Saturated fat and cardiovascular disease

Most medical, scientific, heart-health, governmental, and professional authorities agree that saturated fat is a risk factor for cardiovascular disease, including the World Health Organization,[1] the Food and Nutrition Board of the National Academy of Medicine,[2] the Academy of Nutrition and Dietetics,[3] the Dietitians of Canada,[3] the Association of UK Dietitians,[4] the American Heart Association,[5] the British Heart Foundation,[6] the Heart and Stroke Foundation of Canada,[7] the World Heart Federation,[8] the British National Health Service,[9] the United States Food and Drug Administration,[10] and the European Food Safety Authority.[11]

This article is about the health risks of saturated fat. For the risks of blood cholesterol, see Lipid hypothesis.

There is moderate quality evidence that reducing the proportion of saturated fat in the diet, and replacing it with unsaturated fats over a period of at least two years, leads to a reduction in the risk of cardiovascular disease.[12]

History

The hypothesis that saturated fat has a detrimental effect on human health gained prominence in the 1950s as a result of the work of Ancel Keys, a US nutritional scientist.[13] At that time in the USA, the incidence of heart disease was rapidly increasing, for reasons that were not clear.[13] Keys postulated a correlation between circulating cholesterol levels and cardiovascular disease, and initiated a study of Minnesota businessmen (the first prospective study of CVD).[14]

Keys presented his diet-lipid-heart disease hypothesis at a 1955 expert meeting of the World Health Organization in Geneva.[15] In response to criticism at the conference, he set out to conduct the years-long Seven Countries Study.[16] Ancel Keys joined the nutrition committee of the American Heart Association (AHA) and successfully promulgated his idea such that in 1961, with the result that the AHA became the first group anywhere in the world to advise cutting back on saturated fat (and dietary cholesterol) to prevent heart disease.[17] This historic recommendation was reported on the cover of Time Magazine in that same year.[18]

Reviews

A meta-analysis in 2014 concluded that "current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats".[19] This meta-analysis was called "seriously misleading" by Walter Willett, chair of the Department of Nutrition at Harvard, who explained that the paper contained major errors and omissions, most notably that the foods used to replace saturated fats were other unhealthy foods like refined sugars and starches.[20]

A 2017 review by the American Heart Association recommended that decreasing saturated fat intake and increasing consumption of monounsaturated fats and polyunsaturated fats could lower the risk of cardiovascular diseases by about 30%.[5]

A 2020 review found that reducing saturated fat intake for at least two years reduced cardiovascular risk factors, mainly by replacing saturated fat with sources of polyunsaturated fat or carbohydrates.[12]

See also

References
  1. Joint WHO/FAO Expert Consultation (2003). Diet, Nutrition and the Prevention of Chronic Diseases (WHO technical report series 916) (PDF). World Health Organization. pp. 81–94. ISBN 978-92-4-120916-8. Archived from the original (PDF) on 24 July 2015. Retrieved 2011-03-11.
  2. Food and Nutrition Board (2005). "10: Dietary Fats: Total Fat and Fatty Acids". Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press. p. 422. Retrieved 25 July 2017.
  3. Kris-Etherton, PM; Innis, S; American Dietetic, Association; Dietitians Of, Canada (September 2007). "Position of the American Dietetic Association and Dietitians of Canada: Dietary Fatty Acids" (PDF). Journal of the American Dietetic Association. 107 (9): 1599–1611 [1603]. doi:10.1016/j.jada.2007.07.024. PMID 17936958. S2CID 21213410. Retrieved 2011-03-18.
  4. "Food Fact Sheet - Cholesterol" (PDF). Association of UK Dietitians. 1 December 2018. Retrieved 28 July 2019.
  5. Sacks, Frank M.; Lichtenstein, Alice H.; Wu, Jason H.Y.; Appel, Lawrence J.; Creager, Mark A.; Kris-Etherton, Penny M.; Miller, Michael; Rimm, Eric B.; Rudel, Lawrence L.; Robinson, Jennifer G.; Stone, Neil J.; Van Horn, Linda V. (15 June 2017). "Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association". Circulation. 136 (3): e1–e23. doi:10.1161/CIR.0000000000000510. PMID 28620111. S2CID 367602.
  6. "Fats explained". Retrieved 2012-05-03.
  7. "Dietary fats, oils and cholesterol". Heart and Stroke Foundation of Canada. Retrieved 25 July 2017.
  8. "Cardiovascular Risk Factors". World Heart Federation. 30 May 2017.
  9. "Eat less saturated fat". National Health Service. 1 June 2017. Retrieved 28 July 2019.
  10. "Nutrition Facts at a Glance - Nutrients: Saturated Fat". Food and Drug Administration. 2009-12-22. Archived from the original on September 17, 2011. Retrieved 2012-05-03.
  11. "Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol". European Food Safety Authority. 2010-03-25. Retrieved 3 May 2012.
  12. Hooper, Lee; Martin, Nicole; Jimoh, Oluseyi F.; Kirk, Christian; Foster, Eve; Abdelhamid, Asmaa S. (21 August 2020). "Reduction in saturated fat intake for cardiovascular disease". The Cochrane Database of Systematic Reviews. 8: CD011737. doi:10.1002/14651858.CD011737.pub3. ISSN 1469-493X. PMID 32827219.
  13. Teicholz, Nina (6 May 2014). "The Questionable Link Between Saturated Fat and Heart Disease". The Wall Street Journal. Retrieved 9 May 2015.
  14. Keys, Ancel; Taylor, Henry Longstreet; Blackburn, Henry; Brozek, Josef; Anderson, Joseph T.; Simonson, Ernst (1 September 1963). "Coronary Heart Disease among Minnesota Business and Professional Men Followed Fifteen Years". Circulation. 28 (3): 381–95. doi:10.1161/01.cir.28.3.381. PMID 14059458.
  15. Famous Polemics on Diet-Heart Theory. Henry Blackburn, School of Public Health, University of Minnesota. http://www.epi.umn.edu/cvdepi/essay.asp?id=33 accessed 18th March 2014
  16. Keys, Ancel (1980). Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Harvard University Press. ISBN 978-0-674-80237-7.
  17. "Dietary Fat and Its Relation to Heart Attacks and Strokes". JAMA. 175 (5): 389–391. 4 February 1961. doi:10.1001/jama.1961.63040050001011. PMID 14447694.
  18. "TIME Magazine Cover: Ancel Keys". TIME.com. 13 January 1961. Retrieved 23 July 2017.
  19. Chowdhury Rajiv; Warnakula Samantha; Kunutsor Setor; Crowe Francesca; Ward Heather A.; Johnson Laura; Franco Oscar H.; Butterworth Adam S.; Forouhi Nita G.; Thompson Simon G.; Khaw Kay-Tee; Mozaffarian Dariush; Danesh John; Di Angelantonio Emanuele (2014). "Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 160 (6): 398–406. doi:10.7326/M13-1788. PMID 24723079.
  20. "Dietary fat and heart disease study is seriously misleading".
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