Dietary Fats and Cholesterol: Impact on Arterial Health

Fat Classification & Vascular Effects

Type	Sources	LDL Effect	HDL Effect	Recommendation
Monounsaturated (MUFA)	Olive oil, avocado, nuts, canola	↓	↑/neutral	Preferred
Polyunsaturated (PUFA)	Fatty fish (ω-3), flax, walnuts, soybean, sunflower (ω-6)	↓	↑/neutral	Preferred (ω-3 especially)
Saturated (SFA)	Red meat, butter, cheese, coconut, palm oil	↑	↑	Limit <10% calories (AHA: <7%)
Trans Fat	Partially hydrogenated oils (banned), ruminant fat	↑↑	↓	Avoid completely

Cholesterol Fractions

• LDL-C: Delivers cholesterol to arteries → atherosclerosis. Lower is better.
• HDL-C: Reverse cholesterol transport → cardioprotective. Higher is better (but drugs raising HDL failed to improve outcomes).

Dietary Cholesterol

Dietary cholesterol (eggs, shellfish) modestly raises LDL in hyper-responders; saturated fat has greater impact. Current guidelines focus on dietary pattern, not cholesterol milligrams.

Actionable Advice

• Replace SFA/TFA with MUFA/PUFA.
• Emphasize fatty fish, nuts, seeds, olive oil.
• Limit processed meats, fried foods, commercial baked goods.
• Combine with exercise, weight management, smoking cessation.