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Palm oil and blood lipid-related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials.
Am J Clin Nutr 2014; 99(6):1331-50AJ

Abstract

BACKGROUND

Palm oil (PO) may be an unhealthy fat because of its high saturated fatty acid content.

OBJECTIVE

The objective was to assess the effect of substituting PO for other primary dietary fats on blood lipid-related markers of coronary heart disease (CHD) and cardiovascular disease (CVD).

DESIGN

We performed a systematic review and meta-analysis of dietary intervention trials. Studies were eligible if they included original data comparing PO-rich diets with other fat-rich diets and analyzed at least one of the following CHD/CVD biomarkers: total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, TC/HDL cholesterol, LDL cholesterol/HDL cholesterol, triacylglycerols, apolipoprotein A-I and B, very-low-density lipoprotein cholesterol, and lipoprotein(a).

RESULTS

Fifty-one studies were included. Intervention times ranged from 2 to 16 wk, and different fat substitutions ranged from 4% to 43%. Comparison of PO diets with diets rich in stearic acid, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) showed significantly higher TC, LDL cholesterol, apolipoprotein B, HDL cholesterol, and apolipoprotein A-I, whereas most of the same biomarkers were significantly lower when compared with diets rich in myristic/lauric acid. Comparison of PO-rich diets with diets rich in trans fatty acids showed significantly higher concentrations of HDL cholesterol and apolipoprotein A-I and significantly lower apolipoprotein B, triacylglycerols, and TC/HDL cholesterol. Stratified and meta-regression analyses showed that the higher concentrations of TC and LDL cholesterol, when PO was substituted for MUFAs and PUFAs, were not significant in young people and in subjects with diets with a lower percentage of energy from fat.

CONCLUSIONS

Both favorable and unfavorable changes in CHD/CVD risk markers occurred when PO was substituted for the primary dietary fats, whereas only favorable changes occurred when PO was substituted for trans fatty acids. Additional studies are needed to provide guidance for policymaking.

Authors+Show Affiliations

From the Departments of Environmental Health Sciences (EF) and Epidemiology (CB), IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy; the Department of Food Science, Università di Parma, Parma, Italy (FB); the Department of Clinical Sciences and Community Health, University of Milan, IRCCS Ospedale Maggiore Policlinico, Milan, Italy (CA); and the Department of Policy Analysis and Public Management & Centre for Research on Health and Social Care Management, Università Bocconi, Milan, Italy (GF).From the Departments of Environmental Health Sciences (EF) and Epidemiology (CB), IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy; the Department of Food Science, Università di Parma, Parma, Italy (FB); the Department of Clinical Sciences and Community Health, University of Milan, IRCCS Ospedale Maggiore Policlinico, Milan, Italy (CA); and the Department of Policy Analysis and Public Management & Centre for Research on Health and Social Care Management, Università Bocconi, Milan, Italy (GF).From the Departments of Environmental Health Sciences (EF) and Epidemiology (CB), IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy; the Department of Food Science, Università di Parma, Parma, Italy (FB); the Department of Clinical Sciences and Community Health, University of Milan, IRCCS Ospedale Maggiore Policlinico, Milan, Italy (CA); and the Department of Policy Analysis and Public Management & Centre for Research on Health and Social Care Management, Università Bocconi, Milan, Italy (GF).From the Departments of Environmental Health Sciences (EF) and Epidemiology (CB), IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy; the Department of Food Science, Università di Parma, Parma, Italy (FB); the Department of Clinical Sciences and Community Health, University of Milan, IRCCS Ospedale Maggiore Policlinico, Milan, Italy (CA); and the Department of Policy Analysis and Public Management & Centre for Research on Health and Social Care Management, Università Bocconi, Milan, Italy (GF).From the Departments of Environmental Health Sciences (EF) and Epidemiology (CB), IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy; the Department of Food Science, Università di Parma, Parma, Italy (FB); the Department of Clinical Sciences and Community Health, University of Milan, IRCCS Ospedale Maggiore Policlinico, Milan, Italy (CA); and the Department of Policy Analysis and Public Management & Centre for Research on Health and Social Care Management, Università Bocconi, Milan, Italy (GF).

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

24717342

Citation

Fattore, Elena, et al. "Palm Oil and Blood Lipid-related Markers of Cardiovascular Disease: a Systematic Review and Meta-analysis of Dietary Intervention Trials." The American Journal of Clinical Nutrition, vol. 99, no. 6, 2014, pp. 1331-50.
Fattore E, Bosetti C, Brighenti F, et al. Palm oil and blood lipid-related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials. Am J Clin Nutr. 2014;99(6):1331-50.
Fattore, E., Bosetti, C., Brighenti, F., Agostoni, C., & Fattore, G. (2014). Palm oil and blood lipid-related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials. The American Journal of Clinical Nutrition, 99(6), pp. 1331-50. doi:10.3945/ajcn.113.081190.
Fattore E, et al. Palm Oil and Blood Lipid-related Markers of Cardiovascular Disease: a Systematic Review and Meta-analysis of Dietary Intervention Trials. Am J Clin Nutr. 2014;99(6):1331-50. PubMed PMID: 24717342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Palm oil and blood lipid-related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials. AU - Fattore,Elena, AU - Bosetti,Cristina, AU - Brighenti,Furio, AU - Agostoni,Carlo, AU - Fattore,Giovanni, Y1 - 2014/04/09/ PY - 2014/4/11/entrez PY - 2014/4/11/pubmed PY - 2015/4/22/medline SP - 1331 EP - 50 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 99 IS - 6 N2 - BACKGROUND: Palm oil (PO) may be an unhealthy fat because of its high saturated fatty acid content. OBJECTIVE: The objective was to assess the effect of substituting PO for other primary dietary fats on blood lipid-related markers of coronary heart disease (CHD) and cardiovascular disease (CVD). DESIGN: We performed a systematic review and meta-analysis of dietary intervention trials. Studies were eligible if they included original data comparing PO-rich diets with other fat-rich diets and analyzed at least one of the following CHD/CVD biomarkers: total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, TC/HDL cholesterol, LDL cholesterol/HDL cholesterol, triacylglycerols, apolipoprotein A-I and B, very-low-density lipoprotein cholesterol, and lipoprotein(a). RESULTS: Fifty-one studies were included. Intervention times ranged from 2 to 16 wk, and different fat substitutions ranged from 4% to 43%. Comparison of PO diets with diets rich in stearic acid, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) showed significantly higher TC, LDL cholesterol, apolipoprotein B, HDL cholesterol, and apolipoprotein A-I, whereas most of the same biomarkers were significantly lower when compared with diets rich in myristic/lauric acid. Comparison of PO-rich diets with diets rich in trans fatty acids showed significantly higher concentrations of HDL cholesterol and apolipoprotein A-I and significantly lower apolipoprotein B, triacylglycerols, and TC/HDL cholesterol. Stratified and meta-regression analyses showed that the higher concentrations of TC and LDL cholesterol, when PO was substituted for MUFAs and PUFAs, were not significant in young people and in subjects with diets with a lower percentage of energy from fat. CONCLUSIONS: Both favorable and unfavorable changes in CHD/CVD risk markers occurred when PO was substituted for the primary dietary fats, whereas only favorable changes occurred when PO was substituted for trans fatty acids. Additional studies are needed to provide guidance for policymaking. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/24717342/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.113.081190 DB - PRIME DP - Unbound Medicine ER -