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Background: The lipid-modulatory effects of high intakes of the fish-oil fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are well established and likely to contribute to cardioprotective benefits. Objectives: We aimed to determine the effect of moderate EPA and DHA intakes ( Design: Three hundred twelve adults aged 20-70 y, who were prospectively recruited according to age, sex, and APOE genotype, completed a double-blind placebo-controlled crossover study. Participants consumed control oil, 0.7 g EPA+DHA/d (0.7FO), and 1.8 g EPA+DHA/d (1.8FO) capsules in random order, each for an 8-wk intervention period, separated by 12-wk washout periods. Results: In the group as a whole, 8% and 11% lower plasma triacylglycerol concentrations were evident after 0.7FO and 1.8FO, respectively (P < 0.001): significant sex x treatment (P = 0.038) and sex x genotype x treatment (P = 0.032) interactions were observed, and the greatest triacylglycerol-lowering responses (reductions of 15% and 23% after 0.7FO and 1.8FO, respectively) were evident in APOE4 men. Furthermore, lower VLDL-cholesterol (P = 0.026) and higher LDL-cholesterol (P = 0.010), HDL-cholesterol (P < 0.001), and HDL2 (P < 0.001) concentrations were evident after fish-oil intervention. Conclusions: Supplements providing EPA+DHA at doses as low as 0.7 g/d have a significant effect on the plasma lipid profile. The results of the current trial, which used a prospective recruitment approach to examine the responses in population subgroups, are indicative of a greater triacylglycerol-lowering action of long-chain n-3 polyunsaturated fatty acids in males than in females.

Background: New dietary strategies to reduce cardiovascular disease (CVD) risk include the addition of fiber to the diet. The effect of soluble-fiber consumption derived from Plantago ovata husk on lipid risk factors in patients with CVD is unknown. Objective: We compared the effects of soluble fiber (P. ovata husk) with those of insoluble fiber (P. ovata seeds) on plasma lipid, lipoprotein, and apolipoprotein (apo) concentrations within a CVD secondary prevention program. Design: In a randomized, crossover, controlled, single-blind design, 28 men with CVD (myocardial infarction or stable angina) and an LDL-cholesterol concentration [less than or equal to] 3.35 mmol/L consumed for 8 wk, under controlled conditions, a low-saturated-fat diet supplemented with 10.5 g P. ovata husk/d or 10.5 g P. ovata seeds/d. Fasting plasma lipid concentrations and polymorphisms of genes involved in lipid metabolism, such as apo A-IV, apo E, and fatty acid-binding protein, were measured. Results: Plasma triacylglycerol decreased (6.7%; P < 0.02), the ratio of apo B 100 to apo A-I decreased (4.7%; P < 0.02), and apo A-I increased (4.3%; P < 0.01) in the P. ovata husk consumers. Compared with the intake of insoluble fiber, the intake of P. ovata husk increased HDL-cholesterol concentrations by 6.7% (P = 0.006) and decreased the ratio of total to HDL cholesterol and of LDL to HDL cholesterol by 10.6% (P = 0.002) and 14.2% (P = 0.003), respectively. Conclusion: In the secondary prevention of CVD, P. ovata husk intake induces a more beneficial effect on the cardiovascular lipid risk-factor profile than does an equivalent intake of insoluble fiber. KEY WORDS Dietary fiber, Plantago ovam (Ispaghula husk), psyllium, secondary prevention of cardiovascular disease, blood lipids, low saturated fat, FABP2 gene, apo A-IV gene, apo E gene, polymorphism

