Etherton, P, et al High monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations Am J Clin Nutr 1999;70:1009-15

Trichopoulou A, et al Cancer and Mediterranean dietary traditions. Cancer Epidemiol Biomarkers Prev 2000;9:869 -73

Triochopoulou A, Mediterranean Diet and Longevity. Br J Nutr 2000, Dec 84 Supp 2: S 205-9

Keys A. Seven Countries: A multivariate analysis of death and coronary heart disease. Cambridge, MA. Harvard University Press, 1980

Hu FB, Stumpfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Eng J Med 1997;337:1491-1499

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• Giving Kids a Nutritional Edge with Brain Foods
• Electrifying Surprises Behind Health Benefits of Omega 3's
• Metabolic Syndrome in Children: Translating the Science into Key Educational Messages
• Is Stress Making us Heavier and Unhealthier?
• Metabolic Syndrome and Larger Waists in Youth Point to Health Risks on Horizon
• A Mediterranean Diet Offers a Healthy Inspiration for Decreasing the Risk of Alzheimer’s Disease
• Low Fat Diets: Not Always the Cure All
• Childhood Overweight & Obesity
• Men & Nutrition
• Trans Fats
• Women & Nutrition
• Mind/Body Connection
• Metabolic Syndrome of Obesity in Teens Predicts Risk as an Adult
• Game Plan for Recreational & Professional Athletes
• Obesity - The Metabolic Syndrome
• Stress & Overeating
• Weighing In On Obesity
• Diabetes Affects 17 Million Americans
• Fast Growing Problem
• Immune Function & Diet
• Cancer, Hormones & Weight
• Dieting & Depression
• Obesity & Children
• Dietary Fats & Health
• Mediterranean Cuisines
• Tackling Weighty Topics
• Phytochemicals

Not All Fats are Created Equal:

Key Insights for Heart Disease
by Connie Guttersen, RD PhD,
author of the Sonoma Diet

The important association between the Mediterranean-style diet and lower rates of heart disease has been shown in landmark studies, such as Ancel Key's Seven Countries Studies and the Lyon Heart Studies. The Mediterranean diet is based on olive oil, nuts, seafood, fruits, vegetables, grains, and legumes. The health message derived from these studies is that the type of dietary fat is more important than total fat.Despite the abundant research to support this concept, many Americans have been trying to cut the fat from their diet by eating more fat-free products. Such a diet has not been shown to be the best heart healthy approach. While these diets will reduce cholesterol, it’s at the expense of a decreased level of high-density lipoproteins and an increased level of triglycerides. On the other hand, a diet that contains a moderate amount of fat, primarily monounsaturated, will decrease an elevated blood cholesterol and low-density lipoproteins. It will also maintain the level of high-density lipoproteins and lower the elevated triglyceride levels.

(click on diagrams for larger view)

Current diet controversies are largely related to whether monounsaturated or carbohydrates should be substituted for saturated fat, and what quantity of monounsaturated fats should be consumed. A recent study conducted by Harvard School of Public Health used a regression analysis of data from the Nurses Health Study (80,082 women for 14 years) to show that the intake of monounsaturated fat was protective against coronary heart disease. More recent information compares different sources of monounsaturated fats (olive oil, peanut oil, peanuts and peanut butter) to the American Heart Association: Step II cholesterol lowering diet (low fat, high carbohydrate). In this study, Etherton, et al. proposes that diets moderate in dietary fat, (35% of total calories), and primarily comprised of monounsaturated fat will lower total and low-density lipoprotein cholesterol to a degree similar to that of the Step II diet. Moreover, the monounsaturated studies had the added benefit of not decreasing high-density lipoprotein or increasing triglycerides, as the Step II diet did. In this particular study, all the different monounsaturated sources contained approximately 77% oleic acid. However, differences were seen in their individual ability to decrease cardiovascular risk. These differences in cardiovascular risk reduction may be attributed to additional components such as antioxidants and phytochemicals, which were present prior to refinement.

Cardiovascular disease is also affected by free radical damage in the artery walls as well as in the low-density lipoproteins. Clearly, any process that would increase the presence or activity of antioxidants in these areas would minimize the oxidative damage. Recent investigations have focused studies on oxidized low-density lipoproteins. Oxidized low-density lipoproteins are more atherogenic and are responsible for early formations of atherosclerotic plaque. One of the contributing factors to the formation of oxidized low-density lipoproteins is related to the type and amount of dietary fat consumed--specifically, the degree of unsaturation of the fat. We know that saturated has no double bonds, monounsaturated has one and polyunsaturated has more than one. Degree of unsaturation or number of double bonds is a marker for oil stability and susceptibility for oxidation. Free radical damage tends to occur where there are double bonds, therefore, the more double bonds, the greater the susceptibility for oxidation. Unfortunately, one of the more stable fats, saturated, is also the most atherogenic. However, monounsaturated only have one double bond, thus they are stable and do not have atherogenic properties. Studies have shown that enriching a diet with monounsaturated fats at the expense of polyunsaturated fats leads to low-density lipoproteins that were less susceptible to oxidation. Other data suggest that monounsaturates may also decrease platelet aggregation and reduce blood pressure. All of this data collectively suggest that diets that contain a moderate amount of fat, but primarily comprised of monounsaturated fat, have multiple benefits for cardiovascular risk.

(click on diagram for larger view)

In conclusion, it is necessary to remember what we already know. Limiting the amount of saturated fat and hydrogenated fat in the diet is a good idea. In addition, recent advances in the scientific literature recommend replacing some of the polyunsaturated fats with monounsaturated fats. This chart provides a summary for the foods, which are high in monounsaturated fat and low in saturated fat.

You can find a number of recipes for foodservice and consumers that include olive oil, olives and other foods high in monounsaturated fat throughout this site.

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