AJCN Meta-Analysis on Saturated Fat

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AJCN Meta-Analysis on Saturated Fat

Postby eatplants » Sat Feb 13, 2010 11:40 pm

http://www.ajcn.org/cgi/content/abstrac ... 09.27725v1

What are your thoughts on this Jeff?
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Re: AJCN Meta-Analysis on Saturated Fat

Postby Rjay » Sun Feb 14, 2010 1:03 pm

There are many studies (old and new) coming to this conclusion and they have been, and continue to be, ignored by mainstream nutritionists.

Why?
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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Sun Feb 14, 2010 1:07 pm

They are not ignored, nor have they been here, but it is not the purpose of this forum.

This is not a debate forum, but a support forum for those who have chosen to follow this lifestyle.

However, in regard to saturated fat, you may want to read these discussions.

viewtopic.php?f=22&t=9132

viewtopic.php?f=22&t=6220

In addition, one major problem with this study is they did not look at any studies where the saturated fat intake was less than 7%, which is the level recommended by the AHA, let alone less than 5%, which is the level I recommend and the level one would achieve if following these recommendations. Most of the diets had saturated fat intakes in the range of 10-15% (or more).

So, just like the studies that criticize "low fat" diets, but never analyze any diet that is truly low fat and based on the principles recommended here (very low fat, high fiber, whole plant foods), this study criticizes the impact of lowering saturated fat, but never looked at any diet that truly lowered saturated fat to the level recommended here and through the methods recommended here (very low fat, high fiber, whole plant foods).

Lastly, studies on all-cause mortality trumps findings for subsets such as CHD and CVD. Most all-cause studies demonstrate a direct relation between saturated fat intake and all-cause mortality and the lower the better.

J Nutr. 2005 Mar;135(3):556-61.
The combination of high fruit and vegetable and low saturated fat intakes is more protective against mortality in aging men than is either alone: the Baltimore Longitudinal Study of Aging.

Eur J Epidemiol. 2001;17(5):469-77.
Differences in all-cause, cardiovascular and cancer mortality between Hong Kong and Singapore: role of nutrition.

Int J Epidemiol. 2000 Apr;29(2):260-5.
Saturated fat, vitamin C and smoking predict long-term population all-cause mortality rates in the Seven Countries Study.

Br J Nutr. 2005 May;93(5):709-16.
Comparison of two statistical approaches to predict all-cause mortality by dietary patterns in German elderly subjects.

Arch Intern Med. 2007 Dec 10;167(22):2461-8.
Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH-AARP Diet and Health Study.

So, in general, I agree with the AJCN study, halfway measures and efforts to just lower saturated fat without truly lowering saturated fat and changing the total dietary pattern, will not prove beneficial. :)

Remember, the only diet that has even been consistently and clinically proven in many peer reviewed published studies to actually reverse heart disease, is a very low fat, very low saturated fat, plant based diet.

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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Tue Mar 23, 2010 11:20 am

Another piece of the puzzle from another recent study that specifically adds to why the above study found no relationship.

One issue was that they did not reduce saturated fat enough. A second issue, as pointed out in this new study, is what the subjects replaces saturated fat with. For many, if not most, it was with either (or products containing) hydrogenated/trans fat, while flour, white sugar and/or mono fats.

However, as we know, the only essential (and beneficial) fat is the omega 6 and 3, which are polys. So, no surprise that when they did look at those who replace saturated with Poly's the did better. Of course, not as good as those who follow these recommendations, so do not confuse "better" with "best".

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http://news.harvard.edu/gazette/story/2 ... ated-fats/

Although for nearly 60 years people have been urged to decrease their consumption of saturated fats to prevent heart disease, there has been surprisingly little scientific evidence that doing so actually
decreases the risk of coronary heart disease events.

But a new study by researchers at Harvard School of Public Health (HSPH) provides the first conclusive evidence from randomized clinical trials that people who replace saturated fat in their diet with polyunsaturated fat reduce their risk of coronary heart disease by 19 percent, compared with control groups of people who do not.

By systematically reviewing a large group of randomized clinical trials and conducting a pooled meta-analysis of these studies, the HSPH team found that increasing the intake of polyunsaturated fats as a replacement for saturated fats could significantly reduce the rate of heart attacks and cardiac deaths in the population. The study appears in the March 23 issue of the open-access journal PLoS Medicine.

