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Department of Molecular and Nuclear Medicine, Life Sciences Division, Ernest Orlando Lawrence Berkeley National Laboratory, University of California, Berkeley, CA 94720
Studies employing analysis of LDL subclasses have demonstrated
heterogeneity of the LDL response to low fat, high carbohydrate diets
in healthy nonobese subjects. In individuals with a genetically
influenced atherogenic lipoprotein phenotype, characterized by a
predominance of small dense LDL (LDL subclass pattern B), lowering of
plasma LDL cholesterol levels by diets with
24% fat has been found
to represent a reduction in numbers of circulating mid-sized and small
LDL particles, and hence an expected lowering of cardiovascular disease
risk. In contrast, in the majority of healthy individuals with larger
LDL (pattern A, found in
70% of men and a larger percentage of
women), a significant proportion of the low fat dietinduced reduction
in plasma LDL cholesterol is made by depletion of the cholesterol
content of LDL particles. This change in LDL composition is accompanied
by a shift from larger to smaller LDL particle diameters. Moreover,
with progressive reduction of dietary fat and isocaloric substitution
of carbohydrate, an increasing number of subjects with pattern A
convert to the pattern B phenotype. Studies in families have indicated
that susceptibility to induction of pattern B by low fat diets is under
genetic influence. Thus, diet-gene interactions affecting LDL
subclass patterns may contribute to substantial interindividual
variability in the effects of low fat diets on coronary heart disease
risk.
KEY WORDS: cholesterol LDL diet fat carbohydrate lipoprotein subclasses
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