SFA Intake Research Articles

Dietary Saturated Fats from Different Food Sources Show Variable Associations with the 2015 Healthy Eating Index in the Canadian Population

Although mostly food-based, the majority of dietary guidelines also recommend limiting the consumption of foods high in SFAs. Yet, the association between the consumption of SFAs from different food sources and overall diet quality remains uncertain. The objective of this study was to examine the associations between SFAs from various food sources and the 2015 Healthy Eating Index (HEI-2015) as a proxy of overall diet quality. The study sample included 11,106 respondents between 19 and 70 y of age from the 2015 Canadian Community Health Survey. Dietary intakes as well as the HEI-2015 were calculated using data from a single 24-h recall. An HEI-2015 from which the SFA subscores were subtracted was also calculated. Low nutritive value foods were defined using Health Canada's 4-Tier system. Associations were investigated using multivariable linear regressions with restricted cubic splines. Major sources of SFAs in this population were low nutritive value foods [4.4% of total energy intake (%E)], dairy (2.7%E), and meat products (1.9%E). The associations between SFA consumption (total and from different food sources) and the HEI-2015 were generally inverse and nonlinear (P for the nonlinearity test <0.03 for all). Total SFA intake showed no association with the SFA-subtracted HEI-2015 (P=0.29). SFAs from dairy tended to be associated with an increase in the SFA-subtracted HEI-2015 (P<0.001). Removing the SFA subscore from the HEI-2015 did not materially modify its association with SFAs from meat. SFAs from low nutritive value foods remained significantly and inversely associated with the SFA-subtracted HEI-2015 (P<0.001). These cross-sectional data in Canadian adults suggest that intake of SFAs from low nutritive value foods, but not total SFA intake, is captured by an index of healthy eating that does not account for SFA intake.

Dietary fat intakes in Irish children: changes between 2005 and 2019.

To examine current dietary fat intakes and compliance in Irish children and to examine changes in intakes from 2005 to 2019. Analyses were based on data from the Irish National Children's Food Survey (NCFS) and the NSFS II, two cross-sectional studies that collected detailed food and beverage intake data through 7-day and 4-day weighed food diaries, respectively. NCFS and NCFS II, Republic of Ireland. A nationally representative sample of 594 (NCFS) and 600 (NCFS II) children aged 5-12 years. Current intakes from the NCFS II were compared with those previously reported in the NCFS (www.iuna.net). Current intakes of total fat, SFA, MUFA, PUFA and trans fat as a percentage of total energy are 33·3, 14·0, 13·6, 5·6 and 0·5 %, respectively. Total fat, SFA and trans fat intakes since 2005 remained largely stable over time with all displaying minor decreases of <1 %. Adherence to SFA recommendations remains inadequate, with only 7 % of the population complying. Insufficient compliance with PUFA (71 %) and EPA and DHA (DHA; 16 %) recommendations was also noted. Children in Ireland continue to meet the total fat and trans fat target goals. Adherence to MUFA and PUFA recommendations has also significantly improved. However, deviations for some fats remain, in particular SFA. These findings are useful for the development of dietary strategies to improve compliance with current recommendations.

Changes in human milk fatty acid composition and maternal lifestyle-related factors over a decade: a comparison between the two Ulm Birth Cohort Studies.

Human milk fatty acid composition varies during lactation and is influenced by maternal diet, maternal lifestyle-related factors and genetic background. This is one of the first studies to investigate a period effect, that is, the impact of lifestyle-related changes on human milk fatty acid composition, in two different cohorts. Lactating women were recruited from the general population a decade apart in Ulm, Germany, using similar methodology. Human milk samples collected 6 weeks postpartum were analysed (Ulm Birth Cohort Study (UBCS (2000)), n 567; Ulm SPATZ Health Study (SPATZ (2012)), n 458). Centred log ratio transformation was applied to fatty acid data. Principal component analysis was used to determine study-dependent fatty acid profiles. A general linear model was used to determine the study (or period) effect on fatty acid profiles adjusting for duration of gestation, age, education, delivery mode, smoking and pre-pregnancy BMI. Two principal components were retained (PC1 and PC2). PC1 was associated with UBCS, while PC2 was associated with SPATZ. PC1 comprised high SFA, and low MUFA, n-6 and n-3 long-chain PUFA (LCPUFA). The inverse was true for PC2. Although human milk remains a source of essential fatty acids, infants could be at risk of inadequate n-3 and n-6 LCPUFA intake through human milk. The differences in the human milk fatty acid profiles also reflect changes in maternal dietary habits in the more recent cohort, which may comprise lower intakes of dietary trans-fatty acids and SFA and higher intakes of vegetable oils.

