Participant characteristics at randomization (at the end of the baseline diet)^a.

<p>Participant characteristics at randomization (at the end of the baseline diet)<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0170664#t002fn001" target="_blank">^a</a>.</p

CONSORT flow diagram.

<p>CONSORT flow diagram.</p

Percent changes from baseline in plasma lipoprotein subfractions and lipoprotein remodeling enzyme activities in men and women with atherogenic dyslipidemia after 3 wk of consuming either a low or high saturated fat diet^a.

<p>Percent changes from baseline in plasma lipoprotein subfractions and lipoprotein remodeling enzyme activities in men and women with atherogenic dyslipidemia after 3 wk of consuming either a low or high saturated fat diet<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0170664#t004fn001" target="_blank">^a</a>.</p

Effects of a very high saturated fat diet on LDL particles in adults with atherogenic dyslipidemia: A randomized controlled trial

<div><p>Background</p><p>Previous studies have shown that increases in LDL-cholesterol resulting from substitution of dietary saturated fat for carbohydrate or unsaturated fat are due primarily to increases in large cholesterol-enriched LDL, with minimal changes in small, dense LDL particles and apolipoprotein B. However, individuals can differ by their LDL particle distribution, and it is possible that this may influence LDL subclass response.</p><p>Objective</p><p>The objective of this study was to test whether the reported effects of saturated fat apply to individuals with atherogenic dyslipidemia as characterized by a preponderance of small LDL particles (LDL phenotype B).</p><p>Methods</p><p>Fifty-three phenotype B men and postmenopausal women consumed a baseline diet (55%E carbohydrate, 15%E protein, 30%E fat, 8%E saturated fat) for 3 weeks, after which they were randomized to either a moderate carbohydrate, very high saturated fat diet (HSF; 39%E carbohydrate, 25%E protein, 36%E fat, 18%E saturated fat) or low saturated fat diet (LSF; 37%E carbohydrate, 25%E protein, 37%E fat, 9%E saturated fat) for 3 weeks.</p><p>Results</p><p>Compared to the LSF diet, consumption of the HSF diet resulted in significantly greater increases from baseline (% change; 95% CI) in plasma concentrations of apolipoprotein B (HSF vs. LSF: 9.5; 3.6 to 15.7 vs. -6.8; -11.7 to -1.76; p = 0.0003) and medium (8.8; -1.3 to 20.0 vs. -7.3; -15.7 to 2.0; p = 0.03), small (6.1; -10.3 to 25.6 vs. -20.8; -32.8 to -6.7; p = 0.02), and total LDL (3.6; -3.2 to 11.0 vs. -7.9; -13.9 to -1.5; p = 0.03) particles, with no differences in change of large and very small LDL concentrations. As expected, total-cholesterol (11.0; 6.5 to 15.7 vs. -5.7; -9.4 to -1.8; p<0.0001) and LDL-cholesterol (16.7; 7.9 to 26.2 vs. -8.7; -15.4 to -1.4; p = 0.0001) also increased with increased saturated fat intake.</p><p>Conclusions</p><p>Because medium and small LDL particles are more highly associated with cardiovascular disease than are larger LDL, the present results suggest that very high saturated fat intake may increase cardiovascular disease risk in phenotype B individuals. This trial was registered at clinicaltrials.gov (NCT00895141).</p><p>Trial registration</p><p>Clinicaltrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT00895141" target="_blank">NCT00895141</a>.</p></div

Composition of baseline and experimental diets^a.

<p>Composition of baseline and experimental diets<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0170664#t001fn001" target="_blank">^a</a>.</p

Percent changes from baseline in plasma lipid and lipoprotein concentrations in men and women with atherogenic dyslipidemia after 3 wk of consuming either a low or high saturated fat diet^a.

<p>Percent changes from baseline in plasma lipid and lipoprotein concentrations in men and women with atherogenic dyslipidemia after 3 wk of consuming either a low or high saturated fat diet<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0170664#t003fn001" target="_blank">^a</a>.</p

Effect of haplotype on triglycerides, LDL-cholesterol and HDL-cholesterol in 411 normal to overweight males (Cohort #1) on eucaloric diets.

<p>Abbreviations: LF, low fat diet; HF, high fat diet.</p><p>P-values are presented after adjusting for age and baseline BMI; statistical significance level established at α = 0.01.</p

Effect of haplotype on triglycerides, LDL-cholesterol and HDL-cholesterol in 108 obese females (cohort #3) on calorie restricted diet.^a

<p>Abbreviations: LF, low fat diet; HF, high fat diet; TG, triglycerides; HDL-C, high density lipoprotein cholesterol.</p>a<p>Number of Non Carriers/number of Carriers.</p>b<p>Statistical significance set at α = 0.01.</p>c<p>Subjects were prescribed high fat diet within the context of caloric restriction for weight loss, however, the effects observed between haplotype and HDL-C was independent of weight loss.</p

Effect of H3 haplotype on serum HDL-cholesterol levels in women.

<p>Values shown are mean+standard error. In normal to overweight females, changing from low fat (LF) to high fat (HF) diet increased HDL-C from 49.0±8.0 mg/dl to 62.8±11.2 mg/dl in H3 haplotype carriers and from 49.8±10.9 mg/dl to 57.7±10.9 mg/dl in H3 non-carriers. In obese females, calorically restricted (−15% kcal) HF diet increased HDL-C from 50.11±11.60 mg/dl to 52.29±10.38 mg/dl in H3 haplotype carriers and decreased HDL-C from 47.99±12.90 mg/dl to 45.49±8.95 mg/dl in H3 non-carriers.</p

Baseline characteristics of study subjects (n = 590).

<p>Abbreviations: SD, standard deviation; BMI, body mass index; HDL-C, high density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.</p>*<p>Calculated as weight in kilograms divided by height in meters squared.</p