Food Sources of Saturated Fat and the Association With Mortality: A Meta-Analysis
Open accessAbstract
We summarized the data related to foods high in saturated fat and risk of mortality. We searched Cochrane Library, MEDLINE, EMBASE, and ProQuest for studies from January 1952 to May 2012. We identified 26 publications with individual dietary data and all-cause, total cancer, or cardiovascular mortality as endpoints. Pooled relative risk estimates demonstrated that high intakes of milk, cheese, yogurt, and butter were not associated with a significantly increased risk of mortality compared with low intakes. High intakes of meat and processed meat were significantly associated with an increased risk of mortality but were associated with a decreased risk in a subanalysis of Asian studies. The overall quality of studies was variable. Associations varied by food group and population. This may be because of factors outside saturated fat content of individual foods. There is an ongoing need for improvement in assessment tools and methods that investigate food sources of saturated fat and mortality to inform dietary guidelines.
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Butter consumption is not significantly associated with incident CHD, stroke, or total mortality.
“Butter consumption is also not significantly associated with incident CHD,223 stroke,222 or total mortality58 (Figure 6).”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [58]
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“others with potential unfavourable implications((37,38)).”
Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association?
Gaesser, G. A. (2018) · Advances in Nutrition · doi:10.1093/advances/nmy104 · Cited by 60 · see citing works
“The relationship for processed meat intake is the most consistent, with all meta-analyses reporting significantly higher risk (15–42%) both when comparing the highest with the lowest intakes (4, 41, 42) and in doseresponse analyses (4, 40, 42).”
Does Milk Consumption Contribute to Cardiometabolic Health and Overall Diet Quality?
Lamarche, B., Givens, D. I., Soedamah‐Muthu, S. S., Krauss, R. M., Jakobsen, M. U., Bischoff-Ferrari, H. A., Pan, A., & Després, J. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2015.12.033 · Cited by 56 · see citing works
“Milk consumption also contributes to dietary intake of magnesium, potassium, phosphorus, vitamin B 12 , ribo fl avin, and vitamin A.”
Cavero‐Redondo, I., Álvarez‐Bueno, C., Sotos‐Prieto, M., Gil, Á., Martínez‐Vizcaíno, V., & Ruiz, J. R. (2019) · Advances in Nutrition · doi:10.1093/advances/nmy128 · Cited by 57 · see citing works
“In addition, fermented dairy products, cheese, yogurt, and butter were included as exposures in other meta-analyses (13, 15, 16, 19).”
BackgroundResultHill, E. R., O'Connor, L., Wang, Y., Clark, C., Mcgowan, B., Forman, M., & Campbell, W. N. (2022) · Critical reviews in food science and nutrition · doi:10.1080/10408398.2022.2123778 · Cited by 41 · see citing works
“…studies (Aune, Ursin, and Veierød 2009; Micha, Wallace, and Mozaffarian 2010; Kaluza, Wolk, and Larsson 2012; Akesson et al. 2013; Chen et al. 2013; O'Sullivan et al. 2013; Abete et al. 2014; Lippi, Mattiuzzi, and Sanchis-Gomar 2015; Wang et al. 2016; Yang et al. 2016; Kim et al. 2017;…”
BackgroundYang, Q., Lin, S. L., Yeung, S. L. A., Kwok, M. K., Xu, L., Leung, G. M., & Schooling, C. M. (2017) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2017.8 · Cited by 50 · see citing works
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O’Sullivan, T. A., Schmidt, K. A., & Kratz, M. (2020) · Advances in Nutrition · doi:10.1093/advances/nmaa011 · Cited by 49 · see citing works
“Additionally, higher intakes of whole-fat dairy foods were not associated with increased risk of mortality in a meta-analysis (12).”
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Ma, Y., Zheng, Z., Zhuang, L., HuiTing, W., Li, A., Chen, L., & Liu, L. (2024) · Nutrients · doi:10.3390/nu16010152 · Cited by 47 · see citing works
Specific roles of saturated fatty acids: Beyond epidemiological data
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Nutrición y salud cardiovascular
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Meat in the post-truth era: Mass media discourses on health and disease in the attention economy
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“This is consistent with the inconclusive findings of meta-analyses on the relation between yogurt consumption and mortality (20, 21, 57).”
