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Treatment of hypertriglyceridemia by two diets rich either in unsaturated fatty acids or in carbohydrates: effects on lipoprotein subclasses, lipolytic enzymes, lipid transfer proteins, insulin and leptin

International Journal of Obesity volume 24, pages 1286–1296 (2000)Cite this article

Abstract

BACKGROUND: There is lack of agreement on which dietary regimen is most suitable for treatment of hypertriglyceridemia, especially if high triglyceride concentrations are not due to obesity or alcohol abuse. We compared the effects on blood lipids of a diet high in total and unsaturated fat with a low-fat diet in patients with triglyceride concentrations of >2.3 mmol/l.

METHODS: Nineteen non-obese male outpatients with triglycerides ranging from 2.30 to 9.94 mmol/l received two consecutive diets for 3 weeks each: first a modified high-fat diet (39% total fat, 8% SFA, 15% monounsaturated fatty acids, 1.6% marine n-3 polyunsaturated fatty acids), and then a low-fat diet (total fat 28%, carbohydrates 54%).

RESULTS: The high-fat diet significantly decreased triglycerides (−63%), total cholesterol (−22%), VLDL cholesterol (−54%), LDL cholesterol (−16%), total apoC-III (−27%), apoC-III in apoB containing lipoproteins (apoC-III LpB; −31%) and in HDL (apoC-III nonLpB; −29%), apoE in serum (−33%) and apoB-containing lipoproteins (nonHDL-E; −42%), LpA-I (−16%), insulin (−36%), and leptin (−26%) and significantly increased the means of HDL cholesterol (+8%), LDL size (+6%), lipoprotein lipase (LPL, +11%), hepatic lipase (+13%), and lecithin: cholesterol acyltransferase (LCAT, +2%). The subsequent low-fat diet increased triglycerides (+63%), VLDL cholesterol (+19%), apoC-III (+23%), apoC-III LpB (+44%) apoC-III nonLpB (+17%), apoE (+29%) and nonHDL-E (+43%), and decreased HDL cholesterol (−12%), LPL (−3%), and LCAT (−3%). Changes in triglycerides correlated with changes in LPL activity and insulin levels.

CONCLUSIONS: In hypertriglyceridemic patients, a modified diet rich in mono- and n-3 polyunsaturated fatty acids is more effective than a carbohydrate-rich low-fat diet in correcting the atherogenic lipoprotein phenotype.

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Acknowledgements

We gratefully acknowledge Rita Hagel for her excellent technical assistance; Drs Anja Sägers and Gudula Bannenberg for help in the recruitment and the medical care of the patients; the technical staff of the Institute of Arteriosclerosis Research and the Institute of Clinical Chemistry and Laboratory Medicine, University of Münster, for carrying out the laboratory analysis, especially Gaby Klapdor and Bertram TambyRajah for the measurement of lipids and hormones; Michael Stennecken for his help with the statistical analysis; Professor Robenek for the electronmicroscopy of LDL standards; and Dr Erhard Schulte, Institute for Food Chemistry, University of Münster, for analysis of the nutrient composition of the canned fish. We also thank Dr Paul Cullen for critical reading of the manuscript and for his valuable comments Furthermore, we thank Walter RAU Lebensmittelwerke GmbH & Co KG, Hilter, for providing the margarine, and NORDA, Union Deutsche Lebensmittelwerke GmbH, Cuxhaven, for providing the fish. This study was in part supported by a grant from Interdisziplinäres Zentrum fur Klinische Forschung to Dr Arnold von Eckardstein (project A3).

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  1. Institute of Arteriosclerosis Research at the University of Münster, Domagkstrasse 3, Münster, D-48149, Germany

    B Pieke, A von Eckardstein, E Gülbahçe, A Chirazi, H Schulte, G Assmann & U Wahrburg

  2. Institute of Clinical Chemistry and Laboratory Medicine, University of Münster, Albert-Schweitzer-Strasse 33, Münster, D-48129, Germany

    A von Eckardstein, E Gülbahçe, A Chirazi & G Assmann

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  1. B Pieke
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Correspondence to A von Eckardstein.

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Pieke, B., von Eckardstein, A., Gülbahçe, E. et al. Treatment of hypertriglyceridemia by two diets rich either in unsaturated fatty acids or in carbohydrates: effects on lipoprotein subclasses, lipolytic enzymes, lipid transfer proteins, insulin and leptin. Int J Obes 24, 1286–1296 (2000). https://doi.org/10.1038/sj.ijo.0801440

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