Over the past several decades, the food industry has reduced the amount of saturated fat in many products, and the public has reduced the amount of saturated fat in its food consumption. However, there has been a wide variation in the types of nutrients that have replaced this saturated fat. For example, in many products saturated fats were replaced with trans fats, which have since been determined to be detrimental. And in the overall American diet, saturated fat was generally replaced with increased consumption of refined carbohydrates and grains. (NOTE: and refined sugars)

“The specific replacement nutrient for saturated fat may be very important,” said lead author Dariush Mozaffarian, assistant professor in the Department of Epidemiology at HSPH and the Department of Medicine at Harvard Medical School. “Our findings suggest that polyunsaturated fats would be a preferred replacement for saturated fats for better heart health.”

Results from prior individual randomized controlled trials of saturated fat reduction and heart disease events were mixed, with most showing no significant effects. Other trials focused only on blood cholesterol levels, which are an indirect marker of risk. Large observational studies also generally have shown no relationship between saturated fat consumption and risk of heart disease events. For example, earlier this month, researchers from HSPH and Children’s Hospital Oakland Research Institute performed a pooled meta-analysis of prior observational studies and found no evidence that overall consumption of saturated fat was related to risk of coronary heart disease or stroke events.

Some of these mixed findings may relate to the absence of prior focus on the specific replacement nutrient for saturated fat. In other words, was saturated fat replaced primarily with (REFINED) carbohydrates, monounsaturated fats such as in olive oil, or polyunsaturated fats such as in most vegetable oils?

Mozaffarian and his HSPH colleagues Renata Micha and Sarah Wallace performed a systematic review and meta-analysis of all randomized controlled trials through June 2009 in which participants specifically increased their polyunsaturated fat consumption as a replacement for saturated fat, and in which coronary heart disease events were documented. Eight trials met the inclusion criteria, totaling 13,614 participants with 1,042 coronary heart disease events.

The meta-analysis of the trials showed that increasing polyunsaturated fat consumption as a replacement for saturated fat reduced the risk of coronary heart disease events by 19 percent. For every 5 percent increase (measured as total energy) in polyunsaturated fat consumption, coronary heart disease risk was reduced by 10 percent. This is now just the second dietary intervention — consuming long-chain omega-3 fatty acids is the first — to show a reduction in coronary heart disease events in randomized controlled trials.

(NOTE: Omega 3 IS a POLY fat)
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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Tue Mar 23, 2010 12:18 pm

Here is an overview I posted over 2 years ago in regard to fat.

This overview, remains true to this day.

viewtopic.php?f=22&t=5868

To sum up the issues around fat....

1) The need for essential fats can be meet through whole natural foods without adding any concentrated sources.

2) Unsaturated fats are less harmful than saturated fats.

3) Hydrogenated Fats and Trans fats are probably the worst fats.

4) Substituting saturated fat with unsaturated fats, without adding additional calories, may lower cholesterol levels and the risk for CVD and some cancers and possible DB. This is an "improvement", not an ideal recommendation and is a result of the "substitution" and not the "addition".

5) Substituting refined carbohydrates and/or sugar with unsaturated fats without adding additional calories may lower risk for CVD, DB and some cancers. This is an "improvement", not an ideal recommendation and a result of the "substitution" and not the "addition".

6) there is absolutely no evidence than adding either saturated fats, or
unsaturated fats to an otherwise optimal diet will improve the diet.

7) the Med diet was healthy not because of the olive oil, but in spite of
the olive oil. If the olive oil added any benefit, it was because of
some phytonutrients in the olive oil, and not any specific fat or fatty
acid.

8 ) Oils rich in PUFAs are more unstable than oils rich in MUFA and have been shown to increase growth rate (but not initiate) of some cancers in animals and possibly in humans, especially those which are high in Omega 6s.

9) I have never seen any conclusive evidence putting sat fat in a "healthy" light. Maybe my light needs new bulbs. :)

10) Focus your diet on and consume a variety of healthy unrefined unprocessed fresh fruit, veggies, starchy veggies, whole grains and legumes.


