Saturated fats and coronary heart disease

BALANCED AND FACT BASED

Saturated fat and risk of coronary heart disease

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Saturated fats are fats that tend to be solid at room temperature  Fats in the diet mainly consist of triglyceride, a molecule composed of three fatty acids and a glycerol backbone.  Fatty acids are made of long chains of carbon (C) atoms, which are linked by single bonds (-C-C-) or double bonds (C=C-).  Saturated fatty acids have straight chains of single-bonded carbons, allowing them to arrange in a denser, solid structure.

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Saturated fatty acids naturally occur in all fatcontaining foods  All foods containing fat have a mix of saturated, monounsaturated and polyunsaturated fatty acids.  Saturated fatty acids are mainly found in meat, dairy products, butter, and some vegetable fats and oils, such as coconut and palm oil.1

1. Eilander et al. 2015

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Saturated fatty acids have important functional properties  Saturated fatty acids confer several functional qualities to foods, including structure, plasticity, and organoleptic characteristics, such as creaminess and flavor.  These qualities enhance food palatability, stability, and structure and are difficult to replace without losing important food characteristics.2

2. Patel et al. 2016

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The most commonly consumed saturated fatty acids are palmitic and stearic acid  Saturated fats differ from one another in the length of their carbon chains.  Palmitic (C16) and stearic acids (C18) are predominant in butter, dairy and meat products; lauric (C12) and myristic (C14) acids in butter, dairy foods, coconut, and palm kernel oils.3

3. USDA National Nutrient Database for Standard Reference

Palmitic acid, C16H32O2 or C16:0

Stearic acid , C18H36O2 or C18:0

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Saturated fatty acids are naturally produced in our body  When excess calories are consumed from carbohydrates, the surplus is used to synthesize fatty acids.  The main product of this ‘de novo fatty acid synthesis’ is palmitic acid.  The process is followed by desaturation and elongation reactions to produce a variety of fatty acids.4 Source: Tumenov et al. 2015

4. Tumanov et al. 2015

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Saturated fatty acids have important metabolic functions  Fats are needed for energy, hormone production, cellular membranes, organ padding and body insulation.  Vitamins A, D, E and K rely on fat for absorption and storage.  Certain saturated fatty acids are also needed for important signaling and stabilization processes in the body.5,6,7

5. Chamberlain et al. 2015; 6. Wedegaertner et al. 1998; 7. Beachamp et al. 2007

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Higher intakes of SAFA are not associated with increased risk of CVD when replacing macronutrients are not taken into account

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SAFA replacement by PUFA, but not CHO or MUFA, is related to lower coronary risk Meta analyses of prospective cohort studies using replacement modelling show that SAFA replacement by PUFA but not carbohydrates or MUFA, is related to lower coronary risk.

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Lowering SAFA intake, reduced the risk of combined cardiovascular events In randomised controlled trials lowering SAFA intake, reduced the risk of combined cardiovascular events by on average 17% (effect mainly resulted from replacement of SAFA

by PUFA).

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Dietary SAFA increase LDL-C and HDL-C compared to CHO and UFA Dietary SAFA increase low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) compared to carbohydrates and cisunsaturated fatty acids.

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Individual SAFA have different effects on serum lipids and lipoproteins Compared with carbohydrates, lauric (C12:0), myristic (C14:0), and palmitic acid (C16:0) differently increase LDL-C and HDL-C levels, while stearic acid (C18:0) does not affect these lipoproteins.

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There is no consistent evidence for adverse effects of SAFA on other CHD risk factors  Other markers for CHD risk, such as LDL particle size and several hemostatic, thrombotic, and inflammatory factors, lack a confirmed causal relationship to CHD risk.

Consistent evidence for specific effects of SAFA on any of these markers has not been reported.

8. Nettleton et al. 2017

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Food matrix and source of SAFA may be of importance for their health effects  In a meta-analysis of 5 randomized controlled trials, cheese compared with butter intake was associated with significant reductions in LDL-C and HDL-C.9  In the 10-year MESA study, a higher intake of meat-delivered SAFA was associated with greater CVD risk, whereas dairy SAFA was related to lower CVD risk.10

9. De Goede et al. 2015; 10. de Ol i veira Otto et al. 2012

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In summary (1)  Saturated fats are fats that tend to be solid at room temperature.  Saturated fatty acids naturally occur in all fat-containing foods and have important functional properties.  The most commonly consumed saturated fatty acids are palmitic and stearic acid.  Saturated fatty acids are naturally produced in our body and have important metabolic functions.  Higher intakes of SAFA are not associated with increased risk of CVD when replacing macronutrients are not taken into account.

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In summary (2)  SAFA replacement by PUFA, but not carbohydrates or MUFA, is related to lower coronary risk.  Lowering SAFA intake reduced the risk of combined cardiovascular events.  Dietary SAFA increase LDL-C and HDL-C compared to CHO and UFA.  Individual SAFA have different effects on serum lipids and lipoproteins.  There is no consistent evidence for adverse effects of SAFA on any other CHD risk factors.  Food matrix and source of SAFA may be of importance for their health effects.

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