Abstract
Dietary fats have important effects on the risk of cardiovascular disease (CVD). Abundant evidence shows that partial replacement of saturated fatty acids (SAFA) with unsaturated fatty acids improves the blood lipid and lipoprotein profile and reduces the risk of coronary heart disease (CHD). Low-fat diets high in refined carbohydrates and sugar are not effective. Very long-chain polyunsaturated n-3 or omega-3 fatty acids (n-3 VLCPUFA) present in fish have multiple beneficial metabolic effects, and regular intake of fatty fish is associated with lower risks of fatal CHD and stroke. Food-based guidelines on dietary fats recommend limiting the consumption of animal fats high in SAFA, using vegetable oils high in monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA), and eating fatty fish. These recommendations are part of a healthy eating pattern that also includes ample intake of plant-based foods rich in fiber and limited sugar and salt.
Highlights
Dietary fats are important in the prevention of cardiovascular disease (CVD), as documented in many studies over the past 60 years
Research in the 1950s and 1960s focused on saturated fatty acids (SAFA) and vegetable monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) in relation to blood cholesterol levels and the risk of coronary heart disease (CHD)
The type of dietary fat, but not total fat intake, is an important determinant of CVD risk. It is established by different types of studies that partial replacement of dietary SAFA with unsaturated fatty acids, in particular vegetable PUFA reduces the risk of CHD
Summary
Dietary fats are important in the prevention of CVD, as documented in many studies over the past 60 years. Several recent publications have questioned the evidence and rationale for dietary fat recommendations, especially for SAFA and omega-6 (n-6) PUFA (mainly linoleic acid, LA) intakes [4, 5] These publications and the media attention they attracted have created confusion among consumers and health care professionals about the health effects of different dietary fats. We describe human studies with research designs of the highest relevance for evaluating the effects of diet on human health and setting guidelines [6] These include long-term randomized controlled trials on clinical endpoints (RCTs), prospective analyses from large population studies, and controlled dietary intervention studies on established markers of cardiometabolic risk (metabolic trials). This review considers new insights in the effects of dietary fatty acids on markers of insulin sensitivity and risk of type II diabetes mellitus (T2DM)
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