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Introduction
Treatment guidelines and population-based recommendations evolve from research vetted by the scientific community. Healthcare providers require practice guidelines resulting from rigorous review of the totality of evidence. Open discussion/debate among experts is fundamental and encouraged, but blatant disregard for scientific process can lead to confusion and public distrust. A recent example is the controversy among scientists, healthcare professionals and the public about dietary saturated fat (SFA) recommendations to lower risk of cardiovascular disease (CVD).
Dietary recommendations for SFA from authoritative organisations
More than 60 years ago (in 1957), the American Heart Association (AHA) proposed that modifying dietary fat could reduce the incidence of coronary heart disease (CHD). This was based on research, including controlled feeding studies, and endpoint measures of blood lipids and blood pressure.1 In 1980, the first Dietary Guidelines for Americans recommended ‘avoiding too much SFA’.2 For decades, research has substantiated this consistent dietary recommendation from authoritative organisations to decrease SFA to reduce CVD risk.3–6 Current dietary guidelines for SFA and evidence ratings are summarised in table 1. While the strong evidence to reduce SFA specifically targets decreasing low-density lipoprotein (LDL)-cholesterol, it is very much germane to CVD risk reduction.
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Authoritative recommendations for saturated fat and evidence ratings
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Challenging practice guidelines and population-based recommendations: the SFA SAGA
In 2010, a meta-analysis of 21 prospective epidemiological studies totalling 347 747 subjects reported that higher intake of SFA was not associated with an increased risk of CHD, stroke or CVD.7 Aspects of this methodology were widely …
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