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Saturated Fatty Acids and Cardiovascular DiseaseIDF Factsheet – April 2016

IDF - Factsheet – April 2016

Cardiovascular disease (CVD) remains a leading cause of death in Western countries, and saturated fatty acids (SFAs) have played a key role in hypotheses relating diet to the risk of coronary heart disease (CHD). Early evidence based on animal studies as well as controlled feeding clinical trials with total and LDL cholesterol as the endpoint biomarkers support an adverse effect. However, science is evolving and important information has emerged about the role of SFAs and the applicability of intermediate biomarkers such as total and LDL cholesterol. At present there is no clear relationship between SFA intake and CVD incidence. Recent research highlights the importance of food sources of SFAs, the type of SFAs, and their matrix effects.

• Saturatedfattyacids(SFA)areprovidedbyavarietyoffoods(e.g.fullfatdairyproducts,fattymeatandcertainvegetableoils)andcanbesynthesizedbythebody(fromcarbohydratesamongstothers).SFAchainlengthsrangefrom2to24carbons.

• Ruminant fat is themost complex fat in the human diet, consisting ofmore than 400 distinct fatty acids.SFAsrepresent65-70%oftotalfattyacidsindairyfat.ThemajorSFAsindairyfataremyristicacid(10-12%),palmiticacid(25-30%)andstearicacid(10%).ShortandmediumchainSFAs(C4:0-C12:0)represent10-12%oftotaldairyfattyacids.AwiderangeofdairyproductsisavailablewithverydifferentfatandSFAcontent.

• SFAscannotberegardedasaunitbecausetheydifferintheirstructure,theirmetabolismandtheircellfunctions.

• Forthelast30years,afocusofdietaryrecommendationsforcardiovasculardiseasepreventionandtreatmenthasbeenareductioninsaturatedfatintake,duetotheirLDLcholesterolraisingeffects.However,dietarySFAsmainlyraisethelarge,lessdenseLDLparticles(particlesnotstronglyassociatedwithCVDrisk),andnotthesmalldenseLDLparticlesthataremostassociatedwithdetrimentalCVDriski.

• MostprospectivestudieshavenotsupportedthehypothesisthatintypicaldietsthereisalinkbetweentotalSFAintakeandCVDrisk.Recentreviewsandmeta-analysesfoundnocorrelationbetweendietaryintakesofsaturatedfatsandCVDriskiiiii.

• TheFAO/WHOexpertpanelreportednoconvincingeffectsofSFAsonriskofCVD(otherthanonLDLcholesterollevels)ivv.

o RegardingthelatteranIOMexpertpanelreportedthatLDLcholesterolisnotagoodsurrogateendpointfor

cardiovascularoutcomeswithfoodinterventions(i.e.aneffectonthismarkerviaafoodinterventiondoesnotpredictaspecificcardiovascularoutcome)vi.

• Theroleofsaturatedfatinhealthisdependentonthesourceandtypeofsaturatedfatconsumedratherthanonthetotalamount.ThefoodsourceofSFAmatterswhendeterminingtheeffectofSFAoncardiometabolicrisk:

o SFAsfromdairyproductsareassociatedwithlowerCVDriskwhileSFAfromsomeotherfoodgroupsareassociatedwithhigherriskvii.

o High versus low intakes of full-fat dairy products (such as milk, cheese, yogurt, and even butter)are not associated with an increased risk of mortality (all-cause, cardiovascular or from cancer)while high versus low intakes of some other SFA-rich food groups did increase mortality riskviii.

o Thereisagrowingbodyofevidencethatdairyproducts(includingfullfat)areassociatedwithreducedriskfortype2diabetes.ix

IDF Factsheet – April 2016

IDF Country ReportsIDF - Factsheet – October 2015

International Dairy Federationwww.fil-idf.org

International Dairy Federationwww.fil-idf.org

iBierDM.Saturatedfatsandcardiovasculardisease:interpretationsnotassimpleastheyoncewere.CritRevFoodSciNutr2015MarDOI:

10.1080/10408398.2014.998332iiSiri-TarinoPW,SunQ,HuFB,KraussRM.Meta-analysisofprospectivecohortstudiesevaluatingtheassociationofsaturatedfatwithcardiovasculardisease.

AmJClinNutr.2010Mar;91(3):535-46iiiChowdhuryR,WarnakulaS,KunutsorS,etal.Associationofdietary,circulating,andsupplementfattyacidswithcoronaryrisk:asystematicreviewand

meta-analysis.AnnInternMed.2014Mar18;160(6):398-406ivFatsandfattyacidsinhumannutrition.ProceedingsoftheJointFAO/WHOExpertConsultation.November10-14,2008.Geneva,Switzerland.(2009).Ann

NutrMetab.,55(1-3):5-300vdeSouza,RJ,Mente,A,Maroleanu,A.Intakeofsaturatedandtransunsaturatedfattyacidsandriskofallcausemortality,cardiovasculardisease,andtype2

diabetes:systematicreviewandmeta-analysisofobservationalstudies.BMJAugust2015;351viInstituteofMedicine(2010).Evaluationofbiomarkersandsurrogateendpointsinchronicdisease.MicheelCMandBallJR,Editors.TheNationalAcademies

Press,WashingtonDC.viiDeOliveiraOttoMC,MozaffarianD,KromhoutD,etal.Dietaryintakeofsaturatedfatbyfoodsourceandincidentcardiovasculardisease:theMulti-Ethnic

StudyofAtherosclerosis.AmJClinNutr.2012;96(2):397---404viiiO’SullivanTA,HafekostK,MitrouF,LawrenceD.Foodsourcesofsaturatedfatandtheassociationwithmortality:ameta-analysis.AmJPublicHealth.2013

Sep;103(9):e31-42ixEricson,U.,S.Hellstrand,etal.Foodsourcesoffatmayclarifytheinconsistentroleofdietaryfatintakeforincidenceoftype2diabetes."AmJClinNutr.

2015