Dietary monounsaturated versus polyunsaturated fatty acids: Which is really better for protection from coronary heart disease?

Current Opinion in Lipidology

Volumn 14, Issue 1, 2003, Pages 41-46

  Lada, Aaron T ^a   Rudel, Lawrence L ^a  

^a WAKE FOREST SCHOOL OF MEDICINE   (United States)

Author keywords

Atherosclerosis; Dietary fatty acids; Monounsaturated; Polyunsaturated

Indexed keywords

HIGH DENSITY LIPOPROTEIN; LOW DENSITY LIPOPROTEIN CHOLESTEROL; MONOUNSATURATED FATTY ACID; POLYUNSATURATED FATTY ACID;

ATHEROSCLEROSIS; CARBOHYDRATE DIET; CARDIOVASCULAR RISK; FAT INTAKE; HEART PROTECTION; HUMAN; ISCHEMIC HEART DISEASE; LIPID BLOOD LEVEL; LOW FAT DIET; NONHUMAN; PRIORITY JOURNAL; REVIEW; RISK FACTOR;

CHOLESTEROL; CORONARY DISEASE; DIETARY FATS; FATTY ACIDS, MONOUNSATURATED; FATTY ACIDS, UNSATURATED; GENE EXPRESSION REGULATION; HUMANS; LIPOPROTEINS, LDL;

ANIMALIA;

EID: 0037315020     PISSN: 09579672     EISSN: None     Source Type: Journal    
DOI: 10.1097/00041433-200302000-00008     Document Type: Review

References (52)

