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→‎Cardiovascular diseases: Added 10 studies and 3 review papers supporting the claim that saturated fat is not associated with heart attack risk or CHD.
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===Cardiovascular diseases===
===Cardiovascular diseases===


The vast majority of observational studies have found no connection between saturated fat consumption and heart attack risk.<ref> {{cite journal|title=A Longitudinal Study of Coronary Heart Disease|journal=Circulation|date=1963|first=|last=|coauthors=|volume=|issue=|pages=|id= |url=http://www.circ.ahajournals.org/cgi/content/abstract/28/1/20|format=|accessdate= }}</ref><ref> {{cite journal|title=Diet and heart: a postscript.|journal=Br Med J.|date=1977|first=|last=|coauthors=|volume=|issue=|pages=|id= |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1632514/|format=|accessdate= }}</ref><ref> {{cite journal|title=Dietary intake and the risk of coronary heart disease in Japanese men living in Hawaii|journal=American Journal of Clinical Nutrition|date=1978|first=|last=|coauthors=|volume=31|issue=|pages=1270-1279|id= |url=http://www.ajcn.org/cgi/content/abstract/31/7/1270|format=|accessdate= }}</ref><ref> {{cite journal|title=Relationship of dietary intake to subsequent coronary heart disease incidence: The Puerto Rico Heart Health Program|journal=American Journal of Clinical Nutrition|date=1980|first=|last=|coauthors=|volume=33|issue=|pages=1818-1827|id= |url=http://www.ajcn.org/cgi/content/abstract/33/8/1818|format=|accessdate= }}</ref><ref> {{cite journal|title=Diet, serum cholesterol, and death from coronary heart disease. The Western Electric study|journal=The New England Journal of Medicine|date=1981|first=|last=Shekelle|coauthors=|volume=304|issue=|pages=65-70|id= |url=http://content.nejm.org/cgi/content/abstract/304/2/65|format=|accessdate= }}</ref><ref> {{cite journal|title=Diet and 20-y mortality in two rural population groups of middle-aged men in Italy|journal=American Journal of Clinical Nutrition|date=1989|first=|last=Farchi|coauthors=|volume=50|issue=|pages=1095-1103|id= |url=http://www.ajcn.org/cgi/content/abstract/50/5/1095|format=|accessdate= }}</ref><ref> {{cite journal|title=Diet and incident ischaemic heart disease: the Caerphilly Study|journal=British Journal of Nutrition|date=1993|first=|last=Fehily|coauthors=|volume=69|issue=|pages=303-314|id= |url=http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=872408|format=|accessdate= }}</ref><ref> {{cite journal|title=Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States |journal=British Medical Journal|date=1996|first=|last=|coauthors=|volume=313|issue=|pages=84-90|id= |url=http://www.bmj.com/cgi/content/full/313/7049/84?view=long&pmid=8688759|format=|accessdate= }}</ref><ref> {{cite journal|title=Dietary Fat Intake and the Risk of Coronary Heart Disease in Women|journal=New England Journal of Medicine|date=1997|first=|last=|coauthors=|volume=337|issue=|pages=1491-1499|id= |url=http://content.nejm.org/cgi/content/full/337/21/1491|format=|accessdate= }}</ref><ref> {{cite journal|title=Dietary fat intake and early mortality patterns – data from The Malmö Diet and Cancer Study|journal=Journal of Internal Medicine|date=2005|first=|last=|coauthors=|volume=258|issue=2|pages=153-165|id= |url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118738758/HTMLSTART|format=|accessdate= }}</ref> Three review papers, one of them including 21 cohort studies, concluded that there is no significant association between coronary heart disease and saturated fat consumption.<ref> {{cite journal|title=Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease|journal=American Journal of Clinical Nutrition|date=2010|first=|last=|coauthors=|volume=|issue=|pages=|id= {{doi|10.3945/ajcn.2009.27725}}|url=http://www.ajcn.org/cgi/content/abstract/ajcn.2009.27725v1|format=|accessdate= }}</ref><ref> {{cite journal|title=The questionable role of saturated and polyunsaturated fatty acids in cardiovascular disease.|journal=Journal of clinical epidemiology|date=1998|first=|last=Ravnskov|coauthors=|volume=|issue=|pages=|id=PMID 9635993 |url=http://www.ncbi.nlm.nih.gov/pubmed/9635993|format=|accessdate= }}</ref><ref> {{cite journal|title=A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease.|journal=Archives of internal medicine|date=2009|first=|last=|coauthors=|volume=|issue=|pages=|id=PMID 19364995 |url=http://www.ncbi.nlm.nih.gov/pubmed/19364995|format=|accessdate= }}</ref>
[[Diet (nutrition)|Diet]]s high in saturated fat have been [[correlated]] with an increased incidence of [[atherosclerosis]]<ref>{{cite web|url=http://www.nhlbi.nih.gov/health/dci/Diseases/Atherosclerosis/atherosclerosis_risk.html|title=Risk factors for atherosclerosis|publisher=National Heart, Lung, and Blood Institute |accessdate=8 March 2010}}</ref> and [[coronary heart disease]]<ref>{{cite web|url=http://www.nhlbi.nih.gov/health/dci/Diseases/hdw/hdw_whoisatrisk.html|title=Risk factors for coronary heart disease in women|publisher=National Heart, Lung, and Blood Institute|accessdate=8 March 2010}}</ref>.