Background: Replacing dietary saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) lowers LDL cholesterol, but the underlying mechanisms remain unclear. Objective: We assessed the effects of replacing dietary SFAs with MUFAs on concentrations and subclass distributions of VLDL, intermediate-density lipoprotein, LDL, and HDL and on VLDL apolipoprotein B kinetics. Design: Thirty-five moderately hypercholesterolemic, middle-aged volunteers consumed for 6 wk, in random order, diets containing low (L-MUFA; 7.8% of energy from MUFAs), moderate (M-MUFA; 10.3% from MUFAs), or high (H-MUFA; 13.7% from MUFAs) amounts of MUFAs. Fasting blood samples were taken from all subjects after each intervention. VLDL apolipoprotein B kinetic studies were performed in a subgroup after the L-MUFA and H-MUFA diets. Results: Plasma cholesterol concentrations decreased in a dose-dependent manner with increasing intakes of dietary MUFAs. This change was entirely accounted for by reduced LDL cholesterol (-0.20 and -0.49 mmol/L after the M-MUFA and H-MUFA diets, respectively, compared with the concentration after the L-MUFA diet; P for trend < 0.01). Plasma triacylglycerol and HDL cholesterol were not significantly affected by the dietary intervention, nor were the concentrations of [VLDL.sub.1] ([S.sub.f] 60-400), [VLDL.sub.2] ([S.sub.f] 20-60), or intermediate-density lipoprotein ([S.sub.f] 12-20). Production and catabolic rates for [VLDL.sub.1] and [VLDL.sub.2] were also unaffected. HDL and LDL subclass distributions were not significantly altered, but as a consequence of the overall LDL lowering, concentrations of atherogenic LDL-III were 25% lower after the H-MUFA diet than after the L-MUFA diet (P = 0.02). Conclusion: The effects of replacing dietary SFAs with MUFAs on lipoprotein metabolism appear to be almost exclusively limited to the LDL density class. KEY WORDS Monounsaturated fatty acids, saturated fatty acids, LDL, VLDL, lipoprotein subfractions, cholesterol

Background: Cafestol is a diterpene in unfiltered coffee that raises plasma triacylglycerol in humans. Objective: We studied whether cafestol increases plasma triacylglycerol by increasing the production rate or by decreasing the fractional catabolic rate of [VLDL.sub.1] [Svedberg flotation unit ([S.sub.f]) 60-400] apolipoprotein (apo) B. In addition, we studied the effect of cafestol on the composition of [VLDL.sub.1] and [VLDL.sub.2] ([S.sub.f] 20-60). Design: Eight healthy normolipidemic men were administered a daily dose of 75 mg cafestol for 2 wk. A bolus injection of 7 mg L-[5,5,5-[sup.2][H.sub.3]]leucine/kg body wt was given after a baseline period with no cafestol and again after treatment with cafestol. We derived kinetic constants to describe the metabolism of [VLDL.sub.1] apo B by using a multicompartmental model. Results: Cafestol significantly increased plasma triacylglycerol by 31% or 0.32 mmol/L (95% CI: 0.03, 0.61); the increase was due mainly to a nonsignificant rise in [VLDL.sub.1] triacylglycerol of 57% or 0.23 mmol/L (95% CI: -0.02, 0.48). Cafestol significantly increased the mean rate of [VLDL.sub.1] apo B production by 80% or 755 mg/d (95% CI: 0.2, 5353), whereas it did not significantly change the mean fractional catabolic rate of [VLDL.sub.1] apo B (mean increase of 3 pools/d; 95% CI: -4, 10]). Cafestol did not change the composition of [VLDL.sub.1]. A significant increase in the ratio of [VLDL.sub.2] cholesteryl ester to triacylglycerol indicates that [VLDL.sub.2] became enriched with cholesteryl esters at the cost of triacylglycerol. Conclusion: Cafestol increases plasma triacylglycerol by increasing the production rate of [VLDL.sub.1] apo B, probably via increased assembly of [VLDL.sub.1] in the liver. Am J Clin Nutr 2001;73:45-52. KEY WORDS Healthy men, cafestol, [VLDL.sub.1] apolipoprotein B, catabolism, VLDL composition, unfiltered coffee, cafetiere coffee, French-press coffee, triacylglycerol, triglyceride