ResultZhang, J., Feng, Y., Yang, X., Yang, L., Wu, Y., Yuan, L., Li, T.-Z., Hu, H., Li, X., Huang, H., et al. (2022) · Advances in Nutrition · doi:10.1093/advances/nmac049 · Cited by 43 · see citing works
Hamdy, O., & Yusof, B. N. M. (2016) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2016.06.010 · Cited by 45 · see citing works
Dairy Consumption and Metabolic Health
Timon, C., O’Connor, A., Bhargava, N., Gibney, E. R., & Feeney, E. L. (2020) · Nutrients · doi:10.3390/nu12103040 · Cited by 39 · see citing works
“However, research investigating the importance of the food source of saturated fatty acids (SFA) suggests that although SFAs from meat and processed-meat are associated with detrimental health effects [30], SFA intake from dairy sources may be associated with either neutral [31] or beneficial effects on cardiovascular…”
BackgroundProduction, Composition and Nutritional Properties of Organic Milk: A Critical Review
Linehan, K., Patangia, D. V., Ross, R. P., & Stanton, C. (2024) · Foods · doi:10.3390/foods13040550 · Cited by 39 · see citing works
Dairy product consumption and development of cancer: an overview of reviews
Jeyaraman, M. M., Abou-Setta, A. M., Grant, L., Farshidfar, F., Copstein, L., Lys, J., Gottschalk, T., Desautels, D. N., Czaykowski, P. M., Pitz, M. W., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-023625 · Cited by 35 · see citing works
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Fats and oils – a scoping review for Nordic Nutrition Recommendations 2023
Rosqvist, F., & Niinistö, S. (2024) · Food & Nutrition Research · doi:10.29219/fnr.v68.10487 · Cited by 32 · see citing works
“A previous meta-analysis from 2013 (29) based on partly the same data (one overlapping study) observed no association between intake of butter and all-cause mortality (RR 0.96 [0.85–1.08] per each additional serving/week), with considerable heterogeneity ( I 2 = 78%).”
BackgroundInfluentialFoscolou, A., Critselis, E., Tyrovolas, S., Chrysohoou, C. A., Sidossis, L. S., Naumovski, N., Matalas, A., Rallidis, L. S., Polychronopoulos, E., Ayuso‐Mateos, J. L., et al. (2019) · Foods · doi:10.3390/foods8010025 · Cited by 32 · see citing works
Dominguez, L. J., Bes‐Rastrollo, M., Basterra-Gortari, F. J., Gea, A., Barbagallo, M., & Martínez‐González, M. Á. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2017.06.013 · Cited by 31 · see citing works
“Regrettably, as with o ther dietary guidelines, the recently released 393 2015-2020 DGA [32] do not specifically limit red or total meat consumption, disregarding the 394 compelling evidence of detrimental effects linked t o an excessive meat consumption [6-18,23-26], 395 and the recent report of IARC/WHO indicating c…”
InfluentialBergholdt, H. K. M., Nordestgaard, B. G., Varbo, A., & Ellervik, C. (2017) · European Journal of Epidemiology · doi:10.1007/s10654-017-0328-x · Cited by 30 · see citing works
“However, metaanalyses investigating food sources of saturated fat it was reported that there was no association between high intake of milk and dairy products and risk of cardiovascular-, cancer-, or all-cause mortality compared to individuals with low intake [2, 4].”
BackgroundA Role for Fatty Acids in Peripheral Neuropathy Associated with Type 2 Diabetes and Prediabetes
Rumora, A. E., Kim, B., & Feldman, E. L. (2022) · Antioxidants and Redox Signaling · doi:10.1089/ars.2021.0155 · Cited by 30 · see citing works
“Red meats, and processed and fried foods contain highlevelsof long-chain saturated FAs, whereas dairy products, such as milk andcheese, arerichinmedium-chainsaturatedFAs (97).”
