dietary fat
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Physiology
Adverse effects
- a single high fat meal, 100 g fat, 50 g saturated fat, 300 g of cholesterol can decrease mean & peak coronary artery flow (20% reduction in mean flow) 5 hours after meal in young, healthy men
- Foods fried in olive oil, sunflower oil, or other vegetable oils not associated with increased cardiac risk[2]
- increased all-cause mortality & increased cardiovascular mortality from replacing saturated fat in diet with linoleic acid (omega-6) (RR = 1.70)[3]
- evidence in support of adverse health effect of saturated fat is weak[6]
- saturated fat in dairy products & coconut may have health benefits[6]
- high-fat diet compared with high carbohydrate diet associated with diminished mortality (RR= 0.84)[10]
- relative risk associated with specific dietary fats replacing dietary carbohydrate
- 0.81 polyunsaturated fatty acid (PUFA)
- 0.89 monounsaturated fatty acid (MUFA)
- 1.08 saturated fat
- 1.13 trans-fat[10]
- relative risk associated with specific dietary fats replacing dietary carbohydrate
Management
Recommendations:
- < 30% of calories from fat
- < 10% of calories from saturated fat or trans fatty acids
- < 1% of calories from trans fatty acids[13] (WHO)
- American Heart Association has recommended >= 5-10% energy from omega-6 polyunsaturated fatty acids[4]
- reducing saturated fat intake while increasing polyunsaturated fat intake is associated with a reduction in cardiovascular events similar to what is achieved by statins[11]
- replacing saturated fats with polyunsaturated or monounsaturated fats lowers LDL cholesterol & serum triglycerides
- polyunsaturated fats appear to be more effective than monounsaturated fats reducing cardiovascular events
- this recommendation may increase mortality[3][9]
- no evidence to support recommenation of limiting overall fat intake to 30% of total calories & saturated fat to 10%[7][11]
- the switch from saturated to unsaturated fats should occur alongside adherence to a healthy eating pattern like the Mediterranean diet or DASH diet[11]
- greater fat intake from plants is associated with lower overall & cardiovascular mortality, especially fat from grains & vegetable oils[15]
- plant sources of monounsaturated fat may reduce all-cause mortality (RR=0.84), whereas animal sources may increase it (RR=1.21)[12]
- polyunsaturated fats lower mortality in type 2 diabetes (RR=0.7)[14]
- only fish-derived fatty acids confer a benefit for cardiovascular mortality
- animal fats increase mortality in type 2 diabetes (RR=1.2)[14]
* 1 serving of fat is 1 tablespoon (15 mL) about 110 kcal
More general terms
More specific terms
- dietary cholesterol
- essential fatty acid
- fish oil
- medium-chain triglyceride
- monounsaturated fat
- polyunsaturated fat
- saturated fat
- vegetable oil
Additional terms
References
- ↑ Journal Watch 22(9):68-69, 2002 Hozuni T et al Change in coronary flow reserve on transthoracic Doppler echocardiography after a single high-fat meal in young healthy men. Ann Intern Med 136:523, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11926787
- ↑ 2.0 2.1 Guallar-Castillon P et al Consumption of fried foods and risk of coronary heart disease: Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study BMJ 2012;344:e363 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22275385 <Internet> http://www.bmj.com/content/344/bmj.e363
Leitzmann MF Fried foods and the risk of coronary heart disease BMJ 2012;344:d8274 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22275384 <Internet> http://www.bmj.com/content/344/bmj.d8274 - ↑ 3.0 3.1 3.2 Ramsden CE et al Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. BMJ 2013;346:e8707 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23386268 <Internet> http://www.bmj.com/content/346/bmj.e8707
Calder PC Old study sheds new light on the fatty acids and cardiovascular health debate. BMJ 2013;346:f493 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23386269 <Internet> http://www.bmj.com/content/346/bmj.f493 - ↑ 4.0 4.1 Harris WS et al Omega-6 Fatty Acids and Risk for Cardiovascular Disease: A Science Advisory From the American Heart Association Nutritional Subcommittee on the Council on Nutirion, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 2009 119:902-907 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19171857 <Internet> http://circ.ahajournals.org/content/119/6/902.full.pdf
- ↑ Baum SJ, Kris-Etherton PM, Willett WC et al Fatty acids in cardiovascular health and disease: a comprehensive update. J Clin Lipidol. 2012 May-Jun;6(3):216-34 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22658146
- ↑ 6.0 6.1 6.2 Lawrence GD. Dietary fats and health: dietary recommendations in the context of scientific evidence. Adv Nutr. 2013 May 1;4(3):294-302. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23674795
- ↑ 7.0 7.1 Harcombe Z et al Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart 2015;2: <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25685363 <Internet> http://openheart.bmj.com/content/2/1/e000196 R
Bahl R The evidence base for fat guidelines: a balanced diet. Open Heart 2015;2: <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25685365 <Internet> http://openheart.bmj.com/content/2/1/e000229 - ↑ 8.0 8.1 2014 DGAC Meeting 7. December 15, 2015 Science Base Chapter. Food and Nutrient Intakes, and Health: Current Status and Trends. Suncommittee 1. http://www.health.gov/dietaryguidelines/2015-BINDER/meeting7/docs/DGAC-Meeting-7-SC-1.pdf
- ↑ 9.0 9.1 Ramsden CE et al Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73). BMJ 2016;353:i1246 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27071971 <Internet> http://www.bmj.com/content/353/bmj.i1246
Veerman JL et al Dietary fats: a new look at old data challenges established wisdom. BMJ 2016;353:i1512 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27072816 Free PMC Article <Internet> http://www.bmj.com/content/353/bmj.i1512 - ↑ 10.0 10.1 10.2 Wang DD, Li Y, Chiuve SE et al Association of Specific Dietary Fats With Total and Cause- Specific Mortality. JAMA Intern Med. Published online July 05, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27379574 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=2530902
- ↑ 11.0 11.1 11.2 11.3 Sacks FM, Lichtenstein AH, Wu JH et al Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation. June 15, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28620111 <Internet> http://circ.ahajournals.org/content/early/2017/06/15/CIR.0000000000000510
- ↑ 12.0 12.1 Melville NA Animal-Based Monounsaturated Fats Linked to Total, CVD Mortality Medscape - Mar 29, 2018. https://www.medscape.com/viewarticle/894598
- ↑ 13.0 13.1 World Health Organizaton (WHO) Call for public comments on the draft WHO Guidelines: Saturated fatty acid and trans-fatty intake for adults and children. Online public consultation open: May 4 - June 1, 2018 http://www.who.int/nutrition/topics/sfa-tfa-public-consultation-4may2018/en/
- ↑ 14.0 14.1 14.2 Jiao J, Liu G, Shin HJ et al Dietary fats and mortality among patients with type 2 diabetes: analysis in two population based cohort studies. BMJ 2019;366:l4009 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31266749 Free Article https://www.bmj.com/content/366/bmj.l4009
- ↑ 15.0 15.1 Zhao B, Gan L, Graubard BI et al Plant and Animal Fat Intake and Overall and Cardiovascular Disease Mortality. JAMA Intern Med. 2024 Aug 12:e243799. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39133482 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle