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The role of saturated fat intake and food source of saturated fat on cardiovascular disease risk 

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: Scientific Basis for Dietary Guidance
: saturated fat, cardiovascular disease
: Gregory Miller22 15 Oct 2012
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The Dietary Guidelines for Americans recommends consuming less than 10% of total calories from saturated fat, due primarily to saturated fat’s role in increasing LDL cholesterol and thus increasing the risk for cardiovascular disease. However, recent research has called into to question the role saturated fat intake make have on cardiovascular disease risk directly, despite the effect it has on LDL cholesterol (1). Moreover, recent findings have indicated that the replacement nutrient for saturated fat may raise or lower cardiovascular disease risk, as exemplified by studies showing that replacement of saturated fat with carbohydrate may actually exacerbate disease risk (2). This has led some researchers to suggest that the total composition of the diet and even specific food compositions must be considered in order to determine cardiovascular disease risk, as opposed to focusing on individual fatty acids contained within a food. Different fatty acid chain lengths have different biological effects while other non-fatty acid nutrients contained within a food may modify disease risk (3). The 2010 Dietary Guidelines Advisory Committee (DGAC) report led the way in identifying that not all saturated fats have the same effect on disease risk, pointing out that fat from dairy products is an area that requires further study, saying: • “Consumption of milk products may not have predictable effects on blood lipids…” • “Future research should examine the role of dairy products in modulating lipid profiles, especially through intervention trials in which all types of dairy products, both low and high fat, are fed. Bioactive components that alter serum lipid levels may be contained in milk fat.” • “Evidence to date does not suggest that high-fat dairy products are more likely than low-fat dairy products to induce metabolic syndrome. Whether there are other protective compounds in milk products, such as calcium, protein, fatty acids, etc. that provide protection requires further research.” Most recently, a study published in 2012 in the American Journal of Clinical Nutrition reported a differential effect of saturated fat intake on disease risk depending on the source of saturated fat (4). Specifically, the researchers found that consumption of saturated fat from dairy was actually associated with a reduced risk for cardiovascular disease, thus providing evidence for a unique effect of dairy fat on cardiovascular health. This is consistent with other findings that have indicated a favorable effect of dairy fat on risk for cardiovascular disease and type 2 diabetes. For example, higher blood levels of saturated fats contained in dairy have been associated with reduced risk for a first heart attack (5), higher blood levels of a specific fatty acid (trans palmitoleic acid) contained in dairy has been associated with reduced risk for type 2 diabetes (6), and higher intake of full-fat dairy foods was associated with a lower risk of cardiovascular mortality (7). The Dietary Guidelines for Americans recommends all Americans 9 years of age or older consume three servings of low-fat or fat-free dairy products per day; however, these recent research findings indicate that there may be unique properties of dairy fat that offer a protective effect on cardiovascular and metabolic health. In light of these findings and the recommendations by the 2010 DGAC, there is a clear need to for more research to advance current knowledge about associations between saturated fat in general, and fat from dairy products in particular, in the risk for cardiovascular and metabolic diseases. References 1. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):535-46. 2. Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids. 2010 Oct;45(10):893-905. 3. Astrup A, Dyerberg J, Elwood P, Hermansen K, Hu FB, Jakobsen MU, Kok FJ, Krauss RM, Lecerf JM, LeGrand P, Nestel P, Risérus U, Sanders T, Sinclair A,Stender S, Tholstrup T, Willett WC. The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010? Am J Clin Nutr. 2011 Apr;93(4):684-8. 4. de Oliveira Otto MC, Mozaffarian D, Kromhout D, Bertoni AG, Sibley CT, Jacobs DR Jr, Nettleton JA. Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2012 Aug;96(2):397-404. 5. Warensjö E, Jansson JH, Cederholm T, Boman K, Eliasson M, Hallmans G, Johansson I, Sjögren P. Biomarkers of milk fat and the risk of myocardial infarction in men and women: a prospective, matched case-control study. Am J Clin Nutr. 2010 Jul;92(1):194-202. 6. Mozaffarian D, Cao H, King IB, Lemaitre RN, Song X, Siscovick DS, Hotamisligil GS. Trans-palmitoleic acid, metabolic risk factors, and new-onset diabetes in U.S. adults: a cohort study. Ann Intern Med. 2010 Dec 21;153(12):790-9. 7. Bonthuis M, Hughes MC, Ibiebele TI, Green AC, van der Pols JC. Dairy consumption and patterns of mortality of Australian adults. Eur J Clin Nutr. 2010 Jun;64(6):569-77.

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