Dietary regulation of serum lipids in healthy, young adults.

When healthy medical students and their wives were fed a diet providing 2,375 kcal per day, 33 per cent of which was derived from fat, and received a cholesterol intake of less than 250 mg. per day, their serum cholesterol levels were significantly reduced. Differences in the change in the phospholipids of the students and their wives suggest a different response of the sexes to the diet. Since increasing the P:S ratio from 0.3 to 1.2 produced comparable lowering of serum lipids, data suggest that cholesterol intake and caloric balance are of prime importance in maintaining the level of serum cholesterol.     

Low vs high dietary fiber and serum, biliary, and fecal lipids in middle-aged men

Cholesterol metabolism was studied in 34 50-y-old men at home on high and low mixed-fiber diets. The high-fiber diet increased fiber intake (26.2 vs 11.6 g/d) and decreased slightly but significantly total energy, carbohydrate, and protein intakes and serum total, low-density-lipoprotein, and high-density-lipoprotein cholesterol values with no effect on dietary cholesterol and fat composition or body weight. Biliary molar lipid percentages were unaffected but deoxycholic acid was increased and chenodeoxycholic acid was decreased by the high-fiber diet. The high-fiber diet changed cholesterol absorption and fecal output of neutral and total sterols nonsignificantly but increased fecal bile acids by 13% (p less than 0.05) and reduced bacterial conversion of fecal sterols to secondary products. The decreased serum cholesterol concentration was probably caused by enhanced fecal output of cholesterol as bile acids resulting in enhanced cholesterol synthesis as indicated by an increased serum concentration of a cholesterol precursor, lathosterol.     

Fecal weight and composition, serum lipids, and diet among subjects aged 18 to 80 years not seeking health care

Sixty-two subjects not seeking health care, aged 18 to 80 yr, recorded diet intake, collected feces for 7 days, and gave fasting blood lipids. There was a great variation in stool weight passed (19 to 278 g/24 h). Fecal constituents (bile acids, sterols, fat, electrolytes) correlated strongly with fecal mass. Fecal mass correlated inversely with transit time. There was no relationship between age and fecal weight or transit time. Multiple regression analysis showed that only dietary fiber contributed to stool weight. No single component of fiber appeared to be responsible for this relationship with stool mass. Multiple regression analysis of serum cholesterol showed a relationship only with age and fecal neutral sterols.     

Influences of "normal" and "prudent" diets on biliary and serum lipids in healthy women

The differential effect of two diets, taken in synchrony with the menstrual cycles for 2 wk each, on serum and bile lipids was investigated in young healthy women. The "normal" diet was high in cholesterol and total fat, and low in polyunsaturated fat and fiber; the "prudent" diet contained a high proportion of polyunsaturated fat and fiber, but was low in cholesterol and total fat; there was little difference in energy content. Both in whole serum and in low-density lipoprotein the concentrations of cholesterol and apolipoprotein B were almost 30% lower with the "prudent" than with the "normal" diet; HDL-cholesterol was 16.3% lower. Triglycerides were increased, only in the very-low-density lipoproteins while cholesterol and apolipoprotein B did not change much in this fraction. The risk to acquire cholesterol gallstones was not less with the use of the "prudent" diet as originally expected. While using the "prudent" diet five of the women had slightly higher lithogenic indices, in two there were much higher values (greater than 25%), and only in three the lithogenic index was unchanged or slightly lower than with the "normal" diet.     

Trends in fatty acid intakes of 10-year-old children, 1973 to 1982

Diets of four groups of 10-year-old children (no. = 871, 30% black, 70% white) were examined over 10 years with 24-hour dietary recalls to study temporal trends in cholesterol, fat, and fatty acid intakes in a community. Boys had higher intakes per day and per kilogram body weight than girls for all nutrients (p less than .0001), but there were no sex differences in nutrients per 1,000 kcal. The only racial difference detected was a higher myristic acid intake in whites (p less than .02). There was a 16% decline in dietary cholesterol intake between 1978 and 1982. Three shifts in fatty acid intake increased the P:S ratio from 0.29 in 1973 to 0.45 in 1978: (a) a 5% decline in oleic acid, coupled with a 5% rise in linoleic acid; (b) a quadrupling of linolenic acid; and (c) less stearic and more myristic acid, with palmitic acid unchanged. Total fat intake provided 38% of the calories in each survey, but the changes in proportions of fatty acids paralleled trends in food consumption patterns and nutrient sources. Despite the changes, few children met prudent diet recommendations, and serum total cholesterol and very-low-density-lipoprotein cholesterol levels did not change over time.     

