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Alwaleed Fayduallah Al Idriss et al, 2020;4(2):538–542.

International Journal of Medicine in Developing Countries

Impact of dietary fats on blood lipids: a review

Alwaleed Fayduallah Al Idriss1, Ghala Abdulaziz Y. Yasin2, Manal Abdulaziz Almutairi3, Hala Ahmed Aljohani4, Muath Suwaileh Alsawat5*, Reham Hamad Alghalth3, Abdulmalek Sadiq Surrati6

Correspondence to: Muath Suwaileh Alsawat

*General Practitioner, Taif University, Jeddah, Saudi Arabia.

Email: M.s.al-sawat [at] hotmail.com

Full list of author information is available at the end of the article.

Received: 25 December 2019 | Accepted: 07 January 2020


ABSTRACT

It was known that dietary fats are composed of groups of fatty acids (saturated and/or unsaturated) that found naturally in foods. At room temperature, saturated fatty acids are in solid form, whereas the liquid form was accompanied by the unsaturated one, which considered the healthiest type of dietary fat. We used an online searching process to obtain scientific articles related to our current subject. We obtained 25 articles related to the current subject, out of them, 18 were excluded as they were duplicate articles, may not focus on the current subject, so only seven articles were included, and they were published till 2018. Articles were selected according to the inclusion criteria that we selected, and then the discussion of the subject was performed under main titles. The study concludes that the presence of unsaturated fats (e.g., olive oil) in food meals found to have a beneficial effect on blood lipids more than a meal that contains butter or cream as a type of saturated fats. Although omega-6 Polyunsaturated Fatty Acids was found to decrease the level of both low- and high-density lipoproteins, it might raise the risk for chronic diseases.


Keywords:

Dietary fats, saturated, unsaturated, omega 3 & 6, PUFA, cholesterol.


Introduction

It was found that dietary fats and blood lipids cause cardiovascular diseases (CVD) [1,2]. Saturated fat was classified as a dietary felon in heart diseases due to its ability for raising the low-density lipoprotein (LDL) level of cholesterol. At the same time, omega-6 of polyunsaturated fats (PUFA) were regarded as heart-healthy O’Keefe due to its ability to reduce total and LDL cholesterol [3]. Substituting saturated fat with omega-6 decreased total and LDL of cholesterol levels [4]. Saturated fats often decrease the small dense, low-density lipoprotein (sd-LDL) and raise the large one [5]; hence, it does not lead to coronary heart disease (CHD) risks. At the same time, CHD risks increased by increasing the level of sd-LDL [6].

Saturated fats, such as lauric acid, increase total, LDL, and HDL of cholesterol [7]. Although unsaturated fatty acids do not lead to raising the high-density lipoprotein (HDL) level of cholesterol, consuming foods containing a high amount of saturated fats might enhance the LDL and HDL levels of cholesterol [8]. Increasing HDL of cholesterol had an effective role in the prevention of heart diseases and coronary artery disease [9]. Therefore, the lipoprotein profile is very important for assessing the risks of heart diseases with the presence of dietary fats [10].

Unsaturated fats contain mono- and poly-unsaturated fats. Polyunsaturated fats contain both omega-3 & 6 fats, that is considered as very essential for a healthy diet, whereas monounsaturated fats contain nuts, avocados, oils (olive, peanut, etc.), and seeds (hemp, flax). Most plant oils, nuts, and seeds are considered a good source of omega-6. A huge number of people take enough amount of omega-6 fats, on the other hand, omega-3 fats are taken in a small amount [3].


Materials and Methods

We used an online searching process to obtain scientific articles related to the current subject. The searching process involved searching through scientific websites, such as Google Scholar and PubMed, using several keywords, such as dietary fats, saturated, unsaturated, omega 3 & 6, PUFA, cholesterol, LDL-C, and HDL-C. We obtained 25 articles related to the current subject, out of them, 18 were excluded as they were duplicate articles and may not focus on the current subject, so only seven articles were included and they were published till 2018.


