Disorders of Lipid Metabolism
Welcome to the Disorders of Lipid Metabolism (DLM) Project
Saturated Fat
Heart disease is the leading cause of death for adults living in the United States according to the Centers for Disease Control and Prevention.1 Dietary advice to prevent and treat heart disease has changed overtime, particularly for saturated fat. The majority of recommendations to reduce saturated fat are primarily based on the impact on serum blood lipids.2-5 There is available scientific literature on the impact of saturated fat reduction on morbidities and mortality. However, this evidence is less clear. The debate on the need to reduce saturated fat intake to treat or prevent heart disease is ongoing.6,7 The saturated fat debate is further complicated by the topics of saturated fat replacement, and sources of saturated fat. Multiple systematic reviews were conducted and evaluated to support the development of three evidence-based nutrition practice recommendations.
Saturated Fat 2023 Evidence-Based Nutrition Practice Guideline
The objective of the Saturated Fat guideline is to inform registered dietitian nutritionists or international equivalents, and other healthcare providers to provide adults with nutritional care relating to saturated fat intake to prevent or treat heart disease. This guideline specifically focused on three topics:
- Amount of saturated fat intake
- Replacement of saturated fat with other nutrients
- Source of saturated fat
For tips on implementing the guideline recommendations, download the Saturated Fat Practitioner Guide. This one-page guide is designed with clear and unambiguous language that may help practitioners and their patients/clients to actively participate in shared decision making for their nutrition care.
Saturated Fat 2018-2021 Systematic Review
The goal of the 2018-2021 systematic review supporting the Saturated Fat Evidence-based Practice Guideline was to evaluate available evidence on saturated fat intake and the prevention or treatment of heart disease among adults. The panel evaluated the effect of the amount of saturated fat intake, the effect of replacement nutrients, and the effect that different food containing saturated fat may have on mortality, morbidities (coronary heart disease, stroke, cardiovascular disease), blood lipids, inflammation, and endothelial function.
Key Findings
- Mortality: Observational evidence did not find an association with varying amounts of saturated fat intake regardless of replacement nutrients, or source of saturated fat with mortality.
- CVD and CHD: Observational evidence found that a reduction in saturated fat intake may reduce cardiovascular events. However, the association with coronary heart disease (CHD) events and stroke is unclear. Evidence evaluating replacement of saturated fat with polyunsaturated fat also found a reduction in cardiovascular events. One systematic review did find a reduction in coronary heart disease with higher cheese intake. The same review found an increase in coronary heart disease with high fat milk intake, but not low-fat milk intake. No association was found between yogurt intake or butter intake and CVD or CHD.
- Blood Lipids: Observational evidence found that a reduction of saturated fat intake will likely reduce total and LDL cholesterol. No significant effect was found on HDL or triglycerides. Evidence evaluating replacement of saturated fat with polyunsaturated found a reduction in total cholesterol and triglycerides, but no clear differential effect on HDL or LDL.
- Endothelial Function and Inflammation: The expert panel identified endothelial function and inflammation as outcomes of interest that have yet to be extensively explored. The available evidence was sparse, and little to no effect was found on most outcomes.
Use the left navigation to view the results of the Saturated Fat guideline and the supporting systematic review. Expand the section below titled Saturated Fat Project Team and Disclosures for a listing of individuals who contributed to the development of the project, disclosures and project funding information.
References
- Centers for Disease Control and Prevention. Heart Disease Facts. U.S. Department of Health & Human Services. www.cdc.gov/heartdisease/facts. Published 2022. Accessed January 25, 2023.
- Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S76-99.
- Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):e177-e232.
- Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1082-e1143.
- Lichtenstein AH, Appel LJ, Vadiveloo M, et al. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2021;144(23):e472-e487.
- Krauss RM, Kris-Etherton PM. Public health guidelines should recommend reducing saturated fat consumption as much as possible: NO. Am J Clin Nutr. 2020;112(1):19-24.
- Kris-Etherton PM, Krauss RM. Public health guidelines should recommend reducing saturated fat consumption as much as possible: YES. Am J Clin Nutr. 2020;112(1):13-18.
2/2/2023
- Resources and Articles
- Saturated Fat Guideline and Systematic Review Project Team and Disclosures (2018-23)