Saturated fat

A saturated fat is a type of fat in which the fatty acid chains have all or predominantly single bonds. A fat is made of two kinds of smaller molecules: glycerol and fatty acids. Fats are made of long chains of carbon (C) atoms. Some carbon atoms are linked by single bonds (-C-C-) and others are linked by double bonds (-C=C-).[1] Double bonds can react with hydrogen to form single bonds. They are called saturated, because the second bond is broken and each half of the bond is attached to (saturated with) a hydrogen atom. Most animal fats are saturated. The fats of plants and fish are generally unsaturated.[1] Saturated fats tend to have higher melting points than their corresponding unsaturated fats, leading to the popular understanding that saturated fats tend to be solids at room temperatures, while unsaturated fats tend to be liquid at room temperature with varying degrees of viscosity (meaning both saturated and unsaturated fats are found to be liquid at body temperature).

Various fats contain different proportions of saturated and unsaturated fat. Examples of foods containing a high proportion of saturated fat include animal fat products such as cream, cheese, butter, other whole milk dairy products and fatty meats which also contain dietary cholesterol.[2] Certain vegetable products have high saturated fat content, such as coconut oil and palm kernel oil.[3] Many prepared foods are high in saturated fat content, such as pizza, dairy desserts, and sausage.[2][4]

Guidelines released by many medical organizations, including the World Health Organization, have advocated for reduction in the intake of saturated fat to promote health and reduce the risk from cardiovascular diseases. Many review articles also recommend a diet low in saturated fat and argue it will lower risks of cardiovascular diseases,[5] diabetes, or death.[6] A small number of contemporary reviews have challenged these conclusions, though predominant medical opinion is that saturated fat and cardiovascular disease are closely related.[7][8][9]

Fat profiles

While nutrition labels regularly combine them, the saturated fatty acids appear in different proportions among food groups. Lauric and myristic acids are most commonly found in "tropical" oils (e.g., palm kernel, coconut) and dairy products. The saturated fat in meat, eggs, cacao, and nuts is primarily the triglycerides of palmitic and stearic acids.

Saturated fat profile of common foods; Esterified fatty acids as percentage of total fat[10]
FoodLauric acidMyristic acidPalmitic acidStearic acid
Coconut oil47%18%9%3%
Palm kernel oil48%1%44%5%
Butter3%11%29%13%
Ground beef0%4%26%15%
Salmon0%1%29%3%
Egg yolks0%0.3%27%10%
Cashews2%1%10%7%
Soybean oil0%0%11%4%

Examples of saturated fatty acids

Some common examples of fatty acids:

  • Butyric acid with 4 carbon atoms (contained in butter)
  • Lauric acid with 12 carbon atoms (contained in coconut oil, palm kernel oil, and breast milk)
  • Myristic acid with 14 carbon atoms (contained in cow's milk and dairy products)
  • Palmitic acid with 16 carbon atoms (contained in palm oil and meat)
  • Stearic acid with 18 carbon atoms (also contained in meat and cocoa butter)
FoodSaturatedMono-
unsaturated
Poly-
unsaturated
As weight percent (%) of total fat
Cooking oils
Canola oil086428
Coconut oil871300
Corn oil132459
Cottonseed oil[11]271954
Olive oil[12]147311
Palm kernel oil[11]861202
Palm oil[11]513910
Peanut oil[13]174632
Rice bran oil253837
Safflower oil, high oleic[14]067514
Safflower oil, linoleic[11][15]061475
Soybean oil152458
Sunflower oil[16]112069
Mustard oil115921
Dairy products
Butterfat[11]663004
Cheese, regular642903
Cheese, light603000
Ice cream, gourmet622904
Ice cream, light622904
Milk, whole622804
Milk, 2%623000
*Whipping cream[17]662605
Meats
Beef333805
Ground sirloin384404
Pork chop354408
Ham354916
Chicken breast293421
Chicken342330
Turkey breast302030
Turkey drumstick322230
Fish, orange roughy231546
Salmon283328
Hot dog, beef424805
Hot dog, turkey284022
Burger, fast food364406
Cheeseburger, fast food434007
Breaded chicken sandwich203932
Grilled chicken sandwich264220
Sausage, Polish374611
Sausage, turkey284022
Pizza, sausage413220
Pizza, cheese602805
Nuts
Almonds dry roasted096521
Cashews dry roasted205917
Macadamia dry roasted157902
Peanut dry roasted145031
Pecans dry roasted086225
Flaxseeds, ground082365
Sesame seeds143844
Soybeans142257
Sunflower seeds111966
Walnuts dry roasted092363
Sweets and baked goods
Candy, chocolate bar593303
Candy, fruit chews144438
Cookie, oatmeal raisin224727
Cookie, chocolate chip354218
Cake, yellow602510
Pastry, Danish503114
Fats added during cooking or at the table
Butter, stick632903
Butter, whipped622904
Margarine, stick183939
Margarine, tub163349
Margarine, light tub194633
Lard394511
Shortening254526
Chicken fat304521
Beef fat414303
Goose fat[18]335511
Dressing, blue cheese165425
Dressing, light Italian142458
Other
Egg yolk fat[19] 364416
Avocado[20] 167113
Unless else specified in boxes, then reference is:[21]
* 3% is trans fats