Combined cholesterol and saturated fat feeding has shown an increase in cholesterol levels of [[African green monkeys]]<ref>MS Wolfe, JK Sawyer, TM Morgan, BC Bullock and LL Rudel [http://atvb.ahajournals.org/cgi/content/abstract/14/4/587 Dietary polyunsaturated fat decreases coronary artery atherosclerosis in a pediatric-aged population of African green monkeys] ''Arteriosclerosis and Thrombosis'' Vol 14, 587–597</ref>, while one study with baboons showed the opposite effect on LDL cholesterol.<ref>{{pmid|7625361}}</ref>
Combined cholesterol and saturated fat feeding has shown an increase in cholesterol levels of [[African green monkeys]]<ref>MS Wolfe, JK Sawyer, TM Morgan, BC Bullock and LL Rudel [http://atvb.ahajournals.org/cgi/content/abstract/14/4/587 Dietary polyunsaturated fat decreases coronary artery atherosclerosis in a pediatric-aged population of African green monkeys] ''Arteriosclerosis and Thrombosis'' Vol 14, 587–597</ref>, while one study with baboons showed the opposite effect on LDL cholesterol.<ref>{{pmid|7625361}}</ref>

Revision as of 13:59, 18 March 2010

Types of fats in food
Components
Manufactured fats

Saturated fat is fat that consists of triglycerides containing only saturated fatty acid radicals. There are several kinds of naturally occurring saturated fatty acids, which differ by the number of carbon atoms, ranging from 3 carbons (propionic acid) to 36 (Hexatriacontanoic acid). Saturated fatty acids have no double bonds between the carbon atoms of the fatty acid chain and are thus fully saturated with hydrogen atoms.

Fat that occurs naturally in tissue contains varying proportions of saturated and unsaturated fat. Examples of foods containing a high proportion of saturated fat include dairy products (especially cream and cheese but also butter and ghee); animal fats such as suet, tallow, lard and fatty meat; coconut oil, cottonseed oil, palm kernel oil, chocolate, and some prepared foods[1].

Serum saturated fatty acid is generally higher in smokers, alcohol drinkers and obese people.[2]

Fat profiles

While nutrition labels usually combine them, the saturated fatty acids appear in different proportions among food groups. Lauric and myristic acid radicals are most commonly found in "tropical" oils (e.g. palm kernel, coconut) and dairy products. The saturated fat in meat, eggs, chocolate, and nuts is primarily the triglycerides of palmitic and stearic acid.

