Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Meeting Report

Open Access Gateway

Saturated Fat Consumption and Risk of Coronary Heart Disease and Ischemic Stroke: A Science Update

Nettleton J.A.a · Brouwer I.A.b · Geleijnse J.M.c · Hornstra G.d

Author affiliations

aScienceVoice Consulting, Denver, CO, USA; bVrije Universiteit Amsterdam, Amsterdam, cDepartment Agrotechnology and Food Sciences, Wageningen University, Wageningen, and dExperimental Nutrition (ret'd), Maastricht University, Maastricht, The Netherlands

Corresponding Author

Dr. Joyce A. Nettleton

ScienceVoice Consulting

2931 Race Street

Denver, CO 80205 (USA)

E-Mail sciencevoice1@gmail.com

Related Articles for ""

Ann Nutr Metab 2017;70:26-33

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Abstract

At a workshop to update the science linking saturated fatty acid (SAFA) consumption with the risk of coronary heart disease (CHD) and ischemic stroke, invited participants presented data on the consumption and bioavailability of SAFA and their functions in the body and food technology. Epidemiological methods and outcomes were related to the association between SAFA consumption and disease events and mortality. Participants reviewed the effects of SAFA on CHD, causal risk factors, and surrogate risk markers. Higher intakes of SAFA were not associated with higher risks of CHD or stroke apparently, but studies did not take macronutrient replacement into account. Replacing SAFA by cis-polyunsaturated fatty acids was associated with significant CHD risk reduction, which was confirmed by randomized controlled trials. SAFA reduction had little direct effect on stroke risk. Cohort studies suggest that the food matrix and source of SAFA have important health effects.

© 2017 The Author(s) Published by S. Karger AG, Basel


References

  1. de Souza RJ, Mente A, Maroleanu A, Cozma AI, et al: Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ 2015;351:h3978.
  2. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM: Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr 2010;91:535-546.
  3. Jakobsen MU, O'Reilly EJ, Heitmann BL, Pereira MA, et al: Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 2009;89:1425-1432.
  4. Hooper L, Martin N, Abdelhamid A, Davey Smith G: Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev 2015;6:CD011737.
  5. Mozaffarian D, Micha R, Wallace S: Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med 2010;7:e1000252.
  6. Mensink RP: Effects of Saturated Fatty Acids on Serum Lipids and Lipoproteins: A Systematic Review and Regression Analysis. Geneva, World Health Organization, 2016.
  7. Ridker PM: LDL cholesterol: controversies and future therapeutic directions. Lancet 2014;384:607-617.
  8. DiNicolantonio JJ: The cardiometabolic consequences of replacing saturated fats with carbohydrates or Ω-6 polyunsaturated fats: do the dietary guidelines have it wrong? Open Heart 2014;1:e000032.
  9. Hoenselaar R: Saturated fat and cardiovascular disease: the discrepancy between the scientific literature and dietary advice. Nutrition 2012;28:118-123.
  10. Eilander A, Harika RK, Zock PL: Intake and sources of dietary fatty acids in Europe: are current population intakes of fats aligned with dietary recommendations? Eur J Lipid Sci Technol 2015;117:1370-1377.
  11. US Department of Agriculture, Agricultural Research Service: National Nutrient Database for Standard Reference, Release 28; Fats and Oils. US Department of Agriculture. 2015. https://ndb.nal.usda.gov/ndb/search/list.
  12. Harika RK, Eilander A, Alssema M, Osendarp SJ, et al: Intake of fatty acids in general populations worldwide does not meet dietary recommendations to prevent coronary heart disease: a systematic review of data from 40 countries. Ann Nutr Metab 2013;63:229-238.
  13. Kubow S: The influence of positional distribution of fatty acids in native, interesterified and structure-specific lipids on lipoprotein metabolism and atherogenesis. J Nutr Biochem 1996;7:530-541.
    External Resources
  14. Berry SE: Triacylglycerol structure and interesterification of palmitic and stearic acid-rich fats: an overview and implications for cardiovascular disease. Nutr Res Rev 2009;22:3-17.
  15. Eyres L, Eyres MF, Chisholm A, Brown RC: Coconut oil consumption and cardiovascular risk factors in humans. Nutr Rev 2016;74:267-280.
  16. Chamberlain LH, Shipston MJ: The physiology of protein S-acylation. Physiol Rev 2015;95:341-376.
  17. Wedegaertner PB: Lipid modifications and membrane targeting of G alpha. Biol Signals Recept 1998;7:125-135.
  18. Beauchamp E, Goenaga D, Le Bloc'h J, Catheline D, et al: Myristic acid increases the activity of dihydroceramide delta4-desaturase 1 through its N-terminal myristoylation. Biochimie 2007;89:1553-1561.
  19. Dabadie H, Peuchant E, Bernard M, LeRuyet P, et al: Moderate intake of myristic acid in sn-2 position has beneficial lipidic effects and enhances DHA of cholesteryl esters in an interventional study. J Nutr Biochem 2005;16:375-382.
  20. Patel AR, Dewettinck K: Edible oil structuring: an overview and recent updates. Food Funct 2016;7:20-29.
  21. Hamm W, Hamilton RJ, Calliauw G (eds): Edible Oil Processing, ed 2. Wiley-Blackwell, 2013, p 342.
    External Resources
  22. Marangoni AG, Wesdorp LH: Structure and Properties of Fat Crystal Networks, ed 2. CRC Press, 2012.
  23. Norlida HM, Md Ali AR, Muhadhir I: Blending of palm oil, palm stearin and palm kernel oil in the preparation of table and pastry margarine. Int J Food Sci Nutr 1996;47:71-74.
  24. Wong ND: Epidemiological studies of CHD and the evolution of preventive cardiology. Nat Rev Cardiol 2014;11:276-289.
  25. Davey Smith G, Hemani G: Mendelian randomization: genetic anchors for causal inference in epidemiological studies. Hum Mol Genet 2014;23:R89-R98.
  26. Marz W, Scharnagl H, Gouni-Berthold I, Silbernagel G, et al: LDL-cholesterol: standards of treatment 2016: a German perspective. Am J Cardiovasc Drugs 2016;16:323-336.
  27. Jacobs DR Jr, Anderson JT, Blackburn H: Diet and serum cholesterol: do zero correlations negate the relationship? Am J Epidemiol 1979;110:77-87.
    External Resources
  28. Jacobson TA, Maki KC, Orringer CE, Jones PH, et al: National lipid association recommendations for patient-centered management of dyslipidemia: part 2. J Clin Lipidol 2015;9:S1-S122.e1.
  29. Berneis KK, Krauss RM: Metabolic origins and clinical significance of LDL heterogeneity. J Lipid Res 2002;43:1363-1379.
  30. Hoogeveen RC, Gaubatz JW, Sun W, Dodge RC, et al: Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: the Atherosclerosis Risk In Communities (ARIC) study. Arterioscler Thromb Vasc Biol 2014;34:1069-1077.
  31. Melander O, Shiffman D, Caulfield MP, Louie JZ, et al: Low-density lipoprotein particle number is associated with cardiovascular events among those not classified into statin benefit groups. J Am Coll Cardiol 2015;65:2571-2573.
  32. Dreon DM, Fernstrom HA, Miller B, Krauss RM: Low-density lipoprotein subclass patterns and lipoprotein response to a reduced-fat diet in men. FASEB J 1994;8:121-126.
    External Resources
  33. Mangravite LM, Chiu S, Wojnoonski K, Rawlings RS, et al: Changes in atherogenic dyslipidemia induced by carbohydrate restriction in men are dependent on dietary protein source. J Nutr 2011;141:2180-2185.
  34. Krauss RM, Blanche PJ, Rawlings RS, Fernstrom HS, et al: Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia. Am J Clin Nutr 2006;83:1025-1031; quiz 1205.
    External Resources
  35. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, et al: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001;344:3-10.
  36. Chiu S, Bergeron N, Williams PT, Bray GA, et al: Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial. Am J Clin Nutr 2016;103:341-347.
  37. Krauss RM: All low-density lipoprotein particles are not created equal. Arterioscler Thromb Vasc Biol 2014;34:959-961.
  38. Gordon T, Castelli WP, Hjortland MC, Kannel WB, et al: High density lipoprotein as a protective factor against coronary heart disease. The Framingham study. Am J Med 1977;62:707-714.
  39. Emerging Risk Factors Collaboration, Di Angelantonio E, Sarwar N, Perry P, et al: Major lipids, apolipoproteins, and risk of vascular disease. JAMA 2009;302:1993-2000.
  40. Fielding CJ, Fielding PE: Cholesterol transport between cells and body fluids. Role of plasma lipoproteins and the plasma cholesterol esterification system. Med Clin North Am 1982;66:363-373.
  41. Rader DJ: Spotlight on HDL biology: new insights in metabolism, function, and translation. Cardiovasc Res 2014;103:337-340.
  42. Zanoni P, Khetarpal SA, Larach DB, Hancock-Cerutti WF, et al: Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease. Science 2016;351:1166-1171.
  43. Keene D, Price C, Shun-Shin MJ, Francis DP: Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients. BMJ 2014;349:g4379.
  44. Annema W, von Eckardstein A: Dysfunctional high-density lipoproteins in coronary heart disease: implications for diagnostics and therapy. Transl Res 2016;173:30-57.
  45. Rohatgi A, Khera A, Berry JD, Givens EG, et al: HDL cholesterol efflux capacity and incident cardiovascular events. N Engl J Med 2014;371:2383-2393.
  46. Hegele RA, Ginsberg HN, Chapman MJ, Nordestgaard BG, et al: The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management. Lancet Diabetes Endocrinol 2014;2:655-666.
  47. Nordestgaard BG, Varbo A: Triglycerides and cardiovascular disease. Lancet 2014;384:626-635.
  48. Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A: Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA 2007;298:299-308.
  49. Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, et al: Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation 2007;115:450-458.
  50. Graham I, Cooney MT, Bradley D, Dudina A, et al: Dyslipidemias in the prevention of cardiovascular disease: risks and causality. Curr Cardiol Rep 2012;14:709-720.
  51. Varbo A, Nordestgaard BG: Remnant cholesterol and ischemic heart disease. Curr Opin Lipidol 2014;25:266-273.
  52. Jeppesen J, Hein HO, Suadicani P, Gyntelberg F: Triglyceride concentration and ischemic heart disease: an eight-year follow-up in the Copenhagen male study. Circulation 1998;97:1029-1036.
  53. Nordestgaard BG: Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease: new insights from epidemiology, genetics, and biology. Circ Res 2016;118:547-563.
  54. Jorgensen AB, Frikke-Schmidt R, West AS, Grande P, et al: Genetically elevated non-fasting triglycerides and calculated remnant cholesterol as causal risk factors for myocardial infarction. Eur Heart J 2013;34:1826-1833.
  55. Triglyceride Coronary Disease Genetics Consortium and Emerging Risk Factors Collaboration, Sarwar N, Sandhu MS, et al: Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. Lancet 2010;375:1634-1639.
  56. Li Y, Li C, Gao J: Apolipoprotein C3 gene variants and the risk of coronary heart disease: a meta-analysis. Meta Gene 2016;9:104-109.
  57. Jorgensen AB, Frikke-Schmidt R, Nordestgaard BG, Tybjærg-Hansen A: Loss-of-function mutations in APOC3 and risk of ischemic vascular disease. N Engl J Med 2014;371:32-41.
  58. Emerging Risk Factors Collaboration, Kaptoge S, Di Angelantonio E, Pennells L, et al: C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med 2012;367:1310-1320.
  59. Lowe G, Rumley A: The relevance of coagulation in cardiovascular disease: what do the biomarkers tell us? Thromb Haemost 2014;112:860-867.
  60. Go AS, Bauman MA, Coleman King SM, Fonarow GC, et al: An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension 2014;63:878-885.
  61. Sima AV, Stancu CS, Simionescu M: Vascular endothelium in atherosclerosis. Cell Tissue Res 2009;335:191-203.
  62. Okwuosa TM, Klein O, Chan C, Jenny NS, et al: 13-year long-term associations between changes in traditional cardiovascular risk factors and changes in fibrinogen levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Atherosclerosis 2013;226:214-219.
  63. Gilmour KM, Iversen L, Hannaford PC: Long-term survival benefits of thrombolysis: the Royal College of General Practitioners' myocardial infarction study. Fam Pract 2015;32:192-197.
  64. Kannel WB: Overview of hemostatic factors involved in atherosclerotic cardiovascular disease. Lipids 2005;40:1215-1220.
  65. Sabater-Lleal M, Huang J, Chasman D, Naitza S, et al: Multiethnic meta-analysis of genome-wide association studies in >100 000 subjects identifies 23 fibrinogen-associated Loci but no strong evidence of a causal association between circulating fibrinogen and cardiovascular disease. Circulation 2013;128:1310-1324.
  66. Cooper JA, Miller GJ, Bauer KA, Morrissey JH, et al: Comparison of novel hemostatic factors and conventional risk factors for prediction of coronary heart disease. Circulation 2000;102:2816-2822.
