Document Detail


Saturated fat, carbohydrate, and cardiovascular disease.
MedLine Citation:
PMID:  20089734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A focus of dietary recommendations for cardiovascular disease (CVD) prevention and treatment has been a reduction in saturated fat intake, primarily as a means of lowering LDL-cholesterol concentrations. However, the evidence that supports a reduction in saturated fat intake must be evaluated in the context of replacement by other macronutrients. Clinical trials that replaced saturated fat with polyunsaturated fat have generally shown a reduction in CVD events, although several studies showed no effects. An independent association of saturated fat intake with CVD risk has not been consistently shown in prospective epidemiologic studies, although some have provided evidence of an increased risk in young individuals and in women. Replacement of saturated fat by polyunsaturated or monounsaturated fat lowers both LDL and HDL cholesterol. However, replacement with a higher carbohydrate intake, particularly refined carbohydrate, can exacerbate the atherogenic dyslipidemia associated with insulin resistance and obesity that includes increased triglycerides, small LDL particles, and reduced HDL cholesterol. In summary, although substitution of dietary polyunsaturated fat for saturated fat has been shown to lower CVD risk, there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate. Furthermore, particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.
Authors:
Patty W Siri-Tarino; Qi Sun; Frank B Hu; Ronald M Krauss
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2010-01-20
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  91     ISSN:  1938-3207     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-03-30     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  502-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Atherosclerosis Research Children's Hospital Oakland Research Institute Oakland, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Atherosclerosis / prevention & control
Cardiovascular Diseases / etiology*,  prevention & control
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Diet*
Dietary Carbohydrates / administration & dosage*
Dietary Fats / administration & dosage*,  adverse effects
Dyslipidemias / prevention & control
Fatty Acids / administration & dosage*,  adverse effects
Fatty Acids, Unsaturated / administration & dosage
Health Promotion
Humans
Obesity
Risk Factors
Grant Support
ID/Acronym/Agency:
HL60712/HL/NHLBI NIH HHS; UL1 RR024131-01/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Dietary Carbohydrates; 0/Dietary Fats; 0/Fatty Acids; 0/Fatty Acids, Unsaturated
Comments/Corrections
Comment In:
Am J Clin Nutr. 2010 Mar;91(3):497-9   [PMID:  20130097 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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