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Abstract
Recent meta-analyses have found no association between heart disease and dietary saturated fat; however, higher proportions of plasma saturated fatty acids (SFA) predict greater risk for developing type-2 diabetes and heart disease. These observations suggest a disconnect between dietary saturated fat and plasma SFA, but few controlled feeding studies have specifically examined how varying saturated fat intake across a broad range affects circulating SFA levels. Sixteen adults with metabolic syndrome (age 44.9±9.9 yr, BMI 37.9±6.3 kg/m2) were fed six 3-wk diets that progressively increased carbohydrate (from 47 to 346 g/day) with concomitant decreases in total and saturated fat. Despite a distinct increase in saturated fat intake from baseline to the low-carbohydrate diet (46 to 84 g/day), and then a gradual decrease in saturated fat to 32 g/day at the highest carbohydrate phase, there were no significant changes in the proportion of total SFA in any plasma lipid fractions. Whereas plasma saturated fat remained relatively stable, the proportion of palmitoleic acid in plasma triglyceride and cholesteryl ester was significantly and uniformly reduced as carbohydrate intake decreased, and then gradually increased as dietary carbohydrate was re-introduced. The results show that dietary and plasma saturated fat are not related, and that increasing dietary carbohydrate across a range of intakes promotes incremental increases in plasma palmitoleic acid, a biomarker consistently associated with adverse health outcomes.
Highlights
Current dietary guidelines recommend that Americans decrease saturated fat to 7– 10% of total energy and to consume the majority of calories from carbohydrate [1]
Compared to baseline (46 g/day), saturated fat intake was nearly doubled at C1 (84 g/day) and gradually decreased to levels below baseline at C6 (32 g/day)
A cornerstone of dietary guidelines has been the restriction of saturated fat, but that position is being questioned in large part because recent analyses have found that saturated fat intake is unrelated to risk of disease [2]
Summary
Current dietary guidelines recommend that Americans decrease saturated fat to 7– 10% of total energy and to consume the majority of calories from carbohydrate [1]. To accomplish these goals requires limiting whole foods that contain saturated fat (e.g., beef, eggs, high-fat dairy). De novo lipogenesis (DNL) increases several-fold when carbohydrate is fed above energy needs [3], but isocaloric high-carbohydrate diets [4] and highcarbohydrate meals [5, 6] promote DNL and hypertriglyceridemia in individuals with insulin resistance. High-carbohydrate intake in individuals with an impaired ability to oxidize glucose stimulates DNL and secretion of SFA- and MUFAenriched VLDL particles; a serum profile associated with insulin resistance [7]
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