PLASMA-LIPID AND LIPOPROTEIN RESPONSES TO DIETARY-FAT AND CHOLESTEROL- A METAANALYSIS

Quantitative relations between dietary fat and cholesterol and plasma lipid concentrations have been the subject of much study and some cont roversy during the past 40 y. Previous meta-analyses have focused on t he most tightly controlled, highest-quality experiments. To test wheth er the findings of these investigations are generalizable to broader e xperimental settings and to the design of practical dietary education interventions, data from 224 published studies on 8143 subjects in 366 independent groups including 878 diet-blood lipid comparisons were su bjected to weighted multiple-regression analysis. Inclusion criteria s pecified intervention studies published in English between 1966 and 19 94 reporting quantitative data on changes in dietary cholesterol and f at and corresponding changes in serum cholesterol, triacylglycerol, an d lipoprotein cholesterol concentrations. Regression models are report ed for serum total cholesterol, triacylglycerol, and low-density- high -density-, and very-low-density-lipoprotein cholesterol, with multiple correlations of 0.74, 0.65, 0.41, 0.14, and 0.34, respectively. Inter actions of dietary factors, initial dietary intakes and serum concentr ations, and study and subject characteristics had little effect on the se models. Predictions indicated that compliance with current dietary recommendations (30% of energy from fat, < 10% from saturated fat, and < 300 mg cholesterol/d) will reduce plasma total and low-density-lipo protein-cholesterol concentrations by approximate to 5% compared with amounts associated with the average American diet.