Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?

Arne Astrup¹, Nina Teicholz², Faidon Magkos³, Dennis M Bier⁴, J Thomas Brenna^{5

6

7}, Janet C King⁸, Andrew Mente^{9

10}, José M Ordovas^{11

12}, Jeff S Volek¹³, Salim Yusuf^{9

14}, Ronald M Krauss^{15

16}

Affiliations

¹ Healthy Weight Center, Novo Nordisk Foundation, Tuborg Havnevej 19, 2900 Hellerup, Denmark.
² The Nutrition Coalition, New York, NY 10011, USA.
³ Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark.
⁴ Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
⁵ Department of Pediatrics, Dell Pediatric Research Institute, University of Texas at Austin, Austin, TX 78723, USA.
⁶ Department of Chemistry, Dell Pediatric Research Institute, University of Texas at Austin, Austin, TX 78723, USA.
⁷ Department of Nutrition, Dell Pediatric Research Institute, University of Texas at Austin, Austin, TX 78723, USA.
⁸ Department of Nutritional Sciences and Toxicology, University of California-Berkeley, Berkeley, CA 94720, USA.
⁹ Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON L8L 2X2, Canada.
¹⁰ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹¹ Nutrition and Genomics Laboratory, Human Nutrition Research Center of Aging, Tufts University, Boston, MA 02111, USA.
¹² IMDEA Food Institute, 28049 Madrid, Spain.
¹³ Department of Human Sciences, Ohio State University, Columbus, OH 43210, USA.
¹⁴ Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹⁵ Department of Pediatrics, University of California-San Francisco, San Francisco, CA 94609, USA.
¹⁶ Department of Medicine, University of California-San Francisco, San Francisco, CA 94609, USA.

PMID: 34684304
PMCID: PMC8541481
DOI: 10.3390/nu13103305

Review

Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?

Arne Astrup et al. Nutrients. 2021.

. 2021 Sep 22;13(10):3305.

doi: 10.3390/nu13103305.

Authors

Affiliations

¹ Healthy Weight Center, Novo Nordisk Foundation, Tuborg Havnevej 19, 2900 Hellerup, Denmark.
² The Nutrition Coalition, New York, NY 10011, USA.
³ Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark.
⁴ Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
⁵ Department of Pediatrics, Dell Pediatric Research Institute, University of Texas at Austin, Austin, TX 78723, USA.
⁶ Department of Chemistry, Dell Pediatric Research Institute, University of Texas at Austin, Austin, TX 78723, USA.
⁷ Department of Nutrition, Dell Pediatric Research Institute, University of Texas at Austin, Austin, TX 78723, USA.
⁸ Department of Nutritional Sciences and Toxicology, University of California-Berkeley, Berkeley, CA 94720, USA.
⁹ Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON L8L 2X2, Canada.
¹⁰ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹¹ Nutrition and Genomics Laboratory, Human Nutrition Research Center of Aging, Tufts University, Boston, MA 02111, USA.
¹² IMDEA Food Institute, 28049 Madrid, Spain.
¹³ Department of Human Sciences, Ohio State University, Columbus, OH 43210, USA.
¹⁴ Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹⁵ Department of Pediatrics, University of California-San Francisco, San Francisco, CA 94609, USA.
¹⁶ Department of Medicine, University of California-San Francisco, San Francisco, CA 94609, USA.

PMID: 34684304
PMCID: PMC8541481
DOI: 10.3390/nu13103305

Abstract

The last decade has seen nearly 20 papers reviewing the totality of the data on saturated fats and cardiovascular outcomes, which, altogether, have demonstrated a lack of rigorous evidence to support continued recommendations either to limit the consumption of saturated fatty acids or to replace them with polyunsaturated fatty acids. These papers were unfortunately not considered by the process leading to the most recent U.S. Dietary Guidelines for Americans, the country's national nutrition policy, which recently reconfirmed its recommendation to limit saturated fats to 10% or less of total energy intake, based on insufficient and inconsistent evidence. Continuation of a cap on saturated fat intake also fails to consider the important effects of the food matrix and the overall dietary pattern in which saturated fatty acids are consumed.

Keywords: Dietary Guidelines for Americans; cardiovascular disease; dietary guidelines; evidence-based; heart disease; nutrition guidelines; polyunsaturated fats; saturated fats.

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Conflict of interest statement

F.M., J.K., A.M., J.O. and S.Y. declare no conflicts of interest. A.A. is currently employed as project director at the Novo Nordisk Foundation to develop a National Center for Healthy Weight, and also reports advisory board memberships in Groupe Éthique et Santé, France; personal fees from Weight Watchers, USA; personal fees and other from Gelesis, USA; outside the submitted work. In addition, A.A. has a patent Methods of inducing weight loss, treating obesity and preventing weight gain pending owned by University of Copenhagen and Gelesis, USA. A.A. is co-owner and member of the board of the consultancy company Dentacom Aps, Denmark, 2005 Flaxslim ApS (also member of board, 2015-); co-founder and co-owner of Personalised Weight Management Research Consortium ApS (Gluco-diet.dk, 2017-). N.T. receives royalty payments for a book on saturated fats. D.B. has received consultant and/or lecture fees and/or reimbursements for travel, hotel and other expenses from the International Life Sciences Institute; the International Council on Amino Acid Science; Nutrition and Growth Solutions, Inc.; Ajinomoto, Co.; the Lorenzini Foundation; the Nutrition Coalition, the CrossFit Foundation; the International Glutamate Technical Committee; Nestlé S.A.; Ferrero SpA; Indiana University; the National Institutes of Health; Mallinckrodt Pharmaceuticals; the Infant Nutrition Council of America; and the Israel Institute. J.T.B. has received honorarium for symposium participation from the National Cattleman’s Beef Association and honoraria from Danone, S.A. for expert panel and symposia participation. J.V. receives royalties for low-carbohydrate nutrition books, is co-founder and has equity in Virta Health Corp., and is scientific advisor to Simply Good Foods. R.K. is a scientific advisor to Virta Health Corp., Day Two, and Seraphina Therapeutics, and receives a royalty for the book “Nutrition and Cardiometabolic Health”.

References

1. U.S. Department of Agriculture. U.S. Department of Health and Human Services . Dietary Guidelines for Americans. 3rd ed. U.S. Department of Health and Human Services; Washington, DC, USA: 1990. [(accessed on 30 June 2021)]. Available online: https://health.gov/our-work/food-nutrition/previous-dietary-guidelines/1990.
1. U.S. Department of Agriculture. U.S. Department of Health and Human Services . Dietary Guidelines for Americans, 2020–2025. 9th ed. U.S. Department of Health and Human Services; Washington, DC, USA: 2020. [(accessed on 30 June 2021)]. Available online: https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines....
1. U.S. Congress . National Nutrition Monitoring and Related Research Act of 1990. U.S. Congress; Washington, DC, USA: 1990.
1. Keys A. Coronary Heart Disease in Seven Countries. Circulation. 1970;3:1–211. doi: 10.1016/S0899-9007(96)00410-8. - DOI - PubMed
1. Teicholz N. The Big Fat Surprise. Simon & Schuster; New York, NY, USA: 2014. pp. 36–42.

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Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?

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Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?

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Conflict of interest statement

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