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Dietary Fat and Risk of Cardiovascular Disease: Recent Controversies and Advances
Abstract
Health effects of dietary fats have been extensively studied for decades. However, controversies exist on the effects of various types of fatty acids, especially saturated fatty acid (SFA), on cardiovascular disease (CVD). Current evidence supports that different types of dietary fatty acids have divergent effects on CVD risk, and the effects also depend strongly on the comparison or replacement macronutrient. A significant reduction in CVD risk can be achieved if SFAs are replaced by unsaturated fats, especially polyunsaturated fatty acids. Intake of industrially produced trans fat is consistently associated with higher CVD risk. Both n-6 and n-3 polyunsaturated fatty acids are associated with lower CVD risk, although the effects of fish oil supplementation remains inconsistent. The 2015–2020 Dietary Guidelines for Americans place greater emphasis on types of dietary fat than total amount of dietary fat and recommend replacing SFAs with unsaturated fats, especially polyunsaturated fatty acids for CVD pre...

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  • References (152)
  • Cited By (10)
Dariush Mozaffarian107
Estimated H-index: 107
(Brigham and Women's Hospital),
Jason H.Y. Wu32
Estimated H-index: 32
We reviewed available evidence for cardiovascular effects of n-3 polyunsaturated fatty acid (PUFA) consumption, focusing on long chain (seafood) n-3 PUFA, including their principal dietary sources, effects on physiological risk factors, potential molecular pathways and bioactive metabolites, effects on specific clinical endpoints, and existing dietary guidelines. Major dietary sources include fatty fish and other seafood. n-3 PUFA consumption lowers plasma triglycerides, resting heart rate, and ...
868 Citations Download PDF Cite
1972 in The Lancet [IF: 53.25]
Matti Miettinen6
Estimated H-index: 6
,
MarttiJ. Karvonen8
Estimated H-index: 8
,
Osmo Turpeinen9
Estimated H-index: 9
... more
Abstract The mortality from coronary heart-disease (C.H.D.) and other causes was studied in two mental hospitals during a long-term (twelve-year) controlled preventive trial. The trial was cross-over in design. In one of the hospitals a serum-cholesterol-lowering diet was introduced and the other hospital using a normal diet served as the control. After six years the diets were reversed, and the trial was continued for six more years. In men, the use of the cholesterol-lowering diet was associat...
304 Citations Source Cite
1970 in Circulation [IF: 18.88]
Ancel Keys67
Estimated H-index: 67
1,508 Citations Source
2012 in Journal of Internal Medicine [IF: 6.75]
Walter C. Willett290
Estimated H-index: 290
(Harvard University)
Abstract. Willett WC (Harvard School of Public Health, Boston, MA, USA). Dietary fats and coronary heart disease (Review). J Intern Med 2012; 272: 13–24. The relation of dietary fat to risk of coronary heart disease (CHD) has been studied extensively using many approaches, including controlled feeding studies with surrogate end-points such as plasma lipids, limited randomized trials and large cohort studies. All lines of evidence indicate that specific dietary fatty acids play important roles in...
145 Citations Source Cite
Gudrun V. Skuladottir4
Estimated H-index: 4
(RMIT University),
Ragnhildur Heidarsdottir4
Estimated H-index: 4
(RMIT University),
David O. Arnar22
Estimated H-index: 22
(RMIT University)
... more
Eur J Clin Invest 2011; 41 (9): 995–1003 Abstract Background The anti-inflammatory or anti-arrhythmic effects of n-3 long-chain polyunsaturated fatty acids (LC-PUFA) may decrease the risk of postoperative atrial fibrillation (POAF), but interventional studies have yielded conflicting results. We examined the association between n-3 LC-PUFA and n-6 LC-PUFA in plasma phospholipids (PL) and POAF in patients undergoing coronary artery bypass grafting (CABG). Methods A total of 125 patients undergoin...
