ABSTRACT
I. Introduction ....................................................................................................................... 552 II. Dietary Fats ....................................................................................................................... 552 III. Lipoproteins ...................................................................................................................... 552 IV. Metabolism of Dietary Fatty Acids and Lipoproteins ...................................................... 553
A. Exogenous Pathway................................................................................................... 553 B. Endogenous Pathway................................................................................................. 554
V. Plasma Lipoproteins and Coronary Heart Disease ........................................................... 555 VI. Dietary Fats and Plasma Lipoproteins .............................................................................. 555
A. Earlier Studies............................................................................................................ 555 B. Recent Studies............................................................................................................ 556
1. Saturated Fatty Acids.......................................................................................... 556 2. Monounsaturated Fatty Acids ............................................................................. 558 3. Polyunsaturated Fatty Acids ............................................................................... 559 4. Trans Fatty Acids ............................................................................................... 559
C. Conclusion ................................................................................................................. 560 VII. Oxidizability of Low-Density Lipoproteins...................................................................... 560
A. Low-Density Lipoprotein Oxidation ......................................................................... 560 1. Measurement of Low-Density Lipoprotein Oxidation ....................................... 562 2. Low-Density Lipoprotein Oxidation and Coronary Heart Disease .................... 564 3. Dietary Effects .................................................................................................... 565
B. Conclusion ................................................................................................................. 566 VIII. Hemostasis......................................................................................................................... 567
A. Platelet Aggregation .................................................................................................. 567 1. Measurement of Platelet Aggregation ................................................................ 568 2. Platelet Aggregation and Coronary Heart Disease ............................................. 568 3. Dietary Fats and Platelet Aggregation ................................................................ 568
B. Coagulation................................................................................................................ 569 1. Measurement of Coagulation.............................................................................. 570 2. Coagulation and Coronary Heart Disease........................................................... 570 3. Dietary Fats and Coagulation ............................................................................. 570
C. Fibrinolysis................................................................................................................. 572 1. Measurement of Fibrinolytic Capacity of Plasma .............................................. 572 2. Fibrinolysis and Coronary Heart Disease ........................................................... 572 3. Dietary Fats and Fibrinolysis.............................................................................. 573
D. Conclusion ................................................................................................................. 574 References ..................................................................................................................................... 574
Many factors are associated with increased risk for coronary heart disease (CHD), a major cause of morbidity and mortality in prosperous Western countries. Some of these factors, such as increasing age or a family history of premature CHD, are not amenable to preventive intervention, but other factors are. Three of these preventable factors-the distribution of plasma cholesterol over the lowdensity and high-density lipoproteins (LDLs and HDLs), the oxidizability of LDLs, and hemostasis-can be modified by changing the sources and amount of fats and oils in the diet. The purpose of this chapter is to review some of the most recent and important findings on the effects of dietary fatty acids on these three risk factors.
