MULTICENTER STUDIES OF DIET & LIPOPROTEINS IN HUMANS

有强有力的证据表明，膳食成分，特别是膳食脂肪， 可对冠心病危险因素产生显著影响 冠心病（CHD）。 人们普遍认为，从饮食中摄入饱和的 脂肪应该减少。 碳水化合物、单不饱和脂肪和多不饱和脂肪 每种脂肪都被推荐来代替膳食饱和脂肪。 增加n3-脂肪酸摄入量的额外建议。 我们假设，特定类别的饮食水平的改变 脂肪酸（饱和的、单不饱和的、多不饱和的和n-3脂肪酸 酸）将对已知或疑似CHD风险产生不同影响 因素;对于受试者人群，具体建议 关于特定的膳食脂肪酸种类，可以制定 最大限度地减少他们明显的冠心病风险，这些建议将 对于给定人群和/或共病状况是唯一的。 为了检验这一假设，我们建议检查一系列的影响， 关于脂肪酸摄入量的饮食建议（减少SFA和 总脂肪;用MUFA或PUFA替代SFA;补充 含n3-脂肪酸的饮食）对已知或疑似风险的影响 多种族男女人群中冠心病的因素。 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）LDL 和HDL亚群分布; 4）LDL对氧化应激的敏感性 修饰; 5）类花生酸代谢指数;和6）胰岛素 阻力 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， 受试者群体可能对饮食反应不同， 修改，老年男性和女性以及肥胖男性和女性。

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.