Intake of carbohydrates and SFA and risk of CHD in middle-age adults: the Hordaland Health Study (HUSK).

Limiting SFA intake may minimise the risk of CHD. However, such reduction often leads to increased intake of carbohydrates. We aimed to evaluate associations and the interplay of carbohydrate and SFA intake on CHD risk. Prospective cohort study. We followed participants in the Hordaland Health Study, Norway from 1997-1999 through 2009. Information on carbohydrate and SFA intake was obtained from a FFQ and analysed as continuous and categorical (quartiles) variables. Multivariable Cox regression estimated hazard ratios (HR) and 95 % CI. Theoretical substitution analyses modelled the substitution of carbohydrates with other nutrients. CHD was defined as fatal or non-fatal CHD (ICD9 codes 410-414 and ICD10 codes I20-I25). 2995 men and women, aged 46-49 years. Adjusting for age, sex, energy intake, physical activity and smoking, SFA was associated with lower risk (HRQ4 v. Q1 0·44, 95 % CI 0·26, 0·76, Ptrend = 0·002). For carbohydrates, the opposite pattern was observed (HRQ4 v. Q1 2·10, 95 % CI 1·22, 3·63, Ptrend = 0·003). SFA from cheese was associated with lower CHD risk (HRQ4 v. Q1 0·44, 95 % CI 0·24, 0·83, Ptrend = 0·006), while there were no associations between SFA from other food items and CHD. A 5 E% substitution of carbohydrates with total fat, but not SFA, was associated with lower CHD risk (HR 0·75, 95 % CI 0·62, 0·90). Higher intake of predominantly high glycaemic carbohydrates and lower intake of SFA, specifically lower intake from cheese, were associated with higher CHD risk. Substituting carbohydrates with total fat, but not SFA, was associated with significantly lower risk of CHD.

Beneficial effect on serum cholesterol levels, but not glycaemic regulation, after replacing SFA with PUFA for 3 d: a randomised crossover trial

Replacing intake of SFA with PUFA reduces serum cholesterol levels and CVD risk. The effect on glycaemic regulation is, however, less clear. The main objective of the present study was to investigate the short-term effect of replacing dietary SFA with PUFA on glycaemic regulation. Seventeen healthy, normal-weight participants completed a 25-d double-blind, randomised and controlled two-period crossover study. Participants were allocated to either interventions with PUFA products or SFA products (control) in a random order for three consecutive days, separated by a 1·5-week washout period between the intervention periods. Glucose, insulin and TAG were measured before and after an oral glucose tolerance test. In addition, fasting total cholesterol, NEFA and plasma total fatty acid profile were measured before and after the 3-d interventions. Fasting and postprandial glucose, insulin, and TAG levels and fasting levels of NEFA and plasma fatty acid profile did not differ between the groups. However, replacing dietary SFA with PUFA significantly reduced total cholesterol levels by 8 % after 3 d (P = 0·002). Replacing dietary SFA with PUFA for only 3 d has beneficial cardio-metabolic effects by reducing cholesterol levels in healthy individuals.

Relationship between dietary fats and serum antioxidants with atheromatic index in regular blood donors.

