Dietary guidelines for saturated fatty acids are not supported by the evidence

Dietary guidelines recommend that intake of saturated fat should be <7–10% of daily energy. Supporting evidence relates mainly to saturated fatty acids (SFA) increasing blood total and LDL-cholesterol levels, which are risk factors for coronary heart disease (CHD). Recent meta-analyses of prospective cohort studies and of randomised controlled trials that substituted polyunsaturated fatty acids for SFA did not find any meaningful association between SFA intake and risk of CHD. The most likely alternative to a high-fat, high-SFA diet is a diet low in fat and high in refined carbohydrate. These diets may produce atherogenic dyslipidaemia that comprises a triad of high triglyceride levels, high levels of small dense LDL particles and decreased HDL-cholesterol concentrations, which are important risk factors for CHD. Low-fat, high-refined carbohydrate diets may also induce de novo lipogenesis that results in increased levels of circulating SFA. Community-based intensive education programs to reduce risk factors for CHD have not been successful in preventing the disease.