Dietary Fat and Coronary Heart Disease

  • K. C. Hayes
Part of the Nutrition ◊ and ◊ Health book series (NH)


Numerous experimental and epidemiological studies have revealed the relationship between an elevated blood cholesterol value and development of atherosclerosis (1,2). Since the early days when the association was based on gross pathology, a plethora of investigations, including those from cell biology (3) have carefully documented the pathogenesis of the atherosclerotic process, linking thrombogeneis, the inflammatory response, and an elevated LDL/HDL ratio with atherogenesis and coronary heart disease (CHD). More recently, the possible oxidation of the LDL particle within the damaged arterial intima has developed into a promising avenue of atherogenesis research with implications for modulation by diet (3,4).


Plasma Cholesterol Trans Fatty Acid Dietary Cholesterol Dietary Fatty Acid Elaidic Acid 
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  1. 1.
    Fats and Other Lipids. Diet and Health: Implications for reducing Chronic Disease Risk, National Research Council, Washington, DC, National Academy Press, 1989; 159–258.Google Scholar
  2. 2.
    Coronary Heart Disease. Surgeon’s General Report on Nutrition and Health, U.S. Department of Health and Human Services, US Government Printing Office, Washington, DC, 1988; 83–137.Google Scholar
  3. 3.
    Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993; 362:801–809.CrossRefGoogle Scholar
  4. 4.
    Reaven P, Paarthasarathy S, Grasse BJ, Mille E, Steinberg D, Witztum JL, Effects of oleate-rich and linoleate-rich diets on the susceptibility of low density lipoprotein oxidative modification in mildly hypercholesterolemic subjects. J Clin Invest 1993; 91:668–676.CrossRefGoogle Scholar
  5. 5.
    Kinsell LW, Michaels GD, Partridge JW, Boling LA, Balch HE, Cochrane GC. Effect upon serum cholesterol and phospholipids of diets containing large amounts of vegetable fat. J Clin Nutr 1953; 1:231–244.Google Scholar
  6. 6.
    Bronte-Stewart B, Antonis A, Eales L, Brock JF. Effect of feeding different fats on the serum cholesterol level. Lancet 1956; 1:521–527.CrossRefGoogle Scholar
  7. 7.
    Turpeinen AM, Alfthan G, Valsta L, Hietanen E, Salonen JT, Schunk H, Nyyssonen K, Mutanen M. Plasma and lipoprotein lipid peroxidation in humans on sunflower and rapeseed oil diets. Lipids 1995; 30:485–492.CrossRefGoogle Scholar
  8. 8.
    Suarna, C, Dean, RT, May J, Stocker, R. Human atherosclerotic plaque contains both oxidized lipids and relatively large amounts of a-tocopherol and ascorbate. Arterioscler Thromb Vasc Biol 1995; 15:1616–1624.CrossRefGoogle Scholar
  9. 9.
    Siguel EN, Lerman RH. Altered fatty acid metabolism in patients with angiographically documented coronary artery disease. Metabolism 1994; 8:982–993.CrossRefGoogle Scholar
  10. 10.
    Kingsbury KJ, Brett C, Stovold R, Chapman A, Anderson J, Morgan DM. Abnormal fatty acid composition and human atherosclerosis. Postgrad Med J 1974; 50:425 440.Google Scholar
  11. 11.
    Rudel LL, Parks JS, Sawyer JK. Compared with dietary monounsaturated and saturated fat, polyunsaturated fat prortects African Green monkeys frmn coronary artery atherosclerosis. Arterio Thromb Vasc Biol 1995•15•2101–2110Google Scholar
  12. 12.
    Sundram K, Hayes KC, Siru OH. Both dietary 18:2 and 16:0 may be required to improve the serum LDL/HDL cholesterol ratio in normocholesterolemic men. J Nutr Biochem 1995; 6:179–187.CrossRefGoogle Scholar
  13. 13.
    Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA 1993; 269:3015–3023.CrossRefGoogle Scholar
  14. 14.
