EAL

DLM: Fish (2001)

Citation:

Study Design:

Class:

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Quality Rating:

Research Purpose:

Inclusion Criteria:

Exclusion Criteria:

Description of Study Protocol:

Data Collection Summary:

Description of Actual Data Sample:

Population Studied: Epidemiological and Clinical Trials on the relationship between type of fat and CHD

Summary of Results:

Primary Outcome Measures and Results:

Saturated fatty acids (C12:0 to C16:0) total and LDL cholesterol levels whereas C18:0 and MUFA (cis C18:1) are neutral when substituted for carbohydrate and n-6 PUFAs lower serum cholesterol.
Long chain n-3 fatty acids lower serum TG and trans fatty acids lower serum cholesterol.
Epidemiological studies have shown that saturated fat intake is associated with an increased risk of CHD. The greatest risk decrease is associated with PUFA intake and to a lesser extent of risk decrease with MUFA intake.
Both n-6 (linoleic acid) and n-3 ( - linolenic acid) PUFAs are protective.
Trans fatty acids are strong predictors of risk CHD compared with saturated fat or carbohydrates.
Several hemostatic factors are influenced by dietary components. For example, when a high-fat diet is replaced by a lower-fat, higher fiber diet, the activity of Factor VII decreases and the capacity of the endogenous fibrinolytic system.

Author Conclusion:

Individual fatty acids have remarkably diverse effects on risk factors for CVD. With respect to effects on lipids and lipoproteins, we have a reasonably good understanding of the effects of individual fatty acids. Much remains to be learned about individual fatty acids with regard to other risk factors such as hemostatic factors, platelet function, blood pressure, and endothelial function as well as the development of artherosclerosis.
In general, the unsaturated fatty acids (excluding trans fatty acids) favorably affect a number of factors that are cardioprotective. Unsaturated fatty acids lower total and LDL cholesterol levels when substituted for saturated fatty acids (C12:0 to C16:0)
Long-chain n-3 fatty acids from fish oil decrease TG levels, favorably affect platelet function, and decrease blood pressure slightly in hypertensive individuals.
Oleic acid has been shown to decrease postprandial factor VII activity.

Funding Source:

University/Hospital:

Pennsylvainia University

Not-for-profit

Foundation associated with industry:

Reviewer Comments:

This worksheet does not have information for all the fields above because it was originally completed for the 2001 hyperlipidemia guideline published on CD. The format has changed.

This Summary provides a global overview of research on fatty acids up to June of 2000. There is not specific information on how the research papers that were reviewed were selected. Overall results were discussed, but there were no detailed discussion regarding the quality of specific studies. Due to these limitations, this consensus statement is considered neutral in quality.

Quality Criteria Checklist: Review Articles
Relevance Questions
	1.	Will the answer if true, have a direct bearing on the health of patients?	Yes
	2.	Is the outcome or topic something that patients/clients/population groups would care about?	Yes
	3.	Is the problem addressed in the review one that is relevant to dietetics practice?	Yes
	4.	Will the information, if true, require a change in practice?	Yes

Validity Questions
	1.	Was the question for the review clearly focused and appropriate?	Yes
	2.	Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described?	No
	3.	Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased?	No
	4.	Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible?	No
	5.	Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined?	Yes
	6.	Was the outcome of interest clearly indicated? Were other potential harms and benefits considered?	Yes
	7.	Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described?	No
	8.	Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included?	Yes
	9.	Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed?	Yes
	10.	Was bias due to the review's funding or sponsorship unlikely?	Yes