Effect of a diet enriched with monounsaturated or polyunsaturated fatty acids on levels of low-density and high-density lipoprotein cholesterol in healthy women and men.N Engl J Med. 1989 Aug 17; 321(7):436-41.NEJM
Polyunsaturated fatty acids are thought to lower the serum cholesterol level more effectively than monounsaturated fatty acids. It is unclear whether the difference--if any--is due to a lowering of the level of high-density lipoprotein (HDL) or low-density lipoprotein (LDL) cholesterol. We therefore placed 31 women and 27 men on a mixed natural diet rich in saturated fat (19.3 percent of their daily energy intake from saturated fat, 11.5 percent from monounsaturated fat, and 4.6 percent from polyunsaturated fat) for 17 days. For the next 36 days, they received a mixed diet with the same total fat content, but enriched with olive oil and sunflower oil ("monounsaturated-fat diet": 12.9 percent saturated fat, 15.1 percent monounsaturated fat, and 7.9 percent polyunsaturated fat) or with sunflower oil alone ("polyunsaturated-fat diet": 12.6 percent saturated fat, 10.8 percent monounsaturated fat, and 12.7 percent polyunsaturated fat). The serum LDL cholesterol level decreased by 17.9 percent in those on the monounsaturated-fat diet and by 12.9 percent in those on the polyunsaturated-fat diet (95 percent confidence interval for the difference between the effects of the two unsaturated-fat diets, -9.9 percent to 0.0 percent). In men, the HDL cholesterol level fell slightly but not significantly with both diets. In women, the HDL cholesterol level did not change with either. We conclude that a mixed diet rich in monounsaturated fat was as effective as a diet rich in (n-6)polyunsaturated fat in lowering LDL cholesterol. Both diets lowered the level of HDL cholesterol slightly in men but not in women.