University of Oslo, Faculty of Medicine
Exchanging few commercially regular-consumed food items with
improved fat quality reduces total and LDL cholesterol. A new double-blind
randomized controlled trial published in British Journal of
Nutrition suggests almost
30% reduction in cardiovascular disease risk
Polyunsaturated fat
Exchanging
few regular-consumed food items with improved fat quality in the daily diet for
eight weeks reduces the serum total cholesterol and LDL-cholesterol by 9 % and
11 %, respectively. This change corresponds to a 27 % reduction in
cardiovascular disease risk. In the human trial saturated fat was replaced by
polyunsaturated fat in key food items such as spread on bread, fat for cooking,
cheese, bread and cereals.
Cardiovascular
disease (CVD) remains the major contributor to the global burden of disease
worldwide. Even though there has been substantial reduction in CVD mortality
over the last 30 years, new reports show an increase in acute myocardial
infarction among the younger population in Norway, and similar observations
have been reported also from other countries.
Cholesterol
Elevated
plasma low-density lipoprotein cholesterol (LDL-C) is an established risk
factor of CVD, and dietary fatty acids play a significant role in modulating
plasma LDL-C and thereby influencing the risk of CVD. In particular there is
strong evidence that replacing saturated fatty acids (SFA) with polyunsaturated
fatty acids (PUFA) will reduce the risk of CVD. However, controversy still
exist about beneficial versus potential harmful effects of n-6 PUFA since n-6
PUFA has been suggested to promote inflammation.
The Nordic diet
Adherence
to a healthy Nordic diet based on the Nordic nutrition recommendations has
previously been shown to have beneficial effect on blood lipids among subjects
at risk of CVD. However the extent of food changes needed to achieve these
effects is less explored. In order to increase compliance to dietary fat intake
recommendations in the general population it is important that one can achieve
this with relatively small dietary changes, leading to improved lipid profile.
Scientific Abstract
The
aim of the study was to investigate the effects of exchanging few commercially
regularly-consumed key food items (e.g. spread on bread, fat for cooking,
cheese, bread and cereals) with improved fat quality on total cholesterol,
LDL-C and inflammatory markers in a double-blind randomized, controlled trial.
In
total 115 moderately hypercholesterolemic non-statin treated adults (25-70 y)
were randomly assigned to an experimental diet group (Ex-diet group) or control
diet group (C-diet group) for eight weeks with commercially available food
items with different fatty acid composition (replacing saturated fatty acids
with mostly n-6 polyunsaturated fatty acids).
In
the Ex-diet group, serum total cholesterol (P<0.001) and LDL-C (P<0.001)
were reduced after eight weeks, compared to the C-diet group. The difference in
change between the two groups at the end of the study was -9 % and -11 % in
total cholesterol and LDL-C, respectively. No difference in change in plasma
levels of inflammatory markers was observed between the groups.
In
conclusion, exchanging few regularly-consumed food items with improved fat
quality reduces total cholesterol, with no negative effect on levels of
inflammatory markers. This shows that an exchange of few commercially available
food items was easy and manageable and leads to clinically relevant cholesterol
reduction potentially affecting future CVD risk.