    NIH Consensus Panel. Triglyceride, HDL and coronary heart disease. JAMA 1993; 269:505–510.CrossRefGoogle Scholar
  15. 15.
    Heiss G, Johnson NJ, Reiland S, Davis CE, Tyroler HA. High-denisty lipoprotein cholesterol levels. The Lipid Research Clinics Program Prevalence Study. Circulation 1980; 62:116s-136s.CrossRefGoogle Scholar
  16. 16.
    Gordon DJ, Probstfield JL, Garrison RJ. High-denisty lipoprotein cholesterol and cardiovascular disease. Circulation 1989; 79:8–15.CrossRefGoogle Scholar
  17. 17.
    Shepherd J, Cobbe SM, Ford I, Isles CG. Prevention of coronary heart disease with pravastatin in men with hvpercholesterolemia 1995. New Engl J Med 1959; 333, 1301–1307.CrossRefGoogle Scholar
  18. 18.
    Oliver M, Poole-Wilson P, Shepherd J, Tikkanen Mi. Lower patients’ cholesterol now (editorial). Br Med J 1995; 310:1280,1281.Google Scholar
  19. 19.
    Gould KL, Ornish D, Scherwitz L, Brown S, Edens RP, Hess MJ, Mullani N. Changes in myocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modificatiom. JAMA 1995; 274,894–901.CrossRefGoogle Scholar
  20. 20.
    Dietschy JM, Turley SD, Spady DK. Role of liver in the maintenance of cholesterol and low density lipoprotein homeostasis in different animal species, including humans. J Lipid Res 1993; 34:1637–1659.Google Scholar
  21. 21.
    Katan MB, Beyen AC, de Vries JH, Nobels A. Existence of consistent hypo- and hyper-responders to dietary cholesterol in man. Am J Clin Nutr 1985; 42:190–197.Google Scholar
  22. 22.
    Gylling H, Miettinen TA. Cholesterol absorption and synthesis related to low density lipoprotein metabolism during varying cholesterol intake in men with different apoE phenotypes. J Lipid Res 1992; 33:1361–1371.Google Scholar
  23. 23.
    Botham KM, Bravo E. The role of lipoprotein cholesterol in biliary steroid secretion. Studies with in vivo experimental models. Prog Lipid Res. 1995; 34:71–99.CrossRefGoogle Scholar
  24. 24.
    Gylling H, Miettinen TA. The effect of cholesterol absorption inhibition on low density lipoprotein cholesterol level. Atherosclerosis 1995; 117,305–308.CrossRefGoogle Scholar
  25. 25.
    Hopkins PN. Effects of dietary cholesterol on serum cholesterol: a meta-analysis and review. Am J Clin Nutr 1992; 55:1060–1070.Google Scholar
  26. 26.
    Grundy SM, Denke MA. Dietary influence on serum lipids and lipoproteins. J Lipid Res 1990; 31:1149–1172.Google Scholar
  27. 27.
    Nicolosi RJ, Stucchi AF, Kowala MC, Hennessy LK, Hegsted DM, Schaefer EJ. Effect of dietary fat saturation and cholesterol on low density lipoprotein composition and metabolism. In vivo studies of receptor and non-receptor mediated catabolism of LDL in Cebus monkeys. Arteriosclerosis 1990; 10:119–128.CrossRefGoogle Scholar
  28. 28.
    Howard BV, Hannah JS, Heiser CC, Jablonski KA, Paidi MC, Alarif L, Robbins DC, Howard WJ. Polyunsaturated fatty acids result in greater cholesterol lowering and less triacylglycerol elevation than do monounsaturated fatty acids in a dose-response comparison in a multiracial study group. Am J Clin Nutr 1995; 62:292–402.Google Scholar
  29. 29.
    Barr SL, Ramakrishnan R, Johnson C, Holleran S, Dell RB, Ginsberg HN. Reducing total dietary fat without reducing saturated fatty acids does not significantly lower plasma cholesterol concentrations in normal males. Am J Clin Nutr 1992; 55:675–681.Google Scholar
  30. 30.
