title: Low-fat dietary pattern and lipoprotein risk factors: the Women's Health Initiative Dietary Modification Trial.
abstract: BACKGROUND
  The Women's Health Initiative Dietary Modification Trial tested the effects on chronic disease of a dietary pattern lower in fat and higher in vegetables, fruit, and grains.
  
  
  OBJECTIVE
  The objective was to evaluate the effects of dietary carbohydrate changes on lipids and lipoprotein composition.
  
  
  METHODS
  Postmenopausal women were randomly assigned to an intervention or a comparison group for a mean of 8.1 y. Lipoprotein analyses and subclasses were based on subsamples of 2730 and 209 participants, respectively.
  
  
  RESULTS
  At year 6, the total reported fat intake was 7.8% lower and carbohydrate intake was 7.6% higher in the intervention group than in the comparison group. Triglyceride change between groups differed by 2.3, 3.8, and -0.8 mg/dL at 1, 3, and 6 y, respectively, and HDL-cholesterol change differed by -1.6, -0.7, and -1.0 mg/dL at 1, 3, and 6 y, respectively. Changes did not differ by age, ethnicity, or obesity. In diabetic intervention women who were white, the triglyceride difference between the intervention and comparison groups was 33.8 mg/dL, whereas in black women with diabetes (n = 50 in the intervention group; n = 83 in the comparison group), the triglyceride difference was 6.4 mg/dL (P for 3-factor interaction = 0.049). No significant changes were observed in apolipoprotein or lipoprotein particles. Reductions in LDL cholesterol varied by quartile of reported lowering of saturated or trans fat.
  
  
  CONCLUSIONS
  The replacement of 7-8% of fat intake with complex carbohydrates over 6 y was not associated with clinically adverse effects on triglycerides, HDL cholesterol, or lipoprotein subclasses. Diabetic white women with higher triglyceride concentrations may have greater increases in triglycerides.
authors.affiliation: MedStar Research Institute, Hyattsville, MD 20782, USA. barbara.v.howard@medstar.net
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: J David
authors.initials: JD
authors.lastname: Curb
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.forename: Charles
authors.initials: C
authors.lastname: Kooperberg
authors.forename: Judith
authors.initials: J
authors.lastname: Ockene
authors.forename: John B
authors.initials: JB
authors.lastname: Kostis
authors.forename: Mary
authors.initials: M
authors.lastname: Pettinger
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Rajkovic
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Robinson
authors.forename: Jacques
authors.initials: J
authors.lastname: Rossouw
authors.forename: Gloria
authors.initials: G
authors.lastname: Sarto
authors.forename: James M
authors.initials: JM
authors.lastname: Shikany
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
mesh_terms: D001741:Black or African American; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood* / Q000208:ethnology; D018752:Diet, Fat-Restricted; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D005227:Fatty Acids / Q000008:administration & dosage; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008875:Middle Aged; D017698:Postmenopause; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D014481:United States; D044465:White People
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D005227:Fatty Acids; D005231:Fatty Acids, Unsaturated; D008074:Lipoproteins; D014280:Triglycerides