"Healthy" Diet May Increase Risk for CVD

A diet low in total and saturated fat and high in fruits and vegetables caused an increase in LDL and Lp(a).

There is a plethora of evidence suggesting that low-fat diets, particularly those rich in fruits and vegetables are "healthy." However, in a small study of women, a diet low in total and saturated fat and high in fruits and vegetables caused an increase in the plasma levels of oxidized low-density lipoprotein (OxLDL) and lipoprotein(a).

This finding was unexpected, Dr. Marja-Leena Silaste from the University of Oulu in Finland and colleagues write in the March issue of Arteriosclerosis Thrombosis and Vascular Biology: Journal of the American Heart Association.

To explore how alterations in dietary intakes of fat, vegetables, and fruit affect plasma antioxidant and OxLDL levels, researchers fed 37 healthy women two diets in a crossover design. Both diets were low in total and saturated fat. One was low in vegetables and the other high in vegetables and fruits.

They determined the amount of oxidized LDL in plasma (normalized to apolipoprotein B) using a monoclonal antibody (EO6) that specifically recognizes oxidized phospholipids.

They discovered that the median plasma concentrations of OxLDL-EO6 increased by 27% in response to the low-fat, low-vegetable diet and 19% in response to the low-fat, high-vegetable diet. Lp(a) concentrations rose by 7% and 9%, respectively.

Both diets also produced small but significant decreases in HDL cholesterol and triglyceride levels as well as increases in some plasma antioxidants (alpha-carotene, beta-cryptoxanthin, and vitamin C).

Dr. Silaste and colleagues think the "most likely reason" for the increase in OxLDL-EO6 in response to the diets is the increase in Lp(a). Increased Lp(a) induced by the "healthy" diets may lead to increased transport of oxidized phospholipids and Lp(a) out of the artery wall and other tissues, which would account for the increase in plasma levels, they theorize.

This is certainly possible, Dr. Mohamad Navab and colleagues from the University of California, Los Angeles, write in an editorial, but there are other possibilities as well. "Whatever the explanation, the findings by Silaste et al are sure to provide the basis for further exciting and potentially important studies," Dr. Navab and colleagues write. Arterioscler Thromb Vasc Biol 2004;24:392-393,498-503.

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DID YOU KNOW: Vinegar Improves Insulin Sensitivity in Type 2 Diabetes: Recent large-scale trials (The Diabetes Prevention Program and STOP_NIDDM) have demonstrated that vinegar slightly enhanced post-meal insulin sensitivity in people with Type 2 diabetes and varying degrees of insulin sensitivity. Diabetes Care 2004;27: 281-282

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