Flow-Mediated Dilatation Is Impaired by a High–Saturated Fat Diet but Not by a High-Carbohydrate Diet

Abstract

OBJECTIVE: It is unknown whether a low-fat diet, which may elevate triglycerides and lower high-density lipoprotein (HDL) cholesterol, harms the endothelium. Our aim was to determine whether a low-fat, high-carbohydrate (CARB) diet impaired endothelial vasodilation compared with high saturated fat (SFA), monounsaturated fat (MUFA), or polyunsaturated fat (PUFA) diets. METHODS AND RESULTS: Forty healthy subjects were randomly crossed over to 4, 3-week isocaloric diets high in PUFA, MUFA, or SFA, containing at least 25 g of the relevant fat or a low-fat, CARB, high-glycemic load diet. Flow-mediated dilatation (FMD), fasting blood lipids, high sensitivity C-reactive protein, plasma intercellular, and vascular adhesion molecules plasma E- and P-selectin were measured after each intervention. SFA impaired FMD compared with all other diets (5.41+/-2.45% versus 10.80+/-3.69%; P=0.01). FMD did not change on CARB relative to MUFA or PUFA, despite 23% to 39% rises in triglyceride and 10% to 15% falls in HDL cholesterol. P-selectin was highest after SFA (121+/-52.7 ng/mL) versus MUFA (98+/-44.5 ng/mL; P=0.001) and PUFA (96+/-36.4 ng/mL; P=0.001). CONCLUSIONS: High SFA caused deterioration in FMD compared with high PUFA, MUFA, or CARB diets. Inflammatory responses may also be increased on this diet.