM (1991) Short-term effects of substituting protein for carbohydrate in the diets of moderately hypercholesterolemic human subjects Metabolism 40, 338–343.CrossRefGoogle ScholarPubMed
Vogel, RA, Corretti, MC, & Plotnick, GD (2000) The postprandial effect of components of the Mediterranean diet on endothelial function. Journal of the American College of Cardiology 36 1455–1460.CrossRefGoogle ScholarPubMed
Zampelas, A, Peel, AS, Gould, BJ, Wright, J, & Williams, CM (1994) Polyunsaturated fatty acids of the n-6 and n-3 series: effects on postprandial lipid and apolipoprotein levels in healthy men. European Journal of Clinical Nutrition 48 842–848.Google ScholarPubMed