32 Citations Source Cite
Sjh Biddle3
Estimated H-index: 3
,
Kenneth R Fox56
Estimated H-index: 56
The importance of exercise for health and long-term weight management is now well-established. However, the critical challenge is facilitating increased physical activity in the large sector of young to middle-aged adults who are sedentary and already overweight. The psychology of exercise initiation and adherence in the overweight is seriously under-researched. However, it is possible to infer findings from the general population and from other health behaviours to develop effective exercise pr...
2,627 Citations Source Cite
Yanping Li41
Estimated H-index: 41
(Harvard University),
Adela Hruby17
Estimated H-index: 17
(Harvard University),
Adam M. Bernstein23
Estimated H-index: 23
(Cleveland Clinic)
... more
Abstract Background The associations between dietary saturated fats and the risk of coronary heart disease (CHD) remain controversial, but few studies have compared saturated with unsaturated fats and sources of carbohydrates in relation to CHD risk. Objectives This study sought to investigate associations of saturated fats compared with unsaturated fats and different sources of carbohydrates in relation to CHD risk. Methods We followed 84,628 women (Nurses’ Health Study, 1980 to 2010), and 42,9...
124 Citations Download PDF Cite
Stephanie J. London76
Estimated H-index: 76
,
Frank M. Sacks109
Estimated H-index: 109
,
John Caesar1
Estimated H-index: 1
... more
The distributions of fatty acids in subcutaneous-adipose-tissue aspirates and their relation to intake as assessed by a semiquantitative food-frequency questionnaire were investigated in 1 15 postmenopausal US women free from cancer. Percentages of fatty acids in adipose tissue were significantly correlated with the percentage of total fat intake for polyunsaturated fatty acids (Spearman correlation = 0.37), n-3 fatty acids of marine origin (Spearman correlation = 0.48), and trans fatty acids (S...
179 Citations Source Cite
Qi Sun61
Estimated H-index: 61
(Harvard University),
Jing Ma78
Estimated H-index: 78
(Harvard University),
Hannia Campos57
Estimated H-index: 57
(Harvard University)
... more
Background: The relation between dairy product intake and the risk of ischemic heart disease (IHD) remains controversial. Objective: We aimed to explore biomarkers of dairy fat intake in plasma and erythrocytes and to assess the hypothesis that higher concentrations of these biomarkers are associated with a greater risk of IHD in US women. Design: Among 32 826 participants in the Nurses' Health Study who provided blood samples in 1989-1990, 166 incident cases of IHD were ascertained between base...
87 Citations Source Cite
Jorge Salmerón38
Estimated H-index: 38
,
Frank B. Hu200
Estimated H-index: 200
,
JoAnn E. Manson229
Estimated H-index: 229
... more
Background: The long-term relations between specific types of dietary fat and risk of type 2 diabetes remain unclear. Objective: Our objective was to examine the relations between dietary fat intakes and the risk of type 2 diabetes. Design: We prospectively followed 84204 women aged 34-59 y with no diabetes, cardiovascular disease, or cancer in 1980. Detailed dietary information was assessed at baseline and updated in 1984, 1986, and 1990 by using validated questionnaires. Relative risks of type...
615 Citations Source Cite
  • References (152)
  • Cited By (10)
2016 in Atherosclerosis [IF: 4.47]
Marcus E. Kleber35
Estimated H-index: 35
(Heidelberg University),
Graciela Delgado18
Estimated H-index: 18
(Heidelberg University),
Stefan Lorkowski32
Estimated H-index: 32
(University of Jena)
... more
Background Saturated fatty acids are thought to be harmful by increasing the risk for cardiovascular events. Objective We examined the associations of erythrocyte saturated fatty acids with total and cardiovascular mortality in patients referred for coronary angiography. Methods Red blood cell saturated fatty acid (RBC SFA) proportions were measured by gas chromatography at baseline in 3259 participants of the Ludwigshafen Risk and Cardiovascular Health study. Associations of saturated fatty aci...
20 Citations Source Cite
2017 in PLOS ONE [IF: 2.77]
Lisa Te Morenga8
Estimated H-index: 8
(University of Otago),
Jason M. Montez1
Estimated H-index: 1
(World Health Organization)
Background Elevated cholesterol has been linked to cardiovascular disease in adults and preclinical markers of atherosclerosis in children, thus reducing saturated (SFA) and trans-fatty acids (TFA) intake from an early age may help to reduce cholesterol and the risk of cardiovascular disease later in life. The aim of this review is to examine the evidence for health effects associated with reducing SFA and TFA intake in free-living children, adolescents and young adults between 2 to 19 years of ...
