Types of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review
Types of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review
Year: 2001
Authors: Hu, F.B. Manson, J.E. Willett, W.C.
Publication Name: Journal of the American College of Nutrition
Publication Details: Volume 20; Number 1; Pages 5 – 19.
Abstract:
During the past several decades, reduction in fat intake has been the main focus of national dietary recommendations to decrease risk of coronary heart disease (CHD). Several lines of evidence, however, have indicated that types of fat have a more important role in determining risk of CHD than total amount of fat in the diet. Metabolic studies have long established that the type of fat, but not total amount of fat, predicts serum cholesterol levels. In addition, results from epidemiologic studies and controlled clinical trials have indicated that replacing saturated fat with unsaturated fat is more effective in lowering risk of CHD than simply reducing total fat consumption. Moreover, prospective cohort studies and secondary prevention trials have provided strong evidence that an increasing intake of n-3 fatty acids from fish or plant sources substantially lowers risk of cardiovascular mortality. In this article, we review evidence from epidemiologic studies and dietary intervention trials addressing the relationship between dietary fat intake and risk of CHD, with a particular emphasis on different major types of fat, n-3 fatty acids and the optimal balance between n-3 and n-6 fatty acids. We also discuss the implications of the available evidence in the context of current dietary recommendations. (Author�s abstract)
In this review article, the authors describe data to suggest that over the past several decades, reduction in fat intake has been the main focus of national dietary recommendations to lower risk of coronary heart disease (CHD). Metabolic studies have long established that the type of fat, but not total amount of fat, predicts serum cholesterol levels. Results from epidemiologic studies and controlled clinical trials have indicated that replacing saturated fat with unsaturated fat is more effective in lowering risk of CHD than simply reducing total fat consumption. Prospective cohort studies and secondary prevention trials have provided strong evidence that a higher intake of n-3 fatty acids from fish or plant sources lowers risk of CHD. Recent national dietary guidelines have shifted the emphasis from total fat reduction to distinguishing different types of fat. Further research is required to determine the optimal mixture of different fatty acids in lowering the risk of CHD. The review disputes the role of a �low fat� diet in health. One major purported benefit of a low-fat diet is weight loss but long-term clinical trials have not provided convincing evidence that reducing dietary fat can lead to substantial weight loss. The authors stress that significant educational efforts are needed to communicate nutritional messages about the health effects of different types of fat to the public and to translate current dietary recommendations into dietary practice as well. (Editor's Comments)
In this review article, the authors describe data to suggest that over the past several decades, reduction in fat intake has been the main focus of national dietary recommendations to lower risk of coronary heart disease (CHD). Metabolic studies have long established that the type of fat, but not total amount of fat, predicts serum cholesterol levels. Results from epidemiologic studies and controlled clinical trials have indicated that replacing saturated fat with unsaturated fat is more effective in lowering risk of CHD than simply reducing total fat consumption. Prospective cohort studies and secondary prevention trials have provided strong evidence that a higher intake of n-3 fatty acids from fish or plant sources lowers risk of CHD. Recent national dietary guidelines have shifted the emphasis from total fat reduction to distinguishing different types of fat. Further research is required to determine the optimal mixture of different fatty acids in lowering the risk of CHD. The review disputes the role of a �low fat� diet in health. One major purported benefit of a low-fat diet is weight loss but long-term clinical trials have not provided convincing evidence that reducing dietary fat can lead to substantial weight loss. The authors stress that significant educational efforts are needed to communicate nutritional messages about the health effects of different types of fat to the public and to translate current dietary recommendations into dietary practice as well. (Editor's Comments)
