Low-fat dietary pattern and lipoprotein risk factors: the Women's Health Initiative Dietary Modification Trial.

Abstract

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.

• Authors: 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, Linda Van Horn
• Journal: The American journal of clinical nutrition (Am J Clin Nutr) Vol. 91 Issue 4 Pg. 860-74 (Apr 2010) ISSN: 1938-3207 [Electronic] United States
• PMID: 20164311 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Cholesterol, HDL
• Cholesterol, LDL
• Dietary Carbohydrates
• Dietary Fats
• Fatty Acids
• Fatty Acids, Unsaturated
• Lipoproteins
• Triglycerides

Topics

• Black or African American
• Aged
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Diabetes Mellitus (blood, ethnology)
• Diet, Fat-Restricted
• Dietary Carbohydrates (administration & dosage)
• Dietary Fats (administration & dosage)
• Fatty Acids (administration & dosage)
• Fatty Acids, Unsaturated (administration & dosage)
• Feeding Behavior
• Female
• Humans
• Lipoproteins (blood)
• Middle Aged
• Postmenopause
• Risk Factors
• Triglycerides (blood)
• United States
• White People