Nutritional choices, which include dietary fatty acids (FA), vitamins and sugars, have an important significant impact on the development of atheromatic index levels. Controversial opinions exist in the literature regarding the role of different fat types and their association with atheromatic index. We investigated the relationship between dietary intake with different atheromatic index groups of volunteer regular blood donors (rBDs) recognizing them as a healthy population excluding drug and supplements intake and we correlated their values with serum total antioxidant status (sTAS). 150 individuals used in this study were divided in 3 groups according to their atheromatic index (AI=Total cholesterol/HDL) (AI): Group 1 (AI<3.5) comprised of 50 rBDs, Group 2 (AI 3.5-4.49) of 52 rBDs and Group 3 of 48 rBDs (AI>4.5). Dietary intake was assessed using the 3 day food recall and the Food Processor, computer program for nutrient analysis. sTAS was measured in all samples and correlated with atheromatic index too. Our study showed that rBDs with low dietary intake of all vitamins, Ω3 fatty acids, trans fatty acids and dietary cholesterol presented an increased atheromatic index. On the other hand rBDs with high dietary intake of saturated fat, total fats, monounsaturated and polyunsaturated fats and sugar showed increased atheromatic index. In addition, groups with the higher atheromatic index presented statistically significant higher total antioxidant status. Trans FA are also positively associated with sTAS and on the other hand dietary cholesterol is negatively associated with sTAS and positively in groups B and C. The results of the present study showed that dietary intake of different types of fatty acids should be used separately as atheromatic index predictors. Moreover, sTAS is correlated with dietary intake of SFA, MUFA, PUFA, Cholesterol, Trans FA and sugar. Finally, the measurement of each fatty acid would be of great value for the screening of lipid metabolism disorders in atheromatic index control.

Public health guidelines should recommend reducing saturated fat consumption as much as possible: Debate Consensus

There is ongoing debate as to whether public health guidelines should advocate reducing SFA consumption as much as possible to reduce the risk of chronic diseases, especially cardiovascular disease (CVD). In considering both sides of this question, we identified a number of points of agreement, most notably that the overall dietary patterns in which SFAs are consumed are of greater significance for cardiometabolic and general health than SFA intake alone. Nevertheless, there remained significant disagreements, centered largely on the interpretation of evidence bearing on 4 major questions: 1) does reducing dietary SFAs lower the incidence of CVD, 2) is the LDL-cholesterol reduction with lower SFA intake predictive of reduced CVD risk, 3) do dietary SFAs affect factors other than LDL cholesterol that may impact CVD risk, and 4) is there a sufficient rationale for setting a target for maximally reducing dietary SFAs? Finally, we identified specific research needs for addressing knowledge gaps that have contributed to the controversies.

Public health guidelines should recommend reducing saturated fat consumption as much as possible: NO

The proposition that dietary SFAs should be restricted to the maximal extent possible (e.g., to achieve approximately half of current consumption) is based primarily on observational and clinical trial data that are interpreted as indicating a benefit of such limitation on cardiovascular disease (CVD) risk. Further support is believed to derive from the capacity of SFAs to raise LDL cholesterol, and the evidence that LDL-cholesterol lowering reduces CVD incidence. Despite their apparent merit, these arguments are flawed. In fact, although it is possible that dietary intake of SFAs has a causal role in CVD, the evidence to support this contention is inconclusive. Moreover, other considerations argue against a guideline focused primarily on limiting SFA intake, including the heterogeneity of individual SFAs, the likelihood of clinically meaningful interindividual variation in response to SFA reduction, the potential for unintended health consequences of population-wide promotion of severe restriction, and the critical differences in health impacts among individual SFA-containing foods.

Validation of a New Instrument for Assessing Diet Quality and Its Association with Undernutrition and Non-Communicable Diseases for Women in Reproductive Age in India

Abstract Objectives India has been undergoing a rapid nutrition transition, resulting in the co-existence of undernutrition and nutrition-related non-communicable diseases (NCD). There is a need to develop and validate a diet quality assessment tool to assess risks for the double burden of disease. Methods We included 2915 non-pregnant and non-lactating women (15–49 years) from two Indian cohorts: The Andhra Pradesh Children and Parent Study and the Indian Migration Study. Using dietary data collected from FFQs, we developed a novel diet metric, the Global Diet Quality Score (GDQS). We categorized foods into 25 groups based on similarity of nutrient intake and intake patterns. Each category was assigned a positive or negative score based on prior evidence on their associations with undernutrition and NCD. Scores were calculated from the frequency and intake amounts for each category with higher scores corresponding to better diet quality (maximum total points of 49). We evaluated associations between the GDQS (overall, positive submetric, and negative submetric) and overall nutrient adequacy (&amp;gt;6/12 nutrients intake being adequate), individual micro and macronutrients, BMI, hemoglobin, systolic and diastolic blood pressure (SBP and DBP), high density lipoprotein (HDL), and total cholesterol (TC). Results The mean (SD) of the GDQS was 24 (4) points. In energy-adjusted models, positive associations were found between the overall GDQS and intakes of calcium, fiber, folate, iron, MUFA, protein, PUFA, SFA, total fat, and zinc in energy-adjusted models (r = 0.15–0.33, P &amp;lt; 0.001). Adjusted for age, GDQS was positively associated with overall nutrient adequacy. Quintile analyses showed that GDQS was positively associated with the odds of being overweight, obese and high SBP. Lower intake of foods in the GDQS negative submetric was associated with lower odds of having BMI ≥ 30 kg/m2 (OR = 0.66 (95% CI: 0.56–0.77), TC ≥200 mg/dL (0.87 (0.78–0.97), and DBP ≥ 80 mmHg (0.82 (0.74–0.92). Conclusions Among Indian women, the overall GDQS was positively associated with overall nutrient adequacy. Both the overall and negative submetric were associated with several NCD risk markers. Future studies should validate these metrics against incident diabetes and cardiovascular disease. Funding Sources Intake - Center for Dietary Assessment at FHI Solutions.