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Re: AJCN Meta-Analysis on Saturated Fat

Postby Jaggu » Tue Mar 23, 2010 1:46 pm

Thank you Jeff for your replies, I understand the position you take little better. what is the basis for concluding this way of eating to be the best? As you pointed several times that there are no true low fat whole food plant based diet studies. One thing I agree with you from my own experience is that it may not be that easy for most people to stay on true McDougall diet unless you are determined etc. It's not going to happen just like that, you have to make some concentrated efforts at least in the beginning.
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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Tue Mar 23, 2010 3:16 pm

Jaggu wrote:what is the basis for concluding this way of eating to be the best?


This whole site, including the main site and this forum is dedicated to presenting this case, including all the references.

Dr McDougall writings on the main site, which are all well referenced go back almost 3 decades. This forum, including many of responses to this exact same question to you, go back over 2 years.

Jaggu wrote:As you pointed several times that there are no true low fat whole food plant based diet studies.


Actually, I have never said that.

What I have said is that when we hear of low fat diets being criticized in many (if not most) studies, the low fat diet used is not the diet we are recommending here.

In regard to studies that are based on true low fat plant based diets, I have presented and discussed many of them here, including the Ornish studies on CVD and Cancer, the over 100 Pritikin Studies, the 15 or so Kempner studies, the Esseslsytn studies, the Barnard studies, etc, etc.

However, whenever we hear the low-fat (or low saturated fat) diet criticized in the media and/or in a study, it is never referring to this diet and/or the studies that have been done on them.

This is an essential point to helping clarify the misunderstandings that surround low-fat (low saturated) fat diets and one that has been made here since the forum started.

One thing I agree with you from my own experience is that it may not be that easy for most people to stay on true McDougall diet unless you are determined etc. It's not going to happen just like that, you have to make some concentrated efforts at least in the beginning.


Let me rephrase this comment and put it in proper context.

It is not easy for anyone to accomplish anything that is of lasting value and importance without time, energy, effort and determination, along with a few other habits/traits.

We also value things much more when they have been achieved this way.

However, I can't think of an area these efforts and traits would be better applied.

And, it becomes easier and easier over time.

However, it is very easy to get off track. Just like at the impact of just a 5% or 10% indiscretion.

If someone is consuming a 2000 calorie diet, 10% is 200 calories and 5% is 100 calories. Yes, it is not much. For most people, who are not well, it is not much room, but the focus really needs to be on getting well and not on what they can get away with. That is why I keep pushing everyone to focus on the 95% as that is what really matters. There was a very long discussion recently on this in this forum.

It is also important to understand what someone means when they say the follow the type of diet recommended here. We have to know what that means as many do not properly understand the guidelines or implement them correctly


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Re: AJCN Meta-Analysis on Saturated Fat

Postby f1jim » Thu Mar 25, 2010 11:58 am

We here are an anomoly. The average American IS pouring on the oil. It is everywhere and put in most everything we eat. That is a historical blip we need to see and get over. We also tend to hang on to our oil habits and it's one of the last things reported to go as we move to a fully McDougall diet. It's amazing the reports I hear of from those finally giving up the added oils. I remember John Mackey at one of the Advanced Study Weekends mentioning how he lost 10lbs very quickly after giving up added oils. The data on added oils is pretty clear. Avoiding it pays dividends. No matter our attachment to it. I know this issue has stuck with you for a long time. All I can say is try it the McDougall way and see what happens. No need to have blinders on this plan. The data is on our side!
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While adopting this diet and lifestyle program I have reversed my heart disease, high cholesterol, hypertension, and lost 54 lbs. You can follow my story at https://www.drmcdougall.com/james-brown/
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Re: AJCN Meta-Analysis on Saturated Fat

Postby Jaggu » Thu Mar 25, 2010 1:22 pm

f1jim wrote:
We here are an anomoly. The average American IS pouring on the oil. It is everywhere and put in most everything we eat. That is a historical blip we need to see and get over. We also tend to hang on to our oil habits and it's one of the last things reported to go as we move to a fully McDougall diet. It's amazing the reports I hear of from those finally giving up the added oils. I remember John Mackey at one of the Advanced Study Weekends mentioning how he lost 10lbs very quickly after giving up added oils. The data on added oils is pretty clear. Avoiding it pays dividends. No matter our attachment to it. I know this issue has stuck with you for a long time. All I can say is try it the McDougall way and see what happens. No need to have blinders on this plan. The data is on our side!
f1jim


Thank you for the post.

