Abstract
Postprandial lipemia is the transient increase in blood lipids which occurs after a meal containing fat and is caused by raised levels of triglyceride-rich lipoproteins (TRLs) in the blood. Delayed clearance of TRLs leads to postprandial hyperlipidemia, and there is now a great deal of evidence to support the idea that this condition is an important risk factor for cardiovascular disease (CVD). Western lifestyle habits including: diets low in fresh fruit and vegetables and high in fat and processed food, alcohol consumption, smoking, and lack of exercise tend to promote postprandial hyperlipidemia, and it is a characteristic feature of increasingly common metabolic diseases such as obesity, insulin resistance and type 2 diabetes which are also linked to modern lifestyle behaviour and which carry an increased risk of CVD development. Modification of lifestyle factors such as changing to a healthier diet, weight loss, reducing alcohol consumption and increasing exercise can cause significant reductions in postprandial hyperlipidemia and thus help to reduce this risk. Despite the growing recognition that the extent of postprandial lipemia is a good predictor of CVD, no standardized methodology for its measurement is currently available. Determination of blood TG levels after consumption of a standard test meal is likely to be the most convenient approach for a routine clinical test, and we propose a standard test meal which is easily adaptable for the variations in dietary habits in different countries. Greater use of postprandial lipid determination will aid in the translation of our extensive knowledge on the role of nutrition in health into national and international policy.
Highlights
Cardiovascular disease (CVD) is the main cause of death in Western countries, accounting for over 42% of the total each year in the European Union (EU) [1] and for 34.2% in the United States [2]
Changes in triglyceride-rich lipoproteins (TRLs) particle size and number and lipid and apolipoprotein composition depending on the type of fat in the meal have been demonstrated, with SFA causing the most pronounced lipemia by these criteria, followed by monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) [4]
Work by Proctor and colleagues has indicated that chylomicron remnants (CMR) are co-localized with the proteoglycan, biglycan, in the sub- endothelium of the artery wall in vivo, and they found no difference in the binding affinity of human biglycan for CM/CMR as compared to low density lipoprotein (LDL) in experiments in vitro, the results suggest that the mass of cholesterol bound in CMR is greater than that in LDL [96]
Summary
Cardiovascular disease (CVD) is the main cause of death in Western countries, accounting for over 42% of the total each year in the European Union (EU) [1] and for 34.2% in the United States (data for 2006) [2]. Postprandial lipemia is recognised as a risk factor for atherosclerosis, a major cause of CVD (see below), and strong evidence indicates that it is influenced by the amount and type of fat consumed, and by other lifestyle factors such dietary intake of protein, fibre and micronutrients as well as by exercise, alcohol consumption and smoking [4,5] .
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