Promotion of optimized food-based recommendations to improve dietary practices and nutrient intakes among Minangkabau women of reproductive age with dyslipidemia.

Using a linear programming approach, an optimized food-based recommendations (FBRs) had been formulated for Minangkabau women of reproductive age with dyslipidemia in Indonesia. This study aimed to assess the effectiveness of the promotion of the FBRs for improving dietary practices and nutrient intakes. A community-based, clustered-randomized trial was conducted among Minangkabau women of reproductive age (20-44 years) with dyslipidemia. The subjects were assigned either into the FBR group (n=48), or the non-FBR group (n=54). Baseline and end-line dietary data were assessed through interviews using a one-week semiquantitative food frequency questionnaire (SQ-FFQ) and two replicate 24-hour dietary recalls. The changes in dietary practice and nutrient intakes were analysed using ANCOVA test. Significant changes were observed (p<0.005) in the consumption of the promoted food items and subgroups (sea fish, soy protein, dark green leafy vegetables, and potatoes). Significant changes were also observed in nutrient intake, especially energy intake from carbohydrates and unsaturated fatty acids (total PUFA, MUFA, n-3 and n-6 fatty acids), as well as the dietary P/S ratio and fiber intake. With current dietary practices, intakes of some typical problem nutrients such as n-6, zinc, iron, and fiber still could not achieve 100% of the RNIs, while the intake of SFA still exceeded the recommended intake. Further approaches are needed to expand the population food basket and promote behavioral change to address established cultural food habits, including reducing the use of cooking oil in food preparation and increasing vegetable consumption.

Effects of dietary fat quality on metabolic endotoxaemia: a systematic review.

In this systematic review, we critically evaluated human clinical trials that assessed the effects of dietary fat quality on metabolic endotoxaemia. The studies were selected from three databases (PubMed, Scopus and Cochrane Library), and the keywords were defined according to the Medical Subject Headings indexing terminology. Two authors searched independently, according to the pre-defined selection criteria. Quality and risk assessment of bias for each selected study were also evaluated. The results of the included studies demonstrated associations between higher SFA intake and increased postprandial lipopolysaccharide (LPS) concentrations. On the other hand, after the consumption of PUFA, bloodstream LPS concentrations were lower. However, in none of the long-term studies, the consumption of dietary fats did not seem to exert effects on LPS concentration. Hence, SFA seem to act as a risk factor for transient increase in endotoxaemia, while PUFA demonstrated exerting a protective effect. Taken together, the evidence suggests that the dietary fatty acid profile may influence bloodstream endotoxin concentrations through modulation of factors such LPS clearance, alkaline phosphatase activity, bile acid metabolism, intestinal permeability and intestinal microbiota composition.