    Hayes KC. Specific dietary fatty acids in predicting plasma cholesterol. Am J Clin Nutr 1993; 57:230,231.Google Scholar
  31. 31.
    Hayes KC, Khosla P. Dietary fatty acid thresholds and cholesterolemia. FASEB J 1992; 6:2600–2607.Google Scholar
  32. 32.
    Nelson GI, Schmidt PC, Kelley DS. Low-fat diets do not lower plasma cholesterol levels in healthy men compared to high-fat diets with similar fatty acid composition at constant caloric intake. Lipids 1995; 30; 969–976.CrossRefGoogle Scholar
  33. 33.
    Katan MB, Zock PL, Mensink RP. Dietary oils, serum lipoproteins, and coronary heart disease. Am J Clin Nutr 1995; 61:1368s-1373s.Google Scholar
  34. 34.
    Krauss RM. Dense low density lipoproteins and coronary artery disease. Am J Cardiol 1995; 75:B53–B57.CrossRefGoogle Scholar
  35. 35.
    Hegsted DM, Ausman LM, Johnson JA, Dallal GE. Dietary fat and serum lipids: an evaluation of the experimental data. Am J Clin Nutr 1993: 57:875–883.Google Scholar
  36. 36.
    Rimm, EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ, Willet WC. Vegetable, fruit and cereal fiber intake and risk of coronary heart disease. JAMA 1996; 275:447–451.CrossRefGoogle Scholar
  37. 37.
    Keys A, Anderson JT, Grande F Predication of serum cholesterol response of man to changes in fats in the diet. Lancet 1957: 2:959–966.CrossRefGoogle Scholar
  38. 38.
    Hegsted DM, McGandy RB, Meyers ML, Stare FJ. Quantitative effects of dietary fat on serum cholesterol in man. Am J Clin Nutr 1965; 27:281–295.Google Scholar
  39. 39.
    Pronczuk A, Khosla P, Hayes KC. Dietary myristic, palmitic and linoleic acids modulate cholesterolemia in gerbils. FASEB J 1994; 8:1191–1200.Google Scholar
  40. 40.
    Hayes KC, Khosla P, Pronczuk A. A rationale for plasma cholesterol modulation by dietary fatty acids: modulating the human response in animals. J Nutr Biochem 1995; 6:188–194.CrossRefGoogle Scholar
  41. 41.
    Baudet MF, Dachet C, Lasserre M, Esteva 0, Jacotot B. Modification in the composition and metabolic properties of human LDL and HDL by different fats. J Lipid Res 1984; 25:456–468.Google Scholar
  42. 42.
    Mattson FH, Grundy SM. Comparison of the effects of dietary saturated, monounsaturated, and polyunsaturated fatty acids on plasma lipids and lipoproteins in man. J Lipid Res 1985; 26:194–202.Google Scholar
  43. 43.
    Mensink RP, Katan MB. Effect of a diet enriched with monunsaturated or polyunsaturated fatty acids on levels of low-density and high-density lipoprotein cholesterol in healthy women and men. New Engl J Med 1989; 321:436–441.CrossRefGoogle Scholar
  44. 44.
    Berry EM, Eisenberg S, Haratz D, Friedlander Y, Norman Y, Kaufmann NA, Stein Y. Effects of diets rich in monounsaturated fatty acid on plasma lipoproteins-The Jerusalem study: high MUFAs vs. high PUFA. Am J Clin Nutr 1991; 53:899–907.Google Scholar
  45. 45.
    Ghaforunissa, Reddy V, Sesikaran B. Palm olein and groundnut oil have comparable effects on blood lipids and platelet aggregation in healthy Indian subjects. Lipids 1995; 30:1163–1169.CrossRefGoogle Scholar
  46. 46.
    Hayes KC, Pronczuk A, Lindsey S, Diersen-Schade D. Dietary saturated fatty acids (12:0,14:0,16:0) differ in their impact on plasma cholesterol and lipoproteins in nonhuman primates. Am J Clin Nutr 1991; 53:491–498.Google Scholar
  47. 47.
