Review Calls for Reevaluation of the Fat-CVD Link
Emphasis on reducing dietary saturated fat may miss the target of preventing cardiovascular disease (CVD) in the epidemic of obesity and associated metabolic disturbances, authors of a critical review of the issues concluded.
Limiting intake of carbohydrates, particularly refined carbohydrates, offers the best hope for reducing the CVD burden associated with atherogenic dyslipidemia, Patty W. Siri-Tarino, PhD, of the Children's Hospital Oakland Research Institute in California, and colleagues concluded in an article published in the American Journal of Clinical Nutrition.
"Replacement of saturated fat by polyunsaturated or monounsaturated fat lowers both LDL and HDL cholesterol," they wrote. "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."
"There is little evidence from [clinical] trials or from epidemiologic studies that a reduction in saturated fat intake below about 9% of total energy intake is associated with a reduced CVD risk," they added.
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.
Limit refined carbs.