Postprandial Lipid Metabolism: The Missing Link Between Life-Style Habits and the Increasing Incidence of Metabolic Diseases in Western Countries?

Postprandial lipemia is the transient increase in blood lipids which occurs after a meal containing fat and is caused by raised levels of triglyceride-rich lipoproteins (TRLs) in the blood. Delayed clearance of TRLs leads to post- prandial hyperlipidemia, and there is now a great deal of evidence to support the idea that this condition is an important risk factor for cardiovascular disease (CVD). Western lifestyle habits including: diets low in fresh fruit and vegetables and high in fat and processed food, alcohol consumption, smoking, and lack of exercise tend to promote postprandial hyperlip- idemia, and it is a characteristic feature of increasingly common metabolic diseases such as obesity, insulin resistance and type 2 diabetes which are also linked to modern lifestyle behaviour and which carry an increased risk of CVD develop- ment. Modification of lifestyle factors such as changing to a healthier diet, weight loss, reducing alcohol consumption and increasing exercise can cause significant reductions in postprandial hyperlipidemia and thus help to reduce this risk. De- spite the growing recognition that the extent of postprandial lipemia is a good predictor of CVD, no standardized method- ology for its measurement is currently available. Determination of blood TG levels after consumption of a standard test meal is likely to be the most convenient approach for a routine clinical test, and we propose a standard test meal which is easily adaptable for the variations in dietary habits in different countries. Greater use of postprandial lipid determination will aid in the translation of our extensive knowledge on the role of nutrition in health into national and international pol- icy.