This American Heart Association (AHA) presidential advisory on dietary fats and CVD reviewed and discussed the scientific evidence, including the most recent studies, on the effects of dietary saturated fat intake and its replacement by other types of fats and carbohydrates on CVD.
- Randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced CVD by ≈30%, similar to the reduction achieved by statin treatment;
- Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of CVD and of other major causes of death and all-cause mortality;
- In contrast, replacement of saturated fat with mostly refined carbohydrates and sugars is not associated with lower rates of CVD and did not reduce CVD in clinical trials;
- Replacement of saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of CVD in populations and in clinical trials.
Evidence has accumulated during the past several years that strengthens long-standing AHA recommendations to replace saturated fat with polyunsaturated and monounsaturated fat to lower the incidence of CVD. Reduction in total dietary fat or a goal for total fat intake is not recommended.
It is concluded that this shift from saturated to unsaturated fats should occur simultaneously in an overall healthful dietary pattern such as the DASH or Mediterranean diet as emphasized by the 2013 AHA/American College of Cardiology lifestyle guidelines and the 2015 to 2020 Dietary Guidelines for Americans.
Reference: Frank M. Sacks, Alice H. Lichtenstein, Jason H.Y. Wu, Lawrence J. Appel, Mark A. Creager, Penny M. Kris-Etherton, Michael Miller, Eric B. Rimm, Lawrence L. Rudel, Jennifer G. Robinson, Neil J. Stone, Linda V. Van Horn. Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. 2017. Circulation. 2017;135:00.
You may find the abstract here: Sacks et al., 2017.