Association with diseases


Cardiovascular disease

There are strong, consistent, and graded relationships between saturated fat intake, blood cholesterol levels, and the epidemic of cardiovascular disease.[6] The relationships are accepted as causal.[22][23]

Many health authorities such as the Academy of Nutrition and Dietetics,[24] the British Dietetic Association,[25] American Heart Association,[6] the World Heart Federation,[26] the British National Health Service,[27] among others,[28][29] advise that saturated fat is a risk factor for cardiovascular disease. The World Health Organization in May 2015 recommends switching from saturated to unsaturated fats.[30]

A small, limited number of systematic reviews have examined the relationship between saturated fat and cardiovascular disease and have come to different conclusions.

A 2017 systematic review by the American Heart Association of randomized controlled clinical trials showed that reducing intake of dietary saturated fat and replacing it with monounsaturated and polyunsaturated fats could reduce cardiovascular disease by about 30%, similar to the reduction achieved by statin treatment for maintaining blood cholesterol within normal limits.[6]

A different 2017 systematic review of randomized, controlled trials concluded that replacing saturated fats with mostly n-6 polyunsaturated fats is unlikely to reduce coronary heart disease (CHD) events, CHD mortality or total mortality. The 2017 review showed that inadequately controlled trials (e.g., failing to control for other lifestyle factors) that were included in earlier meta-analyses explain the prior results.[31]

A 2015 systematic review also found no association between saturated fat consumption and risk of heart disease, stroke, or diabetes. However, this study only looked at observational studies, and can therefore not be used to determine cause and effect.[7]

A 2014 systematic review looking at observational studies of dietary intake of fatty acids, observational studies of measured fatty acid levels in the blood, and intervention studies of polyunsaturated fat supplementation concluded that the findings ″do not support cardiovascular guidelines that promote high consumption of long-chain omega-3 and omega-6 and polyunsaturated fatty acids and suggest reduced consumption of total saturated fatty acids.″[32] Researchers acknowledged that despite their results, further research is necessary, especially in people who are initially healthy. Due to potential weaknesses in this review, experts recommend people remain with the current guidelines to reduce saturated fat consumption.[33][34] The American Heart Association noted that these cohort studies, unlike clinical trials, have more difficulty controlling for the consumption of carbohydrates as a replacement macronutrient for those who consumed less saturated fat.[6]

