Intended for healthcare professionals

Letters Saturated fat is not the major issue

We need more data before rejecting the saturated fat hypothesis

BMJ 2013; 347 doi: (Published 19 November 2013) Cite this as: BMJ 2013;347:f6847
  1. Peter Clifton, endocrinologist1
  1. 1University of South Australia, North Terrace, Adelaide, SA, Australia
  1. peter.clifton{at}

Judging by UK newspaper headlines this week I think that Malhotra and the BMJ have done a disservice to the public debate on nutrition.1 Just because glycaemic load and soft drinks are associated with obesity and type 2 diabetes, it does not mean that saturated fat does not cause disease.

Hundreds of experiments have shown that saturated fat increases low density lipoprotein-cholesterol to a small degree.2 In addition, clinical interventions that replace saturated fat with large amounts of polyunsaturated fat reduce cardiac events, even if it is unclear which polyunsaturated fat is best.3 The Lyon Diet Heart Study found that an intervention which, along with many other dietary changes, lowered saturated fat and increased polyunsaturated fat protected against heart disease.4 The benefits of a low glycaemic load diet on cardiovascular events are yet to be shown because no randomised trials have been done. The PREDIMED study found that a large amount of virgin olive oil or nuts reduces strokes in the context of a low saturated fat Mediterranean diet, but it could not show whether a low fat diet was harmful because none of the diets were low in fat.5

We need more data before rejecting the saturated fat hypothesis and confusing the public more.


Cite this as: BMJ 2013;347:f6847


  • Competing interests: None declared.


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