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Nutrition and Disease

Baseline Serum C-Reactive Protein Is Associated with Lipid Responses to Low-Fat and High-Polyunsaturated Fat Diets^1,2

³ Department of Nutrition Sciences, ⁴ General Clinical Research Center, and ⁵ Department of Biostatistics, University of Alabama, Birmingham, AL 35294 and ⁶ New York Obesity Research Center, St. Luke's/Roosevelt Hospital and College of Physicians and Surgeons, Columbia University, New York, NY 10025

Baseline serum C-reactive protein (CRP) concentrations play a role in the lipid response to diet. This study was a randomized, cross-over, controlled feeding study with 3 phases of 25 d each aimed at determining whether baseline CRP concentrations modulate the serum lipid response to diets differing in fat type and quantity. Participants were adult men and women, age 19–65 y, with LDL-cholesterol concentrations of 3.37–4.66 mmol/L. All participants consumed 3 diets differing in the type of snack, either low or high in fat: low-fat (30.8% of energy), moderate in fat and saturated fat (37.9 and 11.4% of energy, respectively), or moderate in fat and polyunsaturated fat (36.3 and 9.7% of energy, respectively). Using baseline CRP as a continuous variable, CRP x diet interactions on change in serum lipoprotein_a (P = 0.045) and HDL-cholesterol (P = 0.06) were observed. When we used previously established categories to define CRP concentrations (low, <1 mg/L; intermediate, 1–3 mg/L; or high, >3 mg/L), we found a CRP x diet interaction on change in triglyceride concentrations (P = 0.03) and trends for CRP x diet interaction on change in LDL (P = 0.06) and total cholesterol (P = 0.07). If replicated, these results suggest that considering baseline CRP concentrations when prescribing dietary interventions to lower lipid concentrations may be useful. Individuals with high baseline CRP concentrations may benefit from moderate-fat, high polyunsaturated fat diets, whereas those with low baseline CRP concentrations may obtain greater lipid-lowering benefits from low-fat diets.

^* To whom correspondence should be addressed. E-mail: ms2554{at}columbia.edu.

Manuscript received 12 August 2008. Initial review completed 10 September 2008. Revision accepted 17 October 2008.