Reformulation initiative for partial replacement of saturated with unsaturated fats in dairy foods attenuates the increase in LDL cholesterol and improves flow-mediated dilatation compared with conventional dairy: the randomized, controlled REplacement of SaturatEd fat in dairy on Total cholesterol (RESET) study

ABSTRACTBackgroundModifying dairy fat composition by increasing the MUFA content is a potential strategy to reduce dietary SFA intake for cardiovascular disease (CVD) prevention in the population.ObjectivesTo determine the effects of consuming SFA-reduced, MUFA-enriched (modified) dairy products, compared with conventional dairy products (control), on the fasting cholesterol profile (primary outcome), endothelial function assessed by flow-mediated dilatation (FMD; key secondary outcome), and other cardiometabolic risk markers.MethodsA double-blind, randomized, controlled crossover 12-wk intervention was conducted. Participants with a 1.5-fold higher (moderate) CVD risk than the population mean replaced habitual dairy products with study products (milk, cheese, and butter) to achieve a high-fat, high-dairy isoenergetic daily dietary exchange [38% of total energy intake (%TE) from fat: control (dietary target: 19%TE SFA; 11%TE MUFA) and modified (16%TE SFA; 14%TE MUFA) diet].ResultsFifty-four participants (57.4% men; mean ± SEM age: 52 ± 3 y; BMI: 25.8 ± 0.5 kg/m2) completed the study. The modified diet attenuated the rise in fasting LDL cholesterol observed with the control diet (0.03 ± 0.06 mmol/L and 0.19 ± 0.05 mmol/L, respectively; P = 0.03). Relative to baseline, the %FMD response increased after the modified diet (0.35% ± 0.15%), whereas a decrease was observed after the control diet (−0.51% ± 0.15%; P< 0.0001). In addition, fasting plasma nitrite concentrations increased after the modified diet, yet decreased after the control diet (0.02 ± 0.01 μmol/L and −0.03 ± 0.02 μmol/L, respectively; P = 0.01).ConclusionsIn adults at moderate CVD risk, consumption of a high-fat diet containing SFA-reduced, MUFA-enriched dairy products for 12 wk showed beneficial effects on fasting LDL cholesterol and endothelial function compared with conventional dairy products. Our findings indicate that fatty acid modification of dairy products may have potential as a public health strategy aimed at CVD risk reduction. This trial was registered at clinicaltrials.gov as NCT02089035.

Abstract 50: Associations of Dietary Saturated Fatty Acids With Incident Coronary Heart Disease Depend on the Food Sources: EPIC-CVD Prospective Case-cohort Study in Nine European Countries

Introduction: The associations of dietary total fatty acids and the classes saturated, monounsaturated, and polyunsaturated fatty acids (SFAs, MUFAs, and PUFAs) with coronary heart disease (CHD) remain contentious. Moreover, the role of isocaloric macronutrient substitutions and specific food sources of SFAs, particularly in European context, is unclear. Hypothesis: We evaluated the hypothesis that associations of dietary fatty acids vary depending on specific macronutrient substitutions and food sources of SFAs. Methods: We conducted case-cohort analyses including 10,529 incident CHD cases and a random subcohort of 16,730 men and women selected from 385,747 eligible participants in nine countries of the European Prospective Investigation into Cancer and Nutrition Study. Habitual diet was assessed using country-specific dietary questionnaires, and macronutrient intakes were estimated using standardised nutrient databases. Country-specific HRs (95% CIs) per 5% energy intake from dietary total fatty acids, SFAs, MUFAs, and PUFAs were estimated using Prentice-weighted Cox regression models and pooled using random-effects meta-analyses, with and without considering isocaloric macronutrient substitutions. The associations of dietary SFAs from different food sources, including specific macronutrient substitutions, with CHD were also investigated. Results: There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, or PUFAs with incident CHD, regardless of the substitution macronutrient. Each 1% higher energy intake of SFAs from yoghurt, cheese, and fish were associated with a 7% (95% CI 1-12%), 2% (0-4%) and 13% (0-25%) lower CHD incidence, while SFAs from red meat and butter were associated with a 7% (2-12%) and 2% (0-4%) higher CHD incidence, respectively. Conclusions: There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, and PUFAs, with CHD incidence, regardless of the substitution nutrients, within the range of intakes in this European population. The opposite direction of associations of SFAs from different food sources such as red meat versus fermented dairy products suggests that public health recommendations should consider foods and overall diets, alongside the macronutrients they contain.

Urban Egyptian Women Aged 19-30 Years Display Nutrition Transition-Like Dietary Patterns, with High Energy and Sodium Intakes, and Insufficient Iron, Vitamin D, and Folate Intakes.

