Top Things to Know: Dietary Fats and Cardiovascular Disease

Published: June 15, 2017

Cardiovascular disease (CVD) is the leading global cause of death, accounting for 17.3 million deaths per year. It is anticipated this number will increase to more than 23.6 million by the year 2030.
Since 1961, the American Heart Association (AHA) has recommended reduction in dietary saturated fat to reduce the risk of CVD.
The purpose of this AHA Presidential Advisory on Dietary Fats and CVD is to review and discuss the scientific evidence, including the most recent studies, on the effects on CVD of dietary saturated fat and its replacement by other types of fats and carbohydrates.
The 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk recommends that individuals with elevated LDL-cholesterol decrease intake of saturated fat to 5-6% of total daily energy (calorie) intake. ⁱ The Dietary Guidelines for Americans 2015-2020 recommends < 10% of calories from saturated fat for the general population and to replace the saturated fat with unsaturated fat. ⁱⁱ
Currently, the average intake of saturated fat in adults in the U.S, is 11-12%; only 29% of the adult population consumes less than 10%. Therefore, most U.S. adults need to reduce their intake of saturated fats to reduce their CVD risk. Reduction in total dietary fat or a goal for total fat intake is not recommended.
After analyzing several randomized controlled trials, the authors concluded that lowering intake of saturated fat and replacing it with polyunsaturated vegetable oil reduced CVD events by approximately 30%, similar to that achieved by statin treatment.
Replacing dietary saturated fats with refined carbohydrates was not associated with a change in coronary heart disease (CHD) risk; however, replacing dietary saturated fats with carbohydrates from whole grains was associated with a 9% lower risk of CHD.
Trans unsaturated fatty acids are monounsaturated or polyunsaturated fatty acids containing at least one double bond in the trans configuration. These fats are low-cost, shelf-stable, and can be produced by partial hydrogenation of other oils. There are several well-documented adverse effects of trans fats including raising LDL-cholesterol levels and CHD risk.
While many consumers consider coconut oil to be healthy, 82% of the fatty acids in coconut oil are saturated fats. The authors advise against the use of coconut oil because it increases LDL-cholesterol and has no known offsetting favorable effects.
Recent evidence continues to support AHA’s long-standing recommendations to replace dietary saturated fats with healthier sources of calories, such as unsaturated fats or whole grains, in a heart healthy dietary pattern to reduce CVD risk.

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Citation

Sacks FM, Lichtenstein AH, Wu JHY, Appel LJ, Creager MA, Kris-Etherton PM, Miller M, Rimm EB, Rudel LL, Robinson JG, Stone NJ, Van Horn LV; on behalf of the American Heart Association. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association [published online ahead of print June 15, 2017]. Circulation. doi: 10.1161/CIR.0000000000000510.