Nutritional and metabolic aspects of postprandial lipemia

The present review deals with the nutritional and metabolic aspects of postprandial lipemia. The postmeal state is characterized by the accumulation of triglyceride-rich lipoproteins (TRL) in the plasma. This is due to the competition for clearance between hepatically-derived very low density lipoproteins (VLDL) and intestinally-derived chylomicrons. At the same time, an important remodeling of the low density lipoprotein (LDL) and high density lipoprotein (HDL) particles takes place. The amplitude and/or time-course of the occurrence of the postprandial triglyceride response is influenced by the quantity of dietary lipids (triglycerides, cholesterol), the fatty acid composition of dietary triglycerides and the amount and nature of dietary carbohydrates and fibers. The preexisting metabolic status of the subjects markedly influences the postprandial response; i.e., hyperlipidemic, diabetic and obese subjects can exhibit an exaggerated increase in triglycerides and lipoprotein remodeling. The hypothesis that postprandial lipid modifications are associated with atheroma deposition and coronary events has been supported by several experimental observations. Despite the significant amount of knowledge already obtained in this field, further research is needed to better elucidate the existing relationships between dietary intake, postprandial response and pathological events.