Conflicts of Interest for Dietary Guidelines Advisory Committee Members: Neither a New Nor Unexplored Issue

Mialon, Mélissa; Serodio, Paulo; Crosbie, Eric; Teicholz, Nina; Naik, Ashka; Carriedo, Angela

doi:10.1016/j.advnut.2023.07.003

Cited by 1 publication

(1 citation statement)

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“…Other critiques have focused on exposing reliance on insufficient evidence [7], food industry pressure [8], and biases and conflicts of interest [9,10] in the formulation of dietary guidelines. This historical review will trace the evolution of this hypothesis, its role in the development of dietary guidelines, and its failure to differentiate natural sources of saturated fat from industrial trans-fats and to place limits on polyunsaturated fat.…”

Section: Introductionmentioning

confidence: 99%

The Lipid–Heart Hypothesis and the Keys Equation Defined the Dietary Guidelines but Ignored the Impact of Trans-Fat and High Linoleic Acid Consumption

Newport,

Dayrit

2024

Nutrients

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In response to a perceived epidemic of coronary heart disease, Ancel Keys introduced the lipid–heart hypothesis in 1953 which asserted that high intakes of total fat, saturated fat, and cholesterol lead to atherosclerosis and that consuming less fat and cholesterol, and replacing saturated fat with polyunsaturated fat, would reduce serum cholesterol and consequently the risk of heart disease. Keys proposed an equation that would predict the concentration of serum cholesterol (ΔChol.) from the consumption of saturated fat (ΔS), polyunsaturated fat (ΔP), and cholesterol (ΔZ): ΔChol. = 1.2(2ΔS − ΔP) + 1.5ΔZ. However, the Keys equation conflated natural saturated fat and industrial trans-fat into a single parameter and considered only linoleic acid as the polyunsaturated fat. This ignored the widespread consumption of trans-fat and its effects on serum cholesterol and promoted an imbalance of omega-6 to omega-3 fatty acids in the diet. Numerous observational, epidemiological, interventional, and autopsy studies have failed to validate the Keys equation and the lipid–heart hypothesis. Nevertheless, these have been the cornerstone of national and international dietary guidelines which have focused disproportionately on heart disease and much less so on cancer and metabolic disorders, which have steadily increased since the adoption of this hypothesis.

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