Lowering plasma cholesterol by diet
New England Journal of Medicine 315(9): 585-587
1986
ISSN/ISBN: 0028-4793 PMID: 3736645 Document Number: 268487
Four letters to the editor critique a recently published paper that concluded that oleic acid has a special effect in lowering plasma cholesterol, followed by a response by the author of the original paper. The first letter elaborates an argument that, although the data reported may be correct, this conclusion is demonstrably unwarranted. The second letter suggests that the rise in serum triglycerides and fall in high-density-lipoprotein levels reported by the paper were due to a considerable glucose overload produced by the diet, and not to the effect of the saturation or amount of fat, as suggested by the paper. The third letter notes that the study reported by the paper used an unspecified "mixture" of 2 types of safflower oil, not olive oil (as implied), and that because of this the study would be difficult to replicate. The fourth letter notes that the author did not address an important dietary variable (viz., the ratio of polyunsaturated to saturated fat (P/S) in each diet), concluding that it may be premature to suggest that a diet rich in monounsaturated fatty acids is at least as effective in lowering plasma cholesterol as a low-fat, high-carbohydrate diet, when the P/S ratio of the former diet is twice that of the latter. The response by the author of the original paper provides a rebuttal, in turn, to each of these 4 letters.(wz)