When we discuss specific issues here, where does what average american does comes into picture?

You may not but some of us will continue to be puzzeled by paradoxes such as below

The East African paradox refers to the Masai tribes in Kenya, Africa. Their diets consist of full fat milk and cream, large amounts of beef, and blood from their cattle during dry season. The average daily caloric intake was estimated to be about 3,000 kcal, with 66% of the calories derived from fat. The estimated average daily cholesterol intake was from 600 to 2,000 mg per person. When Western doctors examined the Masai, they found that their blood cholesterol levels were extremely low, and autopsies of deceased Masai found almost no evidence of arterial plaques.
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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Thu Mar 25, 2010 1:52 pm

Jaggu wrote:When we discuss specific issues here, where does what average american does comes into picture?


Smack in the middle :)

And it is THE crisis we are referring to all the time.

The average American is who we are talking about many times when we are discussing stats and the big picture. It is also who we are talking about in population studies and observational studies, as in the ones which this thread is about. Just read the whole "Triage Your Health" thread.

The average American is no longer overweight, but obese.

The average American is sedentary/inactive.

The average American is very sick and on multiple medications.

The average Americans diet is to high in fat (35% fat) too high in saturated fat (12%), too high in cholesterol (300 mgs), too high in sodium (4000 mgs), too high in refined carbs (90% of carb intake), too high in refined sweeteners (23% of calories), and too low in fiber (only 12-15 grams), too low in unrefined, unprocessed fruits, vegetables, starchy vegetables, intake whole grains and legumes.

It is a travesty.

When you see the same questions (which are of value at first) keep getting asked by the same people, with out any effort of moving forward after a thorough discussion on the topic, and then only to see them re-raise the exact same issue, with the exact same faulty logic every chance it seems to come up, contributes to the sense of frustration that is being expressed in this thread by some.

The criticism of low fat diets does not apply in anyway to what is going on here.


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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Thu Mar 25, 2010 2:00 pm

Jaggu wrote:You may not but some of us will continue to be puzzeled by paradoxes such as below

The East African paradox refers to the Masai tribes in Kenya, Africa. Their diets consist of full fat milk and cream, large amounts of beef, and blood from their cattle during dry season. The average daily caloric intake was estimated to be about 3,000 kcal, with 66% of the calories derived from fat. The estimated average daily cholesterol intake was from 600 to 2,000 mg per person. When Western doctors examined the Masai, they found that their blood cholesterol levels were extremely low, and autopsies of deceased Masai found almost no evidence of arterial plaques.


This is not a completely accurate description and this issue has been fully described and explained here by me and by Dr McDougall on the main site. The Masai are not a paradox as they do have atherosclerosis and do not live long. Life expectancy is 45 years for women and 42 years for men.

I do not see how in anyway, an example of a small group of people who are surviving in an extreme environment with less than ideal dietary practices, and getting away with it to some small extent due to their extremely high levels of physical activity, way beyond what we as Americans could ever do as a nation, should in anyway become an example of a rationale for the dietary practices of Americans, an extremely overweight, obese and inactive nation.

However, if living to your mid 40's, or trying to find out how much someone can get away with is their goal, then keep the Masai in focus, and this forum may not be for them.

We need, and can do, better. Much better.

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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Wed Feb 06, 2013 9:04 am

Another piece of the puzzle...

The blanket recommendation of the AHA to substitute poly-unsaturated fats (omega 6's) for saturated fats, was not healthy and would not result in any benefit and may have cause an increase in death rates.

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From the media report..

"UK dietary recommendations are cautious about high intakes of omega 6 PUFAs, but the American Heart Association recently repeated advice to maintain, and even to increase, intake of omega 6 PUFAs. This has caused some controversy, because evidence that linoleic acid lowers the risk of cardiovascular disease is limited.

An in-depth analysis of the effects of linoleic acid on deaths from coronary heart disease and cardiovascular disease has not previously been possible due to missing data from the Sydney Diet Heart Study - a large randomised controlled trial conducted from 1966 to 1973.

