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Back to Symposium 2010

Saturated Fat and CVD: the state of knowledge in 2010

Arne Vernon  Astrup Arne Vernon Astrup, MD, DSc

University of Copenhagan

Current dietary recommendations advise reducing intake of saturated fatty acids (SFA) to decrease the risk of cardiovascular disease (CVD), but recent findings question the role of SFA in CVD. The evidence from observational epidemiological studies, randomized trials, and mechanistic studies is consistent in finding that CVD risk is only slightly reduced when polyunsaturated fatty acids replace SFA. There is insufficient evidence, both from observational studies and from intervention trials to judge the effect on CVD risk of replacing SFA with monounsatured fatty acids. The effect of replacing SFA with carbohydrate has changed as populations have become more obese and there is currently no evidence of any benefit in substituting carbohydrate for SFA. There is actually evidence to support that replacement of SFA with carbohydrate may increase CVD risk. There is no clear association between SFA intake, insulin resistance, obesity, metabolic syndrome and diabetes risk.

The effect of particular foods on CVD risk cannot be predicted solely by their content of total SFA because individual SFAs have different effects on CVD risk, and major food sources of SFA contain other nutrients influencing CVD risk. Good examples of this are dark chocolate and cheese. Intake of cheese is generally not associated with increased CHD risk in observational studies, and a meta-analysis has found reduced risks of CHD, stroke, and diabetes among high-consumers of dairy products as compared with low consumers.

The special role of cheese may be explained by a beneficial effect on blood lipids (i.e., LDL- and HDL-cholesterol and postprandial triglycerides) and on blood pressure, effects that are exerted by fatty acids, calcium, protein and certain peptides in concert. This new view on SFA emphasizes that more health benefits can be achieved by changing the focus from SFA to reducing the prevalence of obesity, inactivity, and smoking, and promoting dietary changes with elimination of industrially produced trans fat, reduction of sugar-rich soft drinks, and increased intake of whole-grain foods, fruit and vegetables, lean meat and dairy products.

More research is needed to clarify the role of different foods rich in SFA on CVD risk, specifically in comparison with the risk posed by carbohydrates.

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