Cited by 1,253Nutritional Studies and DietFatty Acid Research and HealthCardiovascular Health and Risk Factors

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

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Siri-Tarino, Patty W, Sun, Qi, Hu, Frank B, Krauss, Ronald M·2010·The American Journal of Clinical Nutrition

Abstract

Background A reduction in dietary saturated fat has generally been thought to improve cardiovascular health.Objective The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) in prospective epidemiologic studies.Design Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD.Results During 5-23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results.Conclusions A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

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  • A recent meta-analysis of cohort studies did not show increased relative risk for CHD or CVD with higher saturated fat intake.

    “Recently, a meta-analysis of cohort studies did not show an increase in the relative risk for CHD or CVD with higher intake of saturated fat, 279”
  • Most diets contain high proportions of refined carbohydrates.

    “On the basis of these findings and high proportions of refined carbohydrates in most diets, a focus on reducing SFA consumption, traditionally a major public health goal, needs to be paired with decreasing consumption of refined carbohydrates, starches, and sugars.141,144”

    From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [141]

  • Three recent meta-analyses of all available prospective observational studies found that individuals consuming the highest amounts of saturated fatty acids had a similar incidence of CVD events as those consuming the lowest amounts.

    “Conversely, 3 recent meta-analyses of all available prospective observational studies found that individuals consuming the highest amounts of SFA had a similar incidence of CVD events as those consuming the lowest amounts.61,140,141”

    From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [141]

  • Many longitudinal cohort studies demonstrate largely neutral effects of overall saturated fat intake.

    “This is consistent with the many longitudinal cohort studies demonstrating largely neutral effects of overall saturated fat intake (Figure 7).39, 157, 344”
  • Humans synthesize relatively little EPA and DHA, for which diet remains the major source.

    “Humans also synthesize relatively little EPA and DHA,344 for which diet remains the major source.”

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Authors
Siri-Tarino, P. W., Sun, Q., Hu, F. B., & Krauss, R. M.
Affiliations
Harvard University (US)
Corresponding author
Krauss, Ronald M
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2010-03
Volume
91
Issue
3
Pages
535-546
ISSN
0002-9165 (ISSN-L)
OpenAlex
W2097301645
Cited by
1,253
References
54
Citations by year
2026: 24 · 2025: 22 · 2024: 47 · 2023: 50 · 2022: 63 · 2021: 67 · 2020: 67 · 2019: 111 · 2018: 99 · 2017: 93 · 2016: 96 · 2015: 111 · 2014: 110 · 2013: 82 · 2012: 85
FWCI
13.27
Type
journal article
Language
en
Open access
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (RR024131)
  • National Heart, Lung, and Blood Institute (HL60712, R01HL060712)
  • National Center for Research Resources (UL1RR024131, RR 024131, RR02413101)
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 › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords
dietary saturated fat, cardiovascular disease, coronary artery disease, stroke, saturated fat intake, prospective cohort, relative risk, saturated fat replacement
MeSH terms
Cardiovascular Diseases, Coronary Disease, Diet, Dietary Fats, Fatty Acids, Humans, Prospective Studies, Risk Factors, Cohort Studies, Stroke

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