Wednesday, January 20, 2010

For health replace carbs with saturated fat?

Ok I am extrapolating, but at least cut back on the carbs. Hat tip to Stephan (a true hero of the blogs) for pointing this out.

The paper that I mentioned here - intake of saturated fat is not associated with coronary heart disease, stroke or cardiovascular disease - had an interesting teaser in the conclusion:

More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat
It looks like there is a follow up:

Saturated fat, carbohydrate, and cardiovascular disease

A focus of dietary recommendations for cardiovascular disease (CVD) prevention and treatment has been a reduction in saturated fat intake, primarily as a means of lowering LDL-cholesterol concentrations. However, the evidence that supports a reduction in saturated fat intake must be evaluated in the context of replacement by other macronutrients. Clinical trials that replaced saturated fat with polyunsaturated fat have generally shown a reduction in CVD events, although several studies showed no effects. An independent association of saturated fat intake with CVD risk has not been consistently shown in prospective epidemiologic studies, although some have provided evidence of an increased risk in young individuals and in women. Replacement of saturated fat by polyunsaturated or monounsaturated fat lowers both LDL and HDL cholesterol. However, replacement with a higher carbohydrate intake, particularly refined carbohydrate, can exacerbate the atherogenic dyslipidemia associated with insulin resistance and obesity that includes increased triglycerides, small LDL particles, and reduced HDL cholesterol. In summary, although substitution of dietary polyunsaturated fat for saturated fat has been shown to lower CVD risk, there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate. Furthermore, particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.

1 comment:

Lars Pergou said...

What's missing are trials that replace satfat with high-fibre, and, or low-GI carbohydrates.

CHO of this quality can raise HDL and lower TG. See Jenkins and others.

I would be very surprised if this did not achieve a lowering of CVD risk compared to satfat, considering the literature that already exists re whole grain consumption and reduced incidence of CVD and diabetes.