title: Healthy dietary interventions and lipoprotein (a) plasma levels: results from the Omni Heart Trial.
abstract: BACKGROUND
  Increased lipoprotein(a) [Lp(a)] levels are associated with atherosclerotic cardiovascular disease. Studies of dietary interventions on changes in Lp(a) are sparse. We aimed to compare the effects of three healthy dietary interventions differing in macronutrient content on Lp(a) concentration.
  
  
  METHODS
  Secondary analysis of a randomized, 3-period crossover feeding study including 155 (89 blacks; 66 whites) individuals. Participants were given DASH-type healthy diets rich in carbohydrates [Carb], in protein [Prot] or in unsaturated fat [Unsat Fat] for 6 weeks each. Plasma Lp(a) concentration was assessed at baseline and after each diet.
  
  
  RESULTS
  Compared to baseline, all interventional diets increased mean Lp(a) by 2 to 5 mg/dl. Unsat Fat increased Lp(a) less than Prot with a difference of 1.0 mg/dl (95% CI, -0.5, 2.5; p = 0.196) in whites and 3.7 mg/dl (95% CI, 2.4, 5.0; p < 0.001) in blacks (p-value between races = 0.008); Unsat Fat increased Lp(a) less than Carb with a difference of -0.6 mg/dl, 95% CI, -2.1, 0.9; p = 0.441) in whites and -1.5 mg/dl (95% CI, -0.2, -2.8; p = 0.021) in blacks (p-value between races = 0.354). Prot increased Lp(a) more than Carb with a difference of 0.4 mg/dl (95% CI, -1.1, 1.9; p = 0.597) in whites and 2.2 mg/dl (95%CI, 0.9, 3.5; p = 0.001) in blacks (p-value between races = 0.082).
  
  
  CONCLUSIONS
  Diets high in unsaturated fat increased Lp(a) levels less than diets rich in carbohydrate or protein with greater changes in blacks than whites. Our results suggest that substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets may be preferable over protein or carbohydrates with regards to Lp(a).
  
  
  BACKGROUND
  Clinicaltrials.gov NCT00051350.
authors.affiliation: Department of Internal Medicine I, Comprehensive Heart Failure Ctr, University of Würzburg, Bavaria, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Haring
authors.affiliation: Department of Cardiothoracic Surgery, Froedtert Memorial Hospital & Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
authors.forename: Moritz C Wyler
authors.initials: MC
authors.lastname: von Ballmoos
authors.affiliation: Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Sacks
mesh_terms: D000328:Adult; D000368:Aged; D004032:Diet; D004040:Dietary Carbohydrates / Q000378:metabolism; D004042:Dietary Fats, Unsaturated / Q000378:metabolism; D004044:Dietary Proteins / Q000378:metabolism; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000178:diet therapy* / Q000378:metabolism / Q000517:prevention & control*; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged
chemical_list: D004040:Dietary Carbohydrates; D004042:Dietary Fats, Unsaturated; D004044:Dietary Proteins; D017270:Lipoprotein(a)