ISSFAL 2014 Debate: It Is Time to Update Saturated Fat Recommendations

This paper summarizes a debate on whether to update recommendations for the consumption of saturated fatty acids (SFA); this debate was held at the 11th congress of the International Society for the Study of Fatty Acids and Lipids in Stockholm, Sweden, June 28-July 2, 2014. Recommendations to reduce SFA intakes are based largely on the premise that high intakes of SFA raise low-density lipoprotein (LDL)-cholesterol levels, which in turn increase the risk of coronary heart disease (CHD). Several systematic reviews question whether reducing SFA intakes lowers CHD risk. Arguing to revise SFA recommendations, Philippe Legrand noted that SFA are heterogeneous in structure and function, are synthesized de novo by humans and only certain SFA in excess have been linked to CHD risk. We cannot consider all SFA as a block. The effects of reducing SFA intakes depend on which nutrients replace them and on which biomarkers or endpoints are assessed, Ronald Mensink observed. The effects of reducing SFA on CHD risk vary with the nutrient of comparison, whether carbohydrates, monounsaturated or polyunsaturated fatty acids. Substitution of SFA with polyunsaturated fatty acids was associated with a lower incidence of cardiovascular disease, while the effects of substitution with monounsaturated fatty acids or high-glycemic index carbohydrates are less clear.