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Palm oil and blood lipid–related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials

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Fattore, Elena, Bosetti, Cristina, Brighenti, Furio, Agostoni, Carlo, Fattore, Giovanni·2014·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.113.081190
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Abstract

Background Palm oil (PO) may be an unhealthy fat because of its high saturated fatty acid content.Objective The objective was to assess the effect of substituting PO for other primary dietary fats on blood lipid-related markers of coronary heart disease (CHD) and cardiovascular disease (CVD).Design We performed a systematic review and meta-analysis of dietary intervention trials. Studies were eligible if they included original data comparing PO-rich diets with other fat-rich diets and analyzed at least one of the following CHD/CVD biomarkers: total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, TC/HDL cholesterol, LDL cholesterol/HDL cholesterol, triacylglycerols, apolipoprotein A-I and B, very-low-density lipoprotein cholesterol, and lipoprotein(a).Results Fifty-one studies were included. Intervention times ranged from 2 to 16 wk, and different fat substitutions ranged from 4% to 43%. Comparison of PO diets with diets rich in stearic acid, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) showed significantly higher TC, LDL cholesterol, apolipoprotein B, HDL cholesterol, and apolipoprotein A-I, whereas most of the same biomarkers were significantly lower when compared with diets rich in myristic/lauric acid. Comparison of PO-rich diets with diets rich in trans fatty acids showed significantly higher concentrations of HDL cholesterol and apolipoprotein A-I and significantly lower apolipoprotein B, triacylglycerols, and TC/HDL cholesterol. Stratified and meta-regression analyses showed that the higher concentrations of TC and LDL cholesterol, when PO was substituted for MUFAs and PUFAs, were not significant in young people and in subjects with diets with a lower percentage of energy from fat.Conclusions Both favorable and unfavorable changes in CHD/CVD risk markers occurred when PO was substituted for the primary dietary fats, whereas only favorable changes occurred when PO was substituted for trans fatty acids. Additional studies are needed to provide guidance for policymaking.

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  • A meta-analysis reported that when POo was compared with PUFA-rich fats, TC, LDL cholesterol, apoB, HDL cholesterol, and apoA1 were increased without affecting TC:HDL cholesterol.

    “A meta-analysis reported that when POo was compared with PUFA-rich fats, TC, LDL cholesterol, apoB, HDL cholesterol, and apoA1 were increased without affecting TC:HDL cholesterol (49).”

    From Eucaloric diets enriched in palm olein, cocoa butter, and soybean oil did not differentially affect liver fat concentration in healthy participants: a 16-week randomized controlled trial. (2021) · cites this paper as [49]

    The Results section (Table 5 discussion; page unavailable in our copy) reports higher TC, apoB, HDL cholesterol, and apoA-I when palm oil replaced PUFAs, but says there were no differences in the other markers, including LDL cholesterol. The Discussion reports no change in the TC:HDL cholesterol ratio. Thus the claim is supported except for its assertion of an LDL-cholesterol increase in this specific comparison. (LLM, conf=0.88)

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Research works printed but not linked: 1

  1. Noakes M, Nestel PJ, Clifton PM. Commercial frying fats and plasma lipid-lowering potential. Aust J Nutr Diet 1996;53:25-30.

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Authors
Fattore, E., Bosetti, C., Brighenti, F., Agostoni, C., & Fattore, G.
Affiliations
University of Parma (IT)
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2014-06
Volume
99
Issue
6
Pages
1331-1350
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.113.081190
OpenAlex
W2141508633
Cited by
138
References
96
Citations by year
2026: 3 · 2025: 6 · 2024: 3 · 2023: 17 · 2022: 10 · 2021: 18 · 2020: 18 · 2019: 15 · 2018: 17 · 2017: 10 · 2016: 6 · 2015: 13 · 2014: 2
FWCI
1.18
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio istituzionale della Ricerca - Bocconi (submittedVersion)
  • INFM-OAR (INFN Catania) (submittedVersion, other-oa)
  • Zenodo (CERN European Organization for Nuclear Research) (other-oa)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Physical Sciences › Chemistry › Inorganic Chemistry › Coconut Research and Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
palm oil, saturated fatty acids, fat replacement, serum lipids, cardiovascular risk, coronary artery disease, LDL cholesterol, HDL cholesterol, apolipoprotein A-I, apolipoprotein B, triglycerides, trans fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, myristic acid, lauric acid, stearic acid, total cholesterol, lipoprotein(a)
MeSH terms
Palm Oil, Cardiovascular Diseases, Coronary Disease, Dietary Fats, Unsaturated, Humans, Hyperlipidemias, Lipids, Plant Oils, Risk Factors, Biomarkers, Randomized Controlled Trials as Topic, Cross-Over Studies, Trans Fatty Acids

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