Financiado en parte por GlaxoSmithKline
Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials
Mozaffarian D, Micha R, Wallace S
PLoS medicine · 741 citas
Etiquetas de revisión
Vínculos de autores con la industriaFinanciado por la industriaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiado por la industria
- Organización sin fines de lucro
- Bill and Melinda Gates Foundation
- Organización sin fines de lucro
- Chicago Community Trust
- Empresa
- GlaxoSmithKline
- Gobierno
- World Health Organization
- Gobierno
- National Institutes of Health
- Gobierno
- U.S. Food and Drug Administration
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- NHLBI NIH HHS
- Autores
- Al menos un autor declara un vínculo económico con la industria
- Subvenciones
- National Heart, Lung, and Blood Institute (R01 HL 085710-01); National Heart, Lung, and Blood Institute (R01 HL085710); National Institutes of Health (R01-HL-085710)
Según 8 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2010-03-22 · PLoS Med · vol. 7 · número 3 · pág. e1000252
- Editorial
- Public Library of Science
- Citado
- 1,218 citas · más que el 100% de estudios similares · 11.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 49 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Fatty Acid Research and Health · Nutritional Studies and Diet · Lipoproteins and Cardiovascular Health
- Palabras clave
- polyunsaturated fatty acids, saturated fat replacement, coronary artery disease, myocardial infarction, cardiovascular mortality, dietary fat, cardiovascular risk reduction, study duration, meta-regression, dietary intervention trials, omega-3 fatty acids, omega-6 fatty acids, dietary guidelines, publication bias
- MeSH
- humans, coronary disease, dietary fats, fatty acids, fatty acids, unsaturated, feeding behavior, meta-analysis as topic, randomized controlled trials as topic
3 autores
- Dariush Mozaffarian🇺🇸 · autor de correspondenciaBrigham and Women's Hospital; Harvard University
- Renata Micha🇺🇸Harvard University
- Sarah K. Wallace🇺🇸Harvard University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Reduced saturated fat (SFA) consumption is recommended to reduce coronary heart disease (CHD), but there is an absence of strong supporting evidence from randomized controlled trials (RCTs) of clinical CHD events and few guidelines focus on any specific replacement nutrient. Additionally, some public health groups recommend lowering or limiting polyunsaturated fat (PUFA) consumption, a major potential replacement for SFA.
Methods and findings
We systematically investigated and quantified the effects of increased PUFA consumption, as a replacement for SFA, on CHD endpoints in RCTs. RCTs were identified by systematic searches of multiple online databases through June 2009, grey literature sources, hand-searching related articles and citations, and direct contacts with experts to identify potentially unpublished trials. Studies were included if they randomized participants to increased PUFA for at least 1 year without major concomitant interventions, had an appropriate control group, and reported incidence of CHD (myocardial infarction and/or cardiac death). Inclusions/exclusions were adjudicated and data were extracted independently and in duplicate by two investigators and included population characteristics, control and intervention diets, follow-up duration, types of events, risk ratios, and SEs. Pooled effects were calculated using inverse-variance-weighted random effects meta-analysis. From 346 identified abstracts, eight trials met inclusion criteria, totaling 13,614 participants with 1,042 CHD events. Average weighted PUFA consumption was 14.9% energy (range 8.0%-20.7%) in intervention groups versus 5.0% energy (range 4.0%-6.4%) in controls. The overall pooled risk reduction was 19% (RR = 0.81, 95% confidence interval [CI] 0.70-0.95, p = 0.008), corresponding to 10% reduced CHD risk (RR = 0.90, 95% CI = 0.83-0.97) for each 5% energy of increased PUFA, without evidence for statistical heterogeneity (Q-statistic p = 0.13; I(2) = 37%). Meta-regression identified study duration as an independent determinant of risk reduction (p = 0.017), with studies of longer duration showing greater benefits.
Conclusions
These findings provide evidence that consuming PUFA in place of SFA reduces CHD events in RCTs. This suggests that rather than trying to lower PUFA consumption, a shift toward greater population PUFA consumption in place of SFA would significantly reduce rates of CHD. Please see later in the article for the Editors' Summary.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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