American Heart Association, 2017[6] "Cardiovascular disease (CVD) is the leading global cause of death, accounting for 17.3 million deaths per year, comprising 31.5% of total global deaths in 2013. In 2014, nearly 808,000 people in the United States died of heart disease, stroke, and other CVDs, translating to about 1 of every 3 deaths. Lowering intake of dietary saturated fat and replacing it with monounsaturated and polyunsaturated vegetable oil reduced CVD by about 30%, similar to the reduction achieved by statin treatment. In contrast, replacement of saturated fat with mostly refined carbohydrates and sugars is not associated with lower rates of CVD and did not reduce CVD in clinical trials."
DiNicolantonio, 2016[35] Many lines of evidence implicate added sugars more than saturated fat as etiologic in CHD. We urge dietary guidelines to shift focus away from recommendations to reduce saturated fat and toward recommendations to avoid added sugars.
Harcombe, 2015[36] No reduction in CHD and all-cause mortality were observed when replacing saturated fat with polyunsaturated fat, even though reductions in serum cholesterol were observed.
de Souza, 2015[7] Saturated fats are not associated with all cause mortality, CVD, CHD, ischemic stroke, or type 2 diabetes, but the evidence is heterogeneous with methodological limitations.
Schwab, 2014[37] There was convincing evidence that partial replacement of saturated fat with polyunsaturated fat decreases the risk of cardiovascular diseases, especially in men.
Chowdhury, 2014[32] High levels of saturated fat intake had no effect on coronary disease. The evidence did not clearly support cardiovascular guidelines that encouraged high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.
Hooper, 2012[38] Reducing saturated fat in diets did not reduce mortality, despite reducing the risk of having a cardiovascular event by 14 percent.
Micha, 2010[39] Based on consistent evidence from human studies, replacing saturated fatty acids with polyunsaturated fat modestly lowers coronary heart disease risk, with ~10% risk reduction for a 5% energy substitution; whereas replacing SFA with carbohydrate has no benefit and replacing SFA with monounsaturated fat has uncertain effects.
Mozaffarian, 2010[40] These findings provide evidence that consuming polyunsaturated fats (PUFA) in place of SFA reduces Coronary Heart Disease (CHD) events in randomized controlled trials (RCT). Replacing saturated fats with PUFAs as percentage of calories strongly reduced CHD mortality.
Siri-Tarino, 2010[41] 5–23 years of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. 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.
Danaei, 2009[42] Low PUFA intake has a 1-5% Increased risk of ischemic heart disease: Low dietary PUFA (in replacement of SFA). age 30–44 Increase in RR 1.05.
Mente, 2009[43] Single-nutrient RCTs have yet to evaluate whether reducing saturated fatty acid intake lowers the risk of CHD events. For polyunsaturated fatty acid intake, most of the RCTs have not been adequately powered and did not find a significant reduction in CHD outcomes.
Skeaff, 2009[44] Intake of SFA was not significantly associated with CHD mortality, with a RR of 1.14. Moreover, there was no significant association with CHD death. Intake of PUFA was strongly significantly associated with CHD mortality, with a RR of 1.25. The Health Professionals Follow-up Study and the EUROASPIRE study results mirrored those of total PUFA; intake of linoleic acid was significantly associated with CHD mortality.
Jakobsen, 2009[45] "The associations suggest that replacing saturated fatty acids with polyunsaturated fatty acids rather than monounsaturated fatty acids or carbohydrates prevents CHD over a wide range of intakes."
Van Horn, 2008[46] 25-35% fats but <7% SFA and TFA reduces risk.

While many studies have found that including polyunsaturated fats in the diet in place of saturated fats produces more beneficial CVD outcomes,[6] the effects of substituting monounsaturated fats or carbohydrates are unclear.[47][48]

Dyslipidemia

The consumption of saturated fat is generally considered a risk factor for dyslipidemia, which in turn is a risk factor for some types of cardiovascular disease.[49][50][51][52][53]

Abnormal blood lipid levels, that is high total cholesterol, high levels of triglycerides, high levels of low-density lipoprotein (LDL, "bad" cholesterol) or low levels of high-density lipoprotein (HDL, "good" cholesterol) cholesterol are all associated with increased risk of heart disease and stroke.[26]

Meta-analyses have found a significant relationship between saturated fat and serum cholesterol levels.[6][54] High total cholesterol levels, which may be caused by many factors, are associated with an increased risk of cardiovascular disease.[55][56] However, other indicators measuring cholesterol such as high total/HDL cholesterol ratio are more predictive than total serum cholesterol.[56] In a study of myocardial infarction in 52 countries, the ApoB/ApoA1 (related to LDL and HDL, respectively) ratio was the strongest predictor of CVD among all risk factors.[57] There are other pathways involving obesity, triglyceride levels, insulin sensitivity, endothelial function, and thrombogenicity, among others, that play a role in CVD, although it seems, in the absence of an adverse blood lipid profile, the other known risk factors have only a weak atherogenic effect.[58] Different saturated fatty acids have differing effects on various lipid levels.[59]

Cancer

Breast cancer

A meta-analysis published in 2003 found a significant positive relationship in both control and cohort studies between saturated fat and breast cancer.[60] However two subsequent reviews have found weak or insignificant associations of saturated fat intake and breast cancer risk,[61][62] and note the prevalence of confounding factors.[61][63]

Colorectal cancer

One review found limited evidence for a positive relationship between consuming animal fat and incidence of colorectal cancer.[64]

Ovarian cancer

Meta-analyses of clinical studies found evidence for increased risk of ovarian cancer by high consumption of saturated fat.[65][66]

Prostate cancer

Some researchers have indicated that serum myristic acid[67][68] and palmitic acid[68] and dietary myristic[69] and palmitic[69] saturated fatty acids and serum palmitic combined with alpha-tocopherol supplementation[67] are associated with increased risk of prostate cancer in a dose-dependent manner. These associations may, however, reflect differences in intake or metabolism of these fatty acids between the precancer cases and controls, rather than being an actual cause.[68]

Bones

Mounting evidence indicates that the amount and type of fat in the diet can have important effects on bone health. Most of this evidence is derived from animal studies. The data from one study indicated that bone mineral density is negatively associated with saturated fat intake, and that men may be particularly vulnerable.[70]

