High PUFA slightly better than high MUFA diets in lowering blood lipids

Diets high in polyunsaturated fatty acid (PUFA) demonstrate slightly greater benefits over high monounsaturated fatty acid (MUFA) diets in reducing blood lipids, reports a study.

In this systematic review and meta-analysis, the researchers accessed the databases of PubMed and Web of Science through 2025 to look for randomized clinical trials comparing high PUFA (≥10 percent of energy intake from PUFAs) and high MUFA (≥15 percent of energy intake from MUFAs) diets in adults.

Fasting total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides were then extracted. Finally, the researchers pooled eligible studies using random-effects models and expressed the findings as mean differences (MDs) with 95 percent confidence intervals (CIs).

Fifty-three studies met the eligibility criteria, including a total of 1,690 adult participants.

High PUFA dietary interventions led to slightly higher reductions in TC (MD, ‒5.71 mg/dL, 95 percent CI, ‒8.02 to ‒3.40), LDL cholesterol (MD, ‒3.31 mg/dL, 95 percent CI, ‒5.39 to ‒1.24), HDL cholesterol (MD, ‒0.77 mg/dL, 95 percent CI, ‒1.27 to ‒0.26), and TG (MD, ‒6.59 mg/dL, 95 percent CI, ‒8.77 to ‒4.42) relative to high MUFA diets.

In subgroup analyses, the effects of LDL cholesterol (p=0.03) and TG (p=0.03) were stronger with oil than with nut or diet interventions.

In meta-regression analyses, the benefit derived from high PUFA vs high MUFA diets increases with total fat intake. For each 1-percent increase in energy intake from fat, there was an approximately 0.5-mg/dL greater reduction in TC (p=0.01) and LDL cholesterol (p=0.01).

“High PUFA diets have a small, but significant, advantage for lowering blood lipids compared with high MUFA diets and may be a valuable strategy for improving blood lipids in some populations,” the researchers said.

Notably, these findings should be interpreted with caution due to some “concerns” identified by the Cochrane Risk of Bias tool in most of the included studies, they added.