WASHINGTON—The Women's Health Initiative Dietary Modification Trial tested the effects of a dietary pattern lower in fat and higher in vegetables, fruit and grains on chronic disease. Researcher found replacing 7 to 8 percent of fat intake with complex carbohydrates over six years was not associated with clinically adverse effects on triglycerides, high-density lipoprotein (HDL) cholesterol or lipoprotein subclasses (Am J Clin Nutr. 2010;91:860-874). They also noted diabetic white women with higher triglyceride concentrations may have greater increases in triglycerides.
In the study, postmenopausal women were randomly assigned to an intervention or a comparison group for a mean of 8.1 years. At year six, the total reported fat intake was 7.8 percent lower and carbohydrate intake was 7.6 percent higher in the intervention group than in the comparison group. Triglyceride change between groups differed by 2.3, 3.8 and –0.8 mg/dL at one, three and six years, respectively; and HDL-cholesterol change differed by –1.6, –0.7 and –1.0 mg/dL at one, three and six years, respectively. Changes did not differ by age, ethnicity or obesity. In diabetic intervention women who were white, the triglyceride difference between the intervention and comparison groups was 33.8 mg/dL, whereas in black women with diabetes (n=50 in the intervention group; n=83 in the comparison group), the triglyceride difference was 6.4 mg/dL . No significant changes were observed in apolipoprotein or lipoprotein particles. Reductions in low-density lipoprotein (LDL) cholesterol varied by quartile of reported lowering of saturated or trans fat.
