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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 2015; 351 doi: (Published 12 August 2015) Cite this as: BMJ 2015;351:h3978

Rapid Response:

Not all saturated fats are the same and are not always harmful. However avoid excess

Dear Editor:

It is provocative to peruse this systematic review and meta-analysis.1

Traditionally, saturated fatty acid (SFA) intake has been considered to be atherogenic, and it is suggested that reducing SFA intake prevents atherosclerotic diseases.2 Yet, some meta-analyses have indicated that greater dietary intake of SFA per se may not be associated with increased risk of coronary disease,3,4 In fact,the recent US dietary guidelines has taken off the ceiling limits of dietary cholesterol.5

In the Japanese population, SFAs intake was inversely associated with deep intraparenchymal haemorrhage and lacunar infarction and positively associated with myocardial infarction.6

Not all saturated fats are the same: short-chain saturated fatty acids (present in milk, ghee) can be readily utilized without mitochondrial beta oxidation and hence will not be a contributor to oxidative stress that would damage the myocardium. Milk, ghee, and unhydrogenated coconut oil have been used in India safely for centuries, and India had the lowest incidence of heart disease. After the switch to vegetable oils (particularly refined ones), the incidence has only been on the rise.7

Reverting back to a traditional low-fat cereal-based predominantly lactovegetarian diet,high in fibre content supplemented by omega 3 fat and devoid of fatty, fried, refined, preserved, and processed food, as consumed by our ancestors for centuries, has stood the test- of- time and is the best for health.


1. BMJ 2015;351:h3978

2.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. Diet and Lifestyle Recommendations Revision 2006: a Scientific Statement From the American Heart Association Nutrition Committee. Circulation 2006;114:82-96.

3.Mente A, de Koning L, Shannon H, Anand S. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 2009;169:659-669.

4.Siri-Tarino P, Sun Q, Hu F, Krauss R. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr 2010;91:535-546.


6.Yamagishi K, Iso H, Kubobo Y etal. (2013) Dietary intake of saturated fatty acids and incident stroke and coronary heart diseases in Japanese communities:the JPHC study DOI:http//,1093/eurheratj/eht 043 1225-1232

7.Talim M (2007), Tradidional Diet : Hope for our children. DOI : http/dx/

Competing interests: No competing interests

14 August 2015
Rajeev Gupta
Consultant Cardiologist
Kalba Hospital, Kalba, Sharjah. United Arab Emirates( UAE)
PO Box 11195, Kalba, Sharjah, UAE