Saturated fat is not the major issue

@article{Malhotra2013SaturatedFI,
  title={Saturated fat is not the major issue},
  author={Aseem Malhotra},
  journal={BMJ : British Medical Journal},
  year={2013},
  volume={347}
}
  • Aseem Malhotra
  • Published 22 October 2013
  • Art
  • BMJ : British Medical Journal
Let’s bust the myth of its role in heart disease 

Statins for people at low risk

An independent review of the trial data is an essential next step in the fight against cancer and it is important to take this step now, not later.

Statins and The BMJ

  • F. Godlee
  • Education
    BMJ : British Medical Journal
  • 2014
Lots of lessons, but we still need the data

Saturated Fat: No Definitive Answers on Role in CVD Prevention

The quality of evidence is insufficient to conclusively establish the benefits of this approach, and a modest protective effect of replacing saturated fat with polyunsaturated fat on cardiovascular disease risk is suggested.

Sugar, not fat, is the culprit

Empirical studies of populations such as the Inuit, who traditionally survive almost entirely on animal food sources (and consume large amounts of saturated fat), have a very low incidence of cardiovascular disease.

Adverse effects of statins

  • F. Godlee
  • Psychology
    BMJ : British Medical Journal
  • 2014
The BMJ and authors withdraw statements suggesting that adverse events occur in 18-20% of patients, and instead suggest that adverse event rates are more likely to be in the range of 0.1-0.5% in the general population.

‘Saturated fat doesn't increase coronary heart disease in people with diabetes’

The role played by fatty plaque (containing cholesterol) earlier thinking demonised dietary saturated fat now seems to have been wrong.

We need more data before rejecting the saturated fat hypothesis

Judging by UK newspaper headlines this week, Malhotra and the BMJ have done a disservice to the public debate on nutrition.

Evidence favours an association between saturated fat intake and coronary heart disease

It is found that many patients who now present with myocardial infarction are overweight and have features of the metabolic syndrome, and contrary to Malhotra’s statement that “advice to reduce saturated fat intake has, paradoxically, increased the authors' cardiovascular …

Public Health England endorses limiting saturated fat intake

This article is based on limited evidence and should not be considered a verdict on whether saturated fat intake should be limited or banned in the diet.
...

References

SHOWING 1-10 OF 32 REFERENCES

Trans-fatty acids and nonlipid risk factors

The multiple adverse effects and implicated pathways are consistent with the observed strong associations of TFA consumption with CHD risk, and explain why T FA consumption may adversely impact other non-CHD diseases and end points.

Atherogenic Dyslipidemia: Cardiovascular Risk and Dietary Intervention

A better understanding of the genetic and dietary influences underlying atherogenic dyslipidemia may provide clues to improved interventions to reduce the risk of cardiovascular disease in high-risk individuals.

Discontinuation of Statins in Routine Care Settings

Investigators used an electronic medical record system to analyze statin discontinuation in a large cohort of patients who took statins over 8 years. More than half of the patients discontinued the...

Trans-Palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in U.S. Adults

Circulating trans-palmitoleate is associated with lower insulin resistance, presence of atherogenic dyslipidemia, and incident diabetes, and may explain previously observed metabolic benefits of dairy consumption and support the need for detailed further experimental and clinical investigation.

Dietary Phosphorus, Blood Pressure, and Incidence of Hypertension in the Atherosclerosis Risk in Communities Study and the Multi-Ethnic Study of Atherosclerosis

Phosphorus from dairy products but not from other sources was associated with lower baseline blood pressure and reduced risk of incident hypertension, which could indicate an effect of phosphorus in conjunction with other dairy constituents or of dairy itself without involvement of phosphorus.

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD, and whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

Effects of dietary composition on energy expenditure during weight-loss maintenance.

Among overweight and obese young adults compared with pre-weight-loss energy expenditure, isocaloric feeding following 10% to 15% weight loss resulted in decreases in REE and TEE that were greatest with theLow-fat diet, intermediate with the low-glycemic index diet, and least with the very low-carbohydrate diet.

Low Cholesterol is Associated With Mortality From Stroke, Heart Disease, and Cancer: The Jichi Medical School Cohort Study

Low cholesterol was related to high mortality even after excluding deaths due to liver disease from the analysis, and high cholesterol was not a risk factor for mortality.

Low Cholesterol is Associated with Mortality from Cardiovascular Diseases: A Dynamic Cohort Study in Korean Adults

Based on the results of this study, caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk in Korean adults.

Effect on blood pressure of potassium, calcium, and magnesium in women with low habitual intake.

Potassium, but not calcium or magnesium supplements, has a modest blood pressure-lowering effect in normotensive persons with low dietary intake, which strengthens evidence for the importance of potassium for blood pressure regulation in the general population.