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To the Editor: The studies of the relationship between nonfasting serum triglyceride levels and heart disease by Dr Nordestgaard and colleagues¹ and by Dr Bansal and colleagues² may be important missing pieces in the diet-heart disease puzzle. Recent large epidemiological studies have contradicted the traditional diet-heart disease hypothesis by finding that fat intake has no association with heart disease, whereas carbohydrate intake, especially the glycemic load of carbohydrate intake, has a positive association with heart disease.³

One possible explanation relates the association between nonfasting triglyceride and heart disease with the finding that reducing dietary fat and increasing dietary carbohydrate cause an increase in nonfasting (and fasting) serum triglyceride level.⁴ The intended beneficial effect of lowering serum cholesterol by reducing dietary fat intake, therefore, may be negated by the concomitant increase in serum triglyceride level. Alternatively, reducing dietary carbohydrate intake may lower fasting and nonfasting serum triglyceride.⁵

If dietary carbohydrate has . . . [Full Text of this Article]

William S. Yancy Jr, MD, MHS
yancy006@mc.duke.edu
Department of Medicine
Duke University Medical Center
Durham, North Carolina

Jeff S. Volek, PhD
Human Performance Laboratory
Department of Kinesiology
University of Connecticut
Storrs

Eric C. Westman, MD, MHS
Department of Medicine
Duke University Medical Center

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Nonfasting Triglycerides and Cardiovascular Risk
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Nonfasting Triglycerides and Cardiovascular Risk—Reply
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JAMA. 2007;298(17):2005.
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Nonfasting Triglycerides and Cardiovascular Risk—Reply
Paul M Ridker
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RELATED ARTICLE

Nonfasting Triglycerides and Risk of Myocardial Infarction, Ischemic Heart Disease, and Death in Men and Women
Børge G. Nordestgaard, Marianne Benn, Peter Schnohr, and Anne Tybjærg-Hansen
JAMA. 2007;298(3):299-308.
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