Saturated fat profile of common foods (Esterified fatty acids as percentage of total fat )[3]
Food Lauric acid Myristic acid Palmitic acid Stearic acid
Coconut oil 47% 18% 9% 3%
Butter 3% 11% 29% 13%
Ground beef 0% 4% 26% 15%
Dark chocolate 0% 0% 34% 43%
Salmon 0% 1% 29% 3%
Eggs 0% 0% 27% 10%
Cashews 2% 1% 10% 7%
Soybean oil 0% 0% 11% 4%
Fat composition in different foods
Food Saturated Mono-
unsaturated		 Poly-
unsaturated
As weight percent (%) of total fat
Cooking oils
Algal oil[4] 4 92 4
Canola[5] 8 64 28
Coconut oil 87 13 0
Corn oil 13 24 59
Cottonseed oil[5] 27 19 54
Olive oil[6] 14 73 11
Palm kernel oil[5] 86 12 2
Palm oil[5] 51 39 10
Peanut oil[7] 17 46 32
Rice bran oil 25 38 37
Safflower oil, high oleic[8] 6 75 14
Safflower oil, linoleic[5][9] 6 14 75
Soybean oil 15 24 58
Sunflower oil[10] 11 20 69
Mustard oil 11 59 21
Dairy products
Butterfat[5] 66 30 4
Cheese, regular 64 29 3
Cheese, light 60 30 0
Ice cream, gourmet 62 29 4
Ice cream, light 62 29 4
Milk, whole 62 28 4
Milk, 2% 62 30 0
Whipping cream[11]* 66 26 5
Meats
Beef 33 38 5
Ground sirloin 38 44 4
Pork chop 35 44 8
Ham 35 49 16
Chicken breast 29 34 21
Chicken 34 23 30
Turkey breast 30 20 30
Turkey drumstick 32 22 30
Fish, orange roughy 23 15 46
Salmon 28 33 28
Hot dog, beef 42 48 5
Hot dog, turkey 28 40 22
Burger, fast food 36 44 6
Cheeseburger, fast food 43 40 7
Breaded chicken sandwich 20 39 32
Grilled chicken sandwich 26 42 20
Sausage, Polish 37 46 11
Sausage, turkey 28 40 22
Pizza, sausage 41 32 20
Pizza, cheese 60 28 5
Nuts
Almonds dry roasted 9 65 21
Cashews dry roasted 20 59 17
Macadamia dry roasted 15 79 2
Peanut dry roasted 14 50 31
Pecans dry roasted 8 62 25
Flaxseeds, ground 8 23 65
Sesame seeds 14 38 44
Soybeans 14 22 57
Sunflower seeds 11 19 66
Walnuts dry roasted 9 23 63
Sweets and baked goods
Candy, chocolate bar 59 33 3
Candy, fruit chews 14 44 38
Cookie, oatmeal raisin 22 47 27
Cookie, chocolate chip 35 42 18
Cake, yellow 60 25 10
Pastry, Danish 50 31 14
Fats added during cooking or at the table
Butter, stick 63 29 3
Butter, whipped 62 29 4
Margarine, stick 18 39 39
Margarine, tub 16 33 49
Margarine, light tub 19 46 33
Lard 39 45 11
Shortening 25 45 26
Chicken fat 30 45 21
Beef fat 41 43 3
Goose fat[12] 33 55 11
Dressing, blue cheese 16 54 25
Dressing, light Italian 14 24 58
Other
Egg yolk fat[13] 36 44 16
Avocado[14] 16 71 13
Unless else specified in boxes, then reference is:[citation needed]
* 3% is trans fats

Examples of saturated fatty acids

Main article: List of saturated fatty acids

Some common examples of fatty acids:

Stable deepfry and baking medium

Deepfry oils and baking fats that are high in saturated fats, like palm oil, tallow or lard, can withstand extreme heat (of 180-200 degrees Celsius) and are resistant to oxidation. A 2001 parallel review of 20-year dietary fat studies in the United Kingdom, the United States of America and Spain[15] concluded that polyunsaturated oils like soya, canola, sunflower and corn degrade easily to toxic compounds and trans fat when heated up. Prolonged consumption of trans fat-laden oxidized oils can lead to atherosclerosis, inflammatory joint disease and development of birth defects. The scientists also questioned global health authorities’ wilful recommendation of large amounts of polyunsaturated fats into the human diet without accompanying measures to ensure the protection of these fatty acids against heat- and oxidative-degradation.

Association with diseases

Cardiovascular diseases

The vast majority of observational studies have found no connection between saturated fat consumption and heart attack risk.[16][17][18][19][20][21][22][23][24][25] Three review papers, one of them including 21 cohort studies, concluded that there is no significant association between coronary heart disease and saturated fat consumption.[26][27][28]

Combined cholesterol and saturated fat feeding has shown an increase in cholesterol levels of African green monkeys[29], while one study with baboons showed the opposite effect on LDL cholesterol.[30]