Dietary lectin lowers serum cholesterol and raises fecal neutral sterols in cholesterol-fed rats

This study examined the influence of a low level of dietary lectin (0.34%), at a dose that did not affect body weight or food intake, on the concentration of serum cholesterol and fecal excretion of neutral sterols in rats fed a diet containing 0.50% cholesterol and 0.13% sodium cholate for 12 d. In experiment 1, rats fed a diet with 0.34% lectin, concanavalin A, had significantly lower concentrations of serum total cholesterol and hepatic cholesterol, a higher ratio of HDL-cholesterol to total cholesterol, enhanced excretion of fecal neutral sterols and reduced apparent cholesterol absorption or digestibility as compared with rats fed a diet without lectin. Fecal excretion of acidic sterols was unaffected by dietary lectin. In contrast, dietary 0.34% lectin had no significant effect on concentrations of serum total protein or glucose. In experiment 2, we examined whether the cholesterol-lowering activity of the lectin was responsibility for its carbohydrate-binding activity. The effect of dietary lectin on concentrations of serum and hepatic cholesterol and excretion of fecal neutral sterols was prevented by simultaneous administration of methyl-alpha-D-mannopyranoside with specific affinity for the carbohydrate-binding sites of the lectin. These results suggest that dietary lectins might reduce concentrations of serum and hepatic cholesterol by a mechanism involving higher excretion of neutral sterols and that these alterations might be associated with the carbohydrate-binding activity of lectin.     

Dietary plant sterols alter the serum plant sterol concentration but not the cholesterol precursor sterol concentrations in young children (the STRIP Study). Special Turku Coronary Risk Factor Intervention Project.

Plant sterol supplementation reduces serum cholesterol concentration but may increase serum plant sterol concentrations, especially in children. We determined whether natural dietary plant sterols derived mainly from vegetable oil or margarine in early childhood affect serum concentrations of plant sterols (campesterol and sitosterol) and cholesterol precursor sterols (Delta-8 cholestenol, desmosterol, and lathosterol), reflecting endogenous cholesterol synthesis. We measured the serum sterol concentrations using gas liquid chromatography in 20 healthy 13-mo-old intervention children in a randomized, prospective study designed to decrease exposure of the children to known environmental atherosclerosis risk factors and in 20 control children. The diet of the intervention children was rich in plant sterols due to replacement of milk fat with vegetable fat, whereas the diet of the control children contained only small amounts of plant sterols. The intervention children consumed twice as much plant sterols as the control children (P < 0.001). Their serum concentrations of campesterol and sitosterol were 75% and 44% higher, respectively, than those in the control children (P < 0.001 for both), but serum cholesterol precursor sterol concentrations did not differ between the two groups. We conclude that doubling dietary plant sterol intake almost doubles serum plant sterol concentrations in 13-mo-old children, but has no effect on endogenous cholesterol synthesis. Relative intestinal absorption of natural plant sterols from the diet in early childhood is similar to that in adults.     

Sterol and nutrient excretion in ileostomists on prudent diets.

