Total Matrix of a Food More Important than Saturated Fat in Heart Disease Risk

Although intake of saturated fat has been named one of the culprits leading to coronary heart disease (CHD) in current dietary recommendations, recent evidence from Danish scientists shows that reducing CHD risk is more related to the total makeup of a food than its saturated fat content (Astrup A, et al. Am J Clin Nutr. 2011;93:684-688).

“There is increasing evidence to support that the total matrix of a food is more important than just its fatty acid content when predicting the effect of a food on CHD risk,” wrote lead investigator Arne Astrup, MD, PhD, head of the Department of Human Nutrition, University of Copenhagen, Denmark, and colleagues.

According to the authors, although previous studies show that the risk for CHD is reduced by replacing saturated fatty acids with polyunsaturated fatty acids, the issue is more complex than that. For example, some food sources of saturated fat may contain significant amounts of protein, calcium, and other nutrients that have an effect on CHD risk; therefore, it is not sufficient to evaluate a food’s effect on CHD by its saturated fat content alone but rather by its entire nutrient combination.

Substituting carbohydrates for saturated fatty acids has not been proved as a way to reduce CHD risk, although unrefined carbohydrates with a low glycemic index may be beneficial. In attempts to avoid saturated fat, people may consume trans-saturated fats or highly processed, refined carbohydrates, which could impart little positive effect, or even an adverse effect, on their CHD risk.

Assessing CHD risk by examining the effect of diet on a single biomarker does not provide sufficient evidence to make a substantive evaluation, the researchers stated. Instead, “the combination of multiple biomarkers and the use of clinical end points could help substantiate the effects on CHD.”

The researchers note that although it is difficult to identify specific types of foods that will help to reduce CHD risk, epidemiologic studies have demonstrated a lowered risk for cardiovascular disease from reduced intake of full-fat dairy products and fatty red meats, along with higher intake of polyunsaturated fatty acids from vegetable fats.

In addition, risk is reduced by using nonhydrogenated vegetable oils instead of consuming animal fats. Essentially, an overall healthy diet is largely plantbased, with minimal saturated fat; small-to-modest amounts of low-fat dairy products and lean meats can also be included. “A valuable way to communicate the message is to describe the broad dietary pattern that reduces [CHD] risk,” the researchers wrote.