Current Atherosclerosis Reports

, Volume 7, Issue 6, pp 412–420 | Cite as

Effect of very high-fat diets on body weight, lipoproteins, and glycemic status in the obese

  • Frederick F. Samaha


Given the increased prevalence of obesity in the United States, despite reduced fat intake, there has been increasing interest in the effect of dietary fat on body weight, lipoproteins, and glycemic status. Despite predictions from epidemiologic and physiologic studies, recent prospective trials have demonstrated equivalent weight loss on high-fat versus low-fat diets. Nevertheless, the type of dietary fat consumed has substantially different effects on lipoproteins. Saturated fat raises high-density lipoprotein cholesterol but has unfavorable effects on total cholesterol, and has been associated with increased cardiovascular events. In contrast, unsaturated fats, and particularly omega-3 fatty acids, have the combined benefits of lowering serum cholesterol and raising high-density lipoprotein, as well as favorable effects on insulin resistance and inflammation; they also lower cardiovascular events in high-risk patients. Although current national guidelines modestly liberalize unsaturated fat consumption, important questions still remain about the optimal percentage of unsaturated fats in the diet.


Trans Fatty Acid Mediterranean Diet Nurse Health Study Elaidic Acid Glycemic Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002, 288:1723–1727.PubMedCrossRefGoogle Scholar
  2. 2.
    Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001, 285:2486–2497.CrossRefGoogle Scholar
  3. 3.
    Krauss RM, Eckel RH, Howard B, et al.: AHA Dietary Guidelines: Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association. Circulation 2000, 102:2284–2299.PubMedGoogle Scholar
  4. 4.
    U.S. Department of Health and Human Services. U.S. Department of Agriculture. Accessed July 1, 2005.Google Scholar
  5. 5.
    Department of Health and Human Services. Centers for Disease Control and Prevention. Trends in Energy Intake and Macronutrients. on June 1, 2005.Google Scholar
  6. 6.
    Bray GA, Popkin BM: Dietary fat intake does not affect obesity! Am J Clin Nutr 1998, 68:1157–1173.PubMedGoogle Scholar
  7. 7.
    Willett WC: Dietary fat and obesity: an unconvincing relation. Am J Clin Nutr 1998, 68:1149–1150.PubMedGoogle Scholar
  8. 8.
    Willett WC, Leibel RL: Dietary fat is not a major determinant of body fat. Am J Med 2002, 113:47S-59S.PubMedCrossRefGoogle Scholar
  9. 9.
    Curb JD, Marcus EB: Body fat and obesity in Japanese Americans. Am J Clin Nutr 1991, 51(Suppl):1552S-1555S.Google Scholar
  10. 10.
    Gerstein DE, Woodward-Lopez G, Evans AE, et al.: Clarifying concepts about macronutrients’ effects on satiation and satiety. J Am Diet Assoc 2004, 104:1151–1153.PubMedCrossRefGoogle Scholar
  11. 11.
    Lawton CL, Burley VJ, Wales JK, Blundell JE: Dietary fat and appetite control in obese subjects: weak effects on satiation and satiety. Int J Obes 1993, 17:409–416.Google Scholar
  12. 12.
    Blundell JE, Macdiarmid JI: Fat as a risk factor for overcon-sumption: Satiation, satiety, and patterns of eating. J Am Diet Assoc 1997, 97:S63-S69.PubMedCrossRefGoogle Scholar
  13. 13.
    Prentice AM: Manipulation of dietary fat and energy density and subsequent effects on substrate flux and food intake. Am J Clin Nutr 1998, 67:535S-541S.PubMedGoogle Scholar
  14. 14.
    Jequier E, Bray GA: Low-fat diets are preferred. Am J Med 2002, 113:41S-46S.PubMedCrossRefGoogle Scholar
  15. 15.
    McDevitt RM, Bott SJ, Harding M, et al.: De novo lipogenesis during controlled overfeeding with sucrose or glucose in lean and obese women. Am J Clin Nutr 2001, 74:737–746.PubMedGoogle Scholar
  16. 16.
    Hellerstein MK: No common energy currency: de novo lipogenesis as the road less traveled. Am J Clin Nutr 2001, 74:707–708.PubMedGoogle Scholar
  17. 17.
    Hudgins LC, Hellerstein M, Seidman C, et al.: Human fatty acid synthesis is stimulated by a eucaloric low fat, high carbohydrate diet. J Clin Invest 1996, 97:2081–2091.PubMedCrossRefGoogle Scholar
  18. 18.
    GISSI-Prevenzione Investigators: Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999, 354:447–455.CrossRefGoogle Scholar
  19. 19.
    Kris-Etherton P, Shaomei Y: Individual fatty acid effects on plasma lipids and lipoproteins: human studies. Am J Clin Nutr 1997, 65(Suppl):1628S-1644S.PubMedGoogle Scholar
  20. 20.
    Matthan NR, Welty FK, Hugh P, et al.: Dietary hydrogenated fat increases high-density lipoprotein apoa-1 catabolism and decreases low-density lipoprotein apob-100 catabolism in hypercholesterolemic women. Arterioscler Thromb Vasc Biol 2004, 24:1092–1097.PubMedCrossRefGoogle Scholar
  21. 21.