Nine ileostomists eating three diets (STAND, RESAT and EXFIB) were investigated in order to quantify the changes in sterol and nutrient excretion when shifting between a standard Western diet and two prudent diets. The RESAT diet had a moderate reduction in fat content to 30 per cent of energy, mainly through a reduction in saturated fat. The EXFIB diet had the same fat modification but in addition the dietary fibre content was raised to 3g/MJ according to current Swedish nutrition recommendations. The RESAT diet resulted in a lowered excretion of fat, but the excretion of nitrogen, energy, cholesterol and bile acids did not change compared with the STAND diet. The EXFIB diet resulted in a higher excretion of fat, nitrogen, energy and cholesterol compared with both the STAND and the RESAT diets (P less than 0.01). Bile acids showed no consistent excretion changes. Thus, a prudent diet, with moderate restricted total and saturated fat content, and a moderate increase in dietary fibre from natural food items, increased the excretion of cholesterol and fat from the small bowel when given to healthy ileostomists. A solely fat-modified prudent diet did not significantly change the pattern of excretion compared with a standard diet.     

Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine

BACKGROUND: Cholesterol metabolic studies are simplified in colectomized patients because of rapid intestinal passage and reduced bacterial action. OBJECTIVE: Our objective was to study the effect on cholesterol and plant sterol metabolism of feeding a margarine containing stanol ester to 11 colectomized patients. DESIGN: A margarine containing 2 g stanol was consumed for 7-18 d. Serum, biliary, and fecal lipids were measured before and during consumption of the margarine. RESULTS: Serum cholesterol concentrations and the ratio of plant sterol to cholesterol decreased after 1 d of consumption of stanol esters (P < 0.05). After 7 d, serum cholesterol decreased by 16% (P < 0.01), cholesterol absorption efficiency decreased by approximately 40%, and fecal output of cholesterol as neutral sterols (but not as bile acids) increased by 36%. Biliary bile acid composition and the molar percentage of biliary cholesterol were unchanged. Increased ratios of cholesterol precursor sterols in serum and bile indicated enhanced cholesterol synthesis during consumption of stanol esters; the percentage absorption of plant sterols and the ratios of plant sterols to cholesterol decreased, whereas serum and biliary plant stanols and their biliary secretion gradually increased. In feces, 95% of cholesterol and 90% of plant stanols were in unesterified form. CONCLUSIONS: In colectomized patients, effective inhibition of cholesterol absorption and lowering of serum cholesterol concentrations and plant sterol ratios occurs within 1 d of the start of consumption of stanol esters. The composition of major bile lipids is unchanged, indicating that gallstone formation is unlikely. Small amounts of plant stanols are recovered in serum and bile during consumption of stanol esters but effectively are secreted through bile, thereby balancing the intake-induced increase in their absorption.     

Dietary fat and cholesterol effects on cholesterol metabolism in CBA/J and C57BR/cdJ mice

The aim of this study was to determine how small differences in dietary fats affect cholesterol metabolism in mice hypo- (CBA/J) and hyperresponsive (C57BR/cdJ) to diet-induced hypercholesterolemia. Six-wk-old male mice were fed either a diet corresponding to the U.S. average gross composition (US74, 40% of total energy as fat, 347 mg cholesterol/1000 Kcal, P/S = 0.24) or a modified-fat diet (30% of total energy as fat, 46 mg cholesterol/1000 Kcal, P/S = 0.91). After 8 wk of feeding, neither strain had developed hypercholesterolemia. CBA/J mice had higher concentrations of serum total and high-density lipoprotein (HDL) cholesterol and a higher esterified-to-free cholesterol ratio than did C57BR/cdJ mice. CBA/J mice maintained a constant serum cholesterol concentration mainly by adjusting the hepatic hydroxymethylglutaryl coenzyme A reductase (HMGR) activity, whereas C57BR/cdJ mice did so by changing the fecal excretion of cholesterol. Compared to the modified-fat diet, the US74 diet caused an increase in the ratio of total to HDL serum cholesterol, liver microsomal free cholesterol, fecal cholesterol and hepatic microsomal cholesterol 7 alpha-hydroxylase activity and a decrease in hepatic microsomal HMGR activity. We conclude that the metabolic responses to small differences in dietary fat are different in CBA/J and C57BR/cdJ mice.     

