Dietary intake, biomarkers and supplementation of fatty acids and risk of coronary events: a systematic review and dose-response meta-analysis of randomized controlled trials and prospective observational studies.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials and prospective observational studies.
PubMed 37632423 · doi:10.1080/10408398.2023.2251583
What was done
Authors conducted a systematic review and dose-response random-effects meta-analysis searching PubMed, Embase, CENTRAL, Scopus, and Web of Science through April 2022. They evaluated prospective cohort studies and randomized controlled trials examining dietary intake, circulating biomarkers, or supplementation of various fats and fatty acids in relation to coronary event risk in adults, comparing top versus bottom exposure tertiles.
What was found
The abstract reports directions of association without providing exact numerical effect sizes, relative risks, or confidence intervals. Across 165 included studies, broad dietary intake and biomarkers of total fat, saturated fat, monounsaturated fat, and polyunsaturated fat were not associated with coronary events. Modest positive associations with coronary risk were reported for trans fatty acids, palmitic acid, stearic acid, and saturated fats specifically from meat. Conversely, alpha-linolenic acid, linoleic acid, and long-chain omega-3 fatty acid intake were modestly associated with lower risk. Supplementation with long-chain omega-3s and substituting saturated fats with alpha-linolenic or linoleic acids reduced coronary event risk.
Why it matters
This large meta-analysis supports current cardiovascular dietary guidelines that advocate replacing specific saturated fatty acids (particularly from meat) with plant- and marine-derived polyunsaturated fatty acids rather than simply lowering total fat intake.
Limits
The abstract reports no numerical effect estimates, confidence intervals, or heterogeneity metrics. The synthesis combines randomized controlled trials with prospective observational cohorts, leaving observational components vulnerable to residual nutritional confounding, exposure misclassification, and healthy-user bias.
Cited by
- supports Observational dietary survey data show that higher dietary intake of linoleic acid is associated with lower risk of coronary heart disease.