Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.
Level 3 - non-randomized controlled study
Meta-analysis of prospective observational cohort studies
PubMed 20071648 · doi:10.3945/ajcn.2009.27725
What was done
Searched MEDLINE and EMBASE databases along with secondary references to identify prospective epidemiologic cohort studies evaluating dietary saturated fat intake and incident coronary heart disease (CHD), stroke, and total cardiovascular disease (CVD). A random-effects model was used to calculate pooled relative risks comparing extreme quantiles of saturated fat intake across 21 included studies.
What was found
Across 347,747 subjects followed for 5 to 23 years with 11,006 incident CHD or stroke events, saturated fat intake was not associated with cardiovascular outcomes: - CHD: Pooled RR = 1.07 (95% CI: 0.96 to 1.19; P = 0.22) - Stroke: Pooled RR = 0.81 (95% CI: 0.62 to 1.05; P = 0.11) - Total CVD: Pooled RR = 1.00 (95% CI: 0.89 to 1.11; P = 0.95) Consideration of age, sex, and study quality did not change the results.
Why it matters
This large meta-analysis challenged the dietary assumption that saturated fat intake is independently associated with an increased risk of cardiovascular disease in prospective cohorts.
Limits
The included studies were observational cohorts susceptible to residual confounding and self-reported dietary measurement error. The analysis compared extreme quantiles of intake without evaluating the specific replacement nutrients (such as polyunsaturated fats or refined carbohydrates) used in place of saturated fat.
Cited by
- supports Dr. Siri-Tarino and Dr. Ronald Krauss published a meta-analysis questioning the relationship between saturated fat intake and heart disease risk.