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The American Heart Association doubled down on its dietary recommendations in an advisory calling for switching poly- and mono-unsaturated vegetable oil for saturated fats to help prevent heart disease.
"Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of CVD," said the advisory, published Thursday in .
The AHA president-initiated advisory acknowledged that meta-analyses have disagreed about whether dietary saturated fat really hurts the heart. It has been even more hotly debated on social media and the popular press.
"We want to set the record straight on why well-conducted scientific research overwhelmingly supports limiting saturated fat in the diet to prevent diseases of the heart and blood vessels," lead author Frank Sacks, MD, of the Harvard School of Public Health in Boston, said in an AHA press release.
It emphasized that the fat intake recommendations are only as part of an overall healthful dietary pattern, such as DASH or the Mediterranean diet. Reduction in total dietary fat or a goal for total fat intake were not recommended.
The evidence cited centered on four trials comparing high saturated fat intake against high intake of polyunsaturated fats with at least 2 years of sustained intervention, objective adherence measures, and validated cardiovascular event monitoring. Together, those trials showed a relative risk of 0.71 for coronary heart disease (95% CI 0.62-0.81).
Replacing saturated fat with refined carbohydrates and sugars doesn't have a benefit, other studies suggested.
One largely saturated fat that many see as healthy -- coconut oil -- raised LDL cholesterol more than safflower or olive oil in carefully-controlled studies, on par with other saturated fats like butter and beef fat.
Given the lack of "offsetting favorable effects, we advise against the use of coconut oil," the advisory noted.
Disclosures
Two members of the panel disclosed relationships with industry and advocacy organizations, including Amarin, the California Walnut Commission, Ag Canada, the Canola Oil Council, National Cattlemen's Beef Association, Seafood Nutrition Partnership, TerraVia, and Avocado Nutrition Science Advisors.
Primary Source
Circulation
Sacks FM, et al "Dietary fats and cardiovascular disease: A presidential advisory from the American Heart Association" Circulation 2017; DOI: 10.1161/CIR.0000000000000510.