TY - JOUR
T1 - Impact of replacement of individual dietary SFAs on circulating lipids and other biomarkers of cardiometabolic health
T2 - A systematic review and meta-analysis of randomized controlled trials in humans
AU - Sellem, L.
AU - Flourakis, M.
AU - Jackson, K.G.
AU - Joris, P.J.
AU - Lumley, J.
AU - Lohner, S.
AU - Mensink, R.P.
AU - Soedamah-Muthu, S.S.
AU - Lovegrove, J.A.
N1 - LS was funded by the Biotechnology and Biological Sciences Research Council (BBSRC) UK Joint Programme Initiative “HDHL Biomarkers: Fatty Acid Metabolism—Interlinking Diet with Cardiometabolic Health (FAME)” (project reference: BB/P028217/1).
PY - 2022
Y1 - 2022
N2 - Little is known of the impact of individual SFAs and their isoenergetic substitution with other SFAs or unsaturated fatty acids (UFAs) on the prevention of cardiometabolic disease (CMD). This systematic literature review assessed the impact of such dietary substitutions on a range of fasting CMD risk markers, including lipid profile, markers of glycemic control and inflammation, and metabolic hormone concentrations. Eligible randomized controlled trials (RCTs) investigated the effect of isoenergetic replacements of individual dietary SFAs for ≥14 d on ≥1 CMD risk markers in humans. Searches of the PubMed, Embase, Scopus, and Cochrane CENTRAL databases on 14 February, 2021 identified 44 RCTs conducted in participants with a mean ± SD age of 39.9 ± 15.2 y. Studies’ risk of bias was assessed using the Cochrane Risk of Bias tool 2.0 for RCTs. Random-effect meta-analyses assessed the effect of ≥3 similar dietary substitutions on the same CMD risk marker. Other dietary interventions were described in qualitative syntheses. We observed reductions in LDL-cholesterol concentrations after the replacement of palmitic acid (16:0) with UFAs (−0.36 mmol/L; 95% CI: −0.50, −0.21 mmol/L; I2 = 96.0%, n = 18 RCTs) or oleic acid (18:1n–9) (−0.16 mmol/L; 95% CI: −0.28, −0.03 mmol/L; I2 = 89.6%, n = 9 RCTs), with a similar impact on total cholesterol and apoB concentrations. No effects on other CMD risk markers, including HDL-cholesterol, triacylglycerol, glucose, insulin, or C-reactive protein concentrations, were evident. Similarly, we found no evidence of a benefit from replacing dietary stearic acid (18:0) with UFAs on CMD risk markers (n = 4 RCTs). In conclusion, the impact of replacing dietary palmitic acid with UFAs on lipid biomarkers is aligned with current public health recommendations. However, owing to the high heterogeneity and limited studies, relations between all individual SFAs and biomarkers of cardiometabolic health need further confirmation from RCTs. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020084241.
AB - Little is known of the impact of individual SFAs and their isoenergetic substitution with other SFAs or unsaturated fatty acids (UFAs) on the prevention of cardiometabolic disease (CMD). This systematic literature review assessed the impact of such dietary substitutions on a range of fasting CMD risk markers, including lipid profile, markers of glycemic control and inflammation, and metabolic hormone concentrations. Eligible randomized controlled trials (RCTs) investigated the effect of isoenergetic replacements of individual dietary SFAs for ≥14 d on ≥1 CMD risk markers in humans. Searches of the PubMed, Embase, Scopus, and Cochrane CENTRAL databases on 14 February, 2021 identified 44 RCTs conducted in participants with a mean ± SD age of 39.9 ± 15.2 y. Studies’ risk of bias was assessed using the Cochrane Risk of Bias tool 2.0 for RCTs. Random-effect meta-analyses assessed the effect of ≥3 similar dietary substitutions on the same CMD risk marker. Other dietary interventions were described in qualitative syntheses. We observed reductions in LDL-cholesterol concentrations after the replacement of palmitic acid (16:0) with UFAs (−0.36 mmol/L; 95% CI: −0.50, −0.21 mmol/L; I2 = 96.0%, n = 18 RCTs) or oleic acid (18:1n–9) (−0.16 mmol/L; 95% CI: −0.28, −0.03 mmol/L; I2 = 89.6%, n = 9 RCTs), with a similar impact on total cholesterol and apoB concentrations. No effects on other CMD risk markers, including HDL-cholesterol, triacylglycerol, glucose, insulin, or C-reactive protein concentrations, were evident. Similarly, we found no evidence of a benefit from replacing dietary stearic acid (18:0) with UFAs on CMD risk markers (n = 4 RCTs). In conclusion, the impact of replacing dietary palmitic acid with UFAs on lipid biomarkers is aligned with current public health recommendations. However, owing to the high heterogeneity and limited studies, relations between all individual SFAs and biomarkers of cardiometabolic health need further confirmation from RCTs. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020084241.
KW - CHAIN TRIACYLGLYCEROLS
KW - CHOLESTEROL-PREDICTIVE EQUATIONS
KW - HIGH-OLEIC-ACID
KW - LINOLEIC-ACID
KW - MYRISTIC ACID
KW - PALM-OIL
KW - PLASMA-LIPIDS
KW - SATURATED FATTY-ACIDS
KW - SERUM-LIPOPROTEIN PROFILE
KW - STEARIC-ACID
KW - fasting lipid profile
KW - glucose
KW - insulin
KW - lipoproteins
KW - medium-chain fatty acids
KW - myristic acid
KW - palmitic acid
KW - saturated fatty acids
KW - stearic acid
KW - unsaturated fatty acids
UR - http://www.scopus.com/inward/record.url?scp=85131395812&partnerID=8YFLogxK
U2 - 10.1093/advances/nmab143
DO - 10.1093/advances/nmab143
M3 - Article
C2 - 34849532
SN - 2161-8313
VL - 13
SP - 1200
EP - 1225
JO - Advances in Nutrition
JF - Advances in Nutrition
IS - 4
ER -