Relationships to Atherosclerosis

A high Intake of saturated fatty acids and cholesterol Is associated with a high Incidence of occluslve arterial lesions Involving both atherosclerosis and thrombosis. The evidence Is based on epidemiological, experimental, and clinical studies. Such dietary habits Increase serum low density llpoproteln cholesterol, a main risk factor for atherosclerosis. The mechanisms by which dietary saturated fatty acids are connected to arterial thrombogenesls are only partly known. Experimental and epidemiological studies also Indicate an association between dietary saturated fatty acids and venous thrombosis; however, the chain of evidence lacks documentation from prospective clinical studies. When unsaturated fatty acids of the (n-9), (n-6), or (n-3) families replace saturated fatty acids In the diet, risk factors related to atherosclerosis may be reduced and the development of atherosclerosis, Inhibited. This potential Is related both to the reduction of saturated fatty acids and, In varying degrees, to the Individual unsaturated fatty acids. The very long-chain fatty acids of the (n-3) family and probably also llnolelc acid of the (n-6) family have the potential to inhibit thrombogenesls. In this respect, the effect of the Individual fatty acids seems even more Important To obtain an optimal dietary llpid composition for the prevention of atherosclerosis and thrombosis, It Is Important to appreciate the metabolic and structural effects of the Individual fatty acids. The Interaction between the various dietary fatty acids and their effects on llpid biosynthesis Is still only partly known. The present nutritional recommendations include a low Intake of saturated fatty acids and cholesterol and a balanced content of the unsaturated fatty acids and represent a well-documented approach to the prevention of both processes. (Arteriosclerosis 10:149-163, March/April 1990)