Current Atherosclerosis Reports

, Volume 7, Issue 6, pp 460–465 | Cite as

The response of lipoproteins to dietary fat and cholesterol in lean and obese persons

  • Martijn B. Katan


Individuals differ in the response of their blood lipoproteins to cholesterol-lowering diets. One characteristic clearly associated with susceptibility to diet is leanness; many studies show that total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol concentrations respond more strongly to dietary fat and cholesterol in lean subjects than in obese subjects. This is unlikely to be due to differences in dietary compliance. A metabolic explanation is that obese people have a higher rate of total body cholesterol synthesis. The low-density lipoprotein receptors in their liver cells are partly suppressed by this large stream of endogenous cholesterol coming in from their enterohepatic circulation, and the amount added by dietary cholesterol relative to the endogenous pool would be less than in lean people. Whatever the mechanism, diets low in saturated fat and cholesterol are less effective in the obese. The most effective way for obese people to normalize their blood lipids is to lose weight, which is, unfortunately, hard to do in our society.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    US Dept of Agriculture: Steps to a Healthier You. Accessed on July 6, 2005.Google Scholar
  2. 2.
    Groen JJ, Tjiong BK, Kamminga CE, Willebrands AF: The influence of nutrition, individuality and some other factors including various forms of stress, on the serum cholesterol: an experiment of nine months duration in 60 normal human volunteers. Voeding (the Netherlands) 1952, 13:556–587.Google Scholar
  3. 3.
    Ahrens EH, Hirsch J, Insull W, et al.: The influence of dietary fats on serum-lipid levels in man. Lancet 1957, 1:943–953.CrossRefGoogle Scholar
  4. 4.
    Connor WE, Connor SL: The key role of nutritional factors in the prevention of coronary heart disease. Prev Med 1972, 1:49–83.PubMedCrossRefGoogle Scholar
  5. 5.
    DeBusk RM, Fogarty CP, Ordovas JM, Kornman KS: Nutritional genomics in practice: where do we begin? J Am Diet Assoc 2005, 105:589–598.PubMedCrossRefGoogle Scholar
  6. 6.
    Ioannidis JP, Ntzani EE, Trikalinos TA, Contopoulos-Ioannidis DG: Replication validity of genetic association studies. Nat Genet 2001, 29:306–309.PubMedCrossRefGoogle Scholar
  7. 7.
    Rebbeck TR, Martinez ME, Sellers TA, et al.: Genetic variation and cancer: improving the environment for publication of association studies. Cancer Epidemiol Biomarkers Prev 2004, 13:1985–1986.PubMedGoogle Scholar
  8. 8.
    Weggemans RM, Zock PL, Meyboom S, et al.: Apolipoprotein A4–1/2 polymorphism and response of serum lipids to dietary cholesterol in humans. J Lipid Res 2000, 41:1623–1628.PubMedGoogle Scholar
  9. 9.
    Masson LF, McNeill G: The effect of genetic variation on the lipid response to dietary change: recent findings. Curr Opin Lipidol 2005, 16:61–67.PubMedCrossRefGoogle Scholar
  10. 10.
    Mensink RP, Zock PL, Kester AD, Katan MB: 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. Am J Clin Nutr 2003, 77:1146–1155.PubMedGoogle Scholar
  11. 11.
    Sacks FM: Dietary fats and coronary heart disease. Overview. J Cardiovasc Risk 1994, 1:3–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Connor WE, Connor SL: Dietary cholesterol and coronary heart disease. Curr Atheroscler Rep 2002, 4:425–432.PubMedGoogle Scholar
  13. 13.
    Stamler JS, Shekelle RB: Dietary cholesterol and human coronary heart disease. Arch Pathol Lab Med 1988, 112:1032–1040.PubMedGoogle Scholar
