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Guidelines that limit dietary fat intake and encourage carbohydrate intake could be increasing the risk of overall mortality.
Findings presented at the European Society of Cardiology call current dietary guidelines into question. While it is generally recommended that patients avoid certain foods to limit fat intake, researchers have found that consumption of fats may lower total mortality and non-cardiovascular mortality.
“Our findings do not support the current recommendation to limit total fat intake to less than 30% of energy and saturated fat intake to less than 10% of energy,” said investigator Mahshid Dehghan, PhD.
In contrast, a diet rich in carbohydrates may lead to a higher risk of mortality and cardiovascular-related mortality, according to the study.
“Limiting total fat consumption is unlikely to improve health in populations, and a total fat intake of about 35% of energy with concomitant lowering of carbohydrate intake may lower risk of total mortality,” Dr Dehghan said. “In fact, individuals with high carbohydrate intake, above 60% of energy, may benefit from a reduction in carbohydrate intake and increase in the consumption of fats.”
Included in the study were 135,335 patients, aged 35 to 70 years, from 18 countries of varying income levels. The authors collected data related to carbohydrate, total fat, and fat consumption from validated food frequency questionnaires to determine mortality risks.
The researchers found that there were 5796 deaths and 4784 major cardiovascular events during the follow-up period.
Interestingly, the highest carbohydrate intake was linked to a 28% increased risk of total mortality compared with the lowest intake, according to the study. However, high carbohydrate intake was not associated with heart disease risk.
A high total fat intake was found to reduce total mortality risk by 23% and reduce the risk of stroke by 18%. Additionally, high fat intake was linked to a 30% reduced risk of non-cardiovascular death.
Although current dietary recommendations advise against consuming saturated fat, the authors found that it reduced mortality by 14%, while monounsaturated and polyunsaturated fats reduced the risk by 19% and 20%, respectively, according to the study.
Interestingly, high intake of saturated fats also reduced stroke risk by 21%.
The authors found that both LDL and HDL cholesterol increased with higher consumption of saturated fat, a net decrease in total cholesterol/HDL ratio, according to the study.
LDL cholesterol may also not be a reliable factor for predicting how saturated fat was impact cardiovascular events. The authors note that ApoB/ApoA1 may be a better indicator, according to the study.
“Focusing on a single lipid marker such as LDL-C alone does not capture the net clinical impact of nutrients on cardiovascular risk,” Dr Dehghan said.
These results suggest that current dietary guidelines should be revisited to ensure that individuals are consuming the right foods to prevent cardiovascular disease (CVD).
“For decades, dietary guidelines have focused on reducing total fat and saturated fatty acid (SFA) intake based on the presumption that replacing SFA with carbohydrate and unsaturated fats will lower LDL-C and should therefore reduce CVD events.”