Has our understanding on saturated fat changed at all?

Heated discussion rose again yesterday evening regarding quality of fat and its associations with cardiovascular health. A popular Finnish TV documentary, MOT tried to refute the fat theory concept. MOT argued that there is no single piece of evidence demonstrating harms of saturated fat. Here is how Pronutritionist responds to allegations.

Low dose of omega-3 fatty acids – no benefit in CAD

Omega-3 fatty acids, at least eicosapentaenic acid (EPA) ja docosahexaenic acid (DHA) have been associated with improved cardiovascular outcomes in earlier randomized trials (JELIS, Gissi Prevenzione ja DART trials). In this recent randomized trial, EPA, DHA ja alfalinolenic acid (ALA) supplementation as margarine did not prevent coronary outcomes vs placebo margarine. The used doses of EPA and DHA were low. Kromhout D et al. N Engl J Med 2010; August 29. (e-pub ahead of print)

Folic acid and vitamin B12 do not help in CAD

Search trial with almost 7 years’ follow up demonstrated that lowering blood homocysteine by folic acid or vitamin B12 do not bring any benefit in cardiac artery disease. These results join into other series of disappointing results on homocysteine lowering. Treatments were well tolerated in spite of high doses used.

Vitamin D supplementation, no effects on lipids or glucose

Low intake of vitamin D is associated with incidence of diabetes and cardiovascular disease in observational studies. However, this one year randomized trial shows that a high dose, 140 micrograms per day, of D3 has no effect on lipids or glucose tolerance. The same study showed similar neutral results on weight management). High doses were well tolerated.

Calcium supplements increase risk of myocardial infarctions

Sufficient intake of calcium is essential for bone health. High dietary intake of calcium is associated with decreased incidence of cardiovasular events in observational studies. Recently some randomized controlled trials show that calcium supplements may worsen cardiovasular health in renal failure. This meta-analysis of randomized controlled trials (British Medical Journal), shows that use of calcium supplements may increase risk of myocardial infarctions in other populations as well.