Dietary recommendations

Recommendations to reduce or limit dietary intake of saturated fats are made by the World Health Organization,[71] American Heart Association,[6] Health Canada,[72] the US Department of Health and Human Services,[73] the UK National Health Service,[74] the Australian Department of Health and Aging,[75] the Singapore Ministry of Health,[76] the Indian Ministry of Health and Family Wellfare,[77] the New Zealand Ministry of Health,[78] and Hong Kong's Department of Health.[79]

In 2003, the World Health Organization (WHO) and Food and Agriculture Organization (FAO) expert consultation report concluded that "intake of saturated fatty acids is directly related to cardiovascular risk.[80] The traditional target is to restrict the intake of saturated fatty acids to less than 10% of daily energy intake and less than 7% for high-risk groups. If populations are consuming less than 10%, they should not increase that level of intake. Within these limits, intake of foods rich in myristic and palmitic acids should be replaced by fats with a lower content of these particular fatty acids. In developing countries, however, where energy intake for some population groups may be inadequate, energy expenditure is high and body fat stores are low (BMI <18.5 kg/m2). The amount and quality of fat supply has to be considered keeping in mind the need to meet energy requirements. Specific sources of saturated fat, such as coconut and palm oil, provide low-cost energy and may be an important source of energy for the poor."[80]

A 2004 statement released by the Centers for Disease Control (CDC) determined that "Americans need to continue working to reduce saturated fat intake…"[81] In addition, reviews by the American Heart Association led the Association to recommend reducing saturated fat intake to less than 7% of total calories according to its 2006 recommendations.[82][83] This concurs with similar conclusions made by the US Department of Health and Human Services, which determined that reduction in saturated fat consumption would positively affect health and reduce the prevalence of heart disease.[84]

The United Kingdom, National Health Service claims the majority of British people eat too much saturated fat. The British Heart Foundation also advises people to cut down on saturated fat. People are advised to cut down on saturated fat and read labels on food they buy.[85][86]

A 2004 review stated that "no lower safe limit of specific saturated fatty acid intakes has been identified" and recommended that the influence of varying saturated fatty acid intakes against a background of different individual lifestyles and genetic backgrounds should be the focus in future studies.[87]

Blanket recommendations to lower saturated fat were criticized at a 2010 conference debate of the American Dietetic Association for focusing too narrowly on reducing saturated fats rather than emphasizing increased consumption of healthy fats and unrefined carbohydrates. Concern was expressed over the health risks of replacing saturated fats in the diet with refined carbohydrates, which carry a high risk of obesity and heart disease, particularly at the expense of polyunsaturated fats which may have health benefits. None of the panelists recommended heavy consumption of saturated fats, emphasizing instead the importance of overall dietary quality to cardiovascular health.[88]

In a 2017 comprehensive review of the literature and clinical trials, the American Heart Association published a recommendation that saturated fat intake be reduced or replaced by products containing monounsaturated and polyunsaturated fats, a dietary adjustment that could reduce the risk of cardiovascular diseases by 30%.[6]

Molecular description

Two-dimensional representation of the saturated fatty acid myristic acid
A space-filling model of the saturated fatty acid myristic acid

The two-dimensional illustration has implicit hydrogen atoms bonded to each of the carbon atoms in the polycarbon tail of the myristic acid molecule (there are 13 carbon atoms in the tail; 14 carbon atoms in the entire molecule).

Carbon atoms are also implicitly drawn, as they are portrayed as intersections between two straight lines. "Saturated," in general, refers to a maximum number of hydrogen atoms bonded to each carbon of the polycarbon tail as allowed by the Octet Rule. This also means that only single bonds (sigma bonds) will be present between adjacent carbon atoms of the tail.

