AHA science advisory: Monounsaturated fatty acids and risk of cardiovascular disease

There is epidemiological evidence that dietary MUFAs have a beneficial effect on the risk of CHD. Moreover, evidence from controlled clinical stud es has shown that MUFAs favorably affect a number of risk factors for CHD, including plasma lipids and lipoproteins, factors related to thrombogenesis, in vitro LDL oxidative susceptibility (compared with PUFA), and insulin sensitivity. Compared with SFA, MUFAs lower total and LDL cholesterol levels, and relative to carbohydrate, they increase HDL cholesterol levels and decrease plasma triglyceride levels. Additional research is needed in humans and appropriate animal models to gain a better understanding of the effects of high-MUFA diets on atherogenesis. A diet high in MUFA (versus a high- carbohydrate diet) improves glycemic control in individuals with NIDDM who maintain body weight. Individuals with elevated triglycerides or insulin levels also may benefit from a high-MUFA diet. A diet that provides as many as 15% of calories from MUFA, ≃7% from PUFA, and ≃8% from SFA maintains the total fat content of the diet at 30% of calories. This Step 1 diet meets the American Heart Association dietary guidelines for Americans. Diets that are higher in MUFA can be used to manage CVD risk provided they do not exceed the SFA recommendation and compromise weight control. Although a high-MUFA diet that exceeds 30% of calories from fat is not a Step 1 or Step 2 diet because it does not meet the criteria for total fat content, it nonetheless is another viable option for managing risk factors in the prevention and treatment of CHD.