Dietary Fats and Chronic Noncommunicable Diseases

Abstract

The role of dietary fat has been long studied as a modifiable variable in the prevention and treatment of noncommunicable cardiometabolic disease. Once heavily promoted to the public, the low-fat diet has been demonstrated to be non-effective in preventing cardiometabolic disease, and an increasing body of literature has focused on the effects of a relatively higher-fat diet. More recent evidence suggests that a diet high in healthy fat, rich in unsaturated fatty acids, such as the Mediterranean dietary pattern, may, in fact, prevent the development of metabolic diseases such as type 2 diabetes mellitus, but also reduce cardiovascular events. This review will specifically focus on clinical trials which collected data on dietary fatty acid intake, and the association of these fatty acids over time with measured cardiometabolic health outcomes, specifically focusing on morbidity and mortality outcomes. We will also describe mechanistic studies investigating the role of dietary fatty acids on cardiovascular risk factors to describe the potential mechanisms of action through which unsaturated fatty acids may exert their beneficial effects. The state of current knowledge on the associations between dietary fatty acids and cardiometabolic morbidity and mortality outcomes will be summarized and directions for future work will be discussed.

Keywords: Mediterranean diet; cardiometabolic disease; low-fat diet; unsaturated fat.

Figure 1

Substitution of different fatty acids for carbohydrate in the Nurse’s Health Study (NHS) and Health Professional’s Follow Up Study (HPFS). Hazard ratios for total mortality by replacing carbohydrates with specific dietary fats. Used with permission from O’Keefe et al. [65].