See also

References

  1. Reece, Jane; Campbell, Neil (2002). Biology. San Francisco: Benjamin Cummings. pp. 69–70. ISBN 978-0-8053-6624-2.
  2. "Saturated fats". American Heart Association. 2014. Retrieved 1 March 2014.
  3. "What are "oils"?". ChooseMyPlate.gov, US Department of Agriculture. 2015. Archived from the original on 9 June 2015. Retrieved 13 June 2015.
  4. "Top food sources of saturated fat in the US". Harvard University School of Public Health. 2014. Retrieved 1 March 2014.
  5. Hooper L, Martin N, Abdelhamid A, Davey Smith G (June 2015). "Reduction in saturated fat intake for cardiovascular disease". The Cochrane Database of Systematic Reviews. 6 (6): CD011737. doi:10.1002/14651858.CD011737. PMID 26068959.
  6. Sacks FM, Lichtenstein AH, Wu JH, Appel LJ, Creager MA, Kris-Etherton PM, Miller M, Rimm EB, Rudel LL, Robinson JG, Stone NJ, Van Horn LV (July 2017). "Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association". Circulation. 136 (3): e1–e23. doi:10.1161/CIR.0000000000000510. PMID 28620111.
  7. de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS (August 2015). "Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies". BMJ. 351 (Aug 11): h3978. doi:10.1136/bmj.h3978. PMC 4532752. PMID 26268692.
  8. Ramsden CE, Zamora D, Leelarthaepin B, Majchrzak-Hong SF, Faurot KR, Suchindran CM, et al. (February 2013). "Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis". BMJ. 346: e8707. doi:10.1136/bmj.e8707. PMC 4688426. PMID 23386268.
  9. Ramsden CE, Zamora D, Majchrzak-Hong S, Faurot KR, Broste SK, Frantz RP, Davis JM, Ringel A, Suchindran CM, Hibbeln JR (April 2016). "Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)". BMJ. 353: i1246. doi:10.1136/bmj.i1246. PMC 4836695. PMID 27071971.
  10. "USDA National Nutrient Database for Standard Reference, Release 20". United States Department of Agriculture. 2007. Archived from the original on 2016-04-14.
  11. Anderson D. "Fatty acid composition of fats and oils" (PDF). Colorado Springs: University of Colorado, Department of Chemistry. Retrieved April 8, 2017.
  12. "NDL/FNIC Food Composition Database Home Page". United States Department of Agriculture, Agricultural Research Service. Retrieved May 21, 2013.
  13. "Basic Report: 04042, Oil, peanut, salad or cooking". USDA. Retrieved 16 January 2015.
  14. "Oil, vegetable safflower, oleic". nutritiondata.com. Condé Nast. Retrieved 10 April 2017.
  15. "Oil, vegetable safflower, linoleic". nutritiondata.com. Condé Nast. Retrieved 10 April 2017.
  16. "Oil, vegetable, sunflower". nutritiondata.com. Condé Nast. Retrieved 27 September 2010.
  17. USDA Basic Report Cream, fluid, heavy whipping
  18. "Nutrition And Health". The Goose Fat Information Service.
  19. "Egg, yolk, raw, fresh". nutritiondata.com. Condé Nast. Retrieved 24 August 2009.
  20. "09038, Avocados, raw, California". National Nutrient Database for Standard Reference, Release 26. United States Department of Agriculture, Agricultural Research Service. Retrieved 14 August 2014.
  21. "Feinberg School > Nutrition > Nutrition Fact Sheet: Lipids". Northwestern University. Archived from the original on 2011-07-20.
  22. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al. (2007). "European guidelines on cardiovascular disease prevention in clinical practice: executive summary". European Heart Journal. 28 (19): 2375–2414. doi:10.1093/eurheartj/ehm316. PMID 17726041.
  23. Labarthe D (2011). "Chapter 17 What Causes Cardiovascular Diseases?". Epidemiology and prevention of cardiovascular disease: a global challenge (2nd ed.). Jones and Bartlett Publishers. ISBN 978-0-7637-4689-6.
  24. Kris-Etherton PM, Innis S (September 2007). "Position of the American Dietetic Association and Dietitians of Canada: Dietary Fatty Acids". Journal of the American Dietetic Association. 107 (9): 1599–1611 [1603]. doi:10.1016/j.jada.2007.07.024. PMID 17936958.
  25. "Food Fact Sheet - Cholesterol" (PDF). British Dietetic Association. Retrieved 3 May 2012.
  26. "Cardiovascular Disease Risk Factors". World Heart Federation. 30 May 2017. Retrieved 2012-05-03.
  27. "Lower your cholesterol". National Health Service. Retrieved 2012-05-03.
  28. "Nutrition Facts at a Glance - Nutrients: Saturated Fat". Food and Drug Administration. 2009-12-22. Retrieved 2012-05-03.
