Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis

Harcombe, Zoë; Baker, Julien S.; Davies, Bruce

doi:10.1136/bjsports-2016-096550

Cited by 52 publications

(37 citation statements)

References 45 publications

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“…Findings from two SRMAs of observational studies showed that high SFA intake was not significantly associated with risk of CVD mortality [6,47] and CHD [6] (see Figures 4B and 5B). However, one SRMA of observational studies found that a high SFA intake was significantly associated with lower risk of ischemic stroke (pooled RR = 0.89; 95%CI: 0.82-0.96) [50] (see Figure 5A).…”

Section: Fat Intakementioning

confidence: 97%

“…Fat intake was classified as (1) total fat intake, (2) saturated fatty acid (SFA), (3) MUFA, (4) n-3 PUFA, (5) n-6 PUFA, and (6) trans fatty acid (TFA). For total fat intake, the results from SRMAs of observational studies found that a high total fat intake did not significantly increase risk of CVD mortality (pooled RRs ranging from 0.94 (95%CI: 0.74-1.18) to 1.04 (95%CI: 0.98-1.10)) [6,47] ( Figure 4C) and CHD (pooled RR = 0.93; 95%CI: 0.84-1.03) [6] ( Figure 5B). Evidence from SRMAs of RCTs also indicated that modification of the amount of total fat intake did not significantly decrease risk of all-cause mortality (pooled RRs ranging from 0.98 (95%CI: 0.86-1.12) to 0.99 (95%CI: 0.94-1.05)) [48,49] (Figure 4B), CVD mortality (pooled RRs ranging from 0.91 (95%CI: 0.77-1.07) to 1.00 (95%CI: 0.80-1.24)) [6,48,49], or CHD (pooled RR = 0.93 (95%CI: 0.84-1.04) [6] ( Figure 5C) in the general population.…”

Section: Fat Intakementioning

confidence: 99%

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Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review

Chareonrungrueangchai

et al. 2020

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Unhealthy diet is a significant risk factor for cardiovascular diseases (CVD). Therefore, this umbrella review aims to comprehensively review the effects of dietary factors, including dietary patterns, food groups, and nutrients on CVD risks. Medline and Scopus databases were searched through March 2020. Systematic reviews with meta-analyses (SRMA) of randomized controlled trials (RCTs) or observational studies measuring the effects of dietary factors on CVD risks were eligible. Fifty-four SRMAs, including 35 SRMAs of observational studies, 10 SRMAs of RCTs, and 9 SRMAs of combined RCT and observational studies, were included for review. Findings from the SRMAs of RCTs suggest the significant benefit of Mediterranean and high-quality diets for lowering CVD risk, with pooled risk ratios (RRs) ranging from 0.55 (95%CI: 0.39-0.76) to 0.64 (95%CI: 0.53-0.79) and 0.70 (95%CI: 0.57-0.87), respectively. For food nutrients, two SRMAs of RCTs found that high intake of n-3 polyunsaturated fatty acid (PUFA) significantly reduced CVD risks, with pooled RRs ranging from 0.89 (95%CI: 0.82, 0.98) to 0.90 (95%CI: 0.85-0.96), while evidence of efficacy of n-6 PUFA and combined n-3 and n-6 PUFA were inconsistent. Moreover, results from the SRMAs of RCTs did not find a significant benefit of a low-salt diet and low total fat intake for CVD prevention. For food groups, results from the SRMAs of cohort studies suggest that high intakes of legumes, nuts, and chocolate, as well as a vegetarian diet significantly reduced the risk of coronary heart disease, with pooled RRs of 0.90 (95%CI: 0.84-0.97), 0.68 (95%CI: 0.59-0.78), 0.90 (95%CI: 0.82-0.97), and 0.71 (95%CI: 0.57-0.87), respectively. Healthy dietary patterns had a significant benefit for CVD prevention. With the substitutional and synergistic interactions between different food groups and nutrients, dietary recommendations for CVD prevention should be focused more on healthy dietary patterns than single food groups or nutrients.Nutrients 2020, 12, 1088 2 of 18 (e.g., fruits, vegetables, nuts, whole grains, and legumes), and food nutrients (e.g., sodium, saturated fat, and monounsaturated fat). However, most evidence has focused on dietary fats, due to the established relationship between serum cholesterol level and CVD risks. Previous evidence on the association between dietary fat intake and CVD prevention is inconsistent and is still being debated. For instance, in 2017 the American Heart Association (AHA) recommended lowering saturated fat intake and replacing it with unsaturated fat, especially polyunsaturated fatty acids (PUFA), for CVD prevention [5]. However, some systematic reviews and meta-analyses (SRMA) of randomized controlled trials (RCT) did not show a significant benefit of PUFA for reducing CVD risks [6,7], and the findings from an 18-country cohort study also concluded that "total fat and types of fat were not associated with CVD" [8]. Similarly, findings from SRMAs [9-12] of the effects of other dietary factors, such as vegetables, fruits, and fibers on CVD risk...

