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Frank M. Sacks, MD; Gail H. Handysides, RN, MS; Gary E. Marais, MD, ChB; Bernard Rosner, PhD; Edward H. Kass, MD, PhD

Arch Intern Med. 1986;146(8):1573-1577.

Abstract
• Lowering the intake of fat to decrease serum cholesterol levels has unknown effects on the proportion of cholesterol in low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Twenty normolipidemic nonvegetarians were given dietary instruction and supervision in a low-fat, semivegetarian diet for three months. Mean consumption of total fat, saturated fat, and cholesterol decreased, whereas intake of carbohydrate increased significantly on a low-fat diet. Plasma LDL levels decreased by 18% and HDL levels by 7% from prestudy baseline levels. The LDL/HDL ratio declined by 11%. Plasma triglyercide levels and body weight were unchanged. In individual subjects, the decrements in consumption of saturated fat and the increments in ingestion of polyunsaturated fat were each significantly correlated with decreases in LDL. One year after the subjects had returned to a self-selected diet, levels of dietary saturated fat and cholesterol and the plasma LDL/HDL ratio remained significantly below prestudy levels. This study and others suggest that a low-fat, high-carbohydrate diet favorably affects the plasma LDL/HDL proportion by decreasing LDL on a percentage basis 2 to three times more than it decreases HDL.

(Arch Intern Med 1986;146:1573-1577)

Author Affiliations
From the Channing Laboratory, Departments of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston (Drs Sacks and Kass); the Departments of Medicine and Cardiac Rehabilitation, New England Memorial Hospital, Stoneham, Mass (Ms Handysides and Dr Marais); and the Department of Preventive Medicine and Clinical Epidemiology, Harvard Medical School (Dr Rosner). Ms Handysides is now with the Department of Nursing, San Diego State University, and Dr Marais is now with the Loma Linda (Calif) School of Medicine.

Footnotes
Accepted for publication Nov 25, 1985.

Reprint requests to Channing Laboratory, 180 Longwood Ave, Boston, MA 02115 (Dr Sacks).

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