12 January - 20 June 2016

Has advice to cut down on saturated fat increased our risk of cardiovascular disease?

23 Oct 13

An observation paper published in the British Medical Journal by Aseem Malhotra, an interventional cardiology specialist registrar at Croydon University Hospital, London entitled “Saturated fat is not the major issue” has questioned the mantra that saturated fat must be removed to reduce the risk of cardiovascular disease.  Current advice is to reduce fat intake to 30% of total energy and saturated fat to 10%.  The paper  reports that elevated concentrations of low density lipoprotein (LDL) cholesterol in saturated fat is thought to have the greatest influence on cardiovascular disease.  However Malhotra states “the reduction in LDL cholesterol from reducing saturated fat intake seems to be specific to large, buoyant (type A) LDL particles, when in fact it is the small, dense (type B) particles responsive to carbohydrate intake that are implicated in cardiovascular disease. “ He reports that recent prospective cohort studies have not supported any significant association, and says that saturated fats have found to be protective, with the source of the saturated fat being important.  Dairy products for example are providers of vitamin A and D. Vitamin D deficiency has been linked to increased risk of cardiovascular mortality and calcium and phosphorous have been reported to have antihypertensive effects.  A very early study published in the Lancet in 1956, compared groups consuming diets of 90% fat versus 90% protein versus 90% carbohydrate and discovered that the greatest weight loss was in the fat consuming group. A more recent JAMA study showed that a “low fat” diet resulted in  the greatest decrease in energy expenditure, an unhealthy lipid pattern, and increased insulin resistance (a precursor to diabetes) compared with a low carbohydrate and low glycaemic index (GI) diet.  Although energy from fat has decreased from 40% to 30% in the US in the last 30 years, obesity has increased. He discusses that in the UK, eight million people take statins regularly which has increased from five million 10 years ago. However he notes the effect of statins on reduced cardiovascular mortality is difficult to demonstrate.  He indicates that high total cholesterol is not a risk factor in a healthy population, reporting that several previous studies have found that low total cholesterol is associated with cardiovascular and non-cardiac mortality.  Malthortra believes that “adopting a Mediterranean diet after a heart attack is almost three times as powerful in reducing mortality as taking a statin.”

RSSL's Lipids Laboratory, part of the Investigative Analysis Team can determine the fatty acid profile of all dietary fats and oils. For more information please contact Customer Services on Freephone 0800 243482 or email  enquiries@rssl.com

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