LDL enriched with either saturated, monounsaturated, n-6 polyunsaturated, or n-3 polyunsaturated fatty acids were used to study the effects of dietary fatty acids on macrophage cholesteryl ester (CE) accumulation, physical state, hydrolysis, and cholesterol efflux. Incubation of THP-1 macrophages with acetylated LDL (AcLDL) from each of the four diet groups resulted in both CE and triglyceride (TG) accumulation, in addition to alterations of cellular CE, TG, and phospholipid fatty acyl compositions reflective of the individual LDLs. Incubation with monounsaturated LDL resulted in significantly higher total and CE accumulation when compared with the other groups. After TG depletion, intracellular anisotropic lipid droplets were visible in all four groups, with 71% of the cells incubated with monounsaturated AcLDL containing anisotropic lipid droplets, compared with 30% of cells incubated with n-3 AcLDL. These physical state differences translated into higher rates of both CE hydrolysis and cholesterol efflux in the n-3 group. These data suggest that monounsaturated fatty acids may enhance atherosclerosis by increasing both cholesterol delivery to macrophage foam cells and the percentage of anisotropic lipid droplets, while n-3 PUFAs decrease atherosclerosis by creating more fluid cellular CE droplets that accelerate the rate of CE hydrolysis and the efflux of cholesterol from the cell. The association of a high-fat, high-cholesterol diet with atherosclerosis has made dietary modification an important method for reducing cardiovascular disease risk. Both epidemiological and dietary studies have shown the benefits of replacing saturated with unsaturated fats (1-7); however, there is debate over which type of fat, monounsaturated or polyunsaturated, should replace saturated fats in the diet. Support for the benefits of a monounsaturated fat diet is based primarily on epidemiological evidence from such studies as the Seven Countries study (1) and the possible positive effect a monounsaturated fat diet has on the plasma lipid profile (8-11). These studies demonstrated that replacing saturated fats with monounsaturated fats lowers LDL concentrations, whereas substituting polyunsaturated for saturated fats lowers both LDL and HDL concentrations.The use of animal models has provided valuable insight into this debate through the generation of more definitive endpoints than would be possible in human studies. In studies with both African green monkeys and transgenic mice, despite the positive effects of monounsaturated fats on the plasma lipid profile, monounsaturated-fat fed animals developed similar levels of atherosclerosis as saturated fat-fed animals, while animals fed polyunsaturated fats developed less atherosclerosis (12, 13). These studies concluded that the monounsaturated-fat diet resulted in the production of a more atherogenic LDL particle, and that the atherogenicity of the LDL particle may be more important than absolute LDL and HDL concentrations (12,13).To better understand the mechanism underlyi...