Effect of Interventions Aimed at Reducing or Modifying Saturated Fat Intake on Cholesterol, Mortality, and Major Cardiovascular Events : A Risk Stratified Systematic Review of Randomized Trials
Steen JP, Klatt KC, Chang Y, Guyatt GH, Zhu H, Swierz MJ, Storman D, Sun M, Zhao Y, Ge L, Thabane L, Ghosh NR, Karam G, Alonso-Coello P, Bala MM, Johnston BC
Annals of internal medicine · 5 citas
Etiquetas de revisión
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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
- 2025-12-15 · Ann Intern Med · vol. 179 · número 2 · págs. 242–255
- Editorial
- American College of Physicians
- Citado
- 9 citas · más que el 98% de estudios similares · 7.5× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 56 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · CC-BY-NC-ND
- Áreas de investigación
- Nutritional Studies and Diet · Fatty Acid Research and Health · Lipoproteins and Cardiovascular Health
- Palabras clave
- saturated fat intake, dietary fat reduction, cholesterol, cardiovascular mortality, major cardiovascular events, myocardial infarction, monounsaturated fatty acids, dietary intervention, cardiovascular risk
- MeSH
- humans, cardiovascular diseases, myocardial infarction, cholesterol, dietary fats, fatty acids, diet, fat-restricted, randomized controlled trials as topic
16 autores
- Jeremy P. Steen🇨🇦University of Toronto
- Kevin C. Klatt🇨🇦🇺🇸University of Toronto; University of California, Berkeley
- Yaping Chang🇨🇦McMaster University
- Gordon Henry Guyatt🇨🇦McMaster University
- Hongfei Zhu🇨🇳Fudan University
- Mateusz Jan Świerz🇵🇱Jagiellonian University
- Dawid Storman🇵🇱Jagiellonian University
- Mingyao Sun🇨🇳Peking University
- Yunli Zhao🇨🇳Second Affiliated Hospital of Chongqing Medical University
- Long Ge🇨🇳Lanzhou University
- Lehana Thabane🇿🇦🇨🇦University of Johannesburg; St. Joseph’s Healthcare Hamilton; McMaster University
- Nirjhar Ghosh🇺🇸Texas A&M University
- Giorgio Karam🇨🇦University of Manitoba
- Pablo Alonso‐Coello🇪🇸Hospital de Sant Pau; Centro de Investigación Biomédica en Red; Iberoamerican Cochrane Centre; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública; Institut de Recerca Sant Pau
- Małgorzata Maria Bała🇵🇱Jagiellonian University
- Bradley C. Johnston🇺🇸Texas A&M University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Debates about optimal saturated fat advice continue.
Purpose
To systematically summarize randomized trial data on reducing or modifying saturated fat intake on cholesterol, mortality, and major cardiovascular events.
Data sources
MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to July 2025.
Study selection
Eligible trials enrolled adults with or without cardiovascular disease and studied the effect of reducing or modifying saturated fat intake.
Data extraction
Standard Cochrane methods.
Data synthesis
There were 17 eligible trials (66 337 participants). Risk stratified evidence provides low to moderate certainty that reducing saturated fat intake may result in a reduction in all-cause mortality (risk ratio [RR], 0.96 [95% CI, 0.88 to 1.06]), cardiovascular mortality (RR, 0.93 [CI, 0.77 to 1.11]), nonfatal myocardial infarction (MI) (RR, 0.86 [CI, 0.70 to 1.06]), and fatal and nonfatal stroke (RR, 0.83 [CI, 0.58 to 1.19]). For persons at low baseline cardiovascular risk, absolute reductions were below our thresholds of importance (5 and 10 per 1000 persons followed over 5 years for fatal and nonfatal outcomes, respectively); for those at high risk, the benefits were above our thresholds, suggesting there may be important absolute reductions. The effects were more pronounced when replacing saturated fat with polyunsaturated fat for nonfatal MI (RR, 0.75 [CI, 0.58 to 0.99]; P for interaction = 0.05; moderate credibility of subgroup effect based on Instrument to assess the Credibility of Effect Modification Analyses assessments).
Limitations
Data were limited on the replacement of saturated fat with monounsaturated fat or protein. Trials varied considerably in their efficacy in reducing saturated fat intake and in their replacement macronutrients and concomitant dietary interventions, and new trials are needed to clarify uncertainty.
Conclusion
For persons at low cardiovascular risk, reducing or modifying saturated fat intake has little or no benefit over a period of 5 years. Among persons at high cardiovascular risk, low- to moderate-certainty evidence was found for important reductions in mortality and major cardiovascular events, particularly for MI, with respect to replacing saturated fat with polyunsaturated fat.
Primary funding source
None. (PROSPERO: CRD42023387377).
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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