Aims: To investigate whether blood lipid response to dietary fat and fibre vary according to the apolipoprotein E (APOE) gene locus.
Methods and results: Regression analysis of intake of dietary fat and lipid fractions according to APOE gene loci was assessed by Pyrosequencing and validated with restriction fragment length polymorphism in 22 915 participants of the Norfolk arm of the European Prospective Investigation of Cancer. There were significant (P < 0.001) differences in serum lipids according to genotype, highest total and low-density lipoprotein (LDL) cholesterol, and lowest high-density lipoprotein and triglycerides in epsilon4/epsilon4 individuals. There were positive associations between total and saturated fat and serum total and LDL cholesterol, and significant inverse associations (P < 0.001) between polyunsaturated fat and dietary fibre and lipid fractions overall. Associations were in the same direction for epsilon2, epsilon3, and epsilon4 expressing individuals with no significant interactions between diet and genotype group on blood lipids, except in the 3% individuals expressing epsilon2/epsilon4 (P < 0.05) in whom the associations were doubled.
Conclusion: In this largest study to date, ApoE gene loci status does not confer exemption from population targets to reduce dietary saturated fat and increase dietary fibre in order to reduce blood lipids and risk of coronary heart disease.