The Implementation and Testing of a Reliable and Valid Oral Fat Tolerance Test (OFTT) for Research and Clinical Purposes


Plasma triglyceride metabolism
Metabolic studies

How to Cite

Bodell NG, Navalta JW, Kawi J, Bungum T. The Implementation and Testing of a Reliable and Valid Oral Fat Tolerance Test (OFTT) for Research and Clinical Purposes. Integr J Med Sci [Internet]. 2023 May 21 [cited 2023 May 31];10. Available from:


Background: Increased fat intake leads to a greater risk of atherosclerosis due to the increase in circulating triglycerides (TG), which damages the endothelial lining. An oral fat tolerance test (OFTT) is usually employed to evaluate postprandial lipid metabolism. However, there has yet to be a standardized procedure for doing an OFTT. This investigation assists in the determination of a standardized, reliable, and valid OFTT. Methods: All participants (n=20) were free of any known cardiovascular or metabolic disease. Participants were allotted 20 minutes to complete the OFTT. Baseline and subsequent blood analyses postfeeding were collected at 1, 2, 3, and 4 hours. One of the three OFTT loads of varying fat concentrations was administered to each participant in a randomized crossover design, containing fat loads of 150 g, 100 g, and 50 g of fat. A single-measure consistency intraclass correlation coefficient was used to determine significance (r>0.75). Results: The test-retest reliability of the OFTT loads (150 g, 100 g, and 50 g) were all significant (p<0.001), with ICC at 0.745, 0.923, and 0.715, respectively. Face Validity was confirmed upon repeat analysis. Conclusions: The 100 g OFTT load was the most reliable and valid measure for observing TG elevation. It is proposed that the 100 g load would be a reliable tool for further research investigation and eventual use for clinical purposes.


Katsanos CS. Prescribing Aerobic Exercise for the Regulation of Postprandial Lipid Metabolism. Sports Med. 2006 Jul 1;36(7):547–60.

Paglialunga S, Cianflone K. Regulation of postprandial lipemia: an update on current trends. Appl Physiol Nutr Metab. 2007 Feb;32(1):61–75.

Manochehri M, Moghadam AJ. Studying the Relation of Postprandial Triglyceride with Coronary Artery Disease (CAD). Med Arch. 2016 Jul 27;70(4):261–4.

Perez-Martinez P, Alcala-Diaz JF, Kabagambe EK, Garcia-Rios A, Tsai MY, Delgado-Lista J, et al. Assessment of postprandial triglycerides in clinical practice: Validation in a general population and coronary heart disease patients. J Clin Lipidol. 2016 Sep 1;10(5):1163–71.

Mohanlal N, Holman RR. A Standardized Triglyceride and Carbohydrate Challenge: The oral triglyceride tolerance test. Diabetes Care. 2004 Jan 1;27(1):89–94.

Gabriel B, Ratkevicius A, Gray P, Frenneaux MP, Gray SR. High-intensity exercise attenuates postprandial lipaemia and markers of oxidative stress. Clin Sci. 2012 Sep 1;123(5):313–21.

Murphy M, Nevill A, Hardman A. Different patterns of brisk walking are equally effective in decreasing postprandial lipaemia. Int J Obes. 2000 Oct;24(10):1303–9.

Harbis A, Perdreau S, Vincent-Baudry S, Charbonnier M, Bernard M-C, Raccah D, et al. Glycemic and insulinemic meal responses modulate postprandial hepatic and intestinal lipoprotein accumulation in obese, insulin-resistant subjects. Am J Clin Nutr. 2004 Oct 1;80(4):896–902.

Monfort-Pires M, Delgado-Lista J, Gomez-Delgado F, Lopez-Miranda J, Perez-Martinez P, Ferreira SRG. Impact of the Content of Fatty Acids of Oral Fat Tolerance Tests on Postprandial Triglyceridemia: Systematic Review and Meta-Analysis. Nutrients. 2016 Sep;8(9):580.

Shepherd J, Packard CJ, Patsch JR, et al. Effects of dietary polyunsaturated and saturated fat on the properties of high density lipoproteins and the metabolism of apolipoprotein AI. J Clin Invest. 1978;61(6):1582-92.

Bade G, Shah S, Nahar P, Vaidya S. Effect of menopause on lipid profile in relation to body mass index. Chron Young Sci. 2014 Jan 1;5(1):20.

Cohen JC, Noakes TD, Benade AJS. Postprandial lipemia and chylomicron clearance in athletes and in sedentary men. Am J Clin Nutr. 1989 Mar 1;49(3):443–7.