ABSTRACTBackgroundRecent changes in Egyptian dietary habits can be attributed to more urban and sedentary lifestyles and to alterations in the dietary and economic context. The mean BMI of Egyptian women is one of the highest worldwide, and 50% have iron deficiency.ObjectiveThe aim was to quantify food and nutrient intakes of urban Egyptian women and conduct a detailed analysis of micronutrients commonly consumed in inadequate amounts, such as iron, vitamin D, and folate.MethodsUrban Egyptian women aged 19–30 y (n = 130) were recruited during 2016–2017. Energy needs were estimated using the Henry equation, assuming a low physical activity level (1.4). Dietary intakes and iron bioavailability were estimated from a 4-d food diary. Macronutrient intakes were compared with WHO/FAO population goals and micronutrient intakes with Egyptian recommendations. Iron needs were determined for each subject.ResultsThe mean BMI (kg/m2) was 27.9 ± 4.9. The mean total energy intake (TEI; 2389 ± 715 kcal/d) was significantly higher than needs (2135 ± 237 kcal/d; P = 0.00018). Total fat (33%TEI) and SFA (11%TEI) intakes were slightly higher than population goals (15–30%TEI and <10%TEI, respectively). Diets provided 18 ± 8 g/d of fiber, 98 ± 54 g/d of total sugars, and nearly twice the recommended sodium intake (intake: 2787 ± 1065 mg/d; recommendation: <1500 mg/d). Estimated dietary iron bioavailability was low (9.2% ± 1.6%), and 79% of women consumed less iron than the average requirement (17.5 ± 7 mg/d). Overall, 82% and 80% of women consumed less vitamin D and folate, respectively, than recommended.ConclusionsEgyptian women aged 19–30 y have high intakes of energy and sodium, whereas iron, vitamin D, and folate intakes are insufficient, with only low concentrations of bioavailable iron. These results call for further investigation into measures that would improve this population's diet quality.

Dietary saturated fat and heart disease: a narrative review.

The American Heart Association (AHA) recently published a meta-analysis that confirmed their 60-year-old recommendation to limit saturated fat (SFA, saturated fatty acid) and replace it with polyunsaturated fat to reduce the risk of heart disease based on the strength of 4 Core Trials. To assess the evidence for this recommendation, meta-analyses on the effect of SFA consumption on heart disease outcomes were reviewed. Nineteen meta-analyses addressing this topic were identified: 9 observational studies and 10 randomized controlled trials. Meta-analyses of observational studies found no association between SFA intake and heart disease, while meta-analyses of randomized controlled trials were inconsistent but tended to show a lack of an association. The inconsistency seems to have been mediated by the differing clinical trials included. For example, the AHA meta-analysis only included 4 trials (the Core Trials), and those trials contained design and methodological flaws and did not meet all the predefined inclusion criteria. The AHA stance regarding the strength of the evidence for the recommendation to limit SFAs for heart disease prevention may be overstated and in need of reevaluation.

The association of dietary patterns and adherence to WHO healthy diet with metabolic syndrome in children and adolescents: Tehran lipid and glucose study

BackgroundThe optimal dietary pattern for reducing the extent of metabolic syndrome (MetS) has not been well established yet. The aim of this study was to evaluate dietary patterns and adherence to WHO healthy diet in children and adolescents and their associations with MetS.MethodsSubjects of this cohort study were selected from among children and adolescents of the Tehran Lipid and Glucose Study participants, aged 6–18 years (n = 424). Dietary measurements were collected using a valid and reliable food frequency questionnaire. MetS was defined as the existence of at least 3 risk factors according to the Cook criteria. Diet was assessed based on dietary components of the WHO healthy diet. Dietary patterns were defined by principal component analysis.ResultsThe mean ± SD age of participants (42% boys and 57% girls) was 13.5 ± 3.7 years. The most consistency with the WHO healthy diet was observed for cholesterol, free sugar and protein consumption in both genders, and the least was for n-3 poly-unsaturated fatty acid, trans-fatty acid and salt. Intake of SFA up to 12% of energy intake (third quartile) reduced the risk of MetS, compared to the first quartile. Subjects in the third quartile of n-6 poly-unsaturated fatty acid intake (6.2% of energy) showed the lowest odds ratio of MetS compared to the first quartile (OR: 0.18, CI: 0.04–0.66). In the adjusted model, the risk of MetS reduced across quartiles of MUFA intake by 60% (OR: 1, 0.40, 0.40, 0.42; P trend = 0.05). No significant trends were observed in the risk of MetS components across quartiles of the WHO healthy diet components. Three major dietary patterns were identified, the healthy, unhealthy and cereal/meat. An increased risk of MetS was observed in the highest quartile of unhealthy dietary pattern score compared to the lowest quartile (OR: 1, 0.81, 0.93, 2.49; P trend = 0.03).ConclusionsOur results demonstrated that the majority of our population did not meet some components of WHO healthy diet recommendations. The quality and quantity of fatty acid intakes were associated with risk of MetS. Adherence to unhealthy dietary pattern was associated with two-fold increase in MetS risk.

