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Saturated fat and heart disease

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i6257 (Published 23 November 2016) Cite this as: BMJ 2016;355:i6257
  1. Russell J de Souza, assistant professor1 2 3,
  2. Sonia S Anand, professor of medicine and epidemiology1 4 5
  1. 1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ONL8S 4K1, Canada
  2. 2Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
  3. 3Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
  4. 4Department of Medicine, McMaster University, Hamilton, ON, Canada
  5. 5Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada
  1. Correspondence to: R J de Souza rdesouz{at}mcmaster.ca

A new focus on whole dietary patterns should clear some of the confusion

Recent meta-analyses,1 2 3 commentaries,4 5 and bestselling books6 7 have called for an end to the proscription of saturated fats (SFAs), reversing years of dietary advice. Advocates of this shift draw support from prospective cohort studies since 1984, which when pooled find no association between SFA and risk of cardiovascular diseases.1 2 3 Limitations of this work include measurement error in assessment of diet, the choice of carbohydrate as the comparison nutrient, inconsistent adjustment for other dietary and lifestyle factors, and over-adjustment for changes in risk factors on the causal pathway. All will modify relations between SFAs and cardiovascular disease outcomes.

In this issue, Zong and colleagues (doi:10.1136/bmj.i5796) report the results of a pooled prospective cohort study of the association of dietary SFAs and coronary heart disease in male health professionals (Health Professionals Follow-up Study) and female nurses (Nurses’ Health Study).8 They report that around a 5% higher intake of longer chain dietary SFAs (12-18 carbons), found in hard cheese, whole milk, butter, beef, and chocolate, is associated with a 25% increased risk of coronary heart disease during 24-28 …

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