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Am J Clin Nutr (January 13, 2010). doi:10.3945/ajcn.2009.27725
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© 2010 American Society for Clinical Nutrition

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease1,2,3,4,5

Patty W Siri-Tarino, Qi Sun, Frank B Hu and Ronald M Krauss

1 From the Children's Hospital Oakland Research Institute Oakland CA (PWS-TRMK)the Departments of Nutrition (QSFBH)Epidemiology (FBH) Harvard School of Public Health Boston MA.

2 PWS-T and QS contributed equally to this work.

3 The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of the National Center for Research Resources (http://www.ncrr.nih.gov) or the National Institutes of Health.

4 Supported by the National Dairy Council (PWS-T and RMK) and made possible by grant UL1 RR024131-01 from the National Center for Research Resources, a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research (PWS-T and RMK). QS was supported by a Postdoctoral Fellowship from Unilever Corporate Research. FBH was supported by NIH grant HL60712.

5 Address correspondence to RM Krauss, Children's Hospital Oakland Research Institute, 5700 Martin Luther King Junior Way, Oakland, CA 94609. E-mail: rkrauss{at}chori.org.

ABSTRACT

Background: A reduction in dietary saturated fat has generally been thought to improve cardiovascular health.

Objective: The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) in prospective epidemiologic studies.

Design: Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD.

Results: During 5–23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results.

Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

Received for publication March 6, 2009. Accepted for publication November 25, 2009.




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