© 1998 American Heart Association, Inc.
Original Contributions |
Effects of Reducing Dietary Saturated Fatty Acids on Plasma Lipids and Lipoproteins in Healthy Subjects
The Delta Study, Protocol 1
From the Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY (H.N.G., R. Ramakrishnan); Nutrition Department, Pennsylvania State University, University Park (P.K.-E.); Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill (B.D., P.S., N.A.); Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis (P.J.E.); Division of Heart and Vascular Diseases, NHLBI, National Institutes of Health, Bethesda, Md (A.E.); Pennington Biomedical Research Center, Baton Rouge, La (M.L.); Research Institute, Mary Imogene Bassett Hospital, Cooperstown, NY (T.P., R. Reed); Department of Physiology, Louisiana State University School of Medicine, New Orleans (P.R.); and Department of Biochemistry and Anaerobic Microbiology, Virginia Polytechnic Institute and State University, Blacksburg (K.S., K.P.).
Correspondence to Henry N. Ginsberg, MD, Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th St, New York, NY 10032.
Abstract—Few well-controlled
diet studies have investigated the effects of reducing dietary
saturated fatty acid (SFA) intake in premenopausal and postmenopausal
women or in blacks. We conducted a multicenter, randomized,
crossover-design trial of the effects of reducing dietary SFA on plasma
lipids and lipoproteins in 103 healthy adults 22 to 67 years old. There
were 46 men and 57 women, of whom 26 were black, 18 were postmenopausal
women, and 16 were men 
40 years old. All meals and snacks, except
Saturday dinner, were prepared and served by the research centers. The
study was designed to compare three diets: an average American diet
(AAD), a Step 1 diet, and a low-SFA (Low-Sat) diet. Dietary
cholesterol was constant. Diet composition was validated
and monitored by a central laboratory. Each diet was consumed for 8
weeks, and blood samples were obtained during weeks 5 through 8. The
compositions of the three diets were as follows: AAD, 34.3% kcal fat
and 15.0% kcal SFA; Step 1, 28.6% kcal fat and 9.0% kcal SFA; and
Low-Sat, 25.3% kcal fat and 6.1% kcal SFA. Each diet provided 
275
mg cholesterol/d. Compared with AAD, plasma total
cholesterol in the whole group fell 5% on Step 1 and 9%
on Low-Sat. LDL cholesterol was 7% lower on Step 1 and
11% lower on Low-Sat than on the AAD (both P<.01).
Similar responses were seen in each subgroup. HDL
cholesterol fell 7% on Step 1 and 11% on Low-Sat (both
P<.01). Reductions in HDL cholesterol were
seen in all subgroups except blacks and older men. Plasma
triglyceride levels increased 9% between AAD and Step 1
but did not increase further from Step 1 to Low-Sat. Changes in
triglyceride levels were not significant in most subgroups.
Surprisingly, plasma Lp(a) concentrations increased in a stepwise
fashion as SFA was reduced. In a well-controlled feeding study,
stepwise reductions in SFA resulted in parallel reductions in plasma
total and LDL cholesterol levels. Diet effects were
remarkably similar in several subgroups of men and women and in blacks.
The reductions in total and LDL cholesterol achieved in
these different subgroups indicate that diet can have a significant
impact on risk for atherosclerotic cardiovascular
disease in the total population.
Key Words: lipids • lipoproteins • cholesterol • diet • saturated fat
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