Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis
- PMID: 24723079
- DOI: 10.7326/M13-1788
Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis
Erratum in
- Ann Intern Med. 2014 May 6;160(9):658
Abstract
Background: Guidelines advocate changes in fatty acid consumption to promote cardiovascular health.
Purpose: To summarize evidence about associations between fatty acids and coronary disease.
Data sources: MEDLINE, Science Citation Index, and Cochrane Central Register of Controlled Trials through July 2013.
Study selection: Prospective, observational studies and randomized, controlled trials.
Data extraction: Investigators extracted data about study characteristics and assessed study biases.
Data synthesis: There were 32 observational studies (530,525 participants) of fatty acids from dietary intake; 17 observational studies (25,721 participants) of fatty acid biomarkers; and 27 randomized, controlled trials (103,052 participants) of fatty acid supplementation. In observational studies, relative risks for coronary disease were 1.02 (95% CI, 0.97 to 1.07) for saturated, 0.99 (CI, 0.89 to 1.09) for monounsaturated, 0.93 (CI, 0.84 to 1.02) for long-chain ω-3 polyunsaturated, 1.01 (CI, 0.96 to 1.07) for ω-6 polyunsaturated, and 1.16 (CI, 1.06 to 1.27) for trans fatty acids when the top and bottom thirds of baseline dietary fatty acid intake were compared. Corresponding estimates for circulating fatty acids were 1.06 (CI, 0.86 to 1.30), 1.06 (CI, 0.97 to 1.17), 0.84 (CI, 0.63 to 1.11), 0.94 (CI, 0.84 to 1.06), and 1.05 (CI, 0.76 to 1.44), respectively. There was heterogeneity of the associations among individual circulating fatty acids and coronary disease. In randomized, controlled trials, relative risks for coronary disease were 0.97 (CI, 0.69 to 1.36) for α-linolenic, 0.94 (CI, 0.86 to 1.03) for long-chain ω-3 polyunsaturated, and 0.89 (CI, 0.71 to 1.12) for ω-6 polyunsaturated fatty acid supplementations.
Limitation: Potential biases from preferential publication and selective reporting.
Conclusion: Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.
Primary funding source: British Heart Foundation, Medical Research Council, Cambridge National Institute for Health Research Biomedical Research Centre, and Gates Cambridge.
Comment in
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Evidence does not support guidelines on saturated fat, researchers say.BMJ. 2014 Mar 19;348:g2238. doi: 10.1136/bmj.g2238. BMJ. 2014. PMID: 24647174 No abstract available.
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Fatty acids and coronary risk.Am J Nurs. 2014 Sep;114(9):70. doi: 10.1097/01.NAJ.0000453764.00001.76. Am J Nurs. 2014. PMID: 25166256 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):453. doi: 10.7326/L14-5018. Ann Intern Med. 2014. PMID: 25222393 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):453-4. doi: 10.7326/L14-5018-2. Ann Intern Med. 2014. PMID: 25222394 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):454. doi: 10.7326/L14-5018-3. Ann Intern Med. 2014. PMID: 25222395 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):454-5. doi: 10.7326/L14-5018-4. Ann Intern Med. 2014. PMID: 25222396 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):455. doi: 10.7326/L14-5018-5. Ann Intern Med. 2014. PMID: 25222397 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):455-6. doi: 10.7326/L14-5018-6. Ann Intern Med. 2014. PMID: 25222398 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):456. doi: 10.7326/L14-5018-7. Ann Intern Med. 2014. PMID: 25222399 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):456-7. doi: 10.7326/L14-5018-8. Ann Intern Med. 2014. PMID: 25222400 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):457-8. doi: 10.7326/L14-5018-9. Ann Intern Med. 2014. PMID: 25222401 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk.Ann Intern Med. 2014 Sep 16;161(6):458. doi: 10.7326/L14-5018-10. Ann Intern Med. 2014. PMID: 25222402 No abstract available.
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Association of dietary, circulating, and supplement fatty acids with coronary risk. In response.Ann Intern Med. 2014 Sep 16;161(6):458-9. doi: 10.7326/L14-5018-11. Ann Intern Med. 2014. PMID: 25222403 No abstract available.
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Review: In high-risk patients, fatty acid supplementation does not prevent coronary events.Ann Intern Med. 2014 Sep 16;161(6):JC7. doi: 10.7326/0003-4819-161-6-201409160-02007. Ann Intern Med. 2014. PMID: 25222419 No abstract available.
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Saturated fatty acids are not off the hook.Nutr Metab Cardiovasc Dis. 2015 Dec;25(12):1071-8. doi: 10.1016/j.numecd.2015.09.010. Epub 2015 Oct 9. Nutr Metab Cardiovasc Dis. 2015. PMID: 26626084
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Meta-analysis in Research on Nutrition-Reply.JAMA. 2018 Mar 13;319(10):1050-1051. doi: 10.1001/jama.2017.21684. JAMA. 2018. PMID: 29536094 No abstract available.
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