    Sundram K, Hayes KC, Siru OH. Dietary palmitic acid results in a lower serum cholesterol than a lauricmyrsitic acid combination in normolipemic humans. Am J Clin Nutr 1994; 59:841–846.Google Scholar
  48. 48.
    Tholstrup T, Marckmann P, Jespersen J, Sandstrom B. Fat high in stearic acid favorably affects blood lipids and factor VII coagulant activity in comparison with fats high in palmitic acid or high in myristic and lauric acids. Am J Clin Nutr 1994; 59:371–377.Google Scholar
  49. 49.
    Bach AC, Babayan VK. Medium-chain triglycerides: an update. Am J Clin Nutr 1982; 36:950–962.Google Scholar
  50. 50.
    Dougherty RM, Allman MA, Iacono JM. Effects of diets containing high or low amounts of stearic aid on plasma lipoprotein fractions and fecal fatty acid excretion of men. Am J Clin Nutr 1995; 61:1120–1128.Google Scholar
  51. 51.
    Pearson TA. Stearic acid: a unique saturated fatty acid. Am J Clin Nutr 1994; 60:983(s)-1071(s).Google Scholar
  52. 52.
    Vergroesen AJ, Gottenbus JJ. The role of fats in human nutrition: an introduction. In: The Role of Fats in Human Nutrition, 2nd ed. Vergroesen, AJ, Crawford M, eds. New York: Academic, 1975, pp. 1–44.Google Scholar
  53. 53.
    Khosla P, Hayes KC. Comparison between dietary saturated (16:0), monounsaturated (18:1) and polyunsaturated (18:2) fatty acids on plasma lipoprotein metabolism in cebus and rhesus monkeys fed cholesterolfree diets. Am J Clin Nutr 1992; 55:51–62.Google Scholar
  54. 54.
    Ng TKW, Hayes KC, de Witt GF, Jegathesan M, Satgunasingham N, Ong ASH, Tan DTS. Palmitic and oleic acids exert similar effects on serum lipid profile in normocholesterolemic human. J Am Coll Nutr 1992; 11:383–390.Google Scholar
  55. 55.
    Sundram K, Hayes KC, Siru OH. A balance between dietary 18:2 and 16:0 optimizes the serum LDL/HDL cholesterol ratio in normocholesterolemic men. J Nutr Biochem 1995; 6:179–187.CrossRefGoogle Scholar
  56. 56.
    Choudry N, Tan L, Truswell AS. Comparison of palmolein and olive oil: effects on plasma lipids and vitamin E in young adults. Am J Clin Nutr 1965; 61:1043–1051.Google Scholar
  57. 57.
    Khosla P, Hayes KC. Dietary palmitic acid raises LDL cholesterol relative to oleic acid only at a high intake of cholesterol. Biochim Bionhys Acta 1993; 1210:13–22.CrossRefGoogle Scholar
  58. 58.
    Hayes KC. Saturated fats and blood lipids: new slant on an old story. Can J Cardiol 1995; 11:39G–46G.Google Scholar
  59. 59.
    Katan MB, Zock PL, Mensink RP. Trans fatty acids and their effects on lipoproteins in humans. Ann Rev Nutr 1995; 5:473–493.CrossRefGoogle Scholar
  60. 60.
    Khosla P, Hayes KC. Dietary trans- monounsaturated fatty acids negatively impact plasma lipids in humans: critical review of the evidence. J Am Coll Nutr 1996; 15:325–339.Google Scholar
  61. 61.
    Willett WC, Ascherio A. Trans fatty acids: Are the effects only marginal? Am J Public Health 1994; 84.722–724.CrossRefGoogle Scholar
  62. 62.
