Dietary fat intake and prevention of cardiovascular disease: systematic review.
OBJECTIVE
To assess the effect of reduction or modification of dietary fat intake on total and cardiovascular mortality and cardiovascular morbidity.


METHODS
Systematic review.


METHODS
Cochrane Library, Medline, Embase, CAB abstracts, SIGLE, CVRCT registry, and biographies were searched; trials known to experts were included.


METHODS
Randomised controlled trials stating intention to reduce or modify fat or cholesterol intake in healthy adult participants over at least six months. Inclusion decisions, validity, and data extraction were duplicated. Meta-analysis (random effects methodology), meta-regression, and funnel plots were performed.


RESULTS
27 studies (30 902 person years of observation) were included. Alteration of dietary fat intake had small effects on total mortality (rate ratio 0.98; 95% confidence interval 0.86 to 1.12). Cardiovascular mortality was reduced by 9% (0.91; 0.77 to 1.07) and cardiovascular events by 16% (0.84; 0.72 to 0.99), which was attenuated (0.86; 0.72 to 1.03) in a sensitivity analysis that excluded a trial using oily fish. Trials with at least two years' follow up provided stronger evidence of protection from cardiovascular events (0.76; 0.65 to 0.90).


CONCLUSIONS
There is a small but potentially important reduction in cardiovascular risk with reduction or modification of dietary fat intake, seen particularly in trials of longer duration.
Manchester Dental and Education Centre, University Dental Hospital of Manchester, Manchester M15 6FH, UK.
L
L
Hooper
C D
CD
Summerbell
J P
JP
Higgins
R L
RL
Thompson
N E
NE
Capps
G D
GD
Smith
R A
RA
Riemersma
S
S
Ebrahim
D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000401:mortality / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D004041:Dietary Fats / Q000008:administration & dosage*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D004041:Dietary Fats; D002784:Cholesterol