Händel, M. N., Cardoso, I., Rasmussen, K. M., Rohde, J. F., Jacobsen, R., Nielsen, S. M., Christensen, R., & Heitmann, B. L. (2019) · PLoS ONE · doi:10.1371/journal.pone.0223883 · Cited by 30 · see citing works
“[35], and only 5 out of 22 systematic reviews fulfilled that [30,33,34,39,40].”
BackgroundMethodButter and Plant-Based Oils Intake and Mortality
Zhang, Y., Chadaideh, K. S., Li, Y., Li, Y., Gu, X., Liu, Y., Guasch‐Ferré, M., Rimm, E. B., Hu, F. B., Willett, W. C., et al. (2025) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2025.0205 · Cited by 28 · see citing works
Li, D., Misialek, J. R., Ma, J., Tsai, M. Y., Eckfeldt, J. H., Steffen, L. M., Knopman, D. S., Wruck, L. M., Gottesman, R. F., Mosley, T. H., et al. (2020) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqaa048 · Cited by 27 · see citing works
“For example, meta-analyses of observational studies have failed to show an association between higher intake of SFAs or their food sources and increased risk of overall mortality (1) or cardiovascular diseases (2).”
BackgroundSubali, D., Christos, R. E., Givianty, V. T., Ranti, A., Kartawidjajaputra, F., Antono, L., Dijaya, R., Taslim, N. A., Rizzo, G., & Nurkolis, F. (2023) · Nutrients · doi:10.3390/nu15112599 · Cited by 26 · see citing works
“High consumption of red meat also affects athletes’ health, because it contains high saturated fat and is linked to causing colon and rectal cancer [13].”
BackgroundGlanville, J., Brown, S., Shamir, R., Szajewska, H., & Eales, J. F. (2015) · Frontiers in Pharmacology · doi:10.3389/fphar.2015.00246 · Cited by 25 · see citing works
“Methods: The review was guided by a protocol agreed a priori and informed by an extensive literature search conducted in November 2013.”
MethodImpulsivity influences food intake in women with generalized anxiety disorder
Fonseca, N. K. D. O. D., Molle, R. D., Costa, M. D. A., Gonçalves, F. G., Silva, A. C., Rodrigues, Y., Price, M., Silveira, P. P., & Manfro, G. G. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2019-0556 · Cited by 24 · see citing works
“Saturated fat is associated with cardiovascular disease and mortality, 37 and generally related to an unhealthy lifestyle, since w Correlation significant at p o 0.05 (two-tailed).”
InfluentialAdherence to the MIND diet is associated with 12-year all-cause mortality in older adults
Corley, J. (2020) · Public Health Nutrition · doi:10.1017/s1368980020002979 · Cited by 24 · see citing works
“Physical activity (level) was derived from responses to a questionnaire item which asked: ‘What level of physical activity do youmainly do?’ and responses were on a sixpoint scale: (1) moving only in connection with necessary (household) chores; (2) walking or other outdoor activities 1–2 times/week; (3) walking or ot…”
MethodZhang, Y., Wu, Y., Zhang, Y., Cao, D., He, H., Cao, X., Wang, Y., Jia, Z., & Jiang, J. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.1034323 · Cited by 22 · see citing works
Nutrition and Cardiovascular Health
Berciano, S., & Ordovás, J. M. (2014) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2014.05.003 · Cited by 22 · see citing works
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Plant-based alternative proteins—are they nutritionally more advantageous?
Tay, W. L. W., Quek, R. Y. C., Lim, J. C. L., Kaur, B., Ponnalagu, S., & Henry, C. J. (2023) · European Journal of Clinical Nutrition · doi:10.1038/s41430-023-01328-1 · Cited by 22 · see citing works
“Saturated fat is one of the dominant fats found in meat, processed meat, and dairy products, and is associated with higher risks of myocardial infarction, stroke, and cardiovascular disease [44, 45].”
