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Dietary Fat and Risk of Cardiovascular Disease: Recent Controversies and Advances
Published on Aug 21, 2017in Annual Review of Nutrition 8.89
· DOI :10.1146/annurev-nutr-071816-064614
Dong D. Wang16
Estimated H-index: 16
Frank B. Hu200
Estimated H-index: 200
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...
  • References (152)
  • Cited By (10)
Published on Nov 1, 2011in Journal of the American College of Cardiology 16.83
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 ...
896 Citations Source Cite
Published on Oct 21, 1972in The Lancet 53.25
Matti Miettinen6
Estimated H-index: 6
MarttiJ. Karvonen8
Estimated H-index: 8
+ 2 AuthorsErkki Paavilainen5
Estimated H-index: 5
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...
314 Citations Source Cite
Published on Jan 1, 1970in Circulation 18.88
Ancel Keys67
Estimated H-index: 67
1,525 Citations
Published on Jul 1, 2012in Journal of Internal Medicine 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...
150 Citations Source Cite
Published on Sep 1, 2011in European Journal of Clinical Investigation 3.09
Gudrun V. Skuladottir4
Estimated H-index: 4
(RMIT University),
Ragnhildur Heidarsdottir4
Estimated H-index: 4
(RMIT University)
+ 5 AuthorsOlafur S. Indridason22
Estimated H-index: 22
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...
31 Citations Source Cite
Published on Jan 1, 1998in International Journal of Obesity 5.16
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...
2,638 Citations Source Cite
Published on Oct 1, 2015in Journal of the American College of Cardiology 16.83
Yanping Li41
Estimated H-index: 41
(Harvard University),
Adela Hruby17
Estimated H-index: 17
(Harvard University)
+ 8 AuthorsWalter C. Willett290
Estimated H-index: 290
(Harvard University)
132 Citations Source Cite
Published on Aug 1, 1991in The American Journal of Clinical Nutrition 6.55
Stephanie J. London76
Estimated H-index: 76
Frank M. Sacks109
Estimated H-index: 109
+ 3 AuthorsWalter C. Willett290
Estimated H-index: 290
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...
181 Citations Source Cite
Published on Oct 1, 2007in The American Journal of Clinical Nutrition 6.55
Qi Sun61
Estimated H-index: 61
(Harvard University),
Jing Ma78
Estimated H-index: 78
(Harvard University)
+ 1 AuthorsFrank B. Hu200
Estimated H-index: 200
(Harvard University)
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...
89 Citations Source Cite
Published on Jun 1, 2001in The American Journal of Clinical Nutrition 6.55
Jorge Salmerón38
Estimated H-index: 38
Frank B. Hu200
Estimated H-index: 200
+ 4 AuthorsWalter C. Willett290
Estimated H-index: 290
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...
621 Citations Source Cite
Cited By10
Published on Sep 1, 2016in Atherosclerosis 4.47
Marcus E. Kleber35
Estimated H-index: 35
(Heidelberg University),
Graciela Delgado18
Estimated H-index: 18
(Heidelberg University)
+ 2 AuthorsClemens von Schacky24
Estimated H-index: 24
(Ludwig Maximilian University of Munich)
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
Published on Nov 17, 2017in PLOS ONE 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
Published on Dec 30, 2017in International Journal of Molecular Sciences 3.69
Andreina Alfieri6
Estimated H-index: 6
Esther Imperlini10
Estimated H-index: 10
+ 5 AuthorsAnnamaria Mancini6
Estimated H-index: 6
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
Published on Aug 22, 2018in PLOS ONE 2.77
Marianne Uhre Jakobsen25
Estimated H-index: 25
(Technical University of Denmark),
Anders Gorst-Rasmussen17
Estimated H-index: 17
(Aalborg University)
+ 6 AuthorsKim Overvad109
Estimated H-index: 109
(Aarhus University)
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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Published on Dec 1, 2018in BMC Family Practice 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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Published on Sep 30, 2018in Nutrients 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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Published on Dec 3, 2018in Essays in Biochemistry 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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View next paperDietary fats and cardiovascular health: a summary of the scientific evidence and current debate