Meals high in saturated fat impair 'good' cholesterol's ability to protect against clogged arteries

New research shows negative effects can occur after eating just one high-fat meal

Before you bite into that burger or devour that doughnut, first chew on this: New research shows that just one meal high in saturated fat can affect the body's ability to protect itself against some of the underlying causes of heart disease and stroke.

The research, conducted at The Heart Research Institute in Sydney, Australia, appears in the Aug. 15, 2006, issue of the Journal of the American College of Cardiology.

According to the study, even a single meal high in saturated fat can reduce the ability of the body's "good" cholesterol, or high-density lipoproteins (HDL), to protect the inner lining of the arteries from inflammatory agents that promote the formation of artery-clogging plaques. A single high-fat meal also can affect the ability of the arteries to expand in order to carry adequate blood to tissues and organs.

On the other hand, according to the research, eating a meal high in polyunsaturated fat, a healthier form of fat, can increase the anti-inflammatory properties of HDL, helping to protect the inner lining of the arteries, called the endothelium, from plaque buildup.

"The take-home, public-health message is this: It's further evidence to support the need to aggressively reduce the amount of saturated fat consumed in the diet," said researcher Stephen J. Nicholls, MB, BS, PhD, now a cardiologist at Cleveland Clinic in Ohio. "This study helps to explain the mechanisms by which saturated fat supports the formation of plaques in the arterial wall, and we know these plaques are the major cause of heart attack and stroke."

Saturated fats are found in both animal and plant products, and typically are solid at room temperature. Examples include butter, lard and palm oil. The American College of Cardiology and the American Heart Association recommend that people limit their intake of saturated fat to no more than 7 percent of their total daily calories. Polyunsaturated fats, on the other hand, come mainly from plants and are liquid at room temperature. Examples include sunflower and corn oil.

For the study, Dr. Nicholls and his colleagues recruited 14 healthy volunteers and supplied them with two meals, eaten one month apart. The volunteers, ranging in age from 18 to 40, were examined and had blood drawn before eating (following an overnight fast), three hours after eating and again six hours after eating their supplied meals. Neither the participants nor the researchers knew which meal was eaten during which visit.

The meals were identical, except that one was high in saturated fat (coconut oil), while the other was high in polyunsaturated fat (safflower oil). Each meal consisted of a slice of carrot cake and a milkshake. All meals were specially prepared so that each participant consumed 1 gram of fat per kilogram of body weight or 1 gram of fat for every 2.2 pounds. (For a 150-pound person, that's nearly the fat equivalent of eating a double cheeseburger, a large order of french fries and a large milkshake at one meal.)

In examining the volunteers, Dr. Nicholls and his colleagues found that after three hours, the saturated fat meal had reduced the ability of the endothelium to expand the arteries in order to increase blood flow. The researchers determined this by using a blood pressure cuff to restrict blood flow and then monitoring the body's response. The polyunsaturated meal also reduced this ability slightly, but the results were not statistically significant.

After six hours, researchers found the meal high in saturated fat had diminished the protective qualities of HDL, allowing more inflammatory agents to accumulate in the arteries than had been present before the volunteers ate. The polyunsaturated meal, however, seemed to boost the anti-inflammatory abilities of the body's good cholesterol, with the researchers finding fewer inflammatory agents in the arteries than before the volunteers ate.

"In putting this all together," Dr. Nicholls said, "we have a difference between the two meals regarding a number of factors that influence the early stages of plaque formation. We have a situation where consumption of a single meal containing a high level of saturated fat is associated with impairment of vascular reactivity and impairment of a normal protective property of HDL. In contrast, consumption of a meal high in polyunsaturated fat results in HDL that is more protective.

"It is a small study," he concluded, "but I think the findings have broad implication because diet and exercise are the cornerstones of all strategies for preventing heart disease."

Robert Vogel, MD, a cardiologist and professor of medicine at the University of Maryland Medical Center, did not participate in the research, but agrees it provides "one more nail in the coffin" against eating diets high in saturated fat.

"This study helps to flesh out just why we shouldn't eat too much saturated fat," Dr. Vogel said. "Traditionally, we think of unhealthy foods as raising cholesterol or raising blood pressure, but this demonstrates that depending on what you eat, you can actually change the effect of HDL typically thought of as 'good' cholesterol from protective to detrimental. This opens up new insights and avenues for research."

Also in this issue of JACC

Two separate studies examine the potential dangers of stun guns, using animal models to determine how being stunned affects the electrical function of the heart and whether being stunned is more dangerous to the heart if cocaine is present in the recipient's system.

The first study, from the University of Toronto, examined the effects of stun guns when used near the chest vs. other areas of the body. Different types of stun guns, also called neuromuscular incapacitating devices (NID), were used to examine the effects of higher- and lower-voltage discharges. According to the researchers: "In an experimental model, NID discharges across the chest can produce cardiac stimulation at high rates. This study suggests that NIDs may have cardiac risks that require further investigation in humans."

The second study, from Cleveland Clinic and Toronto General Hospital, examined how the presence of cocaine in the body impacted the effects of being stunned on the heart. As in the first study, different voltages were tested on different parts of the body. Researchers discovered the presence of cocaine did not increase the risks of being stunned, but instead actually decreased the likelihood of the stun gun causing ventricular fibrillation (VF) in the animal model. During VF, the lower chambers of the heart beat erratically and are unable to pump blood, creating a medical emergency. The researchers also found that using stun guns at the standard voltage rate "is unlikely to cause life-threatening arrhythmias, at least in the normal heart."

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Dr. Nicholls reports receiving a Young Investigator Award from Pfizer Inc. to support this research.

The American College of Cardiology (ACC) provides these news reports of clinical studies published in the Journal of the American College of Cardiology as a service to physicians, the media, the public and other interested parties. However, statements or opinions expressed in these reports reflect the view of the author(s) and do not represent official policy of the ACC unless stated so.

The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The College is a 34,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at www.acc.org.


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