But now, a team of researchers from the US and Australia have recovered and re-analysed the original data from this trial, using modern statistical methods to compare death rates from all causes, cardiovascular, and coronary heart disease."


http://www.alphagalileo.org/ViewItem.as ... ureCode=en

From the actual article

http://www.bmj.com/content/346/bmj.e8707

What is already known on this topic?

- Increasing dietary omega-6 linoleic acid in the place of saturated fat lowers total cholesterol and low density lipoprotein cholesterol

- Advice to substitute linoleic acid for saturated fat is one component of dietary guidelines to reduce the risk of coronary heart disease; however, clinical benefits specific to linoleic acid have not been established

- A comprehensive analysis of the effects of linoleic acid on death from coronary heart disease and cardiovascular disease was previously not possible, owing to missing outcome data from the Sydney Diet Heart Study, a randomized controlled clinical trial

What this study adds

- In this cohort, substituting omega 6 linoleic acid for saturated fat did not provide the intended benefits, but increased all cause morality, cardiovascular death, and death from coronary heart disease

- An updated meta-analysis incorporating these missing data showed no evidence of benefit, and suggested a possible increased risk of cardiovascular disease from replacing saturated fat with omega-6 linoleic acid

- These findings could have important implications for worldwide dietary advice to substitute omega-6 linoleic acid (or polyunsaturated fatty acids in general) for saturated fatty acids

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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Sat Sep 28, 2013 9:54 am

Saturated fat is still unhealthy. :)

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1) Saturated Fat and CVD and all cause death

- Comparison of predictive performance of various fatty acids for the risk of cardiovascular disease events and all-cause deaths in a community-based cohort. Atherosclerosis. 2013 Sep;230(1):140-7. doi: 10.1016/j.atherosclerosis.2013.06.015. Epub 2013 Jul 12.

http://www.ncbi.nlm.nih.gov/pubmed/23958266

"CONCLUSIONS: Our data provides strong evidence to support that plasma saturated fats and trans fats can predict all-cause death and CVD more effectively than other fatty acid markers."

2) Saturated fats and the risk of stroke.

- Plasma Fatty Acid Composition and Incident Ischemic Stroke in Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study.
Cerebrovasc Dis. 2013 Jul 30;36(1):38-46.

http://www.ncbi.nlm.nih.gov/pubmed/23920478

"Conclusions: In this US cohort of whites, we found significant positive associations of plasma saturated and monounsaturated fatty acids, especially of palmitoleic acid, with ischemic stroke. We also found an inverse nonlinear association between linoleic acid and ischemic stroke."


- Serum Fatty Acids and Incidence of Ischemic Stroke Among Postmenopausal Women.
http://www.ncbi.nlm.nih.gov/pubmed/23899914
Stroke. 2013 Jul 30. [Epub ahead of print]

"These findings suggest that individual serum trans, saturated, and monounsaturated fatty acids are positively associated with particular ischemic stroke subtypes, whereas individual n3 and n6 polyunsaturated fatty acids are inversely associated".


3) On cholesterol, inflammation and Heart Disease.

Elevated Remnant Cholesterol Causes Both Low-Grade Inflammation and Ischemic Heart Disease, While Elevated Low-Density Lipoprotein Cholesterol Causes Ischemic Heart Disease without Inflammation.
Circulation. 2013 Aug 7. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/23926208


4) Saturated fatty acid metabolism is key link between cell division, cancer, and senescence in cellular and whole organism aging. Age (Dordr). 2010 Jun;32(2):231-7. Epub 2010 Jan 14. PMID: 20431990

http://www.ncbi.nlm.nih.gov/pubmed/20431990

"Elevated concentrations of palmitic acid are toxic to mitochondria and endoplasmic reticulum and can induce apoptosis without the involvement of reactive oxygen species. This has been demonstrated in many different cell types including cardiomycocytes (Hickson-Bick et al. 2002), hematopoietic cells (Paumen et al. 1997), pancreatic B-cells (Shimabukuro et al. 1998), and astrocytes (Blazquez et al. 2000). Relatively minor changes in palmitate concentration cause dramatic changes."

