Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials.
Level 1 - systematic review of randomized trials
Meta-analysis of 60 controlled trials
PubMed 12716665 · doi:10.1093/ajcn/77.5.1146
What was done
The authors performed a meta-analysis of 60 selected controlled trials to calculate the effects of the amount and type of dietary fatty acids and carbohydrates on the total:HDL cholesterol ratio, serum lipids, and apolipoproteins.
What was found
The abstract reports directional findings without exact numerical effect sizes: - Replacing saturated fatty acids with carbohydrates did not change the total:HDL cholesterol ratio, whereas replacing saturated fatty acids with cis unsaturated fatty acids decreased the ratio. - Replacing trans fatty acids with a mix of carbohydrates and cis unsaturated fatty acids had an effect on the total:HDL ratio nearly twice as large as replacing saturated fatty acids. - Lauric acid substantially increased total cholesterol, but largely via HDL cholesterol, so lauric acid-rich oils decreased the total:HDL cholesterol ratio. - Myristic and palmitic acids had little effect on the ratio, while stearic acid reduced it slightly. - Replacing dietary fats with carbohydrates increased fasting triacylglycerol concentrations.
Why it matters
This meta-analysis demonstrates that assessing dietary fats solely via LDL cholesterol overlooks significant HDL changes that influence the total:HDL ratio. It establishes that replacing saturated and trans fatty acids with cis unsaturated fatty acids yields the most favorable lipid profile, whereas carbohydrate substitution raises triglycerides without improving the ratio.
Limits
The abstract reports no numerical values, confidence intervals, or total participant count across the 60 trials. Furthermore, the findings measure surrogate serum lipid markers rather than hard clinical coronary artery disease endpoints.
Cited by
- supports Stearic acid, the predominant saturated fat in chocolate or cacao, does not seem to affect blood lipids.