Tan M, Fat RCM, Boutcher YN, Boutcher SH. Effect of High-Intensity Intermittent Exercise on Postprandial Plasma Triacylglycerol in Sedentary Young Women. Int J Sport Nutr Exerc Metab. 2014 Feb;24(1):110–8.

Hashimoto S, Ootani K, Hayashi S, Naito M. Acute Effects of Shortly Pre- Versus Postprandial Aerobic Exercise on Postprandial Lipoprotein Metabolism in Healthy but Sedentary Young Women. J Atheroscler Thromb. 2011;18(10):891–900.

Ferreira AP, Ferreira CB, de Souza VC, Córdova COA, Silva GCB, Nóbrega OT, França NM. The influence of intense intermittent versus moderate continuous exercise on postprandial lipemia. Clinics (Sao Paulo). 2011;66(4):535-41.

Maraki M, Christodoulou N, Aggelopoulou N, Magkos F, Skenderi KP, Panagiotakos D, et al. Exercise of low energy expenditure along with mild energy intake restriction acutely reduces fasting and postprandial triacylglycerolaemia in young women. Br J Nutr. 2008 Jun;101(3):408–16.

Gill JMR, Al-Mamari A, Ferrell WR, Cleland SJ, Sattar N, Packard CJ, et al. Effects of a moderate exercise session on postprandial lipoproteins, apolipoproteins and lipoprotein remnants in middle-aged men. Atherosclerosis. 2006 Mar 1;185(1):87–96.

Weiss EP, Fields DA, Mittendorfer B, Haverkort MAD, Klein S. Reproducibility of postprandial lipemia tests and validity of an abbreviated 4-hour test. Metabolism. 2008 Oct 1;57(10):1479–85.

Pescatello LS, Arena R, Riebe D, Thompson PD, editors. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014. 456 p.

Pietiläinen KH, Kaye S, Karmi A, Suojanen L, Rissanen A, Virtanen KA. Agreement of bioelectrical impedance with dual-energy X-ray absorptiometry and MRI to estimate changes in body fat, skeletal muscle and visceral fat during a 12-month weight loss intervention. Br J Nutr. 2013 May;109(10):1910–6.

Ferreira CE dos S, França CN, Correr CJ, Zucker ML, Andriolo A, Scartezini M. Clinical correlation between a point-of-care testing system and laboratory automation for lipid profile. Clin Chim Acta. 2015 Jun 15;446:263–6.

Pfeiffer M, Ludwig T, Wenk C, Colombani PC. The influence of walking performed immediately before meals with moderate fat content on postprandial lipemia. Lipids Health Dis. 2005 Oct 6;4(1):24.

Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016 Jun 1;15(2):155–63.

Carstensen M, Thomsen C, Hermansen K. Incremental area under response curve more accurately describes the triglyceride response to an oral fat load in both healthy and type 2 diabetic subjects. Metabolism. 2003 Aug 1;52(8):1034–7.

Reed GF, Lynn F, Meade BD. Use of Coefficient of Variation in Assessing Variability of Quantitative Assays. Clin Diagn Lab Immunol. 2002 Nov 1;9(6):1235–9.

Confidence Interval - Definition, Interpretaion, and How to Calculate [Internet]. [cited 2019 Dec 13]. Available from:

Kolovou GD, Mikhailidis DP, Kovar J, Lairon D, Nordestgaard BG, Ooi TC, et al. Assessment and Clinical Relevance of Non-Fasting and Postprandial Triglycerides: An Expert Panel Statement. 2011 ;9(3):258-70.

Herd SL, Lawrence JEM, Malkova D, Murphy MH, Mastana S, Hardman AE. Postprandial lipemia in young men and women of contrasting training status. J Appl Physiol. 2000 Nov 1;89(5):2049–56.

Tsetsonis NV, Hardman AE, Mastana SS. Acute effects of exercise on postprandial lipemia: a comparative study in trained and untrained middle-aged women. Am J Clin Nutr. 1997 Feb 1;65(2):525–33.

Zhang JQ, Thomas TR, Ball SD. Effect of exercise timing on postprandial lipemia and HDL cholesterol subfractions. J Appl Physiol. 1998 Oct 1;85(4):1516–22.

Gill JMR, Herd SL, Hardman AE. Moderate exercise and post-prandial metabolism: issues of dose-response. J Sports Sci. 2002 Jan 1;20(12):961–7.

Graf S, Egert S, Heer M. Effects of whey protein supplements on metabolism: evidence from human intervention studies. Curr Opin Clin Nutr Metab Care. 2011 Nov;14(6):569-80.

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