Saturated fat, carbohydrate, and cardiovascular disease.

Abstract (PubMed)

A focus of dietary recommendations for cardiovascular disease (CVD) prevention and treatment has been a reduction in saturated fat intake, primarily as a means of lowering LDL-cholesterol concentrations. However, the evidence that supports a reduction in saturated fat intake must be evaluated in the context of replacement by other macronutrients. Clinical trials that replaced saturated fat with polyunsaturated fat have generally shown a reduction in CVD events, although several studies showed no effects. An independent association of saturated fat intake with CVD risk has not been consistently shown in prospective epidemiologic studies, although some have provided evidence of an increased risk in young individuals and in women. Replacement of saturated fat by polyunsaturated or monounsaturated fat lowers both LDL and HDL cholesterol. However, replacement with a higher carbohydrate intake, particularly refined carbohydrates, can exacerbate the atherogenic dyslipidemia associated with insulin resistance and obesity. In summary, although substituting dietary saturated fat with carbohydrate decreases LDL cholesterol, an overall unfavorable metabolic effect of increased carbohydrate intake is possible.