Discussion

Mono-unsaturated fatty acids (MUFA)

It is considered as an important type of dietary fat in the Mediterranean region with a bit effect on heart diseases, and it has a harmful effect on arteries when consumed in a large amount. It was found that oleic acid might lead to the formation of big chylomicrons that contain triglycerides [4]. The largest one of the lipoproteins was the chylomicrons that carrying exogenous dietary triglycerides. Therefore, more consumption of olive oil led to an increased amount of triglycerides. This was proved by comparing foods containing a high amount of oleic acid with food that contains a high content of saturated fats [11]. Consumption of food containing high content of butter and cream and a low amount of unsaturated fats could lead to an increase in chylomicrons risks because of its ability to penetrate into the endothelium. The smaller particles were found to penetrate more than the large ones that could cause atherosclerosis. This theory was proved by a researcher [12], who reported that consumption of foods that contain a high content of unsaturated fats might increase the rate of fat oxidation, in addition to a reduction of blood coagulation risk factors by increasing weight loss [12]. Finally, it was reported that a high amount of unsaturated fatty acid might lead to a reduction of LDL level when compared with the consumption of food containing a high amount of saturated fat [13].

Omega-3 versus omega-6

A different randomized trial was conducted, from which one was conducted in Europe and included 99 patients, testing for such type of diet as isocaloric one [14]. This diet included a high percentage of fats (saturated and monounsaturated), in addition to carbohydrate (oleic sunflower oil), and contained a low amount of omega-3 polyunsaturated fats. After 12 weeks, it was reported that the LDL level increased, while the level of the total cholesterol decreased, which might lead to an increment of heart disease risk according to the size of LDL [15]. The particle size of LDL might be decreased by consumption of vegetable oils that contain a high amount of Omega-6, not only this but also Omega-6 might cause an increment of chronic heart diseases and stroke risk factors [16]. This might be attributed to small particles of LDL due to their sensitivity toward oxidation and more affinity to LDL-receptors that found in the liver that obligates it to be out of blood for the long term [17]. Additionally, omega-3 was found to have more ability to increase cholesterol levels of LDL. Omega-3 also led to an increase in large LDL particles, which might be attributed to an increase of gene expression of lipoprotein lipase enzyme, especially in plasma [18]. This could be explained through a reason that Omega-3 PUFAs might increase LDL oxidation, while other authors reported a reversed result that omega-3 didn't affect LDL oxidation [19].

In another randomized trial for hyperlipidemia among families for eight weeks, it was found a decrease in the content of triglyceride by 27% [20]. Eicosapentaenoic acid and Docosahexaenoic acid, as a type of omega-3 fat, were found to increase cholesterol level of LDL, while reducing its density [20]. This might be because of DHA that could regulate the receptors of LDL [21]. Cholesterol levels decreased through all diets, and the level of triglyceride was reduced with groups of fish and flax oil. In this concern, the group of fish oil decreased the small particles of LDL while increased HDL, in addition to reducing the ratio of triglyceride to HDL that considered a good indicator of chronic heart diseases. A significant reduction in small particles of LDL and in triglyceride was found after the consumption of fishy-oil, which was accompanied by increasing the level of DHA [22]. The authors finally concluded that omega-3 fats were reported to raise the particle size of LDL or to convert its size from small to large one [23].

Another randomized trial was conducted by Khaw [24] to test the effect of consumption of some oils (such as coconut) and buttercream for four weeks on lipids of blood, risk factors of heart diseases in both males and females. This trial occurred through a definite comparison between different varieties, such as weight loss or gain, lipid of blood profile, distributed at Cambridgeshire, the UK, among the general population (males and females) with definite dose (50 g per day for four weeks). Khaw [24] reported a significant alteration in the concentration of LDL-C and HDL-C. Consumption of coconut oil led to a significant increase in the choevel concentration of HDL. While the ratio between cholesterol and HDL-C increased after consumption of butter. Consumption of coconut oil increased LDL-C when compared to safflower oil as a type of polyunsaturated oil [25], beef fat [26], and palm oil [27].

