Reduced or modified dietary fat for prevention of cardiovascular disease
Hooper L, Summerbell CD, Higgins JP, Thompson RL, Clements G, Capps N, Davey Smith G, Riemersma RA, Ebrahim S
The Cochrane database of systematic reviews · 24 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2000-04-24 · Cochrane Database Syst Rev · número 2 · pág. CD002137
- Editorial
- Elsevier BV
- Citado
- 112 citas
- Referencias
- 436 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Nutritional Studies and Diet · Fatty Acid Research and Health · Lipoproteins and Cardiovascular Health
- Palabras clave
- dietary fat reduction, saturated fat, unsaturated fat, cardiovascular disease prevention, cardiovascular mortality, all-cause mortality, cardiovascular morbidity, cholesterol intake, cardiovascular risk factors, lifestyle intervention, statins, trial duration, vulnerable populations, low-risk population, meta-regression, funnel plot, heterogeneous effects, publication bias
- MeSH
- humans, cardiovascular diseases, dietary fats, diet, fat-restricted, risk factors
9 autores
- Lee Hooper🇬🇧University of East Anglia; University Dental Hospital of Manchester
- Carolyn Summerbell🇬🇧Teesside University
- Julian P. T. Higgins🇬🇧MRC Biostatistics Unit
- Rachel L Thompson🇬🇧Southampton General Hospital
- Gillian Clements🇬🇧Royal Shrewsbury Hospital
- Nigel E. Capps🇬🇧Princess Royal Hospital
- George Davey Smith🇬🇧University of Bristol
- Rudolph Arend Riemersma🇬🇧University of Edinburgh
- Shah B J Ebrahim🇬🇧London School of Hygiene & Tropical Medicine
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Reduction or modification of dietary fat can improve total cholesterol levels, but may also have a variety of effects, both positive and negative, on other cardiovascular risk factors.
Objectives
The aim of this systematic review was to assess the effect of reduction or modification of dietary fats on total and cardiovascular mortality and cardiovascular morbidity over at least 6 months, using all available randomized clinical trials.
Search strategy
The Cochrane Library, MEDLINE, EMBASE, CAB Abstracts, CVRCT registry and related Cochrane Groups' trial registers were searched through spring 1998, SIGLE to January 1999. Trials known to experts in the field and biographies were included through May 1999.
Selection criteria
Trials fulfilled the following criteria: 1) randomized with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) healthy adult humans, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Inclusion decisions were duplicated, disagreement resolved by discussion or a third party.
Data collection and analysis
Rate data were extracted by two independent reviewers and meta-analysis performed using random effects methodology. Meta-regression and funnel plots were used.
Main results
Twenty seven studies were included (40 intervention arms, 30,901 person-years). There was no significant effect on total mortality (rate ratio 0.98, 95% CI 0.86 to 1.12), a trend towards protection form cardiovascular mortality (rate ratio 0.91, 95% CI 0. 77 to 1.07), and significant protection from cardiovascular events (rate ratio 0.84, 95% CI 0.72 to 0.99). The latter became non-significant on sensitivity analysis. Trials where participants were involved for more than 2 years showed significant reductions in the rate of cardiovascular events and a suggestion of protection from total mortality. The degree of protection from cardiovascular events appeared similar in high and low risk groups, but was statistically significant only in the former.
Reviewer's conclusions
The findings are suggestive of a small but potentially important reduction in cardiovascular risk in trials longer than two years. Lifestyle advice to all those at high risk of cardiovascular disease (especially where statins are unavailable or rationed), and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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