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To the Editor: In the systematic review of high-density lipoprotein as a therapeutic target by Dr Singh and colleagues,¹ the authors summarized nonpharmacological interventions to increase levels of high-density lipoprotein cholesterol (HDL-C). When discussing interventions involving dietary factors, they stated that "Diets rich in saturated fatty acids and trans-fatty acids can increase HDL-C levels. . . . " However, this statement is not entirely consistent with the effect of individual dietary fatty acids on serum lipids.

Saturated fatty acids increase levels of low-density lipoprotein cholesterol (LDL-C) and HDL-C,² whereas trans-fatty acids increase LDL-C level but decrease HDL-C level.^2-3 This distinction is important, because trans-fatty acids are more strongly associated with the risk of cardiovascular disease than saturated fatty acids due to their undesirable effects on LDL-C and HDL-C levels, endothelial cell function, adipocytes, and inflammatory response.^3-4

Financial Disclosures: None reported.

Dae Hyun Kim, MD, MPH
dae-hyun.kim@mail.tju.edu
Department of Medicine
Jefferson Medical College
Philadelphia, Pennsylvania

1. Singh IM, Shishehbor MH, Ansell BJ. High-density lipoprotein as a therapeutic target: a systematic review. JAMA. 2007;298(7):786-798. FREE FULL TEXT 2. Kris-Etherton PM, Yu S. Individual fatty acid effects on plasma lipids and lipoproteins: human studies. Am J Clin Nutr. 1997;65(5)(suppl):1628S-1644S. PUBMED 3. Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Engl J Med. 2006;354(15):1601-1613. FREE FULL TEXT 4. Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997;337(21):1491-1499. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;298(19):2263-2264.

RELATED LETTER

High-Density Lipoprotein and Dietary Fatty Acids—Reply
Inder M. Singh, Mehdi H. Shishehbor, and Benjamin J. Ansell
JAMA. 2007;298(19):2264.
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RELATED ARTICLE

High-Density Lipoprotein as a Therapeutic Target: A Systematic Review
Inder M. Singh, Mehdi H. Shishehbor, and Benjamin J. Ansell
JAMA. 2007;298(7):786-798.
ABSTRACT | FULL TEXT