  29. "Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol". European Food Safety Authority. 2010-03-25. Retrieved 3 May 2012.
  30. "Healthy diet Fact sheet N°394". May 2015. Retrieved 12 August 2015.
  31. Hamley S (May 2017). "The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials". Nutrition Journal. 16 (1): 30. doi:10.1186/s12937-017-0254-5. PMC 5437600. PMID 28526025.
  32. Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L, et al. (March 2014). "Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis". Annals of Internal Medicine. 160 (6): 398–406. doi:10.7326/M13-1788. PMID 24723079.
  33. "Saturated fats and heart disease link 'unproven'". NHI Choices. March 18, 2014.
  34. "Dietary fat and heart disease study is seriously misleading". The Nutrition Source. 2014-03-19. Retrieved 2018-12-10.
  35. DiNicolantonio JJ, Lucan SC, O'Keefe JH (March 2016). "The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease". Progress in Cardiovascular Diseases. 58 (5): 464–72. doi:10.1016/j.pcad.2015.11.006. PMC 4856550. PMID 26586275.
  36. Harcombe, Zoë; Baker, Julien S; Cooper, Stephen Mark; Davies, Bruce; Sculthorpe, Nicholas; DiNicolantonio, James J; Grace, Fergal (January 2015). "Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis". Open Heart. 2 (1): e000196. doi:10.1136/openhrt-2014-000196. PMC 4316589. PMID 25685363.
  37. Schwab U, Lauritzen L, Tholstrup T, Haldorssoni T, Riserus U, Uusitupa M, Becker W (2014). "Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review". Food & Nutrition Research. 58: 25145. doi:10.3402/fnr.v58.25145. PMC 4095759. PMID 25045347.
  38. Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, Davey Smith G (May 2012). "Reduced or modified dietary fat for preventing cardiovascular disease". The Cochrane Database of Systematic Reviews. 5 (5): CD002137. doi:10.1002/14651858.CD002137.pub3. PMC 6486029. PMID 22592684.
  39. Micha R, Mozaffarian D (October 2010). "Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence". Lipids. 45 (10): 893–905. doi:10.1007/s11745-010-3393-4. PMC 2950931. PMID 20354806.
  40. Mozaffarian D, Micha R, Wallace S (March 2010). "Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". PLoS Medicine. 7 (3): e1000252. doi:10.1371/journal.pmed.1000252. PMC 2843598. PMID 20351774.
  41. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM (2010). "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease". American Journal of Clinical Nutrition. 91 (3): 535–546. doi:10.3945/ajcn.2009.27725. PMC 2824152. PMID 20071648.
  42. Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, Ezzati M (April 2009). "The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors". PLoS Medicine. 6 (4): e1000058. doi:10.1371/journal.pmed.1000058. PMC 2667673. PMID 19399161.
  43. Mente A, de Koning L, Shannon HS, Anand SS (April 2009). "A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease". Arch. Intern. Med. 169 (7): 659–69. doi:10.1001/archinternmed.2009.38. PMID 19364995. Free full-text
  44. Skeaff CM, Miller J (2009). "Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomised controlled trials". Ann. Nutr. Metab. 55 (1–3): 173–201. doi:10.1159/000229002. PMID 19752542.
  45. Jakobsen MU, O'Reilly EJ, Heitmann BL, Pereira MA, Bälter K, Fraser GE, Goldbourt U, Hallmans G, Knekt P, Liu S, Pietinen P, Spiegelman D, Stevens J, Virtamo J, Willett WC, Ascherio A (2009). "Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies". The American Journal of Clinical Nutrition. 89 (5): 1425–32. doi:10.3945/ajcn.2008.27124. PMC 2676998. PMID 19211817.
  46. Van Horn L, McCoin M, Kris-Etherton PM, Burke F, Carson JA, Champagne CM, Karmally W, Sikand G (February 2008). "The evidence for dietary prevention and treatment of cardiovascular disease". Journal of the American Dietetic Association. 108 (2): 287–331. doi:10.1016/j.jada.2007.10.050. ISSN 0002-8223. PMID 18237578.
  47. Astrup A, Dyerberg J, Elwood P, Hermansen K, Hu FB, Jakobsen MU, Kok FJ, Krauss RM, Lecerf JM, LeGrand P, Nestel P, Risérus U, Sanders T, Sinclair A, Stender S, Tholstrup T, Willett WC (April 2011). "The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010?". Am. J. Clin. Nutr. 93 (4): 684–8. doi:10.3945/ajcn.110.004622. PMC 3138219. PMID 21270379.
