Fat

Dietary

fats:

Polyunsaturated fatty acids

Monounsaturated fatty acids
Saturated fatty acids

Cholesterol

It is recommended that dietary saturated

fat intake be <7% of energy to reduce
CHD risk

Fat
Dietary

fats and cholesterol play a major

role in CHD development
Saturated fatty acids: contain no double
bonds and generally vary in chain
length from 12 to 18 carbons.
Major sources of saturated fat in diet:
dairy, beef, pork, poultry, and lamb
products

Saturated Fatty Acids

Saturated fatty acids increase LDLcholesterol concentrations by decreasing LDL

receptormediated catabolism
This effect is mediated both by decreased
LDL receptor messenger RNA (mRNA)
expression and decreased membrane fluidity
This latter effect causes less receptor
recycling across the cell membrane.
It is recommended that dietary saturated fat
intake be <7% of energy to reduce CHD risk

Monounsaturated fatty
acids

The major monounsaturated fatty acid in

the diet is oleic acid, which contains one
double bond at the number 9 carbon
Monounsaturated fatty acids, as compared
with dietary carbohydrates, were neutral
with respect to their effects on plasma total
cholesterol concentrations
When substituted for dietary saturated fatty
acids, monounsaturated fatty acids have a
hypocholesterolemic effect

Monounsaturated fatty acids

Monounsaturated

fats do not lower LDL

or HDL cholesterol relative to saturated
fat as much as does polyunsaturated fat
Food sources: olive oil, peanut oil,
margarine, chicken fat

Trans Fatty Acids

Trans

Fatty acids are formed during the

hydrogenation process, a process that
converts vegetable oils to a semisolid
state
Major sources: baked products,
processed foods, and margarines
Increases plasma concentrations of
lipoprotein(a), an independent risk
factor for CHD

Polyunsaturated fatty
acids

Subclassified: n6 and n3
The major n6 fatty acid in the diet is linoleic acid, the precursor for arachidonic
acid (20:4n6)
-Linoleic acid is not synthesized by the body
and is therefore an essential fatty acid.
Food sources: vegetables and vegetable oils
(corn, soybean, safflower, and sunflower),
with the exception of coconut and palm oils

-3 fatty acid

linolenic acid (18:3n3)

hypocholesterolemic effect: reducing both LDLand HDL-cholesterol concentrations, lower
platelet aggregation, lower immune response,
and lower blood pressure
fish oil, especially eicosapentaenoic acid, lower
triacylglycerol concentrations significantly
recommended that the polyunsaturated fat
intake be <10% of energy
An optimal ratio of n6 to n3 fatty acids in the
diet is believed to be 4:1.

Cholesterol
1.3

egg yolks/d containing 272 mg

cholesterol
increases LDL cholesterol
Cholesterol with saturated fat, should be
restricted in the diet to 200 mg/d to
decrease CHD risk

National Cholesterol Education Program coronary heart disease

(CHD) risk factors- NCEP
in addition to diabetes and elevated LDL cholesterol1
Subtract one risk factor for HDL cholesterol 1.6 mmol/L (60
mg/dL). Diabetes has been defined as a CHD risk equivalent.
1

Defined as CHD in a male first-degree relative aged <55 y or a

female first-degree relative aged <65 y.
2

1) Male 45 y
2) Female 55 y
3) Family history of premature CHD2
4) Hypertension
5) Cigarette smoking
6) HDL cholesterol <1.0 mmol/L (40 mg/dL)

National Cholesterol Education Program guidelines on dietary therapy

(Am J Clin Nutr February 2002 vol. 75 no. 2 191-212)
Therapeutic lifestyle
Nutrient
Average US diet2
changes
Saturated fat (% of
energy)

12

<7

Monounsaturated fat
(% of energy)

13

<20

<10

Polyunsaturated fat
(% of energy)
Cholesterol (mg/d)

270

<200

Total energy

To achieve and maintain

a desirable body weight

Carbohydrate (% of
energy)

51

5060

Protein (% of energy)

15

15

Hypertension
Calcium,

potassium, magnesium,
phosphorus, and fiber that would be
included in a diet containing adequate
amounts of dairy products and fruit and
vegetables.
Reduce salt intake (< 5 g/day)
Maintenance body weight