Abstract

Background/ObjectivesHypercholesterolaemic effects of saturated fatty acids (SFA) may be influenced not only by the chain length, but also by their specific location within the triacylglycerol (TAG) molecule. We examined the hypothesis that dietary fats rich in SFA, but containing mostly unsaturated fatty acids in the sn-2 position with most SFA in sn-1 and -3 (palm olein [PO] and cocoa butter [CB]) will have similar serum lipid outcomes to unsaturated olive oil (OO).Subjects/MethodsThirty-eight participants (20–40 yr, 18.5– ≤ 27.5 kg/m2) completed a 4-week randomised 3 × 3 crossover feeding intervention, preceded by 2-week run-in and separated by 2-week washout periods. Background diet contained 35 percentage of total energy (%E) fat, 18%E protein, 48%E carbohydrates, differing in test fats only (palm olein (PO), CB, OO; 20%E). Total cholesterol (TC)/high density lipoprotein cholesterol (HDL-C) ratio and related variables; TC, HDL-C, low density lipoprotein cholesterol (LDL-C), TAG, apoA1, ApoB, ApoA1 (apolipoprotein A1)/ApoB (apolipoprotein B), lipoprotein (a) (Lp(a)), NEFA, LDL sub-fractions, were assessed pre- and post-intervention. Data were analysed using mixed effects longitudinal models with a P-value < 0.05 considered significant.ResultsChanges in plasma fatty acids (P < 0.05) confirmed compliance; C18:1 increased with OO compared to PO and CB; C16:0 decreased with OO and C18:0 increased following CB. No differences were seen for TC/HDL-C (mean [95%CI] change for PO, 0.08[0.00, 0.15] mmol/L; CB, 0.06 [−0.05, 0.16] mmol/L; and OO, −0.01 [−0.15, 0.13] mmol/L; P = 0.53] or any other parameter including LDL sub-fractions. OO decreased IDL-A compared to PO (−2.2 [−4.31, −0.21] mg/dL, P = 0.03).ConclusionIn healthy young participants, plasma lipid responses to PO and CB, enriched in SFA but having primarily unsaturated fatty acid in the sn-2 position of TAG, did not differ from OO.

Highlights

  • Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, accounting for one-third of all global deaths [1]

  • Baseline characteristics did not differ between completers and withdrawals (P > 0.05) except for serum TC that was slightly higher in withdrawals compared to completers

  • Those who consumed the diets in the order palm olein (PO)-OO-CB showed increases in low density lipoprotein cholesterol (LDL-C) during the PO diet compared to those who received the diets in the order OOCB-PO

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Summary

Results

Fifty-eight (58) participants commenced the run-in diet; 38 completed all treatments (Fig. 1). No further changes were seen in weight or BMI during the trial with any of the dietary fats (Supplementary Table 2). No differences were seen between any diets on serum lipids, including TC:HDL-C, TC, LDL-C, TAG, HDL-C, ApoA1, ApoB, Lp(a) or NEFA (Table 4). Significant allocation order interactions occurred for TC, LDL-C and ApoB, but the overall result of no difference between diets did not change. Those who consumed the diets in the order PO-OO-CB showed increases in LDL-C during the PO diet compared to those who received the diets in the order OOCB-PO. BMI body mass index, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, TAG triacylglycerol, TC total cholesterol aAll participants who commenced the dietary interventions. One female participant was diagnosed with low iron status, possibly related to the study diets as she was on the lowest energy intake bracket providing less iron (12.8 mg/ day) than the RDI (18 mg/day)

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Participants
Study design
Discussion
Compliance with ethical standards
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