    Aro A, Kardinaal AFM, Salminen I, Kark JD, Riemersma RA, Delgado-Rodriguez M, Gomez-Aracena J, Huttunen JK, Kohlmeier L, Martin BC, Martin-Moreno JM, Mazaev VP, Ringstad J, Thamm M, van’t Veer P, and Kok FJ. Adipose tissue isomeric trans fatty aids and risk of myocardial infarction in nine countries: the Euramic Study. Lancet, 1995; 345:273–278.CrossRefGoogle Scholar
  63. 63.
    Almendingen K, Jordal O, Kierulf P, Sandstad B, Petersen JI. Effects of partially hydrogenated fish oil, partially hydrogenated soybean oil, and butter on serum lipoproteins and Lp(a) in men. J Lipid Res 1995; 36:1370–1384.Google Scholar
  64. 64.
    Sundram K, Anisah I, Hayes KC, Jeyamalara R, Pathmanathan R, Trans-18:1 raises cholesterol more than cis-mono or saturated fats in humans. FASEB J 1995; 9:A440.Google Scholar
  65. 65.
    Schonfeld G, Patsch W, Rudel LL, Nelson C, Epstein M, Olson E. Effects of dietary cholesterol and fatty acids on plasma lipoproteins. J Clin Invest 1982; 9:1072–1080.CrossRefGoogle Scholar
  66. 66.
    Fielding CJ, Havel RJ, Todd KM, Yeo KE, Schloetter MC, Weinberg V, Frost PH. Effects of dietary cholesterol and fat saturation on plasma lipoprotein in an ethnically diverse population of healthy young men. J Clin Invest 1995; 95:611–618.CrossRefGoogle Scholar
  67. 67.
    Khosla P, Hayes KC. Dietary fat saturation in rhesus monkeys affects LDL concentrations by modulating the independent production of LDL apolipoprotein B. Biochem Biophys Acta 1991; 1083:46–56.CrossRefGoogle Scholar
  68. 68.
    McGandy RB, Hegsted DM, Meyers ML. Use of semisynthetic fats in determining the effects of specific fatty acids on serum lipids in man. Am J Clin Nutr 1970; 23:1288–1298.Google Scholar
  69. 69.
    Zock PL, De Vries JHM, Katan MB. Impact of myristic acid versus palmitic acid on serum lipid and lipoprotein levels in healthy women and men. Arterioscler Thromb 1994; 14:567–575.CrossRefGoogle Scholar
  70. 70.
    Tholstrup T, Marckman P, Jespersen J, Vessby B, Jart A, Sandstrom B. Effect on blood lipids, coagulation and fibrinolysis of a fat high in myrisitc acid and a fat high in palmitic acid. Am J Clin Nutr 1994; 60:919–925.Google Scholar
  71. 71.
    Christophe A, Matthys F, Geers R, Verdonk G. Nutritional studies with randomized butter. Cholesterolemic effects of butter-oil and randomized butter-oil in man. Arch Internat Physiol Biochim 1978; 86:414,415.Google Scholar
  72. 72.
    Mukherjee S, Sengrupa S. Serum cholesterol lowering effects of butterfats nteresterified with edible oils with or without polyunsaturated acids. Proc 13th World Cong. Intl Soc Fat Res 1976; 23–39.Google Scholar
  73. 73.
    Innis SM, Quinlan P, Diersen-Schade D. Saturated fatty acid chain length and positional distribution in infant formulas: effects on growth and plasma lipids and ketones in piglets. Am J Clin Nutr 1993; 57:382–90.Google Scholar
  74. 74.
    Zock PL, De Vries JHM, de Fauro NJ, Katan MB. Positional distribution of fatty acids in dietary triglycerides: effects on fasting blood lipoprotein concentrations in humans. Am J Clin Nutr 1995; 61:48–55.Google Scholar
  75. 75.
    Tholstrup T, Marckmann P, Vessby B, Sandstrom B. Effect of fats high in individual saturated fatty acids on plasma lipoprotein (a) levels in young healthy men. J Lipid Res 1995; 36:1447–1452.Google Scholar

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© Springer Science+Business Media New York 1997

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  • K. C. Hayes

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