A glucomannan and chitosan fiber supplement decreases plasma cholesterol and increases cholesterol excretion in overweight normocholesterolemic humans

OBJECTIVE: Both chitosan and glucomannan have demonstrated hypocholesterolemic effects. A recent study in rats indicates that the combination of the two is also a potent hypocholesterolemic agent that increases fecal fat excretion. The objective of the present study was to determine the hypocholesterolemic effect of a supplement containing equal amounts of chitosan and glucomannan on blood lipid concentrations and fecal excretion of fat, neutral sterols and bile acids. METHODS: Twenty-one overweight normocholesterolemic subjects (11 males and 10 females) were fed 2.4 g/day of a supplement containing equal amounts of chitosan and glucomannan. Prior to taking the supplement (initial period) and after 28 days (final period), blood was drawn for measurement of serum lipids and a three-day fecal sample collected for determination of fat, neutral sterol and bile acid excretion. Subjects maintained their normal dietary and activity patterns during the study. RESULTS: Caloric intake and intake of fat and dietary fiber (excluding the supplement) did not differ between the initial and final periods. Serum total, HDL and LDL cholesterol concentrations were significantly lower (p < 0.05) in the final period compared to the initial period. Serum triacylglycerol concentration did not change between periods. There was a trend towards greater fecal excretion of neutral sterols and bile acids (p = 0.13 and 0.16, respectively) in the final period. However, fecal fat excretion did not differ between periods. CONCLUSIONS: Serum cholesterol reduction by a chitosan/glucomannan supplement is likely mediated by increased fecal steroid excretion and is not linked to fat excretion.     

The effect of daily consumption of coconut fat and soya-bean fat on plasma lipids and lipoproteins of young normolipidaemic men

The present paper reports the influence on plasma lipids of isoenergetic diets containing 30% of energy as fat, with a polyunsaturated: saturated fat ratio of 4.00 or 0.25, consumed for 8 weeks by twenty-five young normolipidaemic males. Approximately 70% of the fat energy was provided by the test fats: soya-bean fat and coconut fat. During the soya-bean-fat-eating period the total plasma cholesterol level fell significantly compared with baseline values (P less than 0.001) and during the coconut-fat-eating phase total plasma cholesterol level increased significantly compared with the soya-bean-eating period (P less than 0.001). On the soya-bean-fat diet, high-density-lipoprotein (HDL)-cholesterol decreased by 15% (range 6-35%) and plasma triacylglycerols decreased by 25% (range 13-37%). Results of the present study show that even when the proportion of total fat in the diet is low, a high intake of linoleic acid lowers both total plasma cholesterol and HDL-cholesterol, while a high intake of saturated fat elevates both these lipid fractions. Application of regression formulas to the present findings indicates that short-chain saturated fatty acids have a neutral effect on serum cholesterol.     

Effects of calcium and plant sterols on serum lipids in obese Zucker rats on a low-fat diet

Ca may interfere with fat and cholesterol metabolism through formation of insoluble soaps with fatty and bile acids in the intestine. In the present study, we examined the effects of different dietary Ca levels on the serum lipid profile and cholesterol metabolism in obese Zucker rats fed a low-fat diet. We also tested whether dietary Ca interfered with the lipid-lowering effects of a pine oil-derived plant sterol mixture. Increase in dietary Ca intake from 0.2 to 0.8%, and further to 2.1% (w/w) dose-dependently decreased serum total cholesterol (r -0.565, P=0.002, n 27), LDL-cholesterol (r -0.538, P=0.006, n 25), and triacylglycerol (r -0.484, P=0.014, n 25) concentrations, and increased HDL-cholesterol (r -0.478, P=0.016, n 25) and HDL: LDL cholesterol (r 0.672, P<0.001, n 25) in rats fed a 1% cholesterol diet. Analysis of serum campesterol: cholesterol and sitosterol: cholesterol suggested that Ca dose-dependently increased intestinal cholesterol absorption (r 0.913, P<0.001, n 18), whereas serum desmosterol: cholesterol and lathosterol: cholesterol indicated that Ca dose-dependently increased endogenous cholesterol synthesis (r 0.691, P=0.003, n 18). Therefore, the decrease of serum LDL-cholesterol appeared to be due to Ca-induced increase in the conversion of cholesterol to bile acids. The increase in Ca intake did not interfere with the beneficial effects of plant sterols on serum total cholesterol, LDL-cholesterol and HDL-cholesterol concentrations. The high-Ca diet with plant sterol supplementation further increased the HDL-cholesterol concentration and HDL: LDL cholesterol. The present findings indicate that the beneficial effects of dietary Ca on the serum lipid profile during a low-fat diet are dose-dependent, and resemble those of bile acid sequestrants. Increased dietary Ca did not impede the lipid-lowering effects of natural plant sterols.     

