Effect on lipoprotein profile of replacing butter wit margarine in a low fat diet: randomised crossover study with hypercholesterolaemic subjects

BMJ 1996;312:931-934 (13 April)

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Effect on lipoprotein profile of replacing butter wit margarine in a low fat diet: randomised crossover study with hypercholesterolaemic subjects

Alexandra Chisholm, research dietitian,^a Jim Mann, professor of human nutrition,^a Wayne Sutherland, research fellow,^b Ashley Duncan, senior technician,^a Murray Skeaff, lecturer in human nutrition,^a Christopher Frampton, lecturer ^c

^a Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand, ^b Department of Medicine, University of Otago, ^c Centre for Computing and Biometrics, Lincoln University, Canterbury, New Zealand

Correspondence to: Professor Mann.

Abstract

Objective: To examine the effect on lipid and lipoprotein concentrationswhen butter or an unsaturated margarine is used for cookingor spreading in a reduced fat diet.
Design: Randomised crossover study with two intervention periodsof six weeks' duration separated by a five week washout.
Setting: Community setting in New Zealand.
Subjects: 49 volunteers with polygenic hypercholesterolaemiaand baseline total cholesterol concentration in the range 5.5-7.9mmol/l.
Main outcome measures: Concentrations of total and low densitylipoprotein, Lp(a) lipoprotein, high density lipoprotein, apolipoproteinB 100, and apolipoprotein AI.
Results: Concentrations of low density lipoprotein cholesteroland apolipoprotein B were about 10% lower with margarine thanwith butter. Lp(a) lipoprotein and high density lipoproteincholesterol concentrations were similar with the two diets.
Conclusion: Despite concerns about adverse effects on lipoproteinsof trans fatty acids in margarines, the use of unsaturated margarinerather than butter by hypercholesterolaemic people is associatedwith a lipoprotein profile that would be expected to reducecardiovascular risk.

Key messages

Key messages
These findings suggest that the relatively small amounts of trans fatty acids that are typically present in unsaturated margarine have no adverse effects on lipid and lipoprotein concentrations
The effects of unsaturated margarine on oxidation of low density lipoproteins are still to be examined
Nevertheless, unsaturated margarine seems to be an appropriate substitute for saturated fat in diets recommended to people with hyperlipidaemia

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