food sources of saturated fat and risk of heart disease

Food Sources of Saturated Fat and Risk of Heart Disease

Dariush Mozaffarian, MD DrPH

Division of Cardiovascular Medicine, BWH/HMSDepartment of Epidemiology, HSPH

Saturated or Not: Does Type of Fat Matter?Harvard School of Public Health

April 25, 2014

Meta-analysis of 60 feeding RCTs. Mensink & Katan, AJCN 2003

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Dietary Fats & Blood Lipids

PUFA

MUFA

SFA

PUFA

MUFASFA

PUFA

MUFA

SFA

PUFA

MUFA

SFA

No Δ ApoB

Chowdury et al, Annals Intern Med 2014

Dietary Fats & CHD Events

Saturated Fat & CHD Events

Siri-Tarino et al, AJCN 2010

No Significant Association

16 prospectivecohort studies from

around the world

RR comparing extreme categories (highest vs. lowest)

of saturated fat intake

Food Sources of Saturated Fat in the US

Based on NHANES 2005-06. From USDA Dietary Guidelines 2010

Micha et al., Circulation 2010

Food Sources: Meats & CHD

Unprocessed Red Meat (100 g/d)

RR = 1.00(0.81, 1.23)

Processed Meat (50 g/d)

RR = 1.42(1.07, 1.89)

Food Sources: Meats & CVD Mortality

Total Red Meat

RR = 1.09(0.93, 1.27)

Processed Meat

RR = 1.17(1.02, 1.33)

O’Sullivan et al., Am J Public Health 2013

Food Sources: Meats & CVD Mortality

Total Red Meat (100 g/d)

RR = 1.09(1.00, 1.18)

Processed Meat (100 g/d)

RR = 1.69(1.37, 2.10)

Rohrmann et al., BMC Medicine 2013

Among 448,568 European men and women (EPIC),

including 5,556 CVD deaths

Food Sources: Dairy & CVD Mortality

MilkRR = 0.96(0.81, 1.13)

CheeseRR = 1.00(0.81, 1.24)

O’Sullivan et al., Am J Public Health 2013

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Milk Yogurt Cheese

P-trend=0.50

Adjusted for age, sex, center, education, smoking, physical activity, alcohol intake, and consumption offruits, vegetables, red meat, processed meat, sugar sweetened beverages, coffee, cereals, and cerearl products.

Quintiles of Consumption

Dairy Foods & Diabetes

Sluijis et al., AJCN 2012

Among 340,234 Europeans from 8 countries, with 12,403 cases of incident diabetes

P-trend=0.06 P-trend=0.01RR of

Diabetes

Estruch et al. NEJM 2013

Healthy Diet Patterns & CVD Events

HR = 0.70 (0.55, 0.89)

Randomized controlled trial among 7447 Spanish adults at higher risk

No change in saturated fat.

Global Disease Burdens Due to Major Risk Factors in 2010

Lim et al, Lancet 2012

Diet high in SFA & low in PUFA0.47

Healthy Food Replacements

Healthy Food Replacements

Healthy Food Replacements

Prioritizing Fat or Saturated Fat: Useful ?

Preventing Chronic Diseases: Food Patterns

EAT:

• Seafood

• Fruits

• Nuts

• Vegetables

• Vegetable Oils

• Whole grains

• Yogurt

Essential Dietary Habits for Health

LIMIT:

• Starches, refined grains, sugars

• Processed Meats

• Sweetened Drinks

• Industrial Trans Fat *

• Salt *

Mozaffarian, Appel, & Van Horn. Circulation 2011

Also: Don’t smoke, turn off the TV, get enough sleep, and be physically active.