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Saturated Fat Not Associated with Heart Disease

A meta-analysis was conducted on 21 prospective cohort studies that examined the effect of saturated fat consumption on cardiovascular health. During 5 to 23 years of follow-up on a total of 347,747 subjects, 11,006 cases of coronary heart disease or stroke were documented. No significant association was found between intake of saturated fat and risk of coronary heart disease, stroke, or cardiovascular disease. Consideration of age, gender, and study quality did not change the results.

Commentary by Alan Gaby, MD

The prevailing point of view is that a heart disease prevention program should include restriction of saturated fat intake, because consumption of saturated fat increases serum cholesterol levels. However, the relationship between saturated fat and cardiovascular disease is not straightforward. Saturated fat per se may not necessarily be atherogenic, as suggested by findings in a Polynesian population living near the equator. Saturated fat intake in this population is very high (47% of total energy, chiefly from [raw] coconut), but vascular disease is uncommon.

While saturated fat may be less harmful than is commonly believed, certain foods that are high in saturated fat may be atherogenic for reasons unrelated to their saturated fat content. For example, advanced glycation end products and cholesterol oxides (both of which promote the development of atherosclerosis) form during cooking and processing of foods that are high in saturated [and unsaturated] fat such as beef, dairy products, and eggs [and processed/junk foods - chips, baked goods]. The effect of saturated-fat containing foods on heart disease risk may depend on at least as much on how the foods are prepared as on the amount of saturated fat they contain.

The results of this study also raise the issue of the cancer-related risk of margarine as a substitute for butter.


Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010;91:535-546.

reprinted with exclusive permission of the Townsend Letter for Doctors and Patients; June 2010.

Key concepts: saturated fat, cardiovascular health