Question:

Both the American Heart Association and the American College of Cardiology recommend to restrict the intake of saturated fatty acids (SFA) to

Methods:

Queries of literature were performed using the electronic databases MEDLINE, EMBASE and the Cochrane Library with restrictions to long-term RCTs comparing low SFA vs. higher SFA diets. Outcome parameters included “hard clinical endpoints” and cardiovascular risk factors. Pooled effects were calculated using an inverse-variance random effect meta-analysis.

Results:

A total of 12 studies with 7150 participants were included in the meta-analyses. Adopting a low SFA diet was associated with a 25% risk reduction for combined cardiovascular events [RR: 0.75, (95% CI 0.58 to 0.96), p=0.02]. In addition, weighted mean differences (WMD) in change of total cholesterol (TC) [WMD: -14.68 mg/dl, (95% CI -23.24 to -6.13), p=0.0008] and triacylglycerols [WMD: -13.31 mg/dl, (95% CI -22.47 to -4.15), p=0.004] were significantly more pronounced following the low SFA diet as compared to their high SFA counterparts. Meta-regression showed a significant dose-response relationship between intake of polyunsaturated fatty acids and TC reduction.

Conclusion:

The present systematic review provides evidence for a beneficial long-term effect of reduced SFA intake on biomarkers of CVD as well as on hard clinical endpoints.