Zusammenfassung
Fett ist der Nährstoff mit der größten Energiedichte sowie Träger von essenziellen
Fettsäuren und fettlöslichen Vitaminen. Der Fettanteil in der Ernährung in verschiedenen
Kulturen reicht von unter 20 Energie% bis über 40 Energie%. Extreme Relationen der
Makronährstoffe können durchaus nachteilige Folgen haben. Fettarme (20 Energie%) Ernährung
erhöht z. B. die Triglyzeride und das Risiko eines Mangels an fettlöslichen Vitaminen,
fettreiche (40 Energie%) Ernährung, insbesondere an gesättigten Fettsäuren reiche
Ernährung, erhöht das LDL-Cholesterol und begünstigt den Anstieg des Körpergewichts.
Eine fettmoderate (30 Energie%) Ernährung mit mehr ungesättigten und weniger gesättigten
Fettsäuren vermeidet unerwünschte Wirkungen und verspricht präventive Effekte mit
guter Compliance.
Abstract
Fat is the nutrient with the highest energy density and a carrier of essential fatty
acids and fat soluble vitamins. The fat percentage in diets in different cultures
varies from below 20 energy% up to more than 40 energy%. Extreme relations of macronutrients
may have also some adverse effects. Low (20 energy%) fat diets for instance increase
triglyceride concentrations and the risk of fat soluble vitamin deficiency. High (40
energy%) fat diets, especialy high saturated fat diets increase LDL cholesterol and
favour the increase of body weight. A diet moderate (30 energy%) in fat and with more
unsaturated and less saturated fatty acids avoids adverse effects and promises präventive
effects with good compliance.
Schlüsselwörter
fettreiche - fettarme - fettmoderate Ernährung - Vorteile - Nachteile
Key words
diets high - low - moderate in fat - advantages - disadvantages
Literatur
- 1 Deutsche Gesellschaft für Ernährung e. V. .Evidenzbasierte Leitlinie: Fettkonsum
und Prävention ausgewählter ernährungsmitbedingter Krankheiten. Bonn; November 2006
http://www.dge.de/Leitlinie
- 2
Lanza E, Schatzkin A, Daston C. et al .
Implementation of a 4-y, high-fiber, high-fruit-and-vegetable, low-fat dietary intervention:
results of dietary changes in the Polyp Prevention Trial.
Am J Clin Nutr.
2001;
74
387-401
- 3 Elmadfa I, Freisling H, König J. et al .Österreichischer Ernährungsbericht 2003.
1. Auflage. Wien; 2003: 310
- 4
Krauss R M, Dreon D M.
Low-density-lipoprotein subclasses and response to a low-fat diet in healthy men.
Am J Clin Nutr.
1995;
62
478S-487S
- 5
Gordon D J, Rifkind B M.
High-density lipoprotein - the clinical implications of recent studies.
N Engl J Med.
1989;
321
1311-1316
- 6
Mensink R P, Katan M B.
Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of
27 trials.
Arterioscler Thromb.
1992;
12
911-919
- 7
Truswell A S.
Food carbohydrates and plasma lipids - an update.
Am J Clin Nutr.
1994;
59 (Suppl)
710S-718S
- 8
Mensink R P, Zock P L, Kester A DM. et al .
Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL
cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled
trials.
Am J Clin Nutr.
2003;
77
1146-1155
- 9
Leenen R, Kooy K van der, Meyboom S. et al .
Relative effects of weight loss and dietary fat modification on serum lipid levels
in the dietary treatment of obesity.
J Lipid Res.
1993;
34
2183-2191
- 10
Poppitt S D, Keogh G F, Prentice A M. et al .
Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and
serum lipids in overweight subjects with metabolic syndrome.
Am J Clin Nutr.
2002;
75
11-20
- 11
Harbis A, Perdreau S, Vincent-Baudry S. et al .
Glycemic and insulinemic meal responses modulate postprandial hepatic and intestinal
lipoprotein accumulation in obese, insulin-resistant subjects.
Am J Clin Nutr.
2004;
80
896-902
- 12
Sloth B, Krog-Mikkelsen I, Flint A. et al .