The association between dietary fats and lipoproteins was impacted by surrounding factors and genetic factors as mentioned by Mensink and Katan [28]. McMurry [29] conducted a trial among both males and females who were performing a diet with maintaining physical activity. A change in LDL and HDL was observed with a varied intake of cholesterol amount during the diet [30]. Gender (male, female) did not cause any impact [31]. The level of total cholesterol was altered which might be attributed to the alteration of LDL. This result was in harmony with the results of Keys [32] and Hegsted [33] who observed an obvious change in the level of HDL cholesterol during the diet, definitely, when carbohydrates replaced by fats, this replacement led to reduction of triglycerides, and lipoproteins levels. The reduction of HDL cholesterol and the increment of triglycerides might be attributed to a diet containing a high level of carbohydrate. Polyunsaturated oils (such as fish oils) reduce triglycerides level [34].

Numerous authors have reported that (n−6) polyunsaturated fats led to a high reduction in the level of triglyceride when compared to saturated fats [35]. Mensink and Katan [28] found a non-significant effect of polyunsaturated fats and saturated one on the level of serum triglycerides. According to the current analysis, a perfect lipoprotein profile resulted from the replacement of saturated fats by unsaturated fats rather than replacement by carbohydrates that might cause a reduction of LDL and HDL level of cholesterol. On the other hand, surrogate by monounsaturated fats led to a reduction in cholesterol levels (LDL and HDL). Also, this reduction was observed by the replacement of monounsaturated by polyunsaturated fats. Therefore, the substitution of saturated fats by polyunsaturated fats was better than monounsaturated fats. Mensink and Katan [28] findings reported that substitution of saturated fats with monounsaturated or poly-unsaturated fatty acids had the ability to prevent risk factors of heart diseases (polyunsaturated are better than monounsaturated fats). Carbohydrates replacement would have a bit effect on heart diseases. Most of the reports proved that decreasing risk factors of heart disease might be attributed to lowering fat content through diet. This conflict must be clarified as follows; we should prove that risk might decrease or change through alteration of HDL cholesterol level. An alternative to this, the increased risk is associated with low levels of HDL cholesterol, and a high level of LDL cholesterol. Intake of low amounts of fats might lead to weight loss among populations as reported by a study [36]. All the previous findings could be summarized by knowing that to reduce the risk of heart diseases, counteracting the HDL and decreasing the LDL cholesterol, low-fat impact, blood pressure, and a high carbohydrate-containing diet [37], function of the platelets [38], and oxidation of LDL of cholesterol [39] are very important and urgent.


Conclusion

The presence of unsaturated fats (e.g., olive oil) in food meals was found to have a beneficial effect on blood lipids more than a meal that contains butter or cream as a type of saturated fats. Although omega-6 PUFA was found to decrease the level of both low- and high-density lipoproteins, and its particle size; decreasing HDL level, might raise the risk for CHD. Omega-3 fat was found to have a protective effect on blood lipids profile, which might be attributed to the enhancement and increment of LDL and HDL particle size and density, in addition to a reduction in triglycerides.


List of Abbreviations

CHD Coronary heart disease
HDL High-density lipoprotein
LDL Low-density lipoprotein

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.


Funding

None.


Consent for publication

Not applicable.


Ethical approval

Not applicable.


