Fat-rich vs. carbohydrate-rich nutrition and cardiovascular diseases

For decades, conventional medical community has recommended that people have a low-fat, carbohydrate-rich diet to prevent cardiovascular diseases and early death.

The regular Food intake of the participants was recorded using country or region-specific validated questionnaires for the frequency of food (FFQS) at the beginning of the course and included several 24-hour twilight memories of 60 to 250 people from each country as a reference for validated FFQs.

Primary result measurements

The primary endpoints were the overall mortality and serious cardiovascular events (fatal CVD, non -fatal myocardial infarction). [Mi], stroke and heart failure). Secondary endpoints were all heart attacks, stroke, CVD mortality and non-CVD mortality.

important knowledge

The highest quintile of carbohydrate intake (> 60% of the total calories) was associated with a higher overall mortality risk than the lowest quintile of carbohydrate recording (Hazard Ratio [HR]: 1,28; p = 0.0001). The intake of carbohydrates was not associated with an increased risk of cardiovascular diseases or mortality.

The highest quintile of the total fat absorption (> 35 % of the total calories) correlated with a total of 23 % lower overall mortality compared to the lowest quintile ( p = 0.0001). In addition, the individual types of fats consumed were also associated with a lower risk of overall mortality. For example, correlated diets with 10 % to 15 % saturated fatty acids with a 14 % lower totality risk as such with the lowest amount of saturated fatty acids ( p = 0.0088). Diets with the highest content of polyunsaturated and simply unsaturated fats were also lower with 20 % ( p = 0.0001) and 19 % ( p = 0.001).

A higher content of saturated fatty acids was associated with a lower risk of stroke. However, the absorption of fat (overall, saturated or unsaturated) was not significantly associated with the risk of myocardial infarction or cardiovascular mortality.

If 5 %of the calorie intake from carbohydrates were replaced by polyunsaturated fats, a 11 %reduction in the overall mortality and a 16 %reduction in the non-cardiovascular mortality risk was observed. The replacement of carbohydrates with saturated fats was associated with a 20 % lower risk of stroke, while the intake of polyunsaturated and simply unsaturated fats did not seem to affect the risk of stroke.

practice implications

cardiovascular diseases have become a global epidemic. For decades, the conventional medical community has recommended that people have a low-fat, carbohydrate-rich diet to prevent cardiovascular diseases and early death. This idea came mainly from the study by Ancel Keys from 1980, which examined CVD's diet and frequency in 7 countries. His data indicate that an increased cholesterol level in the blood and the absorption of saturated fats with food are a main factor for the occurrence of coronary heart disease and the risk of stroke. To take into account parameters that are influenced by the absorption of saturated fats, such as: which, if they are increased, demonstrably protect against heart diseases.

The present study is inspired by newer meta-analyzes of randomized studies and prospectious cohort studies that either show no connection or even a lower risk of overall mortality and CVD events with higher consumption of saturated fatty acids. Countries in Europe and North America, compared to regions with less access to expensive, fatty foods, could have access to more food fat and a higher total calorie intake and, in contrast, over -nutrition may be malnourished. Most of the observation studies that establish a connection between a high absorption of saturated fatty acids and the overall mortality were carried out in wealthier countries, the inclusion of saturated fatty acids between 7 % and 15 % of the total calories. ^{4 and one of the goals of the authors in the present study was determined whether these results were extrapolated on regions of the world can, in which foods are scarce and the diet mainly includes cheaper carbohydrates.}

The current recommendation to limit the total fat absorption to less than 30 % and saturated fats to less than 10 % of the overall calories recorded is not supported by the results of this study, and people who have a high carbohydrate diet can actually benefit from a replacement. Some of these carbohydrates can actually benefit with fats. The lowest mortality rates were observed if the total carbohydrate recording was less than 60 % of the total calories used; However, diets that made less than 50 % of the daily total amount were not associated with increased benefits. In addition, according to these findings, 35 % of the daily calorie intake from fats seem to be the optimal range of 10 % to 15 % (and no less than 7 %).

One of the main restrictions in this study is that the authors do not differentiate between the sources or types of carbohydrates consumed. We cannot determine whether the participants consumed refined white flour, entire, unprocessed grains, starchy root vegetables or which combination. Fruit and non -starchy vegetables were undoubtedly included in the "carbohydrates" category, but there is no way to know which and how much of them were consumed by every population examined.

(Further information on the health effects of carbohydrates can be found in the edition of this month under "Bread and the microbiome: a personal matter".)

diets that contain a large amount of refined cereals and food with a high glycemic index are associated with an increased risk of cardiovascular diseases. ^{6 diabetes, 7 and several cancer. Vegetables are included with a reduced risk of heart disease, cancer and diabetes.}

In addition, it is generally known that a diet that is rich in antioxidants that are contained in many fruit and vegetable varieties protects against many health states, including cardiovascular diseases. ^{10.11 This is particularly important in the presence of lipids that can accumulate in the blood vessels, since these phytonutrients and lipid peroxidation and Prevent endothestitis, main factors in the development of CVD.}

Without information about the source of carbohydrates in the diet of the participants, it is difficult to close exactly which factors contribute to the results of the present study. All in all, however, the current evidence indicates that food fats, self -saturated fatty acids, are not the enemy that conventional medicine has announced for so many years, and reducing the overall carbohydrates is probably an advantage for most people.