The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials
Hamley S
Nutrition journal · 88 citas
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
- Financiación independiente
- Universidad u hospital
- Deakin University
Según 1 financiador declarado y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2017-05-19 · Nutr J · vol. 16 · número 1 · pág. 30
- Editorial
- BioMed Central
- Citado
- 126 citas · más que el 94% de estudios similares · 1.5× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 89 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
- saturated fat, omega-6 fatty acids, coronary artery disease, fat replacement, coronary heart disease mortality, all-cause mortality, major coronary events, dietary recommendations, omega-3 fatty acids, cardiovascular risk reduction, dietary fat composition, n-6/n-3 ratio
- MeSH
- humans, coronary disease, cholesterol, dietary fats, fatty acids, fatty acids, omega-6, diet, risk factors, randomized controlled trials as topic, observational studies as topic
1 autor
- Steven Hamley🇦🇺 · autor de correspondenciaDeakin University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
A cornerstone of conventional dietary advice is the recommendation to replace saturated fatty acids (SFA) with mostly n-6 polyunsaturated fatty acids (PUFA) to reduce the risk of coronary heart disease (CHD). Many clinical trials aimed to test this advice and have had their results pooled in several meta-analyses. However, earlier meta-analyses did not sufficiently account for major confounding variables that were present in some of those trials. Therefore, the aim of the study was to account for the major confounding variables in the diet heart trials, and emphasise the results from those trials that most accurately test the effect of replacing SFA with mostly n-6 PUFA.
Design
Clinical trials were identified from earlier meta-analyses. Relevant trials were categorised as 'adequately controlled' or 'inadequately controlled' depending on whether there were substantial dietary or non-dietary differences between the experimental and control groups that were not related to SFA or mostly n-6 PUFA intake, then were subject to different subgroup analyses.
Results
When pooling results from only the adequately controlled trials there was no effect for major CHD events (RR = 1.06, CI = 0.86-1.31), total CHD events (RR = 1.02, CI = 0.84-1.23), CHD mortality (RR = 1.13, CI = 0.91-1.40) and total mortality (RR = 1.07, CI = 0.90-1.26). Whereas, the pooled results from all trials, including the inadequately controlled trials, suggested that replacing SFA with mostly n-6 PUFA would significantly reduce the risk of total CHD events (RR = 0.80, CI = 0.65-0.98, P = 0.03), but not major CHD events (RR = 0.87, CI = 0.70-1.07), CHD mortality (RR = 0.90, CI = 0.70-1.17) and total mortality (RR = 1.00, CI = 0.90-1.10).
Conclusion
Available evidence from adequately controlled randomised controlled trials suggest replacing SFA with mostly n-6 PUFA is unlikely to reduce CHD events, CHD mortality or total mortality. The suggestion of benefits reported in earlier meta-analyses is due to the inclusion of inadequately controlled trials. These findings have implications for current dietary recommendations.
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