(10-04-10) Low-fat dietary pattern and lipoprotein risk factors: the Women's Health Initiative Dietary Modification Trial1,2,3,4

Barbara V Howard, J David Curb, Charles B Eaton, Charles Kooperberg, Judith Ockene, John B Kostis, Mary Pettinger, Aleksandar Rajkovic, Jennifer G Robinson, Jacques Rossouw, Gloria Sarto, James M Shikany and Linda Van Horn

1 From the MedStar Research Institute Hyattsville MDGeorgetown University School of Medicine Washington DC (BVH); the University of Hawaii Honolulu HI (JDC); Brown University Providence RI (CBE); Fred Hutchinson Cancer Research Center Seattle WA (CKMP); the University of Massachusetts/Fallon Clinic Worcester MA (JO); the University of MedicineDentistry of New Jersey Newark NJ (JBK); University of Pittsburgh Pittsburgh PA (AR); the University of Iowa Iowa City/Davenport IA (JGR); the National Heart LungBlood Institute Bethesda MD (JR); the University of Wisconsin Madison WI (GS); the University of Alabama at Birmingham Birmingham AL (JMS);Northwestern University Chicago/Evanston IL (LVH).
2 The Women's Health Initiative Investigators are listed in Appendix A.
3 The WHI is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221.
4 Address correspondence to BV Howard, MedStar Health Research Institute and Georgetown University, 6525 Belcrest Road, Hyattsville, MD 20782. E-mail: [email protected] .
Background: The Women's Health Initiative Dietary Modification Trial tested the effects on chronic disease of a dietary pattern lower in fat and higher in vegetables, fruit, and grains.
Objective: The objective was to evaluate the effects of dietary carbohydrate changes on lipids and lipoprotein composition.
Design: Postmenopausal women were randomly assigned to an intervention or a comparison group for a mean of 8.1 y. Lipoprotein analyses and subclasses were based on subsamples of 2730 and 209 participants, respectively.
Results: At year 6, the total reported fat intake was 7.8% lower and carbohydrate intake was 7.6% higher in the intervention group than in the comparison group. Triglyceride change between groups differed by 2.3, 3.8, and ?0.8 mg/dL at 1, 3, and 6 y, respectively, and HDL-cholesterol change differed by ?1.6, ?0.7, and ?1.0 mg/dL at 1, 3, and 6 y, respectively. Changes did not differ by age, ethnicity, or obesity. In diabetic intervention women who were white, the triglyceride difference between the intervention and comparison groups was 33.8 mg/dL, whereas in black women with diabetes (n = 50 in the intervention group; n = 83 in the comparison group), the triglyceride difference was 6.4 mg/dL (P for 3-factor interaction = 0.049). No significant changes were observed in apolipoprotein or lipoprotein particles. Reductions in LDL cholesterol varied by quartile of reported lowering of saturated or trans fat.
Conclusions: The replacement of 7?8% of fat intake with complex carbohydrates over 6 y was not associated with clinically adverse effects on triglycerides, HDL cholesterol, or lipoprotein subclasses. Diabetic white women with higher triglyceride concentrations may have greater increases in triglycerides.

Source: Am J Clin Nutr 91: 860-874, 2010.

News

---

In evidenza

"L'informazione presente nel sito serve a migliorare, e non a sostituire, il rapporto medico-paziente."

Per coloro che hanno problemi di salute si consiglia di consultare sempre il proprio medico curante.