Dietary fatty acids and cardiovascular disease: an epidemiological approach.
The quality of dietary fat in relation to cardiovascular disease forms the basis of the diet-heart hypothesis. Current recommendations on dietary fat now emphasise quality rather than quantity. The focus of this review is to summarise the results from prospective cohort studies on dietary fat and cardiovascular disease outcomes. Relatively few prospective cohort studies have found an association between dietary fat quality and cardiovascular disease, partly because of limitations in estimating dietary intake. Saturated and trans fatty acids have increased cardiovascular risk in several studies. Both n-6 and n-3 polyunsaturated fatty acids have been associated with lower cardiovascular risk. Within the n-6 series, linoleic acid seems to decrease cardiovascular risk. Within the n-3 series the long-chain fatty acids (eicosapentaenoic and docosahexaenoic acids) are associated with decreased risk for especially fatal coronary outcomes, whereas the role of alpha-linolenic acid is less clear. Dietary fat quality also influences the activity of enzymes involved in the desaturation of fatty acids in the body. Serum desaturase indices have been consistently associated with adverse cardiovascular outcomes. Data from metabolic and clinical studies reinforce findings from observational studies supporting recommendations to replace saturated and trans fat with unsaturated fat in the prevention of cardiovascular disease.
Erkkilä
Arja
A
Department of Public Health, School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland.
de Mello
Vanessa D F
VD
Risérus
Ulf
U
Laaksonen
David E
DE
D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage / Q000009:adverse effects; D044943:Fatty Acid Desaturases / Q000097:blood; D005227:Fatty Acids / Q000008:administration & dosage / Q000009:adverse effects; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D044242:Trans Fatty Acids / Q000008:administration & dosage / Q000009:adverse effects
D015415:Biomarkers; D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D044242:Trans Fatty Acids; D044943:Fatty Acid Desaturases