An increase in cholesterol levels has been observed in humans with an increase in saturated fat intake, such as a study of 22 hypercholesterolemic men.[31][32][33] Some studies have suggested that diets high in saturated fat increase the risk of heart disease and stroke. Epidemiological studies have found that those whose diets are high in saturated fats, including lauric, myristic, palmitic, and stearic acid, had a higher prevalence of coronary heart disease.[34][35][36][37] Additionally, controlled experimental studies have found that people consuming high saturated fat diets experience negative cholesterol profile changes.[38][39][40][41] In 2010 a meta-analysis of prospective cohort studies found no statistically significant relationship between cardiovascular disease and dietary saturated fat.[42] However, the authors noted that randomized controlled clinical trials in which saturated fat was replaced with polyunsaturated fat observed a reduction in heart disease, and that the ratio between polyunsaturated fat and saturated fat may be a key factor.[42]

In 1999, volunteers were randomly assigned to either Mediterranean (which replaces saturated fat with mono and polyunsaturated fat) or a control diet showed that subjects assigned to a Mediterranean diet exhibited a significantly decreased likelihood of suffering a second heart attack, cardiac death, heart failure or stroke.[43][44]

An evaluation of data from Harvard Nurses' Health Study found that "diets lower in carbohydrate and higher in protein and fat are not associated with increased risk of coronary heart disease in women. When vegetable sources of fat and protein are chosen, these diets may moderately reduce the risk of coronary heart disease." [45]

Mayo Clinic highlighted oils that are high in saturated fats include coconut, palm oil and palm kernel oil. Those of lower amounts of saturated fats, and higher levels of unsaturated (preferably monounsaturated) fats like olive oil, peanut oil, canola oil, avocados, safflower, corn, sunflower, soy and cottonseed oils are generally healthier.[46] The National Heart, Lung and Blood Institute,[47] and other health authorities like World Heart Federation[48] have urged saturated fats be replaced with polyunsaturated and monounsaturated fats. The health body list olive and canola oils as sources of monosaturated oils while soybean and sunflower oils are rich with polyunsaturated fat. A 2005 research in Costa Rica suggests consumption of non-hydrogenated unsaturated oils like soybean and sunflower over palm oil.[49]

The Cochrane Collaboration published a meta-analyses of fat modification trials finding no significant effect on total mortality, but with significant reductions in the rate of cardiovascular events that was statistically significant in the high risk group.[50]

Fatty acid specificity

Epidemiological studies of heart disease have implicated the four major saturated fatty acids to varying degrees. The World Health Organization has determined that there is "convincing" evidence that myristic and palmitic acid intake increases the probability, "possible" risk from lauric acid, and no increased risk at all from stearic acid consumption.[51]

In 2005, Dutch scientists at Department of Human Biology, Maastricht University compared the effects of stearic acid with oleic and linoleic acids. Forty five subjects (27 women and 18 men) consumed, in random order, three experimental diets, each for five weeks. The results suggest stearic acid is not highly thrombogenic compared with oleic and linoleic acids.[52]

Cancer

Breast cancer

Main article: Epidemiology and etiology of breast cancer § MUFAs on erythrocyte membrane and derived discussion about dietary fatty acids

There is one theorized association between saturated fatty acids intake and increased breast cancer risk.

Prostate cancer

Main article: Prostate cancer § Oils and fatty acids

Myristic and palmitic saturated fatty acids are associated with prostate cancer.

Small intestine cancer

A prospective study of data from the NIH-AARP Diet and Health Study correlated saturated fat intake with cancer of the small intestine.[53]

Dietary recommendations

A 2004 statement released by the Centers for Disease Control (CDC) determined that "Americans need to continue working to reduce saturated fat intake..." [54] Additionally, reviews by the American Heart Association led the Association to recommend reducing saturated fat intake to less than 7% of total calories according to its 2006 recommendations.[55][56] This concurs with similar conclusions made by the World Health Organization (WHO) and the US Department of Health and Human Services, both of which determined that reduction in saturated fat consumption would positively affect health and reduce the prevalence of heart disease.[57][58][59]

The World Health Organization (WHO) has concluded that saturated fats negatively affect cholesterol profiles, predisposing individuals to heart disease, and recommends avoiding saturated fats in order to reduce the risk of a cardiovascular disease.[60][61]

Dr German and Dr Dillard of University of California and Nestle Research Center in Switzerland, in their 2004 review, pointed out that "no lower safe limit of specific saturated fatty acid intakes has been identified". No randomized clinical trials of low-fat diets or low-saturated fat diets of sufficient duration have been carried out. The influence of varying saturated fatty acid intakes against a background of different individual lifestyles and genetic backgrounds should be the focus in future studies.[62]