  67. Meade TW, Mellows S, Brozovic M, Miller GJ, et al: Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet 1986;2:533-537.
  68. Willeit P, Thompson A, Aspelund T, Rumley A, et al: Hemostatic factors and risk of coronary heart disease in general populations: new prospective study and updated meta-analyses. PLoS One 2013;8:e55175.
  69. Woodward M, Rumley A, Welsh P, MacMahon S, et al: A comparison of the associations between seven hemostatic or inflammatory variables and coronary heart disease. J Thromb Haemost 2007;5:1795-1800.
  70. Joint FAO/WHO Expert Consultation: Fats and Fatty Acids in Human Nutrition. Geneva, FAO/WHO, 2008.
    External Resources
  71. Chowdhury R, Warnakula S, Kunutsor S, Crowe F, et al: Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med 2014;160:398-406.
  72. Skeaff CM, Miller J: Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomised controlled trials. Ann Nutr Metab 2009;55:173-201.
  73. Li Y, Hruby A, Bernstein AM, Ley SH, et al: Saturated fats compared with unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: a prospective cohort study. J Am Coll Cardiol 2015;66:1538-1548.
  74. Praagman J, Beulens JW, Alssema M, Zock PL, et al: The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. Am J Clin Nutr 2016;103:356-365.
  75. Praagman J, de Jonge EA, Kiefte-de Jong JC, Beulens JW, et al: Dietary saturated fatty acids and coronary heart disease risk in a Dutch middle-aged and elderly population. Arterioscler Thromb Vasc Biol 2016;36:2011-2018.
  76. Astrup A, Dyerberg J, Elwood P, Hermansen K, et al: The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010? Am J Clin Nutr 2011;93:684-688.
  77. Khaw KT, Friesen MD, Riboli E, Luben R, et al: Plasma phospholipid fatty acid concentration and incident coronary heart disease in men and women: the EPIC-Norfolk prospective study. PLoS Med 2012;9:e1001255.
  78. Schwab U, Lauritzen L, Tholstrup T, Haldorssoni T, et al: Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review. Food Nutr Res 2014;58.
  79. Faghihnia N, Mangravite LM, Chiu S, Bergeron N, et al: Effects of dietary saturated fat on LDL subclasses and apolipoprotein CIII in men. Eur J Clin Nutr 2012;66:1229-1233.
  80. de Oliveira Otto MC, Mozaffarian D, Kromhout D, Bertoni AG, et al: Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr 2012;96:397-404.
  81. Soedamah-Muthu SS, Ding EL, Al-Delaimy WK, Hu FB, et al: Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr 2011;93:158-171.
  82. de Goede J, Geleijnse JM, Ding EL, Soedamah-Muthu SS: Effect of cheese consumption on blood lipids: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2015;73:259-275.
  83. Vors C, Pineau G, Gabert L, Drai J, et al: Modulating absorption and postprandial handling of dietary fatty acids by structuring fat in the meal: a randomized crossover clinical trial. Am J Clin Nutr 2013;97:23-36.
  84. Miller GJ: Dietary fatty acids and the haemostatic system. Atherosclerosis 2005;179:213-227.
  85. Hornstra G, Kester AD: Effect of the dietary fat type on arterial thrombosis tendency: systematic studies with a rat model. Atherosclerosis 1997;131:25-33.
  86. Pieters M, de Maat MP: Diet and haemostasis - a comprehensive overview. Blood Rev 2015;29:231-241.
  87. Blood Pressure Lowering Treatment Trialists' Collaboration, Sundstrom J, Arima H, Woodward M, et al: Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data. Lancet 2014;384:591-598.
  88. Lawes CM, Bennett DA, Lewington S, Rodgers A: Blood pressure and coronary heart disease: a review of the evidence. Semin Vasc Med 2002;2:355-368.
  89. Lewington S, Clarke R, Qizilbash N, Peto R, et al: Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-1913.
  90. Cheng P, Wang J, Shao W, Liu M, et al: Can dietary saturated fat be beneficial in prevention of stroke risk? A meta-analysis. Neurol Sci 2016;37:1089-1098.
  91. Chen M, Li Y, Sun Q, Pan A, et al: Dairy fat and risk of cardiovascular disease in 3 cohorts of US adults. Am J Clin Nutr 2016;104:1209-1217.
  92. Yakoob MY, Shi P, Hu FB, Campos H, et al: Circulating biomarkers of dairy fat and risk of incident stroke in U.S. men and women in 2 large prospective cohorts. Am J Clin Nutr 2014;100:1437-1447.
  93. Alexander DD, Bylsma LC, Vargas AJ, Cohen SS, et al: Dairy consumption and CVD: a systematic review and meta-analysis. Br J Nutr 2016;115:737-750.
  94. Qin LQ, Xu JY, Han SF, Zhang ZL, et al: Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies. Asia Pac J Clin Nutr 2015;24:90-100.
  95. Nordic Council of Ministers: Nordic Nutrition Recommendations 2012. Integrating nutrition and physical activity. Copenhagen, Nordic Council of Ministers, 2014.
  96. US Department of Health and Human ‑Services and US Department of Agriculture: 2015-2020 Dietary Guidelines for Americans, ed 8. Washington, US Department of Health and Human Services, 2015.
  97. Kromhout D, Spaaij CJ, de Goede J, Weggemans RM: The 2015 Dutch food-based dietary guidelines. Eur J Clin Nutr 2016;70:869-878.
  98. Zong G, Li Y, Wanders AJ, Alssema M, et al: Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. BMJ 2016;355:i5796.

Article / Publication Details

First-Page Preview
Abstract of Meeting Report

Received: September 29, 2016
Accepted: December 26, 2016
Published online: January 27, 2017
Issue release date: April 2017

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: https://www.karger.com/ANM


Open Access License / Drug Dosage / Disclaimer

This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.