FALL IN TOTAL CHOLESTEROL CONCENTRATION OVER 5 YEARS IN ASSOCIATION WITH CHANGES IN FATTY-ACID COMPOSITION OF COOKING OIL IN MAURITIUS - CROSS-SECTIONAL SURVEY

Objective-To determine the extent to which reducing the saturated fatt y acid composition of a ubiquitously used cooking oil influenced chang es in cholesterol concentration in the population during a five year i ntervention programme in Mauritius. Design-Cross sectional surveys in 1987 and 1992 determined mean total cholesterol concentrations in the population. A random sample of respondents in the 1992 survey complete d a nutrition questionnaire that included questions on diet in the pre vious 24 hours. Setting-Mauritius. Intervention-In 1987 the government of Mauritius changed the composition of the commonly used cooking oil from being mostly palm oil (high in saturated fatty acids) to being w holly soya bean oil (high in unsaturated fatty acids). Subjects-5080 a nd 5162 subjects in 1987 and 1992 cross sectional surveys, 2059 subjec ts aged 30-64 years were randomly selected from the respondents of the 1992 survey to take part in the nutrition survey Main outcome measure s-Fatty acid composition of phospholipids in pooled serum samples from men and women from the two surveys; measured and predicted change in serum cholesterol concentration. Results-From 1987 to 1992 total chole sterol concentrations fell significantly by 0.79 mmol/l (P<0.001) in m en and 0.82 mmol/l (P<0.001) in women. The estimated intake of saturat ed fatty acids decreased by 3.5% of energy intake in men and by 3.6% i n women, and the intake of polyunsaturated fatty acids increased by 5. 5% and 5.6% of energy intake, respectively. These changes were reflect ed in changes in the fatty acid composition of serum phospholipids, an d according to Keys' formula these changes explained much of the decre ase in serum cholesterol concentrations (predicted decrease of 0.38 mm ol/l in men and by 0.40 mmol/l in women). Conclusion-Dietary changes t hat entailed a reduction in the saturated fat content of a ubiquitous cooking oil explained most of the observed decrease in serum cholester ol concentration over five years in the population of Mauritius.