ratio decreases by 0.04. This is equivalent to replacing SFAs constituting
1.8% of energy with such a mixture. If fat is replaced
exclusively with carbohydrates, then the difference becomes even
larger: isoenergetically replacing trans MUFAs constituting 1%
of energy with carbohydrates has the same effect on this ratio as
isoenergetically replacing SFAs constituting 7.3% of energy with
carbohydrates (Tables 1 and 3). The US diet provides, on average,
2.6% of energy from trans MUFAs and nearly 13% of energy from
SFAs (3), so that the total replacement of trans fatty acids in the
diet with carbohydrates would have a greater effect on total:HDL
cholesterol than would total replacement of SFAs. Therefore, even
low concentrations of trans MUFAs in the diet should deserve
attention as a target for efforts to lower CAD risk.