  14. 14.
    Weggemans RM, Zock PL, Katan MB: Dietary cholesterol from eggs increases the ratio of total cholesterol to high- density lipoprotein cholesterol in humans: a meta-analysis. Am J Clin Nutr 2001, 73:885–891.PubMedGoogle Scholar
  15. 15.
    Mjassnikow AL: Ueber alimentaere Beeiunflussung der Cholesterinaemie beim Menschen. Z f klin Medizin 1926, 103:767–778.Google Scholar
  16. 16.
    Okey R, Stewart D: Diet and blood cholesterol in normal women. J Biol Chem 1933, 99:717–727.Google Scholar
  17. 17.
    Bronsgeest-Schoute HC, Hermus RJ, Dallinga-Thie GM, Hautvast JG: Dependence of the effects of dietary cholesterol and experimental conditions on serum lipids in man. III The effect on serum cholesterol of removal of eggs from the diet of free-living habitually egg-eating people. Am J Clin Nutr 1979, 32:2193–2197.PubMedGoogle Scholar
  18. 18.
    Beynen AC, Katan MB: Reproducibility of the variations between humans in the response of serum cholesterol to cessation of egg consumption. Atherosclerosis 1985, 57:19–31.PubMedCrossRefGoogle Scholar
  19. 19.
    Katan MB, Beynen AC: Hyper-response to dietary cholesterol in man. Lancet 1983, 1:1213.PubMedCrossRefGoogle Scholar
  20. 20.
    Katan MB, Beynen AC, De Vries JH, Nobels AP: Existence of consistent hypo- and hyperresponders to dietary cholesterol in man. Am J Epidemiol 1986, 123:221–234.PubMedGoogle Scholar
  21. 21.
    Katan MB, Van Gastel AC, De Rover C, et al.: Differences in individual responsiveness of serum cholesterol to fat-modified diets in man. Eur J Clin Invest 1988, 18:644–647.PubMedGoogle Scholar
  22. 22.
    Beynen AC, Katan MB, Van Zutphen LF: Hypo- and hyper-responders: individual differences in the response of serum cholesterol concentration to changes in diet. Adv Lipid Res 1987, 22:115–171.PubMedGoogle Scholar
  23. 23.
    Jacobs DR, Anderson JT, Hannan P, et al.: Variability in individual serum cholesterol response to change in diet. Arteriosclerosis 1983, 3:349–356.PubMedGoogle Scholar
  24. 24.
    Harris EK, Kanofsky P, Shakarji G, Cotlove E: Biological and analytic components of variation in long-term studies of serum consistuents in normal subjects. Clin Chem 1970, 16:1022–1027.PubMedGoogle Scholar
  25. 25.
    Jacobs DR, Barrett-Connor E: Retest reliability of plasma cholesterol and triglyceride: the lipid research clinics prevalence study. Am J Epidemiol 1982, 116:878–885.PubMedGoogle Scholar
  26. 26.
    Cole TG, Bowen PE, Schmeisser D, et al.: Differential reduction of plasma cholesterol by the American Heart Association Phase 3 Diet in moderately hypercholesterolemic, premenopausal women with different body mass indexes. Am J Clin Nutr 1992, 55:385–394.PubMedGoogle Scholar
  27. 27.
    Jansen S, Lopez-Miranda J, Salas J, et al.: Plasma lipid response to hypolipidemic diets in young healthy non-obese men varies with body mass index. J Nutr 1998, 128:1144–1149.PubMedGoogle Scholar
  28. 28.
    Katan MB, Berns MA, Glatz JF, et al.: Congruence of individual responsiveness to dietary cholesterol and to saturated fat in man. JLR 1988, 29:883–892.Google Scholar
  29. 29.
    Cox C, Mann J, Sutherland W, Ball M: Individual variation in plasma cholesterol response to dietary saturated fat. BMJ 1995, 311:1260–1264.PubMedGoogle Scholar
  30. 30.
    Hannah JS, Jablonski KA, Howard BV: The relationship between weight and response to cholesterol-lowering diets in women. Int J Obes Relat Metab Disord 1997, 21:445–450.PubMedCrossRefGoogle Scholar
  31. 31.
    Denke MA, Adams-Huet B, Nguyen AT: Individual cholesterol variation in response to a margarine- or butter-based diet: a study in families. JAMA 2000, 284:2740–2747.PubMedCrossRefGoogle Scholar
  32. 32.
    Goff DC, Shekelle RB, Katan MB, et al.: Does body fatness modify the association between dietary cholesterol and risk of coronary death? Results from the Chicago Western Electric Study. Arterioscler Thromb 1992, 12:755–761.PubMedGoogle Scholar
  33. 33.
    Clifton PM, Abbey M, Noakes M, et al.: Body fat distribution is a determinant of the high-density lipoprotein response to dietary fat and cholesterol in women. Arterioscler Thromb Vasc Biol 1995, 15:1070–1078.PubMedGoogle Scholar
  34. 34.
    Katan MB, Beynen AC: Characteristics of human hypo- and hyperresponders to dietary cholesterol. Am J Epidemiol 1987, 125:387–399.PubMedGoogle Scholar
  35. 35.
    Goff DC, Shekelle RB, Moyé LA, et al.: Does body fatness modify the effect of dietary cholesterol on serum cholesterol? Results from the Chicago Western Electric Study. Am J Epidemiol 1993, 137:171–177.PubMedGoogle Scholar
  36. 36.
    Spritz N, Ahrens EH, Grundy SM: Sterol balance in man as plasma cholesterol concentrations are altered by exchanges of dietary fats. J Clin Invest 1965, 44:1482–1493.PubMedGoogle Scholar
  37. 37.
    Spady DK, Dietschy JM: Dietary saturated triacylglycerols suppress hepatic low density lipoprotein receptor activity in the hamster. Proc Natl Acad Sci 1985, 82:4526–4530.PubMedCrossRefGoogle Scholar
  38. 38.
    Lin J, Yang R, Tarr PT, et al.: Hyperlipidemic effects of dietary saturated fats mediated through PGC-1beta coactivation of SREBP. Cell 2005, 120:261–273.PubMedCrossRefGoogle Scholar
  39. 39.
    Brown MS, Goldstein JL: A receptor-mediated pathway for cholesterol homeostatis. Science 1986, 232:34–47.PubMedCrossRefGoogle Scholar
  40. 40.
    Bennion LJ, Grundy SM: Effects of obesity and caloric intake on biliary lipid metabolism in man. J Clin Invest 1975, 56:996.PubMedCrossRefGoogle Scholar
  41. 41.
    Leenen R, Kooy van der K, Meyboom S, et al.: Relative effects of weight loss and dietary fat modification on serum lipid levels in the dietary treatment of obesity. JLR 1993, 34:2183–2191.Google Scholar
  42. 42.
    Lichtenstein AH, Ausman LM, Carrasco W, et al.: Short-term consumption of a low-fat diet beneficially affects plasma lipid concentrations only when accompanied by weight loss. Hypercholesterolemia, low-fat diet, and plasma lipids. Arterioscler Thromb 1994, 14:1751–1760.PubMedGoogle Scholar
  43. 43.
    Oh SY, Miller LT: Effect of dietary egg on variability of plasma cholesterol levels and lipoprotein cholesterol. Am J Clin Nutr 1985, 42:421–431.PubMedGoogle Scholar
  44. 44.
    Knopp RH, Retzlaff B, Fish B, et al.: Effects of insulin resistance and obesity on lipoproteins and sensitivity to egg feeding and fat restricted diet. International Atherosclerosis Society Enewsletter, January 2004. Accessed on May 7, 2005.Google Scholar
  45. 45.
    Knopp RH, Retzlaff B, Fish B, et al.: Effects of insulin resistance and obesity on lipoproteins and sensitivity to egg feeding. Aterioscler Thomb Vasc Biol 2003, 23:1437–1443.CrossRefGoogle Scholar
  46. 46.
    Gylling H, Miettinen TA: Cholesterol absorption: influence of body weight and the role of plant sterols. Curr Atheroscler Rep 2005, In press.Google Scholar

Copyright information

© Current Science Inc 2005

Authors and Affiliations

  • Martijn B. Katan
    • 1
  1. 1.Wageningen Centre for Food Sciences and Division of Human NutritionWageningen UniversityWageningenThe Netherlands

Personalised recommendations