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These results confirm the deleterious effects of high trans fat on blood lipids and indicate that these high may offset the beneficial high effects of polyunsaturated fat. Thus individuals who are replacing butter with margarine high in trans fat to reduce their risks of coronary disease may obtain no benefit or -- if trans fat has deleterious effects beyond those on LDL and HDL -- may even increase their risk. In addition to increasing the LDL/HDL cholesterol ratio, trans fatty acids increase Lp(a) when substituted for saturated fat. A significant increase was reported in nine3, 8, 10, 12-15, 17 of ten trials. The null result was from an investigation that included only 14 subjects who consumed a diet with 3.7% energy from trans fat; the power of this study may have been to low to demonstrate an effect.11 High blood levels of Lp(a) have been associated in some studies with increased risk of CHD, independently of LDL or HDL cholesterol concentrations. However diet-induced variations in blood concentrations of Lp(a) are modest relative to the genetic differences, and their quantitative impact on risk of CHD remains to be established.
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