Low-fat dietary pattern and lipoprotein risk factors: The Women's Health Initiative Dietary Modification Trial

Barbara V. Howard, J. David Curb, Charles B. Eaton, Charles Kooperberg, Judith Ockene, John B. Kostis, Mary Pettinger, Aleksandar Rajkovic, Jennifer G. Robinson, Jacques Rossouw, Gloria Sarto, James M. Shikany, Linda Van Horn

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

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. Design: 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.

Original languageEnglish (US)
Pages (from-to)860-874
Number of pages15
JournalAmerican Journal of Clinical Nutrition
Volume91
Issue number4
DOIs
StatePublished - Apr 1 2010

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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