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Section: Fat Intakementioning

confidence: 97%

Section: Fat Intakementioning

confidence: 99%

Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review

Chareonrungrueangchai

et al. 2020

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“…A previous study reported that high unsaturated fatty acid intake may promote oxidative stress and increase the risk of CHD [17]; further, increased intake of high-fat diet increases the risk of myocardial infarction [18]. However, the relationship remains controversial [19]; a positive association was found between frequent high-fat food consumption and CHD risk in the USA, but not in Europe or Asia [20]. This could be attributed to the different dietary patterns and social conditions, as well as ethnic differences.…”

Section: Discussionmentioning

confidence: 99%

“…Globally, cardiovascular disease is the most common cause of death. CHD accounted for more than 53% of all CVD-related deaths in 2016, and CHD-related mortality rate increased by 19.0% from 2006 to 2016 [1]. As the prevalence of risk factors has been increasing, the mortality rate of CHD has increased by 40.1% during the same period, with CHD accounting for 17.8% of all deaths in China [2].…”

Section: Introductionmentioning

confidence: 99%

Risk of coronary heart disease in the rural population in Xinjiang: A nested case-control study in China

Zhang

et al. 2020

PLoS ONE

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Background and aimCoronary heart disease (CHD) is a chronic complex disease caused by a combination of factors such as lifestyle behaviors and environmental and genetic factors. We conducted this study to evaluate the risk factors affecting the development of CHD in Xinjiang, and to obtain valuable information for formulating appropriate local public health policies. MethodWe conducted a nested case-control study with 277 confirmed CHD cases and 554 matched controls. The association of the risk factors with the risk of CHD was assessed using the multivariate Cox proportional hazard model. Multiplicative interactions were evaluated by entering interaction terms in the Cox proportional hazard model. The additive interactions among the risk factors were assessed by the index of additive interaction. ResultsThe risk of CHD increased with frequent high-fat food consumption, dyslipidemia, obesity, and family history of CHD after adjustment for drinking, smoking status, hypertension, diabetes, family history of hypertension, and family history of diabetes. We noted consistent interactions between family history of CHD and frequent high-fat food consumption, family history of CHD and obesity, frequent high-fat food consumption and obesity, frequent high-fat food consumption and dyslipidemia, and obesity and dyslipidemia. The risk of CHD events increased with the presence of the aforementioned interactions. ConclusionsFrequent high-fat food consumption, family history of CHD, dyslipidemia and obesity were independent risk factors for CHD, and their interactions are important for public health interventions in patients with CHD in Xinjiang. PLOS ONEPLOS ONE | https://doi.org/10.Cases were selected from among the participants who experienced their first CHD event during the follow-up. The presence of CHD was determined on the basis of self-reported questionnaire responses, medical insurance records, and local hospital discharge records from 2009 to 2017. Patients with self-reported CHD findings were required to have a certificate of CHD diagnosis from the medical institution of their township during investigation. Multiple PLOS ONENested case-control study of coronary heart disease PLOS ONE | https://doi.org/10.

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“…In der Argumentation gegen eine Low-Carb-Ernährung wird oft angeführt, dass beim Wegfall von Kohlenhydraten die Zufuhr von Fett und insbesondere von gesättigten Fettsäuren ansteigen könne, was man für schädlich halte. Doch mittlerweile gibt es gute Belege, dass die undi erenzierte Empfehlung, Fett zu sparen und auf gesättigte Fette zu verzichten, zum Zeitpunkt ihrer Einführung nicht evidenzbasiert war und auch durch die neuesten epidemiologischen Daten nicht unterstützt wird [20,21]. Dennoch hält sich das jahrzehntelange Dogma hartnäckig.…”

Section: Sind Gesättigte Fettsäuren Schädlich?unclassified

Kohlenhydratrestriktion bei Typ-2-Diabetes aus Sicht des Präventivmediziners

Johannes

2019

Diabetes aktuell

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ZUSAMMENFASSUNGDie Verminderung der Kohlenhydratzufuhr im Austausch gegen mehr Eiweiß und Fett verbessert den Glukosestoffwechsel bei Typ-2-Diabetespatienten und kann in einem hohen Prozentsatz sogar eine Diabetesremission ermöglichen. Darüber hinaus bewirkt die Restriktion der Kohlenhydratzufuhr eine erhebliche Verbesserung der triglyzeridreichen Lipoproteine und damit des non-HDL-Cholesterins bei gleichzeitigem Anstieg des HDL-Cholesterins. Ein leichter Anstieg des LDL-Cholesterins ist durch die Zunahme der LDL-Partikelgröße bedingt, wohingegen die kleinen, dichten LDL-Partikel (sd-LDL) und das Apolipoprotein B als Maß für die Anzahl der LDL-Partikel abnehmen. Insgesamt zeigen Interventionsstudien mit Reduktion der Kohlenhydratzufuhr eine Verbesserung des kardiovaskulären Risikoprofils bei Typ-2-Diabetespatienten.

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Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis

Abstract: Epidemiological evidence to date found no significant difference in CHD mortality and total fat or saturated fat intake and thus does not support the present dietary fat guidelines. The evidence per se lacks generalisability for population-wide guidelines.

Cited by 52 publications

References 45 publications

Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review

Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review

Risk of coronary heart disease in the rural population in Xinjiang: A nested case-control study in China

Kohlenhydratrestriktion bei Typ-2-Diabetes aus Sicht des Präventivmediziners

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