BackgroundNutrition myths and healthy dietary advice in clinical practice.
Lesser, L. I., Mazza, M. C., & Lucan, S. C. (2015) · PubMed · Cited by 21 · see citing works
Meat Consumption and Health Outcomes
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Wheat flour versus rice consumption and vascular diseases: Evidence from the China Study II data
Kock, N. (2015) · Cliodynamics The Journal of Quantitative History and Cultural Evolution · doi:10.21237/c7clio6227969 · Cited by 19 · see citing works
“This is an important feature in our analyses, because food-mortality associations tend to be nonlinear (Johansson, 1994; O’Sullivan et al., 2013).”
BackgroundMilk and dairy products – a scoping review for Nordic Nutrition Recommendations 2023
Holven, K. B., & Sonestedt, E. (2024) · Food & Nutrition Research · doi:10.29219/fnr.v68.10486 · Cited by 18 · see citing works
Kızılarslanoğlu, M. C., Kilic, M. K., Gokce, D., Şakalar, T., & Ülger, Z. (2016) · The journal of nutrition health & aging · doi:10.1007/s12603-016-0744-8 · Cited by 18 · see citing works
Onni, A. T., Balakrishna, R., Perillo, M., Amato, M., Arjmand, E. J., Thomassen, L. M., Lorenzini, A., & Fadnes, L. T. (2025) · Advances in Nutrition · doi:10.1016/j.advnut.2025.100393 · Cited by 17 · see citing works
Rajendiran, E., Lamarche, B., She, Y., Ramprasath, V. R., Eck, P., Brassard, D., Gigleux, I., Levy, E. H., Tremblay, A., Couture, P., et al. (2021) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqab064 · Cited by 17 · see citing works
Habitual Yogurt Consumption and Health-Related Quality of Life: A Prospective Cohort Study
López‐García, E., León-Muñoz, L. M., Guallar‐Castillón, P., & Rodríguez‐Artalejo, F. (2014) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2014.05.013 · Cited by 17 · see citing works
Egg, S., Erler, J., Perktold, B., Hasenegger, V., Rust, P., Ramoner, R. E., König, J. S., & Purtscher, A. E. (2018) · Public Health Nutrition · doi:10.1017/s1368980018003270 · Cited by 17 · see citing works
“According to O’Sullivan et al.(60), studies using quantitative dietary assessments, such as multiple 24 h recalls, diet histories or diet records with sufficient length of follow-up and sufficient personal and lifestyle data to adequately adjust for potential confounders, are necessary to clarify the scientific eviden…”
BackgroundNutrition and public health economic evaluations under the lenses of post normal science
Piano, S. L., & Robinson, M. (2019) · Futures · doi:10.1016/j.futures.2019.06.008 · Cited by 17 · see citing works
Bard, J., Drouet, L. O., Lairon, D., Cazaubiel, M., Marmonier, C., Ninio, E., Sollier, C. B. D., Martin, J., Boyer, C., Bobin‐Dubigeon, C., et al. (2019) · European Journal of Clinical Nutrition · doi:10.1038/s41430-019-0528-4 · Cited by 17 · see citing works
Wojda, A., Janczy, A., & Małgorzewicz, S. (2021) · Acta Biochimica Polonica · doi:10.18388/abp.2020_5515 · Cited by 17 · see citing works
“It may be suggested that plant-based diet may be more beneficial for reducing CVD risk, however LC-SFA can be also found in plant delivered oils such as coconut (USDA, 2019), palm (Forouhi et al., 2018) and cocoa (Nettleton et al., 2017).”