2 Citations Source Cite
Andreina Alfieri6
Estimated H-index: 6
,
Esther Imperlini10
Estimated H-index: 10
,
Ersilia Nigro9
Estimated H-index: 9
... more
The position of the fatty acids (sn-1, sn-2 and sn-3) (stereospecific numbering (sn)) in triacylglycerol (TAG) molecules produces a characteristic stereospecificity that defines the physical properties of the fats and influences their absorption, metabolism and uptake into tissues. Fat interesterification is a process that implies a positional distribution of fatty acids (FAs) within the TAG molecules, generating new TAG species, without affecting the FA cis-trans natural balance. The interester...
2 Citations Source Cite
Jyrki K. Virtanen29
Estimated H-index: 29
(University of Eastern Finland)
Abstract Several trials in the 1950s through 1970s tested the hypothesis that replacing saturated fat in the diet predominantly with n-6 polyunsaturated fat (PUFA) would reduce the incidence of coronary heart disease (CHD), mainly through modifying blood lipid profile. Most of these trials did observe a reduction in serum total cholesterol in the intervention group, but many trials failed to find a significant reduction in the incidence of CHD. However, some meta-analyses have found a reduced in...
2 Citations Source Cite
2018 in PLOS ONE [IF: 2.77]
Marianne Uhre Jakobsen25
Estimated H-index: 25
(Technical University of Denmark),
Anders Gorst-Rasmussen17
Estimated H-index: 17
(Aalborg University),
Helle Højmark Eriksen2
Estimated H-index: 2
(Aalborg University)
... more
Background The risk of coronary heart disease associated with intake of individual trans fatty acids (TFAs) is not clear. Adipose tissue content of TFAs is a biomarker of TFA intake and metabolism. Objective We investigated the rate of myocardial infarction (MI) associated with the adipose tissue content of total 18:1t, isomers of 18:1t (18:1 Δ6-10t and 18:1 Δ11t) and 18:2 Δ9c, 11t. Methods A case-cohort study, nested within the Danish Diet, Cancer and Health cohort (n = 57,053), was conducted, ...
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2018 in BMC Family Practice [IF: 2.03]
Bruce A. Griffin38
Estimated H-index: 38
(University of Surrey),
John A. A. Nichols2
Estimated H-index: 2
(University of Surrey)
Background When advising patients on diet and health, the general practitioner (GP) makes judgements based on the evidence available. Since current evidence on diet and cardiovascular disease is conflicted and confusing, we surveyed the current consensus amongst GPs. The aim of this study was to determine the views of GPs on dietary saturated fat, carbohydrates and long chain omega-3 fatty acids in the management of cardiovascular disease.
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2018 in Nutrients [IF: 4.20]
Hayley Billingsley3
Estimated H-index: 3
,
Salvatore Carbone12
Estimated H-index: 12
,
Carl J. Lavie80
Estimated H-index: 80
The role of dietary fat has been long studied as a modifiable variable in the prevention and treatment of noncommunicable cardiometabolic disease. Once heavily promoted to the public, the low-fat diet has been demonstrated to be non-effective in preventing cardiometabolic disease, and an increasing body of literature has focused on the effects of a relatively higher-fat diet. More recent evidence suggests that a diet high in healthy fat, rich in unsaturated fatty acids, such as the Mediterranean...
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2018 in Essays in Biochemistry [IF: 3.34]
Alastair J. Barr16
Estimated H-index: 16
(University of Westminster)
This article gives the reader an insight into the role of biochemistry in some of the current global health and disease problems. It surveys the biochemical causes of disease in an accessible and succinct form while also bringing in aspects of pharmacology, cell biology, pathology and physiology which are closely aligned with biochemistry. The discussion of the selected diseases highlights exciting new developments and illuminates key biochemical pathways and commonalities. The article includes ...
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