Comparison of monounsaturated fatty acids and carbohydrates for lowering plasma cholesterol

N Engl J Med. 1986 Mar 20;314(12):745-8. doi: 10.1056/NEJM198603203141204.


To examine the effects of dietary fatty acids and carbohydrate on plasma lipids and lipoproteins, 11 patients with a mean plasma total cholesterol level of 251 +/- 10 mg per deciliter were studied on a metabolic ward during three dietary periods, each lasting four weeks. A liquid diet rich in monounsaturated fatty acids ("High-Mono") and a diet low in fat ("Low-Fat") were compared with a diet high in saturated fatty acids ("High-Sat"). The High-Sat and High-Mono diets contained 40 percent of their total calories as fat and 43 percent as carbohydrate; the Low-Fat diet had 20 percent fat and 63 percent carbohydrate. Body weight was kept constant by adjusting total caloric intake. As compared with the High-Sat diet, both the High-Mono and Low-Fat diets lowered plasma total cholesterol (by 13 percent and 8 percent, respectively) and low-density lipoprotein cholesterol (by 21 percent and 15 percent, respectively). As compared with the High-Sat diet, the Low-Fat diet raised triglyceride levels and significantly reduced plasma high-density lipoprotein cholesterol. In contrast, the High-Mono diet had no effect on levels of triglycerides or high-density lipoprotein cholesterol. The ratio of low-density to high-density lipoprotein cholesterol was also significantly lower when the High-Mono diet rather than the Low-Fat diet was followed. Therefore, in short-term studies in which liquid diets are used and body weight is kept constant, a diet rich in monounsaturated fatty acids appears to be at least as effective in lowering plasma cholesterol as a diet low in fat and high in carbohydrate.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cholesterol / blood*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Dietary Carbohydrates / pharmacology*
  • Dietary Fats / pharmacology*
  • Fatty Acids, Unsaturated / pharmacology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oleic Acid
  • Oleic Acids / pharmacology
  • Triglycerides / blood


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Dietary Carbohydrates
  • Dietary Fats
  • Fatty Acids, Unsaturated
  • Oleic Acids
  • Triglycerides
  • Oleic Acid
  • Cholesterol