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Saturated Fatty Acid Intake as a Risk Factor for Cardiovascular Disease in Healthy Caucasian Adults from Western Populations
Thomas, Patricia Mushtaq, Sohail
Thomas, Patricia
Mushtaq, Sohail
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2014-02-02
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Abstract
ABSTRACT
Background: Cardiovascular disease (CVD) is the leading cause of premature death
globally (WHO, 2010).For over 50 years saturated fatty acids (SFA) have been implicated
as a main dietary risk factor for CVD. Therefore national guidelines recommend limiting
SFA to <10% of total daily energy intake COMA, [1]. However, recent literature has begun
to question this advice due to contra evidence showing SFA not to be a risk factor for
CVD, Hoenselaar [2]. This study’s aim was to investigate the relationship between SFA
and CVD to assess whether or not recommendations should be made to review national
guidelines.
Method: A systematic review and meta-analysis were conducted. Electronic research
databases were searched using variations of the keywords “saturated fatty acids” and
“cardiovascular disease”. Articles were only included if they had a randomised control trial
(RCT) or prospective cohort (PC) study design. Additionally participants had to meet the
following criteria: Caucasian, non-smokers, normal BMI, classed as healthy, no preexisting
CVD related conditions, not taking cholesterol altering drugs and no inborn errors
of lipid metabolism. Articles were also only included if they were conducted in western
populations in an attempt to standardise environmental factors. In the PCs, only data
which was adjusted for these factors was included. Articles were assessed for quality
using the Jadad et al. [3] scoring/CASP tool and for confounding variables, risk of bias and
homogeneity.
Results: A total of 411 articles were identified. Eight articles were included after exclusion
for duplication, study design, not meeting full inclusion criteria, low quality, confounding
variables, high risk of bias and heterogeneity. Of these, 4 were RCTs and 4 were PCs
including 193,409 participants (192,686 female, 723 male). RCT and PC data were
analysed separately. For the RCTs, LDL-cholesterol concentration post high/low SFA
intervention was used as a functional biomarker for CVD risk. For the PCs the number of
CVD related events in the low/high SFA diet groups was used as the marker for CVD risk.
In the RCT meta-analysis there was a standard mean difference (95%CI) of -0.94 (-1.17, -
0.71) (p<0.00001) favouring the low SFA diet to decrease the risk of CVD. In the PC metaanalysis
a risk ratio (95%CI) of 1.00 (0.64, 1.58) (p=1.00) showed there to be no
statistically significant relationship between SFA and CVD. Sensitivity analyses conducted
predominantly showed no change in outcome.
Discussion: RCT outcomes favoured a low SFA diet for lowering CVD risk whereas the
PC outcome showed no relationship. Although these differed they indicate that SFA does
not increase CVD risk in western Caucasian adults. However further research is needed
before requesting recommendations for the review of national guidelines. These findings
correlate with other systematic reviews/meta-analyses e.g. Skeaff and Miller, [4].
Conclusion: From the studies included SFA does not increase CVD risk in affluent
Caucasian adults.
Citation
Thomas, P. & Mushtaq, S. (2014). Saturated Fatty Acid Intake as a Risk Factor for Cardiovascular Disease in Healthy Caucasian Adults from Western Populations. European Journal of Nutrition & Food Safety, 4(3), 250-251.
Publisher
Cambridge University Press
Journal
European Journal of Nutrition & Food Safety
Research Unit
DOI
10.9734/ejnfs/2014/v4i327027
PubMed ID
PubMed Central ID
Type
Article
Language
en
Description
Series/Report no.
ISSN
EISSN
2347-5641