title: A moderate-fat diet for combined hyperlipidemia and metabolic syndrome.
abstract: A low-fat diet is recommended for hyperlipidemia. However, low-density lipoprotein (LDL) responses depend on the type of hyperlipidemia (ie, simple hypercholesterolemia or combined hyperlipidemia). In combined hyperlipidemia, which is typical of patients with metabolic syndrome, LDL levels are only one third as responsive to fat and cholesterol as simple hypercholesterolemia. The diminished dietary sensitivity of combined hyperlipidemia is explained by diminished intestinal absorption of cholesterol, a feature of metabolic syndrome. In turn, combined hyperlipidemia is caused by heightened lipid secretion by the liver. A moderate-fat, moderate-carbohydrate diet employing allowable fats has the promise of reducing endogenous lipoprotein production in combined hyperlipidemia. Triglyceride, LDL, and small-dense LDL should be lower, and high-density lipoprotein, apoprotein A-I, and buoyant LDL should be higher. A test of this dietary strategy on lipoproteins and downstream benefits on inflammatory mediators, oxidative stress, and vascular reactivity is now underway.
authors.affiliation: Northwest Lipid Research Clinic, Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, 325 9th Avenue, Box 359720, Seattle, WA 98104, USA. rhknopp@u.washington.edu
authors.forename: Robert H
authors.initials: RH
authors.lastname: Knopp
authors.forename: Brian
authors.initials: B
authors.lastname: Fish
authors.forename: Alice
authors.initials: A
authors.lastname: Dowdy
authors.forename: Barbara
authors.initials: B
authors.lastname: Retzlaff
authors.forename: Carolyn
authors.initials: C
authors.lastname: Walden
authors.forename: Irina
authors.initials: I
authors.lastname: Rusanu
authors.forename: Pathmaja
authors.initials: P
authors.lastname: Paramsothy
mesh_terms: D018752:Diet, Fat-Restricted / Q000379:methods*; D004041:Dietary Fats / Q000494:pharmacology*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D004041:Dietary Fats; D008055:Lipids