Abstract
BackgroundIncreased lipoprotein(a) [Lp(a)] levels are associated with atherosclerotic cardiovascular disease. Studies of dietary interventions on changes in Lp(a) are sparse. We aimed to compare the effects of three healthy dietary interventions differing in macronutrient content on Lp(a) concentration.MethodsSecondary analysis of a randomized, 3-period crossover feeding study including 155 (89 blacks; 66 whites) individuals. Participants were given DASH-type healthy diets rich in carbohydrates [Carb], in protein [Prot] or in unsaturated fat [Unsat Fat] for 6 weeks each. Plasma Lp(a) concentration was assessed at baseline and after each diet.ResultsCompared to baseline, all interventional diets increased mean Lp(a) by 2 to 5 mg/dl. Unsat Fat increased Lp(a) less than Prot with a difference of 1.0 mg/dl (95% CI, −0.5, 2.5; p = 0.196) in whites and 3.7 mg/dl (95% CI, 2.4, 5.0; p<0.001) in blacks (p-value between races = 0.008); Unsat Fat increased Lp(a) less than Carb with a difference of −0.6 mg/dl, 95% CI, −2.1, 0.9; p = 0.441) in whites and −1.5 mg/dl (95% CI, −0.2, −2.8; p = 0.021) in blacks (p-value between races = 0.354). Prot increased Lp(a) more than Carb with a difference of 0.4 mg/dl (95% CI, −1.1, 1.9; p = 0.597) in whites and 2.2 mg/dl (95%CI, 0.9, 3.5; p = 0.001) in blacks (p-value between races = 0.082).ConclusionDiets high in unsaturated fat increased Lp(a) levels less than diets rich in carbohydrate or protein with greater changes in blacks than whites. Our results suggest that substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets may be preferable over protein or carbohydrates with regards to Lp(a).Trial RegistrationClinicaltrials.gov NCT00051350
Highlights
Lipoprotein(a) [Lp(a)] is a plasma lipoprotein consisting of a cholesterol-rich LDL-like particle having one molecule of apolipoprotein B100 and an additional protein, apolipoprotein(a), attached to apoB via a disulfide bond [1, 2]
Our results suggest that substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets may be preferable over protein or carbohydrates with regards to Lp(a)
Epidemiologic studies have shown that elevated Lp(a) concentration is an independent risk factor for CVD attributed to its similarity to LDL and its structural homology of apolipoprotein(a) with plasminogen resulting in impaired thrombolysis [3, 4, 5, 6, 7]
Summary
Lipoprotein(a) [Lp(a)] is a plasma lipoprotein consisting of a cholesterol-rich LDL-like particle having one molecule of apolipoprotein B100 and an additional protein, apolipoprotein(a), attached to apoB via a disulfide bond [1, 2]. Levels of Lp(a) are similar in men and women but vary among races with non-Hispanic whites having the lowest and blacks the highest [14]. Pharmacological therapies such as niacin and oral estrogens can lower Lp(a) level [9, 15], but investigations examining the effect of various dietary compositions on Lp(a) are sparse [16, 17]. Conclusion: Diets high in unsaturated fat increased Lp(a) levels less than diets rich in carbohydrate or protein with greater changes in blacks than whites. Our results suggest that substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets may be preferable over protein or carbohydrates with regards to Lp(a)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
