Replacing Saturated Fat, Refined Carbs With Healthy Fats Could Ease Global CHD Burden

Abstract

I burdens. This suggests that focus on nsuffi cient omega-6 polyunsaturated increasing healthful n-6 rich vegetable fatty acids (n-6 PUFA), excess trans fat oils may provide important public health and, to a lesser extent, excess saturatbenefits,” Qianyi Wang, ScD, and her ed fat, are signifi cant causes of coronary colleagues said. heart disease, suggests a global study The researchers estimated national recently published online. intakes of saturated fat, n-6 PUFA, “Our anal ysis provides, for the first and trans fat based on country-specific time, a rigorous comparison of global dietary surveys, food availability data, CHD burdens attributable to insufficient and for trans fat, industry reports on n-6 PUFA versus higher saturated fat. fats/oils and packaged foods. The In 80% of nations, n-6 PUFA–attributeffects of dietary fats on CHD mortalable CHD burdens were at least twofold ity were derived from meta-analyses of prospective cohorts, and CHD mortality rates were derived from the 2010 Global Burden of Diseases Study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. The researchers estimated insufficient n-6 PUFA consumption having been replaced by carbohydrate or saturated fat consumption was responsible for 711,800 CHD deaths per year, accounting for 10% of total global CHD mortality and for 187 CHD deaths per year per 1 million adults. The most absolute CHD deaths per year — 547 per 1 million adults — attributable to insufficient n-6 PUFA occurred in Eastern Europe, while Oceania had the highest proportion of n-6 PUFA–attributable CHD deaths. East Asia had both the fewest absolute — 74 per 1 million adults — and lowest proportion — 6.7% — of CHD deaths attributable to inadequate consumption of n-6 PUFA. Excess consumption of saturated fat as a replacement for n-6 PUFA caused an estimated 250,900 CHD deaths per year, accounting for 3.6% of CHD deaths and 66 CHD deaths per year per 1 million adults. T he researchers estimated that excess trans fat consumption caused 537,200 CHD deaths per year, representing 7.7% of global CHD mortality and 141 CHD deaths per year per 1 million adults. High-income nations generally had higher trans fat–attributable CHD mortality than lower-income nations. The highest trans fat–attributable absolute CHD mortality occurred in Egypt, with 1,120 deaths per year per 1 million adults. Canada, Pakistan, and the United States all had more than 475 deaths per year per 1 million adults because of excess consumption of trans fat. Such deaths accounted for more than 17% of corresponding national CHD mortality. Sub-Saharan Africa and the Caribbean had the lowest estimated trans fat–attributable CHD mortality. Additional findings of this study included mean global changes in dietary intakes of saturated fat, n-6 PUFA, and trans fat, and corresponding changes in CHD deaths occurring between 1990 and 2010. Specifically, global proportional CHD mortality attributable to insufficient n-6 PUFA and higher saturated fat consumption decreased by 9% and 21%, respectively. Such decreases occurred in concert with a 0.5% increase in consumption of n-6 PUFA and a 0.2% decrease in consumption of saturated fat. In high-income countries, trans fat consumption declined in parallel with policy strategies to reduce industrial trans fat production. In contrast, global proportional CHD deaths attributable to higher trans fat increased by 4% as global mean dietary intakes of trans fat increased by 0.1%. “Growing evidence indicates that lowering saturated fat provides convincing cardiovascular benefits only when replaced by PUFA, whereas cardiovascular benefits of n-6 PUFA are similar whether replacing saturated fat or total carbohydrates,” said Dr. Wang of the Harvard T.H. Chan School of Public Health, Boston. R ead the study in the Journal of the American Heart Association [doi:10.1161/ JAHA.115.002891]. CfA