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Low-fat dietary pattern and lipoprotein risk factors: the Women's Health Initiative Dietary Modification Trial
Journal article   Open access   Peer reviewed

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, …
The American journal of clinical nutrition, Vol.91(4), pp.860-874
04/2010
DOI: 10.3945/ajcn.2009.28034
PMCID: PMC2844674
PMID: 20164311
url
https://doi.org/10.3945/ajcn.2009.28034View
Published (Version of record) Open Access

Abstract

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. The objective was to evaluate the effects of dietary carbohydrate changes on lipids and lipoprotein composition. 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. 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. 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.
 Diabetes Mellitus - blood Dietary Carbohydrates - administration & dosage United States Humans Middle Aged Risk Factors African Americans European Continental Ancestry Group Feeding Behavior Lipoproteins - blood Diet, Fat-Restricted Dietary Fats - administration & dosage Triglycerides - blood Cholesterol, HDL - blood Diabetes Mellitus - ethnology Fatty Acids - administration & dosage Postmenopause Cholesterol, LDL - blood Female Aged Fatty Acids, Unsaturated - administration & dosage

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