This study examined the effect on the plasma lipids and plasma phospholipid and cholesteryl ester fatty acids of changing from a typical western diet to a very low fat (VLF) vegetarian diet containing one egg/day. The effect of the addition of saturated, monounsaturated or polyunsaturated fat (PUFA) to the VLF diet was also examined. Three groups of 10 subjects (6 women, 4 men) were fed the VLF diet (10% energy as fat) for two weeks, and then in the next two weeks the dietary fat in each group was increased by 10% energy/week using butter, olive oil or safflower oil. The fat replaced dietary carbohydrate. The VLF diet reduced both the low density lipoprotein (LDL)-and high density lipoprotein (HDL)-cholesterol levels; addition of the monounsaturated fats and PUFA increased the HDL-cholesterol levels, whereas butter increased the cholesterol levels in both the LDL- and HDL-fractions. The VLF diet led to significant reductions in the proportion of linoleic acid (18:2ω6) and eicosapentaenoic acid (20:5ω3) and to increases in palmitoleic (16:1), eicosatrienoic (20:3ω6) and arachidonic acids (20:4ω6) in both phospholipids and cholesteryl esters. Addition of butter reversed the changes seen on the VLF diet, with the exception of 16:1, which remained elevated. Addition of olive oil resulted in a significant rise in the proportion of 18:1 and significant decreases in all ω3 PUFA except 22:6 compared with the usual diet. The addition of safflower oil resulted in significant increases in 18:2 and 20:4ω6 and significant decreases in 18:1, 20:5ω3 and 22:5ω3. These results indicate that the reduction of saturated fat content of the diet (<6% dietary energy), either by reducing the total fat content of the diet or by exchanging saturated fat with unsaturated fat, reduced the total plasma cholesterol levels by approximately 12% in normocholesterolemic subjects. Although the VLF vegetarian diet reduced both LDL- and HDL-cholesterol levels, the long-term effects of VLF diets are unlikely to be deteterious since populations which habitually consume these diets have low rates of coronary heart disease. The addition of safflower oil or olive oil to a VLF diet produced favorable changes in the lipoprotein lipid profile compared with the addition of butter. The VLF diets and diets rich in butter, olive oil or safflower oil had different effects on the 20 carbon eicosanoid precursor fatty acids in the plasma. This suggests that advice on plasma lipid lowering should also take into account the effect of the diet on the fatty acid profile of the plasma lipids.