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Saturated fat, carbohydrate, and cardiovascular disease.
Am J Clin Nutr. 2010 Mar; 91(3):502-9.AJ

Abstract

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.

Authors+Show Affiliations

Department of Atherosclerosis Research Children's Hospital Oakland Research Institute Oakland, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

20089734

Citation

Siri-Tarino, Patty W., et al. "Saturated Fat, Carbohydrate, and Cardiovascular Disease." The American Journal of Clinical Nutrition, vol. 91, no. 3, 2010, pp. 502-9.
Siri-Tarino PW, Sun Q, Hu FB, et al. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010;91(3):502-9.
Siri-Tarino, P. W., Sun, Q., Hu, F. B., & Krauss, R. M. (2010). Saturated fat, carbohydrate, and cardiovascular disease. The American Journal of Clinical Nutrition, 91(3), 502-9. https://doi.org/10.3945/ajcn.2008.26285
Siri-Tarino PW, et al. Saturated Fat, Carbohydrate, and Cardiovascular Disease. Am J Clin Nutr. 2010;91(3):502-9. PubMed PMID: 20089734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Saturated fat, carbohydrate, and cardiovascular disease. AU - Siri-Tarino,Patty W, AU - Sun,Qi, AU - Hu,Frank B, AU - Krauss,Ronald M, Y1 - 2010/01/20/ PY - 2010/1/22/entrez PY - 2010/1/22/pubmed PY - 2010/3/31/medline SP - 502 EP - 9 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 91 IS - 3 N2 - 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. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/20089734/Saturated_fat_carbohydrate_and_cardiovascular_disease_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2008.26285 DB - PRIME DP - Unbound Medicine ER -