    Nestel P, Noakes M, Belling B, et al.: Plasma lipoprotein lipid and Lp(a) changes with substitution of elaidic acid for oleic acid in the diet. J Lipid Res 1992, 33:1029–1036.PubMedGoogle Scholar
  22. 22.
    Dyerberg J, Eskesen DC, Andersen PW, et al.: Effects of trans- and n-3 unsaturated fatty acids on cardiovascular risk markers in healthy males. An 8 weeks dietary intervention study. Eur J Clin Nutr 2004, 58:1062–1070.PubMedCrossRefGoogle Scholar
  23. 23.
    Mozzaffarian D, Pischon T, Hankinson SE, et al.: Dietary intake of trans fatty acids and systemic inflammation in women. Am J Clin Nutr 2004, 79:606–612.Google Scholar
  24. 24.
    Brehm BJ, Seeley RJ, D’Alessio DA: A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 2003, 88:1617–1623.PubMedCrossRefGoogle Scholar
  25. 25.
    Dansinger ML, Gleason JA, Griffith JL, et al.: Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for weight loss and heart disease risk reduction. A randomized trial. JAMA 2005, 293:43–53.PubMedCrossRefGoogle Scholar
  26. 26.
    Foster GD, Wyatt HR, Hill JO, et al.: A multi-center, randomized, controlled trial of a low-carbohydrate diet for obesity. N Engl J Med 2003, 348:2082–2090.PubMedCrossRefGoogle Scholar
  27. 27.
    Stern L, Iqbal N, Seshadri P, et al.: The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med 2004, 140:778–785.PubMedGoogle Scholar
  28. 28.
    Samaha FF, Iqbal N, Seshadri P, et al.: Low carbohydrate as compared to low fat diet in severe obesity. N Engl J Med 2003, 348:2074–2081.PubMedCrossRefGoogle Scholar
  29. 29.
    Yancy WS Jr, Olsen MK, Guyton JR, et al.: A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med 2004, 140:769–777.PubMedGoogle Scholar
  30. 30.
    Knopp RH, Retzlaff B, Fish B, et al.: Effects of insulin resistance and obesity on lipoproteins and sensitivity to egg feeding. Arterioscler Thromb Vasc Biol 2003, 23:1437–1443.PubMedCrossRefGoogle Scholar
  31. 31.
    Hatahet W, Cole L, Kudchodkar BJ, Fungwe TV: Dietary fats differentially modulate the expression of lecithin:cholesterol acyltransferase, apoprotein-a1 and scavenger receptor B1 in rats. J Nutr 2003, 133:689–694.PubMedGoogle Scholar
  32. 32.
    Twickler TB, Dallinga-Thie GM, Cohn JS, Chapman MJ: Elevated remnant-like particle cholesterol concentration. a characteristic feature of the atherogenic lipoprotein phenotype. Circulation, 109:1918–1925.Google Scholar
  33. 33.
    Seshadri P, Iqbal N, Stern L, et al.: A randomized trial of a low-carbohydrate and a conventional diet on lipoprotein subfractions and inflammation. Am J Med 2004, 117:398–405.PubMedCrossRefGoogle Scholar
  34. 34.
    Mozaffarian D, Rimm EB, Herrington DM: Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women. Am J Clin Nutr 2004, 80:1175–1184.PubMedGoogle Scholar
  35. 35.
    Knopp RH: Saturated fat prevents coronary artery disease? An American paradox. Am J Clin Nutr 2004, 80:1102–1103.PubMedGoogle Scholar
  36. 36.
    Hu FB, Stampfer MJ, Manson JE, et al.: Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997, 337:1491–1499.PubMedCrossRefGoogle Scholar
  37. 37.
    Hu FB, Manson JE, Willett WC: Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr 2001, 20:5–19.PubMedGoogle Scholar
  38. 38.
    Mensink RP, Katan MB: Effect of monounsaturated fatty acids versus complex carbohydrates on high-density lipoproteins in healthy men and women. Lancet 1987, 1:122–125.PubMedCrossRefGoogle Scholar
  39. 39.
    Esposito K, Marfella R, Ciotola M, et al.: Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome. A randomized trial. JAMA 2004, 292:1440–1446.PubMedCrossRefGoogle Scholar
  40. 40.
    Singh RB, Dubnov G, Niaz MA, et al.: Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial. Lancet 2002, 360:1455–1461.PubMedCrossRefGoogle Scholar
  41. 41.
    de Lorgeril M, Renaud S, Mamelle N, et al.: Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994, 343:1454–1459.PubMedCrossRefGoogle Scholar
  42. 42.
    de Lorgeril M, Salen P, Martin JL, et al.: Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction. Final Report of the Lyon Diet Heart Study. Circulation 1999, 99:779–785.PubMedGoogle Scholar
  43. 43.
    Mozaffarian D, Ascherio A, Hu FB, et al.: Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation 2005, 111:157–164.PubMedCrossRefGoogle Scholar
  44. 44.
    ScientificPsychic. Fats, Oils, Fatty Acids, Triglycerides—Chemical Structure. Accessed on July 1, 2005.Google Scholar
  45. 45.
    USDA Nutrient Data Laboratory data. Accessed on July 1, 2005.Google Scholar

Copyright information

© Current Science Inc 2005

Authors and Affiliations

  • Frederick F. Samaha
    • 1
  1. 1.Department of MedicineDivision of Cardiovascular Disease, Philadelphia Veterans Affairs Medical CenterPhiladelphiaUSA

Personalised recommendations