1. Kinsell LW, Partridge J, Boling L, et al. Dietary modification of serum cholesterol and phospholipid levels. J Clin Endocrinol Metab 1952; 12:909-913.
2. Moore RB, Anderson JT, Taylor HL, et al. Effect of dietary fat on the fecal excretion of cholesterol and its degradation products in man. J Clin Invest 1968; 47:1517-1534.
3. Connor WE, Witiak DT, Stone DB, Armstrong ML. Cholesterol balance and fecal neutral steroid and bile acid excretion in normal men fed dietary fats of different fatty acid composition. J Clin Invest 1969; 48:1363-1375.
4. Keys A. Coronary heart disease in seven countries. Circulation 1970; 41 (Suppl. 1):1-198.
5. Keys A, Anderson JT, Grande F. Effect on serum cholesterol in many of mono-ene fatty acids (oleic acid) in the diet. Metabolism 1965; 14:747-787.
6. Hegsted DM, McGandy RB, Myers ML, Stare FJ. Quantitative effects of dietary fat on serum cholesterol in man. Am J Clin Nutr 1965; 17:281-295.
7. Shekelle RB, Shryock AM, Paul O, et al. Diet, serum cholesterol, and death from coronary heart disease. The Western Electric Study. N Engl J Med 1981; 304:65-70.
8. Kushi LK, Lew RA, Stare FJ, et al. Diet and 20-year mortality from coronary heart disease. The Ireland-Boston Diet-Heart Study. N Engl J Med 1985; 312:811-818.
9. Dayton S, Pearce ML, Hashimoto S, et al. A controlled clinical trial of a diet high in unsaturated fat in preventing complications of atherosclerosis. Circulation 1969; 40 (Suppl. II):1-63.
10. Mattson FH, Grundy SM. Comparison of effects of dietary saturated, monounsaturated, and polyunsaturated fatty acids on plasma lipids and lipoproteins in man. J Lipid Res 1985; 26:194-202.
11. Gardner CD, Kraemer HC. Monounsaturated versus polyunsaturated dietary fat and serum lipids. A meta-analysis. Arterioscler Thromb Vasc Biol 1995; 15:1917-1927.
12. Montoya MT, Porres A, Serrano S, et al. Fatty acid saturation of the diet and plasma lipid concentrations, lipoprotein particle concentrations, and cholesterol efflux capacity. Am J Clin Nutr 2002; 75:484-491. A valuable study that went beyond the effects of fatty acids on the plasma lipid profile and examined the endpoint of the efflux capacity of the serum.
13. Kratz M, Cullen P, Kannenberg F, et al. Effects of dietary fatty acids on the composition and oxidizability of low-density lipoprotein. Eur J Clin Nutr 2002; 56:72-81.
14. Hodson L, Skeaff CM, Chisholm W-AH. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55:908-915.
15. Nicklas TA, Dwyer J, Feldman HA, et al. Serum cholesterol levels in children are associated with dietary fat and fatty acid intake. J Am Dietet Assoc 2002; 102:511-517.
16. Rajaram S, Burke K, Connell B, et al. A monounsaturated fatty acid-rich pecan-enriched diet favorably alters the serum lipid profile of healthy men and women. J Nutr 2002; 131:2275-2279.
17. de Roos NM, Bots ML, Siebelink E, et al. Flow-mediated vasodilation is not impaired when HDL-cbolesterol is lowered by substituting carbohydrates for monounsaturated fat. Br J Nutr 2001; 86:181-188. This is an important study because it addresses the issue of lowered HDL caused by a low-fat, CARBO diet and CHD risk. Such studies are needed to determine if lowered HDL as a result of either CARBO or PUFA diets do indeed increase the risk of CHD.
18. Gulesserian T, Widhalm K. Effect of a rapeseed oil substituting diet on serum lipids and lipoproteins in children and adolescents with familial hypercholesterolemia. J Am Coll Nutr 2002; 21:103-108.
19. Ashton EL, Best JD, Ball MJ. Effects of monounsaturated enriched sunflower oil on CHD risk factors including LDL size and copper-induced LDL oxidation. J Am Coll Nutr 2001; 20:320-326.
20. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? Lancet 1990; 336:129-133.
21. Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998; 280:2001-2007.
22. Ross R. The pathogenesis of atherosclerosis: A perspective for the 1990s. Nature 1993; 362:801-809.
23. Merkel M, Velez-Carrasco W, Hudgins LC, Breslow JL. Compared with saturated fatty acids, dietary monounsaturated fatty acids and carbohydrates increase atherosclerosis and VLDL cholesterol levels in LDL receptor-deficient, but not apolipoprotein E-deficient, mice. Proc Natl Acad Sci U S A 2001; 98:13294-13299. A diet study using two mouse models that suggests that MUFAs may enhance atherosclerosis.
24. Rudel LL, Parks JS, Sawyer JK. Compared with dietary monounsaturated and saturated fat, polyunsaturated fat protects African green monkeys from coronary artery atherosclerosis. Arterioscler Thromb Vasc Biol 1995; 15:2101-2110.
25. Rudel LL, Kelley K, Sawyer JK, et al. Dietary monounsaturated fatty acids promote aortic atherosclerosis in LDL receptor-null, human ApoB100-overexpressing transgenic mice. Arterioscler Thromb Vasc Biol 1998; 18:1818-1827.
26. Lopez-Miranda J, Mata P. Protective effect of dietary monounsaturated fat on arteriosclerosis: beyond cholesterol. Atherosclerosis 2002; 163:385-398.
27. Mertens A, Hotvoet P. Oxidized LDL and HDL: antagonists in atherothrombosis. FASEB J 2001; 15:2073-2084. An excellent review of lipoprotein oxidation. The discussion ranges from mechanisms of oxidation to specific roles of oxidized lipoproteins in CHD.
