Beneficial Effects of a Diet High in Monounsaturated Fatty Acids on Risk Factors for Cardiovascular Disease

Abstract

AbstractCurrent dietary recommendations for the prevention and treatment of cardiovascular disease (CVD) focus on limiting intake of total fat, saturated fat, and cholesterol. Implementation of these guidelines is achieved by the substitution of calories from saturated fat with carbohydrate calories and the reduction of foods rich in dietary cholesterol. Adherence to these low‐fat, high‐carbohydrate diets reduces total serum cholesterol and LDL‐cholesterol, thereby reducing risk for CVD. Recent evidence, however, shows that consumption of low‐fat, high‐carbohydrate diets in weight‐maintaining individuals increases triglycerides and reduces HDL‐cholesterol. These potentially deleterious changes have led many to question the appropriateness of low‐fat, high‐carbohydrate diets for CVD risk reduction. An alternative approach is the substitution of calories from saturated fatty acids with calories from monounsaturated fatty acids (MUFA), which have a neutral effect on plasma cholesterol levels. In this review, results from 18 studies examining effects of low‐fat, high‐carbohydrate vs. high‐MUFA diets on serum lipoproteins are presented. Based on these studies, we conclude that high‐MUFA diets are effective for reducing total and LDL‐cholesterol and may be expected to elicit more beneficial changes in CVD risk than currently prescribed low‐fat, high‐carbohydrate diets, especially in patients who do not require weight loss. A listing of high‐MUFA foods and practical guidelines for diet planning are presented as an aid to clinicians in the implementation of high‐MUFA diets.