Fewkes · The American journal of clinical nutrition 2022 · systematic review and meta-analysis · n=131 studies (90 in meta-analysis)

A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis.

Cited 49 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of human intervention studies

PubMed 35665799 · doi:10.1093/ajcn/nqac153 · record verified 2026-08-29

What was done

A systematic review and meta-analysis of 6 databases through January 2022 evaluated the quantitative effects of a single high-fat meal on endothelial function. Eligible studies assessed fasting and postprandial flow-mediated dilation (FMD). Meta-regression was used to analyze the effect of moderator variables.

What was found

Across 131 included studies (90 suitable for quantitative meta-analysis), a single high-fat meal significantly decreased postprandial FMD at: - 2 hours: -1.02 percentage points (pp) (95% CI: -1.34 to -0.70 pp; P < 0.01; I2 = 93.3%) - 3 hours: -1.04 pp (95% CI: -1.48 to -0.59 pp; P < 0.001; I2 = 84.5%) - 4 hours: -1.19 pp (95% CI: -1.53 to -0.84 pp; P < 0.01; I2 = 94.6%) Younger, healthy-weight participants showed greater postprandial FMD reductions than older, heavier, at-risk groups (P < 0.05). Meal fat percentage was inversely associated with the magnitude of postprandial FMD changes at 3 hours (P < 0.01).

Why it matters

This review quantifies the acute transient impairment of endothelial function (~1.0 to 1.2 percentage points drop in FMD) following a single high-fat meal, highlighting fasting FMD, age, BMI, and meal fat content as key moderators.

Limits

There was very high statistical heterogeneity across all time points (I2 from 84.5% to 94.6%). Total participant count is not reported in the abstract, and long-term clinical vascular outcomes were not evaluated.

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