MULTICENTER STUDIES OF DIET AND LIPOPROTEINS

有强有力的证据表明，饮食成分，特别是饮食脂肪， 会对冠心病的危险因素产生重大影响 疾病(CHD)。人们普遍认为，从食物中摄取饱和的 脂肪应该会减少。碳水化合物、单不饱和脂肪和多不饱和脂肪 每种脂肪都被推荐用来替代饮食中的饱和脂肪。 还提出了增加n3-脂肪酸摄入量的建议。 我们假设特定阶层饮食水平的变化 脂肪酸(饱和、单不饱和、多不饱和和n-3脂肪酸 酸)会对已知或可疑的冠心病风险产生不同的影响 因素；对于大多数受试者，具体的建议 关于特定的饮食脂肪酸类别可以制定，这将 将他们明显的冠心病风险降至最低，这些建议将是 对于给定的人群和/或共病情况是唯一的。 为了检验这一假设，我们建议检验一系列 关于脂肪酸摄入量的饮食建议(减少SFA和 总脂肪；用MUFA或PUFA取代SFA；补充 含n3-脂肪酸的饮食)对一系列已知或可疑风险的影响 男性和女性多种族人群中的冠心病危险因素。 我们建议检查的危险因素包括：1)血脂， 脂蛋白和载脂蛋白水平；2)脂蛋白组成；3)低密度脂蛋白 和高密度脂蛋白亚群分布；4)低密度脂蛋白对氧化的易感性 修饰；5)二十烷类代谢指标；6)胰岛素 抵抗。 最后，我们建议进一步研究上述两种饮食 在另外两项研究中研究它们在降低冠心病风险方面的有效性 可能对饮食有不同反应的受试者群体 修改，老年男性和女性和肥胖的男性和女性。

There is strong evidence that dietary components, especially dietary fat, can exert a significant influence on risk factors for coronary heart disease (CHD). It is generally agreed that dietary intakes of saturated fat should decrease. Carbohydrate, monounsaturated fat and polyunsaturated fat have each been recommended to replace dietary saturated fat. Additional recommendations have been made to increase n3-fatty acid intake. We hypothesize that alterations in the dietary levels of specific classes of fatty acids (saturated, monounsaturated, polyunsaturated, and n-3 fatty acids) will have differential effects on known or suspected CHD risk factors; that for a population of subjects, specific recommendations regarding specific dietary fatty acid classes can be formulated which will minimize their apparent CHD risk, and that these recommendations will be unique for a given population and/or co-morbid condition. To test this hypothesis, we propose to examine the effects of series of dietary recommendations regarding fatty acid intake (reduction in SFA and total fat; replacement of SFA with either MUFA or PUFA; supplementation of diets with n3-fatty acids) on a constellation of known or suspected risk factors for CHD in a multiracial population of men and women. The risk factors which we propose to examine include: 1) plasma lipid, lipoprotein, and apolipoprotein levels; 2) lipoprotein composition; 3) LDL and HDL subpopulation distribution; 4) susceptibility of LDL to oxidative modification; 5) indices of eicosanoid metabolism; and 6) insulin resistance. Finally, we propose to further examine two diets identified in the above studies for their effectiveness in reducing CHD risk in two additional populations of subjects which may differentially respond to the dietary modifications, older men and women and obese men and women.