Author details

Alwaleed Fayduallah Al Idriss1, Ghala Abdulaziz Y. Yasin2, Manal Abdulaziz Almutairi3, Hala Ahmed Aljohani4, Muath Suwaileh Alsawat5, Reham Hamad Alghalth3, Abdulmalek Sadiq Surrati6

  1. General Doctor, Maternity and Child Hospital, Mecca, Saudi Arabia
  2. General Physician, Maternity and Childern Hospital, Mecca, Saudi Arabia
  3. Intern, Unaizah College of Medicine, Unaizah, Saudi Arabia
  4. General Doctor, Hera General Hospital, Mecca, Saudi Arabia
  5. General Practitioner, Taif University, Jeddah, Saudi Arabia
  6. Resident, Alnoor Speciality Hospital, Makkah, Saudi Arabia

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How to Cite this Article
Pubmed Style

Idriss AFA, Yasin GAY, Almutairi MA, Aljohani HA, Alsawat MS, Alghalth RH, Surrati AS. Impact of dietary fats on blood lipids: a review. IJMDC. 2020; 4(2): 538-542. doi:10.24911/IJMDC.51-1577287058


Web Style

Idriss AFA, Yasin GAY, Almutairi MA, Aljohani HA, Alsawat MS, Alghalth RH, Surrati AS. Impact of dietary fats on blood lipids: a review. https://www.ijmdc.com/?mno=79375 [Access: October 15, 2021]. doi:10.24911/IJMDC.51-1577287058


AMA (American Medical Association) Style

Idriss AFA, Yasin GAY, Almutairi MA, Aljohani HA, Alsawat MS, Alghalth RH, Surrati AS. Impact of dietary fats on blood lipids: a review. IJMDC. 2020; 4(2): 538-542. doi:10.24911/IJMDC.51-1577287058



Vancouver/ICMJE Style

Idriss AFA, Yasin GAY, Almutairi MA, Aljohani HA, Alsawat MS, Alghalth RH, Surrati AS. Impact of dietary fats on blood lipids: a review. IJMDC. (2020), [cited October 15, 2021]; 4(2): 538-542. doi:10.24911/IJMDC.51-1577287058



Harvard Style

Idriss, A. F. A., Yasin, . G. A. Y., Almutairi, . M. A., Aljohani, . H. A., Alsawat, . M. S., Alghalth, . R. H. & Surrati, . A. S. (2020) Impact of dietary fats on blood lipids: a review. IJMDC, 4 (2), 538-542. doi:10.24911/IJMDC.51-1577287058



Turabian Style

Idriss, Alwaleed Fayduallah Al, Ghala Abdulaziz Y. Yasin, Manal Abdulaziz Almutairi, Hala Ahmed Aljohani, Muath Suwaileh Alsawat, Reham Hamad Alghalth, and Abdulmalek Sadiq Surrati. 2020. Impact of dietary fats on blood lipids: a review. International Journal of Medicine in Developing Countries, 4 (2), 538-542. doi:10.24911/IJMDC.51-1577287058



Chicago Style

Idriss, Alwaleed Fayduallah Al, Ghala Abdulaziz Y. Yasin, Manal Abdulaziz Almutairi, Hala Ahmed Aljohani, Muath Suwaileh Alsawat, Reham Hamad Alghalth, and Abdulmalek Sadiq Surrati. "Impact of dietary fats on blood lipids: a review." International Journal of Medicine in Developing Countries 4 (2020), 538-542. doi:10.24911/IJMDC.51-1577287058



MLA (The Modern Language Association) Style

Idriss, Alwaleed Fayduallah Al, Ghala Abdulaziz Y. Yasin, Manal Abdulaziz Almutairi, Hala Ahmed Aljohani, Muath Suwaileh Alsawat, Reham Hamad Alghalth, and Abdulmalek Sadiq Surrati. "Impact of dietary fats on blood lipids: a review." International Journal of Medicine in Developing Countries 4.2 (2020), 538-542. Print. doi:10.24911/IJMDC.51-1577287058



APA (American Psychological Association) Style

Idriss, A. F. A., Yasin, . G. A. Y., Almutairi, . M. A., Aljohani, . H. A., Alsawat, . M. S., Alghalth, . R. H. & Surrati, . A. S. (2020) Impact of dietary fats on blood lipids: a review. International Journal of Medicine in Developing Countries, 4 (2), 538-542. doi:10.24911/IJMDC.51-1577287058