Contrary Research

See also: Lipid hypothesis

One confounding issue in studies may be the formation of exogenous (outside the body) advanced glycation endproducts (AGEs) and oxidation products generated during cooking, which it appears some of the studies have not controlled for. It has been suggested that, "given the prominence of this type of food in the human diet, the deleterious effects of high-(saturated)fat foods may be in part due to the high content in glycotoxins, above and beyond those due to oxidized fatty acid derivatives." The glycotoxins, as he called them, are more commonly called AGEs[63]

  • A 3-year study conducted of 235 postmenopausal women with established coronary artery disease, many also having metabolic syndrome concluded that "in postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis." Nevertheless, the authors deemed that "the findings do not establish causality." [64][65]
  • A 2010 meta-analysis in the American Journal of Clinical Nutrition looked at 21 unique studies containing over 350,000 people. They found no association between saturated fat and an increased risk for coronary heart disease, stroke, or cardiovascular disease. [66]
  • A study of 297 Portuguese males with acute myocardial infarction (MI), found that "total fat intake, lauric acid, palmitic acid [two common saturated fats] and oleic acid [a monoinsaturated fat] were inversely associated with acute MI" and concluded that "low intake of total fat and lauric acid from dairy products was related to acute MI". The authors suggest that "recommendations on fatty acid intake should aim for both an upper and lower limit"[67].
  • Fulani of northern Nigeria get around 25% of energy from saturated fat, yet their lipid profile is indicative of a low risk of cardiovascular disease. This finding is likely due to their high activity level and their low total energy intake.[68]
  • A 2004 article in The American Journal of Clinical Nutrition raised the possibility that the supposed causal relationship between saturated fats and heart disease may actually be a statistical bias. The authors take the example of the "Finnish mental hospital study" in which saturated fat intakes were monitored more closely than were total fat intakes, therefore ignoring the possibility that simply a larger fat intake may lead to a higher risk of coronary diseases. It also suggests that other parameters were overlooked, such as carbohydrates intakes.[69]

Molecular description

Two-dimensional representation of the saturated fatty acid myristic acid
A space-filling model of the saturated fatty acid myristic acid