  48. Jebb SA, Lovegrove JA, Griffin BA, Frost GS, Moore CS, Chatfield MD, Bluck LJ, Williams CM, Sanders TA (October 2010). "Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial". Am. J. Clin. Nutr. 92 (4): 748–58. doi:10.3945/ajcn.2009.29096. PMC 3594881. PMID 20739418.
  49. Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom. Position Statement on Fat [Retrieved 2011-01-25].
  50. Report of a Joint WHO/FAO Expert Consultation (2003). "Diet, Nutrition and the Prevention of Chronic Diseases" (PDF). World Health Organization. Retrieved 2011-03-11.
  51. "Cholesterol". Irish Heart Foundation. Retrieved 2011-02-28.
  52. U.S. Department of Agriculture and U.S. Department of Health and Human Services (December 2010). Dietary Guidelines for Americans, 2010 (PDF) (7th ed.). Washington, DC: U.S. Government Printing Office.
  53. Cannon C, O'Gara P (2007). Critical Pathways in Cardiovascular Medicine (2nd ed.). Lippincott Williams & Wilkins. p. 243.
  54. Clarke R, Frost C, Collins R, Appleby P, Peto R (1997). "Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies". BMJ (Clinical Research Ed.). 314 (7074): 112–7. doi:10.1136/bmj.314.7074.112. PMC 2125600. PMID 9006469.
  55. Bucher HC, Griffith LE, Guyatt GH (February 1999). "Systematic review on the risk and benefit of different cholesterol-lowering interventions". Arteriosclerosis, Thrombosis, and Vascular Biology. 19 (2): 187–195. doi:10.1161/01.atv.19.2.187. PMID 9974397.
  56. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, Qizilbash N, Peto R, Collins R (December 2007). "Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths". Lancet. 370 (9602): 1829–39. doi:10.1016/S0140-6736(07)61778-4. PMID 18061058.
  57. Labarthe D (2011). "Chapter 11 Adverse Blood Lipid Profile". Epidemiology and prevention of cardiovascular disease: a global challenge (2 ed.). Jones and Bartlett Publishers. p. 290. ISBN 978-0-7637-4689-6.
  58. Labarthe D (2011). "Chapter 11 Adverse Blood Lipid Profile". Epidemiology and prevention of cardiovascular disease: a global challenge (2nd ed.). Jones and Bartlett Publishers. p. 277. ISBN 978-0-7637-4689-6.
  59. Thijssen MA, Mensink RP (2005). "Fatty acids and atherosclerotic risk". Atherosclerosis: Diet and Drugs. Handbook of Experimental Pharmacology. 170. Springer. pp. 165–94. doi:10.1007/3-540-27661-0_5. ISBN 978-3-540-22569-0. PMID 16596799.
  60. Boyd NF, Stone J, Vogt KN, Connelly BS, Martin LJ, Minkin S (November 2003). "Dietary fat and breast cancer risk revisited: a meta-analysis of the published literature". British Journal of Cancer. 89 (9): 1672–1685. doi:10.1038/sj.bjc.6601314. PMC 2394401. PMID 14583769.
  61. Hanf V, Gonder U (2005-12-01). "Nutrition and primary prevention of breast cancer: foods, nutrients and breast cancer risk". European Journal of Obstetrics, Gynecology, and Reproductive Biology. 123 (2): 139–149. doi:10.1016/j.ejogrb.2005.05.011. PMID 16316809.
  62. Lof M, Weiderpass E (February 2009). "Impact of diet on breast cancer risk". Current Opinion in Obstetrics and Gynecology. 21 (1): 80–85. doi:10.1097/GCO.0b013e32831d7f22. PMID 19125007.
  63. Freedman LS, Kipnis V, Schatzkin A, Potischman N (Mar–Apr 2008). "Methods of Epidemiology: Evaluating the Fat–Breast Cancer Hypothesis – Comparing Dietary Instruments and Other Developments". Cancer Journal (Sudbury, Mass.). 14 (2): 69–74. doi:10.1097/PPO.0b013e31816a5e02. PMC 2496993. PMID 18391610.
  64. Lin OS (2009). Acquired risk factors for colorectal cancer. Methods Mol Biol. Methods in Molecular Biology. 472. pp. 361–72. doi:10.1007/978-1-60327-492-0_16. ISBN 978-1-60327-491-3. PMID 19107442.
  65. Huncharek M, Kupelnick B (2001). "Dietary fat intake and risk of epithelial ovarian cancer: a meta-analysis of 6,689 subjects from 8 observational studies". Nutrition and Cancer. 40 (2): 87–91. doi:10.1207/S15327914NC402_2. PMID 11962260.
  66. Qiu W, Lu H, Qi Y, Wang X (June 2016). "Dietary fat intake and ovarian cancer risk: a meta-analysis of epidemiological studies". Oncotarget. 7 (24): 37390–37406. doi:10.18632/oncotarget.8940. PMC 5095084. PMID 27119509.
