Sammendrag
Objective: The aim of this review is to explore to what degree – if at all – a shift from an intake of predominantly saturated to polyunsaturated fats have reduced the risk of coronary heart disease and mortality related to such disease in randomized controlled trials. Background: The healthy majority of the Norwegian people are encouraged by the ministry of health and care services to actively choose polyunsaturated fats instead of saturated with a view to the assumed impact on the heart. Several studies have pointed to a correlation between diets rich in saturated fats and levels of cholesterol in the blood. Such increases in levels of cholesterol have in turn been associated with a greater risk of developing atherosclerosis and thus coronary heart disease. Despite this assumed link a number of major knowledge summaries have concluded that there is no connection between the intake of saturated fats and coronary heart disease. Method: Literature searches in PubMed performed in summer 2015. Only randomized controlled trials that tested the effect of an increased intake of polyunsaturated fatty acids and a decreased intake of saturated fatty acids on hard endpoints like disease and death were included. A total of 204 studies were found by systematic search in PubMed. Four of these were includes in the review. Four more studies were found by an unsystematic search in PubMed. Results: Replacing saturated fatty acids with polyunsaturated fatty acids had no effect on either the risk for mortality in general or mortality by coronary artery disease in particular in any of the original publications. However, one study revealed a borderline significant reduction in risk in the intervention group when all coronary events (angina pectoris and myocardial reinfarctions) were seen together. A recent publication of data from one study showed a significantly increased risk for mortality from coronary disease in the group that replaced saturated fat with polyunsaturated. Conclusion: Results from randomized controlled trials where the intervention group moved from an intake of predominantly saturated to a diet marked by polyunsaturated fats do not support dietary recommendations that encourage a shift from diets rich in saturated fats to diets predominated by polyunsaturated.
Objective: The aim of this review is to explore to what degree – if at all – a shift from an intake of predominantly saturated to polyunsaturated fats have reduced the risk of coronary heart disease and mortality related to such disease in randomized controlled trials. Background: The healthy majority of the Norwegian people are encouraged by the ministry of health and care services to actively choose polyunsaturated fats instead of saturated with a view to the assumed impact on the heart. Several studies have pointed to a correlation between diets rich in saturated fats and levels of cholesterol in the blood. Such increases in levels of cholesterol have in turn been associated with a greater risk of developing atherosclerosis and thus coronary heart disease. Despite this assumed link a number of major knowledge summaries have concluded that there is no connection between the intake of saturated fats and coronary heart disease. Method: Literature searches in PubMed performed in summer 2015. Only randomized controlled trials that tested the effect of an increased intake of polyunsaturated fatty acids and a decreased intake of saturated fatty acids on hard endpoints like disease and death were included. A total of 204 studies were found by systematic search in PubMed. Four of these were includes in the review. Four more studies were found by an unsystematic search in PubMed. Results: Replacing saturated fatty acids with polyunsaturated fatty acids had no effect on either the risk for mortality in general or mortality by coronary artery disease in particular in any of the original publications. However, one study revealed a borderline significant reduction in risk in the intervention group when all coronary events (angina pectoris and myocardial reinfarctions) were seen together. A recent publication of data from one study showed a significantly increased risk for mortality from coronary disease in the group that replaced saturated fat with polyunsaturated. Conclusion: Results from randomized controlled trials where the intervention group moved from an intake of predominantly saturated to a diet marked by polyunsaturated fats do not support dietary recommendations that encourage a shift from diets rich in saturated fats to diets predominated by polyunsaturated.