CHANGES IN PLASMA TRIACYLGLYCEROL CONCENTRATIONS AMONG FREE-LIVING HYPERLIPIDEMIC MEN ADOPTING DIFFERENT CARBOHYDRATE INTAKES OVER 2 Y - THE DIETARY ALTERNATIVES STUDY

We reported previously that low-fat, high-carbohydrate diets containin g < 26% of energy as fat and > 57% of energy as carbohydrate induce hy pertriglyceridemia (hypertriglyceridemia) in hypercholesterolemic but not in combined hyperlipidemic (CHL) subjects. Because subjects may no t consistently adhere to an assigned diet long term, we examined the e xtent to which plasma triacylglycerols (triglycerides) increase at fou r consistently reported carbohydrate intakes at intervals of up to 2 y . Three hundred seventy-two subjects reported consistent carbohydrate intakes of < 45%, 45-51.9%, 52-59.9%, or greater than or equal to 60% of energy on food records for 3, 12, and 24 mo. Among hypercholesterol emic subjects reporting a carbohydrate intake greater than or equal to 60% of energy, triacylglycerols increased by 0.25, 0.18, and 0.27 mmo l/L, (22, 16, and 24 mg/dL) over baseline at 3, 12, and 24 mo, respect ively (P < 0.01 in each instance), and 0.32 mmol/L (28 mg/dL) above th e group with a carbohydrate intake 52-59.9% of energy (P < 0.05) after 3 mo. No statistically significant effects were observed among CHL su bjects, but compared with baseline, triacylglycerols decreased during the first 3 mo (-0.29 to -0.04 mmol/L, or -26 to -4 mg/dL), were uncha nged over 12 mo, and were increased after 24 mo in three of four carbo hydrate intake strata (0.27-0.36 mmol/L, or 24-32 mg/dL). These data c onfirm our previous observation that a moderately but not extremely lo w-fat, high-carbohydrate diet can be used long-term without deleteriou s effects on plasma triacylglycerols in the management of hypercholest erolemia, whereas CHL is unaffected by the amount of carbohydrate inge sted.