In the recent years the scientific community has been challenged with contrasting findings in relation to the health effects of Saturated Fatty Acid (SAFA) consumption and in particular in relation with their role on Cardiovascular Heart Disease (CVD). These controversial findings have questioned the current SAFA dietary recommendations, generated vigorous debate.
To update and discuss the science linking SAFA consumption to the risk of CHD and ischemic stroke, IEM (International Movement to Improve Diet Quality) held a workshop in November 2015 in Leiden (NL) inviting key experts in the field to debate on this topic. The proceedings were published recently in the peer reviewed paper journal Annals of Nutrition and Metabolism (Nettleton et al., 2017).
The experts concluded that dietary SAFA, when compared to carbohydrates and cis -unsaturated fatty acids, raise plasma LDL-C, a causal risk factor for CHD. Individual SAFA affect plasma lipoprotein levels differently, with each major dietary SAFA except stearic acid resulting in higher levels of LDL- and HDL-C and lower levels of TG.
As shown in prospective observational studies and randomized controlled trials, higher total SAFA intakes were not associated with higher incident CHD events or mortality, but replacement nutrients were not taken into account. The effect of reducing dietary SAFA is most strongly affected by the macronutrients that replace them. The greatest reduction in CHD risk occurs when cis -PUFA replace dietary SAFA. In intervention studies replacement of 10%E from SAFA by cis -PUFA reduced CVD events by 27% and the replacement of 5%E from SAFA by cis -PUFA decreased CHD risk by 10%.
Data are insufficient to confirm a significant benefit for CHD risk by substituting cis – MUFA for SAFA. Emerging evidence suggests that the food matrix may modify the risk of CHD associated with some SAFA-rich foods. Studies on SAFA intakes and risk of ischemic stroke are inconsistent. Compared with the abundant data on SAFA consumption and risk of CHD, there is insufficient evidence to support dietary SAFA recommendations to reduce stroke risk.
In summary, strong evidence supports the partial replacement of SAFA-rich foods with those rich in cis -PUFA to lower LDL-C and reduce CHD risk.