Strength of recommendation – strong: there is high certainty, based on evidence, that the net benefit is substantial.

Evidence Statement 11: when food was supplied to adults in a dietary pattern that achieved a macronutrient composition of 5%–6% saturated fat, 26%–27% total fat, 15%–18% protein and 55%–59% carbohydrate compared with the control diet (14%–15% saturated fat, 34%–38% total fat, 13%–15% protein and 48%–51% carbohydrate), LDL-C was lowered 11–13 mg/dL in two studies and 11% in another study. Strength of evidence: high.

Classification of recommendation (COR): class I: benefit >>> risk; procedure/treatment should be performed/administered.

Level of evidence: level A: multiple populations evaluated; data derived from multiple randomised clinical trials or meta-analyses.

RCTs with minor limitations affecting confidence in, or applicability of, the results. Well-designed, well-executed non-randomised controlled studies and well-designed, well-executed observational studies. Well-conducted meta-analyses of such studies. Moderately certain about the estimate of effect; further research may have an impact on our confidence in the estimate of effect and may change the estimate.

+++ – Marked effects.

Level of evidence – A: data derived from multiple randomised clinical trials or meta-analyses.

ACC, American College of Cardiology; AHA, American Heart Association; COR, Classification of recommendation; CVD, cardiovascular disease; DGAC, Dietary Guidelines Advisory Committee; EAS, European Atherosclerosis Society; ESC, European Society of Cardiology; LDL-C, low-density lipoprotein-cholesterol; MUFA, monounsaturated fatty acid; NHLBI, National Heart, Lung, and Blood Institute; PUFA, polyunsaturated fatty acid; RCT, randomised controlled trial; SFA, Saturated fatty acid.