28. Thomas MJ, Thornburg T, Manning J, et al. Fatty acid composition of low-density lipoprotein influences its susceptibility to autoxidation. Biochemistry 1994; 33:1828-1834.
29. Wright AJA, Southon S, Chopra M, et al. Comparison of LDL fatty acid and carotenoid concentrations and oxidatitve resistance of LDL in volunteers from countries with different rates of cardiovascular disease. Br J Nutr 2002; 87:21-29. An important study that examines the susceptibility of LDL to oxidation with the rate of CHD. The fact that the susceptibility of LDL to oxidation did not positively correlate with CHD questions the use of in-vitro LDL oxidation assays as a CHD risk indicator.
30. Masella R, Giovannini C, Vari R, et al. Effects of dietary virgin olive oil phenols on low density lipoprotein oxidation in hyperlipidemic patients. Lipids 2001; 36:1195-1202.
31. de Gordoa JCR, de Renobales M, del Cerro A, et al. Habitual fish intake is associated with decreased LDL susceptibility to ex vivo oxidation. Lipids 2002; 37:333-341.
32. Fernandez ML, West KL, Roy S, Ramjiganesh T. Dietary fat saturation and gender/hormonal status modulate plasma lipids and lipoprotein composition. J Nutr Biochem 2001; 12:703-710.
33. Wang Y, Oram JF. Unsaturated fatty acids inhibit cholesterol efflux from macrophages by increasing degradation of ATP-binding cassette transporter A1. J Biol Chem 2002; 277:5692-5697.
34. Young SG, Fielding CJ. The ABCs of cholesterol efflux. Nat Genet 1999; 22:316-318.
35. Middaugh JP. Cardiovascular deaths among Alaskan natives, 1980-86. Am J Public Health 1990; 80:282-285.
36. Kromann N, Green A. Epidemiological studies in the Upernavik District, Greenland. Acta Med Scand 1980; 208:401-406.
37. Yamada T, Strong JP, Ishii T, et al. Atherosclerosis and w-3 fatty acids in the populations of a fishing village and a farming village in Japan. Atherosclerosis 2000; 153:469-481.
38. Bucher HC, Hengstler P, Schindler C, Meier G. N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med 2002; 112:298-304. The authors provide an extensive review and analysis of the studies comparing the intake of n-3 PUFAs and CHD.
39. Albert CM, Campos H, Stampfer MJ, et al. Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002; 346:1113-1118. A recent study demonstrating an inverse relationship between n-3 PUFAs of marine origin and the risk of CHD, which corroborates past studies.
40. Hallgren CG, Hallmans G, Jansson J-H, et al. Markers of high fish intake are associated with decreased risk of a first myocardial infarction. Br J Nutr 2001; 86:397-404. A study of fish consumption and the risk of myocardial infarction. The authors used two biomarkers of fish intake to generate data on consumption by subjects.
41. Marhioli R, Barzi F, Bomba E, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction. Time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation 2002; 105:1897-1903.
42. Tavani A, Pelucchi C, Negri E, et al. n-3 polyunsaturated fatty acids, fish, and nonfatal acute myocardial infarction. Circulation 2001; 104:2269-2272.
43. Harper CR, Jacobson TA. The fats of life. The role of omega-3 fatty acids in the prevention of coronary heart disease. Arch Intern Med 2001; 161:2185-2192. A good review of the evidence supporting the benefits of n-3 PUFAs.
44. Demaison L, Moreau D. Dietary n-3 polyunsaturated fatty acids and coronary heart disease-related mortality: a possible mechanism of action. Cell Mol Life Sci 2002; 59:463-477. A good review on n-3 PUFAs, diet studies, and possible mechanisms of action.
45. Jump DB. Dietary polyunsaturated fatty acids and regulation of gene transcription. Curr Opin Lipidol 2002; 13:155-164. A thorough review of PUFAs and gene transcription, including the effects of specific transcription factors.
46. Brown MS, Goldstein JL. The SREBP pathway: regulation of cholesterol metabolism by proteolysis of a membrane-bound transcription factor. Cell 1997; 89:331-340.
47. Yoshikawa T, Shimano H, Yahagi N, et al. Polyunsaturated fatty acids suppress sterol regulatory element-binding protein 1c promoter activity by inhibition of liver X receptor (LXR) binding to LXR response elements. J Biol Chem 2002; 277:1705-1711. In this study, the authors investigate the mechanism for the suppression of SREBP-1c by PUFAs, providing a link to LXR.
48. Jump DB. The biochemistry of n-3 polyunsaturated fatty acids. J Biol Chem 2002; 277:8755-8758.
49. Sethi S, Ziouzenkova O, Ni H, et al. Oxidized omega-3 fatty acids in fish oil inhibit leukocyte-endothelial interactions through activation of PPARα. Blood 2002; 100:1340-1346.
50. Chambrier C, Bastard J-P, Rieusset J, et al. Eicosapentaenoic acid induces mRNA expression of peroxisome proliferator-activated receptor γ. Obesity Res 2002; 10:518-525.
51. Schaefer EJ. Lipoproteins, nutrition, and heart disease. Am J Clin Nutr 2002; 75:191-212. An excellent review on nutrition and CHD, including a discussion of lipoprotein metabolism, type and amount of fat in the diet, and evidence from human and animal dietary studies.
52. Stark AH, Madar Z. Olive oil as a functional food: epidemiology and nutritional approaches. Nutr Rev 2002; 60:170-176.