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Types of Saturated Fatty Acids and Cardiovascular Disease

Synopsis

Recent research suggests that saturated fatty acids do not all have the same effect on cardiovascular health. Saturated fatty acids such as stearic acid and fatty acids found in milk and milk products appear to be beneficial and may diminish the risk for cardiovascular disease.

Highlights

• Stearic acid seems to have a favourable impact on cardiovascular health compared to other saturated fatty acids and trans fatty acid;
• Trans-palmitoleate acid, which correlated strongly with levels of fatty acid biomarkers of dairy fat consumption, was associated with lower presence of atherogenic dyslipidemia;
• There was an inverse association between serum milk fat biomarkers and the risk of myocardial infarction.

The Evidence

A systematic review, published in 2010, assessed the cardiovascular health effects of dietary stearic acid, compared with those of trans, other saturated, and unsaturated fatty acids.¹

• Compared with other saturated fatty acids, stearic acid lowered LDL cholesterol, was neutral with respect to HDL cholesterol, and directionally lowered total cholesterol/ HDL cholesterol ratio;
• Compared with unsaturated fatty acids, stearic acid raised LDL cholesterol, lowered HDL cholesterol, and increased the total cholesterol/HDL cholesterol ratio;
• Substitution of stearic acid for trans fatty acid decreased or had no effect on LDL cholesterol, increased or had no effect on HDL cholesterol, and decreased the total cholesterol/HDL cholesterol ratio.

A 2010 prospective cohort study of 3,736 adults demonstrated that circulating trans-palmitoleate is associated with lower insulin resistance, presence of atherogenic dyslipidemia, and diabetes incidence.²

• Trans-palmitoleate levels correlated strongly with levels of fatty acid biomarkers of dairy fat consumption;
• In multivariate analyses, higher trans-palmitoleate levels were associated with slightly lower adiposity and, independently, with higher HDL cholesterol levels (1.9% across quintiles, p = 0.04), lower triglyceride levels (19%, p < 0.001), a lower total cholesterol/HDL cholesterol ratio (4.7%, p < 0.001), lower C-reactive protein levels (13.8%, p < 0.05), and lower insulin resistance (16.7%, p < 0.001);
• Trans-palmitoleate was associated with a substantial 3-fold reduction in the risk of developing type 2 diabetes with multivariate hazard ratios of 0.38 (95% CI: 0.24-0.62, p_trend < 0.001) for the highest versus lowest quintile.

In a prospective matched case-control study consisting of 444 cases and 556 controls of Swedish men and women aged 30 to 70 years, the association between serum milk fat biomarkers and the risk of myocardial infarction was investigated.³

• There was a significant inverse association between pentadecanoic acid (15:0), heptadecanoic acid (17:0) or their sum and a first myocardial infarction risk in women;
• The tendency was similar in men, but not significant;
• The standardized odds ratios were: 0.74 (95% CI: 0.58-0.94) in women and 0.91 (95% CI: 0.77-1.10) in men;
• After multivariate adjustment for confounding variables, the inverse association remained for both sexes, and was significant in women.

Conclusion

There is good evidence to indicate that stearic acid has a beneficial effect on blood lipids compared to other saturated fatty acids and trans fatty acids.

There is also evidence for an inverse relationship between levels of trans-palmitoleate and metabolic risk factors and diabetes incidence.

In addition, there appears to be a protective association between the consumption of dairy fat and the risk of developing a first myocardial infarction.

More studies on different types of saturated fatty acids and those found in milk products are needed to provide more conclusive findings.

For more information:

• Saturated Fat and Cardiovascular Disease
• Summary of Data on Cardiovascular Diseases and Milk Products

Keywords: cardiovascular disease, coronary heart disease, dietary factors, saturated fat, stroke, trans fat

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