Role of dietary salt in hypertension.

Objective: Both chitosan and glucomannan have demonstrated hypocholesterolemic effects. A recent study in rats indicates that the combination of the two is also a potent hypocholesterolemic agent that increases fecal fat excretion. The objective of the present study was to determine the hypocholesterolemic effect of a supplement containing equal amounts of chitosan and glucomannan on blood lipid concentrations and fecal excretion of fat, neutral sterols and bile acids.

Methods: Twenty-one overweight normocholesterolemic subjects (11 males and 10 females) were fed 2.4 g/day of a supplement containing equal amounts of chitosan and glucomannan. Prior to taking the supplement (initial period) and after 28 days (final period), blood was drawn for measurement of serum lipids and a three-day fecal sample collected for determination of fat, neutral sterol and bile acid excretion. Subjects maintained their normal dietary and activity patterns during the study.

Results: Caloric intake and intake of fat and dietary fiber (excluding the supplement) did not differ between the initial and final periods. Serum total, HDL and LDL cholesterol concentrations were significantly lower (p < 0.05) in the final period compared to the initial period. Serum triacylglycerol concentration did not change between periods. There was a trend towards greater fecal excretion of neutral sterols and bile acids (p = 0.13 and 0.16, respectively) in the final period. However, fecal fat excretion did not differ between periods.

Conclusions: Serum cholesterol reduction by a chitosan/glucomannan supplement is likely mediated by increased fecal steroid excretion and is not linked to fat excretion.     

Influence of caloric contribution and saturation of dietary fat on plasma lipids in premenopausal women

Total cholesterol, HDL cholesterol, and triglycerides were measured in 31 premenopausal women randomized into one of two diet groups: one diet with a P:S ratio of 1.0 and one diet with a P:S ratio of 0.3. Both groups were fed a high-fat diet (40% of energy from fat) for four menstrual cycles per subject followed by a similar interval on a low-fat diet (20% of energy from fat). Changing from the high-fat to the low-fat diet resulted in a nonsignificant mean decrease of 7% in total cholesterol. HDL-cholesterol response to the low-fat regimen was influenced by the P:S ratio. Women in the high P:S group showed no change; mean HDL cholesterol in women in the low P:S group decreased 12%. Plasma triglycerides increased in both groups on the low-fat diet although the increase was greatest in the low P:S group.     

Replacing 40% of dietary animal fat with vegetable oil is associated with lower HDL cholesterol and higher cholesterol ester transfer protein in cynomolgus monkeys fed sufficient linoleic acid

