Does variation in serum LDL-cholesterol response to dietary fatty acids help explain the controversy over fat quality and cardiovascular disease risk?
Does variation in serum LDL-cholesterol response to dietary fatty acids help explain the controversy over fat quality and cardiovascular disease risk?
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DOI：
10.1016/j.atherosclerosis.2021.03.024
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发表时间：
2021-06-29
期刊：
影响因子：
5.3
通讯作者：
Lovegrove, Julie A.
中科院分区：
文献类型：
--
作者：
Griffin, Bruce A.;Mensink, Ronald P.;Lovegrove, Julie A.
关于脂肪质量和心血管疾病风险的争议源于一系列前瞻性队列和随机干预试验的荟萃分析，这些试验几乎没有发现饱和脂肪摄入量与疾病终点之间存在显着关系的证据。这些无效结果的可能解释包括估计真实食物摄入量的固有困难、大量营养素替代和食物组成的混杂效应以及血清LDL-胆固醇反应的显著个体间差异。本叙述性综述的目的是提供证据，证明血清LDL-胆固醇对膳食饱和脂肪替代的反应存在变异和变异的起源，以及其解释后者争议的潜力。该综述提供的证据表明，LDL反应性的变化可能具有混淆饱和脂肪和动脉粥样硬化性心血管疾病风险之间关系的巨大潜力，从而破坏了用不饱和脂肪替代饱和脂肪的膳食指南的有效性。它的结论是，这种现象的一个简单的生物标志物的识别和应用，将有可能量身定制的饮食指南，以低密度脂蛋白反应的个人，谁站在获得更大的好处，他们的心血管健康。
Controversy over fat quality and cardiovascular disease risk stems from a series of meta-analyses of prospective cohort and randomised intervention trials, which found little evidence for a significant relationship between the intake of saturated fat and disease endpoints. Possible explanations for these null findings include difficulties inherent in estimating true food intake, the confounding effects of macronutrient replacement and food composition, and marked inter-individual variation in the response of serum LDL-cholesterol. The aim of this narrative review was to present evidence for the existence and origins of variation in serum LDL-cholesterol response to the replacement of dietary saturated fat, and its potential to explain the controversy over the latter. The review provides evidence to suggest that variation in LDL-responsiveness may harbour significant potential to confound the relationship between saturated fat and atherosclerotic cardiovascular disease risk, thus undermining the effectiveness of the dietary guideline to replace saturated fat with unsaturated fat. It concludes that the identification and application of a simple biomarker of this phenomenon, would make it possible to tailor dietary guidelines to LDL responsive individuals, who stand to gain a greater benefit to their cardiovascular health.