The effects of a 2-month dietary treatment (1,625 +/- 177 kcal, 40 +/- 2.3%
carbohydrate, 35 +/- 3.7% fat, 25 +/- 2%
protein, polyunsaturated/saturated fat ratio = 1.02 +/- 0.06) on the overall composition of serum
lipids,
lipoproteins and the
fatty acid composition of
cholesterol esters and
phospholipids in very low (VLDL), intermediate (IDL), low (
LDL) and high (HDL) density
lipoprotein in 5 patients with primary
familial hypertriglyceridemia type IV were assessed. The data were compared with those for 9 normolipidemic subjects. Treatment decreased serum
triglycerides (-52%) and total
cholesterol (-12%) due to decrease in free
cholesterol (-30%). It produced a significant decrease in all the constituents of VLDL (-58%), but the VLDL remained significantly higher
after treatment than those of control subjects. The diet caused a decrease in
triglycerides (-16%, -29% and -33%, respectively), and an increase in
cholesterol in IDL,
LDL and HDL. The IDL level in the treated patients remained significantly higher than in the controls. The
LDL cholesterol/
HDL cholesterol ratio was unchanged
after treatment. The
fatty acid compositions of the patients before treatment and the controls were not significantly different. The diet caused a decrease in palmitoleic and
oleic acids in the
cholesterol ester fraction and an increase in
linoleic acid, but this was significant only in VLDL and HDL. The diet decreased the
eicosapentaenoic acid but the drop was only significant in IDL and
LDL. There was also a decrease in
linolenic acid, only significant in IDL. The diet induced only minor changes in the
phospholipid fractions. We concluded that a single nutritional regimen can effectively decrease the serum
lipids and normalize the
lipoprotein composition of type IV hypertriglyceridemic patients.