"It is concluded that aging in cells and whole organisms share a common initiation pathway and that cellular senescence is protective against cancer. Healthy longevity is likely to be most enhanced by factors that actively suppress excessive cell division."
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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Mon Mar 10, 2014 10:08 am

Comparison of predictive performance of various fatty acids for the risk of
cardiovascular disease events and all-cause deaths in a community-based
cohort.
Atherosclerosis. 2013 Sep;230(1):140-7. doi:
10.1016/j.atherosclerosis.2013.06.015. Epub 2013 Jul 12.
PMID: 23958266

Abstract

BACKGROUND: The issue of whether saturated fats and trans fats are superior
predictors of all-cause death and cardiovascular disease than n-3
polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA), remains a matter of contention. Furthermore, few
studies have examined the relationship between fatty acids and the outcomes
of cardiovascular disease (CVD) in Asian populations. The aim of this study
was to compare the effectiveness of various plasma fatty acids as predictors
for all-cause death and CVD events in an ethnic Chinese population.

METHODS: This study assembled a community-based prospective cohort,
comprising 1833 participants (60.6±10.5 yrs, 44.5% women) who underwent a
comprehensive evaluation of fatty acids in blood using gas chromatography.
None of the subjects had a history of CVD at the time of recruitment.

RESULTS: A total of 568 individuals died and 275 individuals developed CVD
during the follow-up period (median of 9.6 years; interquartile range of
8.9-10.5 years). Following adjustment for established cardiovascular risk
factors, the relative risk of all-cause death in the highest quartile,
compared with the lowest quartile, was 1.33 for saturated fats (95%
confidence interval [CI], 1.01-1.75, test for trend, P = 0.015), 1.71 for
trans fats (95% CI, 1.27-2.31, test for trend, P = 0.0003), 0.77 for EPA
(95% CI, 0.59-1.00, test for trend, P = 0.048), and 0.89 for DHA (95% CI,
0.68-1.18, test for trend, P = 0.354). Similar patterns were observed for
CVD events. Trans fats presented the largest area under the receiver
operator characteristic curve (0.740, 95% CI, 0.716-0.766) for the
prediction of all-cause death. A mutually adjusted two-marker model
indicated that saturated fats and trans fats were significant predictors of
all-cause death and CVD; however, the other fatty acids were not. In
addition, trans fats presented the greatest improvement in net
reclassification for all-cause death (7.7%, P = 0.003), followed by EPA
(3.8%, P = 0.033). Saturated fats presented the greatest improvement in net
reclassification for CVD events (5.6%, P = 0.039).

CONCLUSIONS: Our data provides strong evidence to support that plasma
saturated fats and trans fats can predict all-cause death and CVD more
effectively than other fatty acid markers
.
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Re: AJCN Meta-Analysis on Saturated Fat

Postby JeffN » Mon Mar 31, 2014 6:41 am

Travis, (Healthy Longevity), does an excellent & very detailed & thorough review of the recent meta-analysis's on saturated fat.

"Clearing Up The Confusion Surrounding Saturated Fat"
by Travis HL

This analysis examines some of the serious omissions in several of the widely cited meta-analysis papers & focuses primarily on how saturated fat and low-carb diets influences fatal heart disease, an important end point that is largely ignored by the authors of these meta-analysis papers.

http://healthylongevity.blogspot.com/20 ... lysis.html

I thought this comment was the most important because it puts all of this in proper context & perspective...

"The findings reviewed here support the hypothesis that saturated fat increases the risk of coronary heart disease mortality. Furthermore, as reviewed previously, evidence also suggests that the hazardous effects of diets rich in saturated fat are also applicable to diets rich in organic, grass-fed animal foods. However, saturated fat is only one of a number of problems as far as chronic diseases are concerned. The effect that a particular food has on the risk of coronary heart disease cannot be fully explained by saturated fat content alone, but rather by multiple nutrients that likely operate together in a complex manner to modify the risk of disease. Therefore, it may be more appropriate to focus attention on recommending healthy dietary patterns that are naturally low in saturated fat, while rich in dietary fiber and other beneficial nutrients; primarily, minimally processed, plant-based diets. Such a focus may be more effective to help lower the intake of saturated fat, while simultaneously improving overall dietary quality compared to the more contemporary reductionist approach of focusing on modifying single nutrients."


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