No difference in body weight decrease between a low-glycemic-index and a high-glycemic-index
diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low-glycemic-index
diet.
Am J Clin Nutr.
2004;
80
337-347
- 13
Dreon D M, Fernstrom H A, Miller B, Krauss R M.
Apolipoprotein E isoform phenotype and LDL subclass response to a reduced-fat diet.
Arterioscler Thromb Vasc Biol.
1995;
15
105-111
- 14
Dreon D M, Fernstrom H A, Campos H, Blanche P, Williams P T, Krauss R M.
Change in dietary saturated fat intake is correlated with change in mass of large
low-density-lipoprotein particles in men.
Am J Clin Nutr.
1998;
67
828-836
- 15
Katan M B.
Alternatives to low-fat diets.
Am J Clin Nutr.
2006;
83
989-990
- 16
Sacks F M, Campos H.
Low-density lipoprotein size and cardiovascular disease: a reappraisal.
J Clin Endocrinol Metab.
2003;
88
4525-4532
- 17
Krauss R M, Blanche P J, Rawlings R S, Fernstrom H S, Williams P T.
Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia.
Am J Clin Nutr.
2006;
83
1025-1031
- 18
Foreyt J P, Poston W SC.
Consensus view on the role of dietary fat and obesity.
Am J Med.
2002;
113
60S-62S
- 19
Halton T L, Willett W C, Liu S. et al .
Low-carbohydrate-diet score and the risk of coronary heart disease in women.
N Engl J Med.
2006;
355
1991-2002
- 20
Gerhard G T, Ahmann A, Meeuws K. et al .
Effect of a low fat diet compared with those of a high-monounsaturated fat diet on
body weight, plasma lipids and lipoproteins and glycemic control in type 2 diabetes.
Am J Clin Nutr.
2004;
80
668-673
- 21
Bonow R O, Eckel R H.
Diet, obesity, and cardiovascular risk.
N Engl J Med.
2003;
348
2057-2058
- 22
Grundy S M, Brewer H B, Cleeman J I. et al .
Definition of metabolic syndrome. Report of the National Heart, Lung, and Blood Institute/American
Heart Association Conference on scientific issues related to definition.
Circulation.
2004;
109
433-438
- 23
Dansinger M L, Gleason J A, Griffith J L. et al .
Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss
and Heart Disease Risk Reduction.
JAMA.
2005;
293
43-53
- 24
Kwiterovich P O, Vining E P, Pyzik P. et al .
Effect of a high-fat ketogenic diet on plasma levels of lipids, lipoproteins, and
apolipoproteins in children.
JAMA.
2003;
290
912-920
- 25
Freedman M R, King J, Kennedy E.
Popular diets: a scientific review.
Obesity Res.
2001;
9
1S-40S
- 26
Council on Foods and Nutrition .
A critique of low-carbohydrate ketogenic weight reduction regimens.
JAMA.
1973;
224
1415-1419
- 27
Brehm B J, Seeley R J, D'Alessio D A.
Randomized trial comparing a very low carbohydrate diet and a calorie-restricted low
fat diet on body weight and cardiovascular risk factors in healthy women.
J Clin Endocrinol Metab.
2003;
88
1617-1623
- 28
Foster G D, Wyatt H R, Hill J O. et al .
A randomized trial of a low-carbohydrate diet for obesity.
N Engl J Med.
2003;
348
2082-2090
- 29
Yancy W S, Olsen M K, Guyton J R. et al .
A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia.
Ann Intern Med.
2004;
140
769-777
- 30
Chen T-Y, Smith W, Rosenstock J L. et al .
A life-threatening complication of Atkins diet.
Lancet.
2006;
367
958
- 31
Stern L, Iqbar N, Seshadri P. et al .
The effects of low-carbohydrate versus conventional weight loss diets in severely
obese adults: one-year follow-up of a randomized trial.
Ann Intern Med.
2004;
140
778-785
- 32
Metges C C, Barth C A.
Metabolic consequences of a high dietary-protein intake in adulthood: assessment of
the available evidence.
J Nutr.
2000;
130
886-889
- 33
Reddy S T, Wang C Y, Sakhaee K, Brinkley L, Pak C Y.
Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming
propensity, and calcium metabolism.
Am J Kidney Dis.
2002;
40
265-274
- 34
Sondike S B, Copperman M, Jacobson M S.
Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factors
in overweight adolescents.
J Pediatr.
2003;
142
253-258
- 35
Obarzanek E, Sacks F M, Vollmer W M. et al .
Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches
to Stop Hypertension (DASH) trial.
Am J Clin Nutr.
2001;
74
80-89
- 36
Saris W HM, Astrup A, Prentice A M. et al .
Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple
vs complex carbohydrates on body weight and blood lipids: the CARMEN study.
Int J Obes Relat Metab Disord.
2000;
24
1310-1318
- 37
Knopp R H, Walden C E, Retzlaff B M. et al .
Long-term cholesterol-lowering effects of 4 fat-restricted diets in hyper-cholesterolemic
and combined hyperlipidemic men.
JAMA.
1997;
278
1509-1515
- 38
Yu-Poth S, Zhao G, Etherton T. et al .
Effects of the National Cholesterol Education Program's Step I and Step II dietary
intervention programs on cardiovascular disease risk factors: a meta-analysis.
Am J Clin Nutr.
1999;
69
632-646
- 39
Eritsland J.
Safety considerations of polyunsaturated fatty acids.
Am J Clin Nutr.
2000;
71 (1 Suppl)
197S-201S
- 40 Deutsche Gesellschaft für Ernährung, Österreichische Gesellschaft für Ernährung,
Schweizerische Gesellschaft für Ernährungsforschung und Schweizerische Vereinigung
für Ernährung .Referenzwerte für die Nährstoffzufuhr. Frankfurt; Umschau Braus 2000
- 41
Saynor R.
Effects of omega-3 fatty acids on serum lipids.
Lancet.
1984;
2
696-697
- 42
Mozaffarian D, Rimm E B.
Fish intake, contaminants, and Human health. Evaluating the risks and the benefits.
JAMA.
2006;
296
1885-1899
- 43
Kris-Etherton P M, Binkoski A E, Zhao G. et al .
Dietary fat: assessing the evidence in support of a moderate-fat diet; the benchmark
based on lipoprotein metabolism.
Proc Nutr Soc.
2002;
61
287-298
- 44
Wang C, Chung M, Balk E. et al .
Effects of omega-3 fatty acids on cardiovascular disease.
Evid Rep Technol Assess (Summ).
2004;
94
1-8
- 45
Brouwer I A, Katan M B, Zock P L.
Dietary alpha-linolenic acid is associated with reduced risk of fatal coronary heart
disease, but increased prostate cancer risk: a meta-analysis.
J Nutr.
2004;
134
919-922
- 46 Hooper L, Thompson R L, Harrison R A. et al .Omega 3 fatty acids for prevention
and treatment of cardiovascular disease (Cochrane Review). In: The Cochrane Library,
Issue 2. Oxford; Update Software 2005
- 47
Zock P L, Katan M B.
Linoleic acid intake and cancer risk: a review and meta-analysis.
Am J Clin Nutr.
1998;
68
142-153
- 48
Kafatos A G, Codrington C A (Special Issue Editors).
Eurodiet Reports and Proceedings.
Public Health Nutrition.
2001;
4
265-435
- 49 WHO .Diet, nutrition and the prevention of chronic diseases. World Health Organ
Tech Rep Ser 2003: 916
- 50 American Heart Association (AHA) .Fat. AHA Recommendation. http://www.americanheart.org/presenter.jhtml?identifier=4582
- 51 Department of Health and Human Services (HHS) and the Department of Agriculture
(USDA) .Dietary Guidelines for Americans. 2005 http://www.healthierus.gov/dietaryguidelines/
- 52 Food and Nutrition Board/Institute of Medicine of the National Acadamies .DIETARY
REFERENCE INTAKES (DRIs) for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol,
Protein, and Amino Acids. The National Academic Press 2005
Prof. Dr. G. Wolfram
Dept. Lebensmittel und Ernährung, TU München
Alte Akademie 16
85350 Freising
Email: gwolfram@wzw.tum.de