See also

References

  1. ^ Saturated fat food sources
  2. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 7661118, please use {{cite journal}} with |pmid=7661118 instead.
  3. ^ U.S. Department of Agriculture, Agricultural Research Service. 2007. USDA National Nutrient Database for Standard Reference, Release 20. Nutrient Data Laboratory Home Page
  4. ^ "Thrive Culinary Algae Oil". Retrieved 7 January 2019.
  5. ^ a b c d e f Anderson D. "Fatty acid composition of fats and oils" (PDF). Colorado Springs: University of Colorado, Department of Chemistry. Retrieved April 8, 2017.
  6. ^ "NDL/FNIC Food Composition Database Home Page". United States Department of Agriculture, Agricultural Research Service. Retrieved May 21, 2013.
  7. ^ "Basic Report: 04042, Oil, peanut, salad or cooking". USDA. Archived from the original on March 9, 2016. Retrieved 16 January 2015.
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  10. ^ "Oil, vegetable, sunflower". nutritiondata.com. Condé Nast. Retrieved 27 September 2010.
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  16. ^ "A Longitudinal Study of Coronary Heart Disease". Circulation. 1963. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  17. ^ "Diet and heart: a postscript". Br Med J. 1977. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  18. ^ "Dietary intake and the risk of coronary heart disease in Japanese men living in Hawaii". American Journal of Clinical Nutrition. 31: 1270–1279. 1978. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  19. ^ "Relationship of dietary intake to subsequent coronary heart disease incidence: The Puerto Rico Heart Health Program". American Journal of Clinical Nutrition. 33: 1818–1827. 1980. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  20. ^ Shekelle (1981). "Diet, serum cholesterol, and death from coronary heart disease. The Western Electric study". The New England Journal of Medicine. 304: 65–70. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
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  23. ^ "Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States". British Medical Journal. 313: 84–90. 1996. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  24. ^ "Dietary Fat Intake and the Risk of Coronary Heart Disease in Women". New England Journal of Medicine. 337: 1491–1499. 1997. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  25. ^ "Dietary fat intake and early mortality patterns – data from The Malmö Diet and Cancer Study". Journal of Internal Medicine. 258 (2): 153–165. 2005. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  26. ^ "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease". American Journal of Clinical Nutrition. 2010. doi:10.3945/ajcn.2009.27725. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
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  28. ^ "A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease". Archives of internal medicine. 2009. PMID 19364995. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  29. ^ MS Wolfe, JK Sawyer, TM Morgan, BC Bullock and LL Rudel Dietary polyunsaturated fat decreases coronary artery atherosclerosis in a pediatric-aged population of African green monkeys Arteriosclerosis and Thrombosis Vol 14, 587–597
  30. ^ PMID 7625361
  31. ^ Francisco Fuentes; José López-Miranda; Elias Sánchez; Francisco Sánchez; José Paez; Elier Paz-Rojas; Carmen Marín; Purificación Gómez; José Jimenez-Perepérez; José M. Ordovás,; and Francisco Pérez-Jiménez Mediterranean and Low-Fat Diets Improve Endothelial Function in Hypercholesterolemic Men Annals of Internal Medicine 19 June 2001, Volume 134, Issue 12, pp. 1115–1119
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  48. ^ Diet & cardiovascular desease World Heart Federation website
  49. ^ Kabagambe, Baylin, Ascherio & Campos (2005). "The Type of Oil Used for Cooking Is Associated with the Risk of Nonfatal Acute Myocardial Infarction in Costa Rica" (135 ed.). Journal of Nutrition. pp. 2674–2679. {{cite web}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  50. ^ [Reduced or modified dietary fat for preventing cardiovascular disease http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD002137/frame.html]
  51. ^ World Health Organization Disease-specific recommendations
  52. ^ Thijssen, Myriam A.M.A.; Hornstra, Gerard; Mensink, Ronald P. (2005). "Stearic, Oleic, and Linoleic Acids Have Comparable Effects on Markers of Thrombotic Tendency in Healthy Human Subjects". Journal of Nutrition. 135 (12): 2805. PMID 16317124.
  53. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 19010900, please use {{cite journal}} with |pmid=19010900 instead.
  54. ^ Trends in Intake of Energy, Protein, Carbohydrate, Fat, and Saturated Fat — United States, 1971–2000
  55. ^ Lichtenstein AH, Appel LJ, Brands M; et al. (2006). "Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee". Circulation. 114 (1): 82–96. doi:10.1161/CIRCULATIONAHA.106.176158. PMID 16785338. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  56. ^ Smith SC, Jackson R, Pearson TA; et al. (2004). "Principles for national and regional guidelines on cardiovascular disease prevention: a scientific statement from the World Heart and Stroke Forum" (PDF). Circulation. 109 (25): 3112–21. doi:10.1161/01.CIR.0000133427.35111.67. PMID 15226228. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  57. ^ World Health Organization Diet, Nutrition and the Prevention of Chronic Diseases
  58. ^ U.S. Department of Health and Human Services U.S. Department of Agriculture Dietary Guidelines for Americans 2005
  59. ^ U.S. Department of Health and Human Services Dietary Guidelines for Americans 2005
  60. ^ World Health Organization Risk factor: lipids
  61. ^ World Health Organization Prevention: personal choices and actions
  62. ^ Saturated fats: what dietary intake? J Bruce German and Cora J Dillard, Am J Clin Nutr, 2004; 80:550–9
  63. ^ Koschinsky T, He CJ, Mitsuhashi T; et al. (1997). "Orally absorbed reactive glycation products (glycotoxins): an environmental risk factor in diabetic nephropathy". Proc. Natl. Acad. Sci. U.S.A. 94 (12): 6474–9. doi:10.1073/pnas.94.12.6474. PMC 21074. PMID 9177242. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  64. ^ 'Surprising' data: saturated fat may slow atherosclerotic progression in postmenopausal women, OB/GYN News, July 2004
  65. ^ Mozaffarian D, Rimm EB, Herrington DM (2004). "Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women". Am. J. Clin. Nutr. 80 (5): 1175–84. PMC 1270002. PMID 15531663. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  66. ^ Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease1
  67. ^ Lopes, Carla; Aro, Antti; Azevedo, Ana; Ramos, Elisabete; Barros, Henrique (2007). "Intake and adipose tissue composition of fatty acids and risk of myocardial infarction in a male portuguese community sample". Journal of the American Dietetic Association. 107 (2). New-York: Elsevier: 276–286.
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  69. ^ Saturated fat prevents coronary artery disease? An American paradox
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