This study was designed to evaluate whether replacing approximately 40 g/100 g dietary animal fat with vegetable oil would improve plasma lipids and lipoproteins when diets contained prudent levels of total saturated acid (SFA), monounsaturated acid (MUFA) and PUFA. Using a cross-over design, male Cynomolgus monkeys (n = 10) were fed purified diets containing a mixture of fats. For the diet based on animal fat (AF-diet), approximately 85 g/100 g of the total fat was derived from pork fat, and approximately 40 g/100 g of this was replaced with olive oil for the vegetable oil-based diet (VO-diet). Thus, the fat content of the VO diet comprised 50% pork fat and 35% olive oil. The remaining 15% of the total fat (for both diets) was safflower oil. Both diets provided approximately 30% of total energy (%en) from fat, <10%en SFA and approximately 6-7%en from PUFA. Monkeys were rotated through two 7-wk feeding periods, during which time plasma lipids and lipoproteins were evaluated. Compared with the AF diet, plasma total cholesterol (TC) concentrations tended to be lower ( approximately 10%) after monkeys consumed the VO diet (3.18 +/- 0.83 vs. 3.52 +/- 0.93 mmol/L, P = 0.099), and this was due entirely to a significant 12% reduction in HDL cholesterol (1.53 +/- 0.41 vs. 1.73 +/- 0.47, mmol/L, P = 0.0009). Although plasma lipoprotein compositional analyses revealed no significant differences in either lipoprotein composition or the estimated particle diameters, the measurement of cholesterol ester transfer protein (CETP) using (3)H-cholesterol ester-labeled HDL revealed that the lower HDL cholesterol (HDL-C) when monkeys consumed the VO diet was associated with a 31% increase in transfer (P = 0.04). However, despite the changes in HDL-C, the TC/HDL-C ratio did not differ between monkeys after the two diet treatments. Regression analyses of data from these monkeys revealed a significant correlation between the dietary 16:0/18:2 ratio and plasma HDL-C. These data suggest that within the context of currently recommended prudent diets, it may be possible to manipulate HDL-C beneficially. Whether a similar effect would occur in humans warrants investigation.     

Effects on cholesterol balance and LDL cholesterol in the rat of a soft-ripened cheese containing vegetable oils

OBJECTIVE: The purpose of this study was to examine effects of a modified soft-ripened cheese containing vegetable oils on cholesterol status, using the rat as the experimental model and the traditional soft-ripened cheese as the control. METHODS: Adult male Wistar rats (approximately 370 g) were divided into two dietary groups (20 rats/group) and fed either the standard diet (STD, containing traditional cheeses made from whole milk) or the experimental diet (EXP, containing modified cheeses made from the combination of skim milk with the following fat mixture: milk fat/oleic acid-enriched sunflower oil/soybean oil mixture). Lipids of the diets came solely from cheeses (14 g/100 g diet); the EXP diet contained (3-fold) less saturated fat, (2-fold) less cholesterol, and (15-fold) more phytosterols than the STD diet. RESULTS: Although serum triglyceride and total cholesterol concentrations were not affected by the type of diet, the EXP diet resulted in a significant reduction of LDL-cholesterol (31%, p < 0.001) and a significant increase of HDL-cholesterol (11%, p < 0.05), compared to the STD diet. Thus, a marked reduction (39%) of serum LDL/HDL cholesterol ratio was observed in the EXP group (p < 0.001). In addition, the two quantitative balances (excreted/ingested) of cholesterol and total neutral sterols (for which phytosterols were excluded) were significantly higher by 183% and 174%, respectively for the EXP group, compared to the STD group (p < 0.05). On another hand, rats fed the EXP diet excreted more cholesterol than they ingested dietary cholesterol (cholesterol balance > 1), indicating that those animals eliminated some endogenous cholesterol in their feces, while the opposite was true for rats fed the STD diet (cholesterol balance < 1). Finally, fecal bile salt concentration was not significantly different between the two dietary groups. CONCLUSIONS: The partial substitution of milk fat by vegetable oils in soft-ripened cheese resulted in a decreased blood LDL/HDL cholesterol ratio and an increased fecal excretion of endogenous cholesterol and neutral sterols and, thus, markedly improved its nutritional qualities. Therefore, the consumption of the described modified cheese may meet the demand of subjects who wish to lower their risk for atherosclerosis and cardiovascular disease.     

Synergistic effects of dietary carbohydrate and cholesterol on serum lipids and lipoproteins in squirrel and spider monkeys.

