It seems clear from clinical and recent observational data that replacing total SFA with PUFA could reduce the risk of CVD. The role of overall SFA intake for cardiometabolic risk has been recently questioned, mainly based on observational data from meta-analyses. Although caveats exist, finite amounts of SFA, when considered separately, may have some beneficial health effects. Healthy food choices can probably include modest amounts of SFA, and low-fat dairy products seem like a prudent food choice in this aspect. The role of high-fat dairy in cardiometabolic diseases is an interesting topic that needs further study in controlled interventions. To regard SFA as a single, homogenous group has probably been too much of an oversimplification, although differences in cardiometabolic risk appear greater between food groups and sources than between separate LC SFA. The current recommendations still appear sound and scientifically well grounded, not only because lowering LDL-C is one of the most established ways to lower cardiovascular risk, but also since the overall available data suggest a health benefit by limiting total SFA (in practice to limit excessive intakes of foodstuffs high in 16:0, 18:0, and 14:0) for replacement with vegetable MUFA and PUFA. SFA should not be replaced with refined (high-GI) carbohydrates. The different cardiometabolic effects of individual SFA are summarized in Figure 5. Based on the current available evidence, it is not possible to give dietary recommendations solely based on the content of individual SFA. Strictly controlled short-term and longer-term intervention studies are needed to test the various associations reported in observational studies.
Clin Lipidology. 2011;6(2):209-223. © 2011 Future Medicine Ltd.