ABSTRACT
Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, London, Ontario, Canada
In the era of powerful lipid-lowering drugs, a common and mistaken assumption is that diet is unimportant, because the drugs are so much more effective in lowering fasting lipids. On average, a low-fat diet only reduces fasting LDL by about 9%, whereas statin drugs reduce it by 50-60%. However, this approach ignores the importance of post-prandial fat. I have commented recently (1) on the conceptual error of focusing only on fasting lipids; they can be thought of as a baseline, on top of which post-prandial fats are superimposed. Since post-prandial fat is what affects the endothelium for about 18 hours of the day, diet is much more important than is appreciated when it is seen only thoursough the lens of fasting lipids. Indeed, a number of studies show that post-prandial fat is probably more important than fasting lipids (2,3).
