The subject disclosure provides compositions for reducing serum cholesterol and/or triglyceride levels in subjects. These compositions can comprise racemic ss-hydroxybutyrate or D-ss-hydroxybutyrate, optionally in the acid form, physiologically compatible salts of racemic ss-hydroxybutyrate or D-ss-hydroxybutyrate, esters of D-ss-hydroxybutyrate, oligomers of D-ss-hydroxybutyrate containing from 2 to 20 or more monomeric units in either linear or cyclic form, racemic 1,3 butandiol or R- 1,3 butandiol alone and can be, optionally, administered in conjunction with a low fat diet to a subject. Alternatively, compositions comprising racemic ss-hydroxybutyrate or D-ss-hydroxybutyrate, optionally in the acid form, physiologically compatible salts of racemic ss-hydroxybutyrate or D-ss-hydroxybutyrate, esters of D-ss-hydroxybutyrate, oligomers of D-ss-hydroxybutyrate containing from 2 to 20 or more monomeric units in either linear or cyclic form, racemic 1,3 butandiol, R- 1,3 butandiol or combinations thereof can be formulated as nutritional supplements (also referred to as nutritional compositions) or incorporated into therapeutic compositions containing a) anti- hypertensive agents b) anti-inflammatory agents c) glucose lowering agents or d) anti- lipemic agents) which are administered to a subject, optionally in combination with a low fat diet, in order to cause a reduction or lowering of: serum cholesterol levels triglyceride levels serum glucose levels, serum homocysteine levels, inflammatory proteins (e.g., C reactive protein) and/or hypertension in treated subjects. Alternatively, compositions disclosed herein can be administered alone, or in combination with other therapeutic agents to prevent or reverse vascular disease.
