A predominance of small dense LDL (sdLDL) particles is a well-established component of the atherogenic lipoprotein phenotype associated with insulin resistance and increased risk for coronary heart disease. However, the influence of diet on LDL particle size distribution is not clear. We investigated (cross-sectionally) the relations between LDL profile and dietary fatty acids (FAs) in 291 healthy men (62-64 y old) with a range of insulin sensitivities. Individuals completed a 7-d dietary record, and fasting plasma insulin, lipid, and lipoprotein concentrations as well as serum and adipose tissue FA composition were determined. The LDL profile was examined by polyacrylamide gradient gel electrophoresis, protein-staining, and quantitative scanning, giving LDL peak particle size and the percentage distribution of LDL in 4 subfractions. The men were divided into tertiles of percentage distribution of sdLDL. Small dense LDL was positively related to plasma triacylglycerol and fasting insulin concentrations (both P < 0.0001) and inversely related to HDL cholesterol (P < 0.0001). No strong relations were found between sdLDL and the reported intake of SFA, monounsaturated fatty acids, or PUFA. However, individual FAs typically found in milk products were associated with a more favorable LDL profile (i.e., fewer sdLDL particles). This was shown for 4:0-10:0 and 14:0 in the diet (both P < 0.05), 15:0 and 17:0 in serum phospholipids (both P < 0.05), and 15:0 in serum nonesterified FAs (P < 0.01). Furthermore, 20:3(n-6) in adipose tissue and serum phospholipids was positively related to sdLDL. Therefore, LDL particle size distribution appears to be modified by dietary factors with an apparently beneficial effect of milk products.