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Human Nutrition and Metabolism

Individual Serum Triglyceride Responses to High-Fat and Low-Fat Diets Differ in Men with Modest and Severe Hypertriglyceridemia

Birgitta Jacobs, Gabriela De Angelis-Schierbaum^*, Sarah Egert, Gerd Assmann and Mario Kratz^1,2

Institute of Arteriosclerosis Research and ^* Institute of Clinical Chemistry and Laboratory Medicine, University of Muenster, Muenster, Germany; and University of Applied Sciences, Muenster, Germany

¹To whom correspondence should be addressed. E-mail: mkratz{at}u.washington.edu.

It is not yet clear whether a low-fat or a high-fat diet is more suitable for the treatment of hypertriglyceridemia. Therefore, we conducted a dietary study with nonobese hypertriglyceridemic men using a randomized crossover design. After a 2-wk acclimation period, the subjects were randomly assigned to 2 groups. One group consumed a low-fat (29% of energy) diet for 3 wk, followed first by a 2-wk washout period, then a 3-wk high-fat (40% of energy) diet period. The second group consumed the low- and high-fat diets in reverse order. Both diets were isocaloric, rich in monounsaturated fatty acids (MUFAs) and long-chain (n-3)-PUFAs, and contained no alcohol. Absolute amounts of long-chain (n-3)-PUFAs and fiber were similar, as were the fatty acid and carbohydrate compositions. Serum triglyceride concentrations in fasting subjects decreased during the high-fat diet period by 34% (95% CI = –19 to –46%, P = 0.001), and during the low-fat diet period by 31% (95% CI = –0.5 to –51.8%, P = 0.048). Triglyceride concentrations did not differ between the low- and high-fat diet periods. However, the high-fat diet lowered triglyceride concentrations more effectively in all subjects with a baseline triglyceride concentration < 4.5 mmol/L, whereas the low-fat diet lowered triglyceride levels more effectively in half of the subjects with a baseline value > 4.5 mmol/L. Based on these findings, we recommend a high-fat triglyceride-lowering diet for patients with only slightly elevated serum triglyceride concentrations (<4.5 mmol/L). However, a lower-fat diet is more suitable for some subjects with more distinctly elevated triglyceride concentrations.

KEY WORDS: • hypertriglyceridemia • lipoproteins • LDL • arteriosclerosis • diet

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