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Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease
Open accessAbstract
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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“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”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [279]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“This is consistent with the many longitudinal cohort studies demonstrating largely neutral effects of overall saturated fat intake (Figure 7).39, 157, 344”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [344]
In the citing paper
“Humans also synthesize relatively little EPA and DHA,344 for which diet remains the major source.”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [344]
In the citing paper
“As a result, SFAs per se no longer appeared to be associated with CHD, emphasizing the potentially deleterious effects of refined, rapidly absorbed carbohydrates.4,5”
From Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta‐Analysis of Prospective Cohorts (2012) · cites this paper as [5]
In the citing paper
“However, recent prospective cohort meta-analyses suggest an even greater increase in CHD risk when highly refined and readily absorbed carbohydrates replaced SFAs.4,5”
From Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta‐Analysis of Prospective Cohorts (2012) · cites this paper as [5]
In the citing paper
“Saturated fats have not been consistently associated with CVD in meta-analyses of cohort studies (odds ratio [OR]: 1.07; 95% CI: 0.96–1.19) of higher compared with lower intakes (156).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [156]
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Hamasalim, H. J. (2014) · Food and public health
The Ideal Eight-Step Urologic Diet and Lifestyle Program: Heart Health = Urologic Health
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Metadata
- 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)
- PMC
- PMC2824152
- 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
- bronze
- doi.org
- Licence
- 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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