Medicine by the Numbers
A Collaboration of TheNNT.com and AFP
Reduction in Saturated Fat Intake for Cardiovascular Disease
Am Fam Physician. 2022 Jan ;105(1):online.
Details for This Review
EFFECTS OF REDUCING SATURATED FAT INTAKE ON CARDIOVASCULAR DISEASE RISK
| Benefits | Harms |
|---|---|
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
| Benefits | Harms |
|---|---|
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
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
show all references1. 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.
Copyright © 2022 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact
afpserv@aafp.org for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions
CME Quiz
More in AFP
Editor's Collections
Related Content
More in Pubmed
MOST RECENT ISSUE
Email Alerts
Don't miss a single issue. Sign up for the free AFP email table of contents.
