Reassessing the Effects of Dietary Fat on Cardiovascular Disease in China: A Review of the Last Three Decades

Abstract

Cardiovascular disease (CVD) is a leading cause of global mortality, and is considered one of diseases with the most rapid growth rate in China. Numerous studies have indicated a closed relationship between an increased incidence of CVD and dietary factors. Dietary fat is one of the three primary nutrients of consumption; however, high fat dietary in causing CVD has been neglected in some official dietary guidelines. Our present review has analyzed the relationship between dietary fat consumption and CVD in China over the past 30 years (from 1990 to 2019). There is a significant correlation between CVD incidence and mortality for consumption of both vegetable oils and animal fats, per capita consumption, and the relative weight of dietary fat exceeding that of other food ingredients (e.g., salt, fruit, and marine food). For fatty acid species, the proportion of ω6 fatty acid consumption increased, causing a significant increase in the ratios of ω6/ω3 fatty acids, whereas the proportion of monounsaturated fatty acid consumption decreased. Such changes have been considered a characteristic of dietary fat consumption in Chinese residents over the past 30 years, and are closely related to the incidence of CVD. Therefore, we suggest that the government should spread awareness regarding the consumption of dietary fat intake to prevent CVD and related health disorders. The public should be educated to avoid high fat diet and increase the intake of monounsaturated fatty acids and ω3 fatty acids.

Keywords: atherosclerosis; cardiovascular diseases; fatty acids; high fat diet; risk factors.

Figure 1

Mortality rate of major diseases in China from 1990 to 2019 [2].

Figure 2

Migration of consumption of vegetable oil (a) and animal fat (b) in China (1990 to 2019) [14,15].

Figure 3

Energy supply ratio of the 3 major nutrients and total energy intake for Chinese residents from 1992 to 2017 [8].

Figure 4

The relationship between per capita dietary fat consumption and cardiovascular diseases in China from 1990 to 2019. (a,b) the linear relationship between per capita vegetable oil (a) and animal fat (b) consumption and cardiovascular diseases by Pearson test. (c,d) the importance ranking based on random forest influencing factors of cardiovascular diseases incidence (c) and mortality (d).

Figure 5

Potential mechanism of high-fat diet-induced cardiovascular diseases. CVD, cardiovascular diseases; TG, triglyceride; TC, total cholesterol; LDL, low-density lipoprotein cholesterol; HDL, high-density lipoprotein cholesterol.

Figure 6

Fatty acid consumption pattern of vegetable oil (a) and animal fat (b) in China (1990 to 2019). Fatty acid composition calculations by standard food composition tables [82]. SFA, saturated fatty acids; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid.

Figure 7

Metabolism of SFA, MUFA, ω6 and ω3 fatty acid link to CVD. SFA, saturated fatty acids; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid; ARA, arachidonic acid; EPA, eicosapentaenoic acid; TC, total cholesterol; LDL, low-density lipoprotein cholesterol; HDL, high-density lipoprotein cholesterol.