BackgroundInfluentialLes effets des nutriments dépendent-ils des aliments qui les portent ? L’effet matrice
Lecerf, J. M., & Legrand, P. (2015) · Cahiers de Nutrition et de Diététique · doi:10.1016/j.cnd.2014.12.003 · Cited by 17 · see citing works
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Parys, A. V., Sæle, J., Puaschitz, N. G., Anfinsen, Å. M., Karlsson, T., Olsén, T., Haugsgjerd, T. R., Vinknes, K. J., Holven, K. B., Dierkes, J., et al. (2022) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwac217 · Cited by 16 · see citing works
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Relations between dairy product intake and blood pressure
Aljuraiban, G. S., Stamler, J., Chan, Q. M., Horn, L. V., Daviglus, M. L., Elliott, P., & Griep, L. M. O. (2018) · Journal of Hypertension · doi:10.1097/hjh.0000000000001779 · Cited by 15 · see citing works
“These findings are compatible with previous systematic reviews of prospective cohort studies showing no association of total dairy intake with CVD mortality [39,40], but an inverse association with”
Shahid, M., Gaines, A., Coyle, D. H., Alessandrini, R., Finnigan, T. J. A., Frost, G. S., Marklund, M., & Neal, B. C. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.03.019 · Cited by 14 · see citing works
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Self-citationEffectiveness of Changes in Diet Composition on Reducing the Incidence of Cardiovascular Disease
Calabrese, I., & Riccardi, G. (2019) · Current Cardiology Reports · doi:10.1007/s11886-019-1176-y · Cited by 14 · see citing works
Lu, Y., Sugawara, Y., Matsuyama, S., Fukao, A., & Tsuji, I. (2021) · European Journal of Nutrition · doi:10.1007/s00394-021-02734-6 · Cited by 13 · see citing works
“Numerous metaanalyses generally reported null associations [16, 18, 19, 21, 22, 24], but studies conducted in Asian populations showed controversial results [27, 44, 46, 47].”
BackgroundResultAbdullah, M. M. H., Cyr, A., Lépine, M.-C., Eck, P., Couture, P., Lamarche, B., & Jones, P. J. H. (2016) · Journal of Nutrition · doi:10.3945/jn.115.222208 · Cited by 13 · see citing works
Coconut and sunflower oil ratios in ice cream influence subsequent food selection and intake
Rizzo, G., Masic, U., Harrold, J. A., Norton, J. E., & Halford, J. C. G. (2016) · Physiology & Behavior · doi:10.1016/j.physbeh.2016.05.040 · Cited by 13 · see citing works
“Moreover, current trends suggest that the recommended fat intake of 30% energy per day is being exceeded in the UK with poor quality saturated fats such as butter (Harwood et al., 2007) which has been reported to be harmful to health (O'Sullivan et al., 2013).”
BackgroundAcides gras saturés et risque cardio-métabolique
Lecerf, J. (2016) · Médecine des Maladies Métaboliques · doi:10.1016/s1957-2557(16)30141-9 · Cited by 13 · see citing works
Stasinopoulos, L. C., Zhou, A., & Hyppönen, E. (2019) · British Journal Of Nutrition · doi:10.1017/s0007114519003076 · Cited by 13 · see citing works
Scherf, B. D. (1961) · American Heart Journal · doi:10.1016/0002-8703(61)90564-6 · Cited by 13 · see citing works
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- Authors
- O’Sullivan, T. A., Hafekost, K., Mitrou, F., & Lawrence, D.
- Affiliations
- Edith Cowan University (AU)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2013-09
- Volume
- 103
- Issue
- 9
- Pages
- e31-e42
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3966685
- OpenAlex
- W2113368413
- Cited by
- 168
- References
- 58
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 10 · 2022: 18 · 2021: 16 · 2020: 14 · 2019: 20 · 2018: 13 · 2017: 12 · 2016: 21 · 2015: 16 · 2014: 7
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Research Online (Edith Cowan University) (submittedVersion)
- Funders
- Dairy Innovation Australia Limited
- National Health and Medical Research Council
- National Medical Research Council
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- saturated fat, mortality, all-cause mortality, cancer mortality, cardiovascular mortality, dairy products, milk, cheese, yogurt, butter, meat consumption, processed meat, dietary assessment, dietary guidelines
- MeSH terms
- Dairy Products, Dietary Fats, Food, Food Analysis, Humans, Mortality, Risk Factors
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