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Reduction in Saturated Fat Intake for Cardiovascular Disease

 

Am Fam Physician. 2022 Jan ;105(1):online.

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EFFECTS OF REDUCING SATURATED FAT INTAKE ON CARDIOVASCULAR DISEASE RISK

BenefitsHarms

Primary outcomes

No adverse events were reported

 No one was helped (no death from any cause or from cardiovascular disease was prevented)

Secondary outcomes

 No one was helped (no coronary heart disease event, death from coronary heart disease, type 2 diabetes mellitus, heart attack, or stroke was prevented)

EFFECTS OF REDUCING SATURATED FAT INTAKE ON CARDIOVASCULAR DISEASE RISK

BenefitsHarms

Primary outcomes

No adverse events were reported

 No one was helped (no death from any cause or from cardiovascular disease was prevented)

Secondary outcomes

 No one was helped (no coronary heart disease event, death from coronary heart disease, type 2 diabetes mellitus, heart attack, or stroke was prevented)

Study Population: Randomized controlled trials of adults (no upper age limit or gender limitations) at any risk of cardiovascular disease (CVD) who were taking or not taking lipid-lowering medications; participants who were acutely ill, pregnant, or breastfeeding were excluded

Efficacy End Points: All-cause mortality, cardiovascular mortality (from myocardial infarction, stroke, or sudden cardiac death), combined cardiovascular events (cardiovascular death, cardiovascular morbidity [nonfatal myocardial infarction, angina, stroke, heart failure, peripheral vascular events, atrial fibrillation], and unplanned cardiovascular interventions); secondary outcomes included myocardial infarctions, stroke, coronary heart disease mortality, coronary heart disease events (myocardial infarction, angina, or sudden cardiac death), type 2 diabetes mellitus incidence, serum lipids and insulin sensitivity, cancer diagnoses and death, weight and body mass index, blood pressure, and quality of life (any measure)

Harm End Points: Cancer diagnoses, cancer deaths, quality of life (any measure)

Narrative: The American Heart Association's 2013 guideline on lifestyle management to reduce cardiovascular risk recommends that adults consume a diet with no more than 5% to 6% of calories from saturated fat.1 The Scientific Report of the 2020 Dietary Guidelines Advisory Committee recommended that adults obtain less than 10% of daily calories from saturated fatty acids (SFA) and, when possible, replace those calories with monounsaturated fatty acids or polyunsaturated fatty acids.2 This guidance is based on disease-oriented evidence that reducing SFA intake decreases serum lipids, which has been used as a surrogate marker for CVD.1

The World Health Organization (WHO) Nutrition Guidance Expert Advisory Group requested a more accurate assessment of the effects of reduced intake of saturated fats on all-cause mortality, cardiovascular morbidity, and other health outcomes. The group also requested further study of the differential effects on health outcomes when saturated fats are replaced with other fats, carbohydrates, or proteins.3

This Cochrane review assessed the effect of reduced SFA intake and replacement with carbohydrates, polyunsaturated or monounsaturated fat, and/or protein on mortality and cardiovascular morbidity, using all available randomized controlled trials. All studies were conducted in industrialized countries and were published between 1965 and 2006. All trials aimed to reduce SFA intake or demonstrated evidence of reduced SFA intake.

The authors analyzed 15 randomized controlled trials (four

Author disclosure: No relevant financial relationships.


Copyright © 2022 MD Aware, LLC (theNNT.com). Used with permission.

This series is coordinated by Christopher W. Bunt, MD, AFP assistant medical editor, and the NNT Group.

A collection of Medicine by the Numbers published in AFP is available at http://www.aafp.org/afp/mbtn.

The views expressed within this publication represent those of the authors and do not reflect the official position of the U.S. Army, Womack Army Medical Center, the Defense Health Agency, the U.S. government, or the U.S. Department of Defense.

References

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1. Eckel RH, Jakicic JM, Ard JD, et al.; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk [published corrections appear in Circulation. 2015;131(4) e326 and Circulation. 2014;129(25 suppl 2):S100–S101]. Circulation. 2014;129(25 suppl 2):S76–S99....

2. Dietary Guidelines Advisory Committee. Scientific report of the 2020 Dietary Guidelines Advisory Committee: advisory report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service. Accessed December 13, 2021. https://www.dietaryguidelines.gov/2020-advisory-committee-report

3. Hooper L, Martin N, Jimoh OF, et al. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2020;(8):CD011737.

4. Hooper L, Martin N, Abdelhamid A, et al. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2015;(6):CD011737.

5. Beresford SAA, Johnson KC, Ritenbaugh C, et al. Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006;295(6):643–654.

 

 

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