Should We Stop Blaming Saturated Fats for Causing Coronary Heart Disease? A Systematic Review of Prospective Cohort Studies

BACKGROUND: Coronary heart disease (CHD) is a leading cause of death worldwide. Saturated fats were known as a risk factor for CHD and dietary guidelines restrict the daily consumption of SFs. However, the association between SFs and higher risk of CHD is not clear. This systematic review includes 14 high-quality prospective cohort studies which reported the association between CHD and SFs.

OBJECTIVE: This systematic review aims to examine the association between SFs intake and higher risk of CHD among prospective cohort studies.

DESIGN: A systematic review was conducted for published literaure in Scopus and ProQuest during the period 2000 to 2017. Studies included if they have a prospective cohort design with follow-up more than 4 years, published in English, and provide information about the association of interest. Data were extracted and summarised into three tables.

RESULTS: A total number of 14 prospective cohort studies were included in this review in which all from developed countries and half of them were from the USA. The total number of participants ranging from 501 to 344,696 in follow-up period from 4.8 to 30 years where 26,322 events of CHD and 629 CHD deaths were reported. The highest positive association HR (95%CI) was 5.17 (1.64-16.36) for CHD mortality and 1.36 (0.98-1.88) for CHD incidence. In contrast, the highest inverse association was found 0.73 (0.53-1.01) for CHD mortality and 0.62 (0.35-1.11) for CHD incidence.

CONCLUSION: This systematic review suggests that SFs intake was not associated with higher incidence or mortality of CHD.