EFFECTS OF LOWERING FAT AND INCREASING DIETARY FIBER ON FASTING AND POSTPRANDIAL PLASMA-LIPIDS IN HYPERCHOLESTEROLEMIC SUBJECTS CONSUMING AMIXED MEDITERRANEAN-WESTERN DIET

The aim of this study was to evaluate the cholesterol-lowering effects of reducing fat and increasing or not increasing dietary fiber in sub jects consuming a mixed Mediterranean-Western diet. Thirty-one free-li ving, mildly hypercholesterolemic subjects were randomly allocated to two groups. Subjects in both groups first shifted for 4 wk to a low-fa t, low-fiber diet (LFLFD). For an additional 4-wk period, subjects in group 1 continued consuming the LFLFD whereas subjects in group 2 cons umed a low-fat, high-fiber diet (LFHFD). Most dietary fatty acids were monounsaturated (38-41%) and fibers, when provided (up to 35 g/d), ca me from unrefined cereals, legumes, and soluble-fiber-enriched ready-t o-eat cereals. After period 1 of the LFLFD, mean serum and low-density -lipoprotein (LDL)-cholesterol concentrations of subjects in groups 1 (-12.5% and -15.5%, respectively) and 2 (-10.5% and -15.5%, respective ly) decreased significantly from baseline (P < 0.05). After period 2, mean serum and LDL-cholesterol concentrations of subjects consuming th e LFLFD (group 1) were still lower (by 8.8% and 9.2%, respectively, fr om baseline) whereas in subjects consuming the LFHFD (group 2) these v alues decreased further to significantly lower values (14.2% and 17.6% from baseline, respectively). Fasting hi,oh-density-lipoprotein (HDL) cholesterol, apolipoprotein A-I, glycemia, and insulinemia did not ch ange significantly. In seven men, postprandial lipemia transiently inc reased more after a breakfast test meal at the completion of the LFHFD period than after the LFLFD period. In conclusion, an LFHFD more comp arable with the traditional Mediterranean diet may improve the dietary management of moderate hypercholesterolemia.