  67. Männistö S, Pietinen P, Virtanen MJ, Salminen I, Albanes D, Giovannucci E, Virtamo J (December 2003). "Fatty acids and risk of prostate cancer in a nested case-control study in male smokers". Cancer Epidemiology, Biomarkers & Prevention. 12 (12): 1422–8. PMID 14693732.
  68. Crowe FL, Allen NE, Appleby PN, Overvad K, Aardestrup IV, Johnsen NF, Tjønneland A, Linseisen J, Kaaks R, Boeing H, Kröger J, Trichopoulou A, Zavitsanou A, Trichopoulos D, Sacerdote C, Palli D, Tumino R, Agnoli C, Kiemeney LA, Bueno-de-Mesquita HB, Chirlaque MD, Ardanaz E, Larrañaga N, Quirós JR, Sánchez MJ, González CA, Stattin P, Hallmans G, Bingham S, Khaw KT, Rinaldi S, Slimani N, Jenab M, Riboli E, Key TJ (November 2008). "Fatty acid composition of plasma phospholipids and risk of prostate cancer in a case-control analysis nested within the European Prospective Investigation into Cancer and Nutrition". The American Journal of Clinical Nutrition. 88 (5): 1353–63. doi:10.3945/ajcn.2008.26369 (inactive 2019-08-20). PMID 18996872.
  69. Kurahashi N, Inoue M, Iwasaki M, Sasazuki S, Tsugane AS (April 2008). "Dairy product, saturated fatty acid, and calcium intake and prostate cancer in a prospective cohort of Japanese men". Cancer Epidemiology, Biomarkers & Prevention. 17 (4): 930–7. doi:10.1158/1055-9965.EPI-07-2681. PMID 18398033.
  70. Corwin RL, Hartman TJ, Maczuga SA, Graubard BI (2006). "Dietary saturated fat intake is inversely associated with bone density in humans: Analysis of NHANES III". The Journal of Nutrition. 136 (1): 159–165. doi:10.1093/jn/136.1.159. PMID 16365076.
  71. see the article Food pyramid (nutrition) for more information.
  72. "Choosing foods with healthy fats". Health Canada. Retrieved 2019-09-24.
  73. "Cut Down on Saturated Fats" (PDF). United States Department of Health and Human Services. Retrieved 2019-09-24.
  74. "Fat: the facts". United Kingdom's National Health Service. Retrieved 2019-09-24.
  75. "Fat". Australia's National Health and Medical Research Council and Department of Health and Ageing. Retrieved 2019-09-24.
  76. "Getting the Fats Right!". Singapore's Ministry of Health. Retrieved 2019-09-24.
  77. "Health Diet". India's Ministry of Health and Family Welfare. Retrieved 2019-09-24.
  78. "Eating and Activity Guidelines for New Zealand Adults" (PDF). New Zealand's Ministry of Health. Retrieved 2019-09-24.
  79. "Know More about Fat". Hong Kong's Department of Health. Retrieved 2019-09-24.
  80. Joint WHO/FAO Expert Consultation (2003). Diet, Nutrition and the Prevention of Chronic Diseases (WHO technical report series 916) (PDF). World Health Organization. pp. 81–94. ISBN 978-92-4-120916-8. Retrieved 2016-04-04.
  81. "Trends in Intake of Energy, Protein, Carbohydrate, Fat, and Saturated Fat — United States, 1971–2000". Centers for Disease Control. 2004. Archived from the original on 2008-12-01.
  82. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, Franklin B, Kris-Etherton P, Harris WS, Howard B, Karanja N, Lefevre M, Rudel L, Sacks F, Van Horn L, Winston M, Wylie-Rosett J (July 2006). "Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee". Circulation. 114 (1): 82–96. doi:10.1161/CIRCULATIONAHA.106.176158. PMID 16785338.CS1 maint: multiple names: authors list (link)
  83. Smith SC, Jackson R, Pearson TA, Fuster V, Yusuf S, Faergeman O, Wood DA, Alderman M, Horgan J, Home P, Hunn M, Grundy SM (June 2004). "Principles for national and regional guidelines on cardiovascular disease prevention: a scientific statement from the World Heart and Stroke Forum" (PDF). Circulation. 109 (25): 3112–21. doi:10.1161/01.CIR.0000133427.35111.67. PMID 15226228.
  84. "Dietary Guidelines for Americans" (PDF). United States Department of Agriculture. 2005.
  85. Eat less saturated fat
  86. Fats explained
  87. German JB, Dillard CJ (September 2004). "Saturated fats: what dietary intake?". American Journal of Clinical Nutrition. 80 (3): 550–559. doi:10.1093/ajcn/80.3.550. PMID 15321792.
  88. Zelman K (2011). "The Great Fat Debate: A Closer Look at the Controversy—Questioning the Validity of Age-Old Dietary Guidance". Journal of the American Dietetic Association. 111 (5): 655–658. doi:10.1016/j.jada.2011.03.026. PMID 21515106.

Further reading

This article is issued from Wikipedia. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.