ABSTRACT
Recommendations for lipid-lowering diets have traditionally focused on fat quantity and composition as a means of lowering total cholesterol and low-density lipoprotein cholesterol, which are independent risk factors for coronary heart disease (CHD). The reduction of saturated fat to lower the risk of CHD raises the question concerning which type of fat substitution is desirable in achieving clinically relevant results for lipid lowering. Dietary manipulations require a control over the fat composition in the diet, by striking a balance between the various fatty acid classes. One of the consequences of decreasing dietary fat saturation is a concomitant decrease in high-density lipoprotein cholesterol concentrations. The role played by cholesteryl ester transfer protein in atherosclerosis is controversial because there are both pro- and antiatherogenic associations during reverse cholesterol transport. Dietary cholesterol has been considered to be second to saturated fatty acids in its ability to raise blood concentrations of cholesterol.