The relationships between sarcopenic skeletal muscle loss during ageing and macronutrient metabolism, obesity and onset of diabetes

Skeletal muscle is integral to the metabolism and utilisation of macronutrients; however, substantial muscle loss and morphological changes occur with ageing. These are associated with loss of muscle function and accelerate rapidly from the age of 60 years, leading to the conditions of sarcopenia and frailty. As the relationship between muscle ageing and macronutrient metabolism and utilisation has seen limited research to date, this review focuses on the interactions between skeletal muscle changes during ageing, metabolism and utilisation of fat, carbohydrates and overall energy expenditure.Skeletal muscle contributes less to resting energy expenditure during ageing, potentially contributing to onset of obesity from middle age. Age-related changes to skeletal muscle lead to glucose dysregulation, with consequent reduction in glycaemic control, increased insulin resistance and ultimately onset of type-2 diabetes. Recent studies indicate that high total fat and SFA intake are detrimental to skeletal muscle, while higher intakes of PUFA are protective. Age-associated changes in skeletal muscle may also reduce total fatty acid utilisation.In conclusion, further research is needed to understand the relationships between macronutrient metabolism and utilisation and age-related changes to skeletal muscle. No dietary recommendations exist specifically for skeletal muscle health during ageing, but we advise individuals to follow healthy eating guidelines, by consuming sufficient protein, fruit and vegetables, and limited SFA and to maintain physically active lifestyles. Clinicians responsible for managing type-2 diabetes need to be aware of growing evidence relating age-related skeletal muscle changes to diabetes onset and progression.

Dietary dilemmas over fats and cardiometabolic risk.

CVD remains the greatest cause of death globally, and with the escalating prevalence of metabolic diseases, including type-2 diabetes, CVD mortality is predicted to rise. While the replacement of SFA has been the cornerstone of effective dietary recommendations to decrease CVD risk since the 1980s, the validity of these recommendations have been recently challenged. A review of evidence for the impact of SFA reduction revealed no effect on CVD mortality, but a significant reduction in risk of CVD events (7-17%). The greatest effect was found when SFA were substituted with PUFA, resulting in 27% risk reduction in CVD events, with no effect of substitution with carbohydrate or protein. There was insufficient evidence from randomised controlled trials to conclude upon the impact of SFA replacement with MUFA on CVD and metabolic outcomes. However, there was high-quality evidence that reducing SFA lowered serum total, and specifically LDL-cholesterol, a key risk factor for CVD, with greatest benefits achieved by replacing SFA with unsaturated fats. The exchange of SFA with either PUFA or MUFA, also produced favourable effects on markers of glycaemia, reducing HbA1c, a long-term marker of glycaemic control. In conclusion, the totality of evidence supports lowering SFA intake and replacement with unsaturated fats to reduce the risk of CVD events, and to a lesser extent, cardiometabolic risk factors, which is consistent with current dietary guidelines.

Dietary saturated fat and low-grade inflammation modified by accelerometer-measured physical activity in adolescence: results from the GINIplus and LISA birth cohorts