Serum lipid and lipoprotein responses to diets with a high level of simple carbohydrate (69% w/w sucrose) and a low level of saturated fat (5% w/w butter-coconut oil, polyunsaturated/saturated fatty acid ratio 0.03) containing 0, 0.1, and 1.0 mg/kcal added cholesterol was studied in five squirrel (Saimiri sciurea) monkeys. Variations in response produced by altering the nature of dietary carbohydrate (sucrose versus dextrin) and the fat (polyunsaturated/saturated fatty acid ratio, 0.03 versus 1.5) in the above diets were studied in three groups (five per group) of spider monkeys (Ateles sp.). In the absence of exogenous cholesterol, feeding a sucrose-saturated fat diet for 6 weeks produced a consistent increase in serum cholesterol in both species and an increase in serum triglycerides only in squirrel monkeys. Exogenous cholesterol had a remarkable synergistic effect on the high carbohydrate diet in increasing the serum cholesterol and had a suppressing effect on serum triglycerides in both species. Polyunsaturated fat reduced the hypercholesterolemic effect of sucrose with or without exogenous cholesterol. Dextrin diets resulted in lower serum cholesterol responses than sucrose diets when the diets contained 0 or 0.1 mg/kcal added cholesterol. Serum cholesterol response was reflected in beta- and alpha-lipoproteins. These results emphasize the varied response of serum lipids and lipoproteins to dietary changes in carbohydrate, fat, and cholesterol that might have a bearing on experimental atherosclerosis.     

Walnuts lower serum cholesterol in Japanese men and women

Recent studies have shown that incorporating moderate quantities of walnuts into the recommended cholesterol-lowering diet in the U.S. decreased serum concentrations of total cholesterol in normal American men. To explore whether walnut consumption would also prove effective as part of the Japanese diet, we studied the effects of walnut consumption on serum lipids and blood pressure in Japanese subjects. We randomly assigned 20 men and 20 women to two mixed natural diets, each to be consumed for 4 wk in a crossover design. Both diets conformed to the average Japanese diet (reference diet) and contained identical foods and macronutrients, except that 12.5% of the energy of the walnut diet was derived from walnuts (43-57 g/d) (offset by lesser amounts of fatty foods, meat and visible fat). Total cholesterol concentration was 0.16 mmol/L lower for men (P = 0.05) and 0.21 mmol/L lower for women (P<0.01) when they consumed the walnut diet than when they consumed the reference diet. The LDL cholesterol concentrations were 0.18 mmol/L lower for men (P = 0.13) and 0.22 mmol/L lower for women (P<0.01) when they consumed the walnut diet. The ratio of LDL cholesterol to HDL cholesterol and the apolipoprotein B concentration were also lowered by the walnut diet (P<0.05). Blood pressures did not differ between the walnut and reference diet periods. Incorporating moderate quantities of walnuts into the average Japanese diet while maintaining the intake of total dietary fat and energy decreases serum total cholesterol concentrations and favorably modifies the lipoprotein profile in Japanese, particularly in women.     

Effect of dietary cholesterol and degree of fat unsaturation on plasma lipid levels, lipoprotein composition, and fecal steroid excretion in normal young adult men

Effect of four test diets differing in the ratio of polyunsaturated to saturated fats (P/S, 1.8 vs 0.28) and two cholesterol levels (1,000 vs 300 mg/day) for each level of the P/S ratio was determined on plasma lipid levels, lipoprotein compositions and concentrations, and fecal steroid excretion in a controlled diet study with 11 normal young men using a crossover design. Plasma cholesterol levels were significantly decreased by the diets high in P/S ratio regardless of the dietary cholesterol levels (14% decrease by high cholesterol and 20% in low cholesterol) while the diets low in P/S ratio increased cholesterol by an average of 24 and 22% in presence of high and low cholesterol, respectively. Lipids and apoproteins of lower-density lipoproteins were changed in accordance with those of plasma cholesterol but changes in high-density lipoprotein (HDL) appear to depend on both cholesterol content and P/S ratio. Dietary cholesterol level profoundly influenced the excretion of neutral sterols and diets high in P/S ratio significantly (p less than 0.05) increased fecal bile acid extraction. The present study demonstrated that dietary polyunsaturated fats, when a moderate amount was consumed, were effective and beneficial hypocholesterolemic nutrients without reducing HDL-cholesterol.