So far, only a few studies have considered the quality of the carbohydrates substituting for SFAs in CHD. This study sought to investigate associations of saturated fats compared with unsaturated fats and different sources of carbohydrates in relation to CHD risk.
The researchers followed 84,628 women (Nurses’ Health Study, 1980 to 2010), and 42,908 men (Health Professionals. Follow-up Study, 1986 to 2010) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by a semi quantitative food frequency questionnaire every 4 years.
It was found that replacing intake of energy from SFAs with energy from MUFAs, PUFAs, or carbohydrates from whole grains was associated with a lower risk of CHD. In addition, isocaloric substitution of carbohydrates from refined starches/added sugars with carbohydrates from whole grains or with energy from PUFAs was also associated with a lower risk of CHD. These findings provide epidemiological evidence of the current dietary guidelines, which recommend both “replacing saturated fatty acids with monounsaturated and polyunsaturated fatty acids” and “replacing refined grains with whole grains”.
In conclusion, the current research suggests that replacing SFAs with PUFAs, MUFAs, or carbohydrates from whole grains is associated with a lower CHD risk. It was further observed that replacing carbohydrates from refined starches/added sugars with PUFAs or carbohydrates from whole grains was associated with a lower risk of CHD. These observations, together with evidence from previous studies, indicate that evidence-based, population level and individual-level recommendations to reduce SFA consumption should specify replacing SFAs with unsaturated fats and/or high-quality carbohydrates.