BackgroundSaturated fatty acids (SFA) have been reported to promote inflammation. Nevertheless, evidence linking dietary SFA and low-grade inflammation in adolescents is scarce and inconsistent. The modulatory role of physical activity (PA) on fat metabolism and inflammation may provide a potential explanation. Thus, we assessed the association of dietary SFA with high-sensitivity C-reactive protein (hsCRP), a marker of low-grade inflammation, in 15-year-olds, and evaluated possible interactions between dietary SFA and different levels of PA.MethodsChildren participating in the 15-year follow-ups of the GINIplus and LISA German birth cohort studies were included (N = 824). SFA intake was estimated by means of a food frequency questionnaire and PA recorded by accelerometers. Average daily minutes of PA were classified into “sedentary”, “light” and “moderate-to-vigorous” (MVPA), using Freedson’s cut-offs. HsCRP concentrations were measured in serum and categorized into 3 sex-specific levels (below detection limit (I), above 75th percentile (III), in between (II)). Sex-stratified cross-sectional associations between SFA and hsCRP were assessed using multinomial logistic regression, adjusting for potential confounders. Interaction terms were included between SFA and the different PA levels; and if significant interactions were observed, analyses stratified by tertiles of the relevant PA levels were performed. Relative risk ratios (RRR) and 95% confidence intervals (95%CI) were presented for a 1% increase in SFA.ResultsAn inverse association was observed between SFA intake and hsCRP (II vs. I) in males (RRR = 0.85 [95%CI = 0.76;0.96], p = 0.008), whereas no significant association was observed in females. A significant interaction was observed with “sedentary” and “light” PA but not with MVPA in both sexes (p < 0.05). Stratified analyses indicated a significant inverse association between SFA and medium hsCRP levels in males in the highest light PA tertile (hsCRP II vs. I: 0.67 [0.517;0.858], p = 0.002).ConclusionOur findings do not support a detrimental role of dietary SFA in low-grade inflammation among adolescents. In males, higher dietary SFA was associated with lower hsCRP, although this should be interpreted in the context of possibly correlated nutrients. Children spending the most time in light PA drove the observed inverse association, suggesting a synergistic effect of SFA and lifestyle PA in the resultant inflammatory response.

BMI modifies the effect of dietary fat on atherogenic lipids: a randomized clinical trial

SFA intake increases LDL cholesterol whereas PUFA intake lowers it. Whether the lipid response to dietary fat differs between normal-weight and obese persons is of relevance to dietary recommendations for obese populations. We compared the effect of substituting unsaturated fat for saturated fat on LDL cholesterol and apoB concentrations in normal-weight (BMI ≤25 kg/m2) and obese (BMI: 30-45) subjects with elevated LDL cholesterol. We randomly assigned 83 men and women (aged 21-70 y) stratified by BMI (normal: n=44; obese: n=39) and elevated LDL cholesterol (mean ± SD, normal weight 4.6 ± 0.9 mmol/L; obese 4.4 ± 0.8 mmol/L) to either a PUFA diet enriched with oil-based margarine ( n=42) or an SFA diet enriched with butter (n=41) for 6 wk. Seven-day dietary records showed differences of ∼9 energy percent (E%) in SFA and ∼4 E% in PUFA between the SFA and PUFA groups. In the total study population, the PUFA diet compared with the SFA diet lowered LDL cholesterol (-0.31 mmol/L; 95% CI: -0.47, -0.15 mmol/L, compared with 0.32 mmol/L; 95% CI: 0.18, 0.47 mmol/L; P<0.001) and apoB (-0.08 g/L; 95% CI: -0.11, -0.05 g/L, compared with 0.07 g/L; 95% CI: 0.03, 0.10 g/L; P<0.001). Tests of the BMI × diet interaction were significant for total cholesterol, LDL cholesterol, and apoB ( P values≤0.009). In normal-weight compared with obese participants post-hoc comparisons found that the respective changes in LDL cholesterol were 9.7% (95% CI: 5.3%, 14.2%) compared with 5.3% (95% CI: -0.7%, 11.2%), P=0.206, in the SFA group, and -10.4% (95% CI: -15.2%, -5.7%) compared with -2.3% (95% CI: -7.4%, 2.8%), P=0.020, in the PUFA group. ApoB changes were 7.5% (95% CI: 3.5%, 11.4%) compared with 3.0% (95% CI: -1.7%, 7.7%), P=0.140, in the SFA group, and -8.9% (95% CI: -12.6%, -5.2%) compared with -3.8% (95% CI: -6.3%, -1.2%), P=0.021, in the PUFA group. Responses to dietary fat were not associated with changes in polyprotein convertase subtisilin/kexin type 9 concentrations. BMI modifies the effect of PUFAs compared with SFAs, with smaller improvements in atherogenic lipid concentrations in obese than in normal-weight individuals, possibly supporting adjustment of dietary recommendations according to BMI. This trial was registered with www.clinicaltrials.gov as NCT02589769.