Woodside Jayne V, Kromhout Daan
Division of Human Nutrition, Wageningen University, The Netherlands.
Proc Nutr Soc. 2005 Nov;64(4):554-64. doi: 10.1079/pns2005465.
During the last century much evidence has accumulated to suggest that from a public health perspective the type of fat is more important than the amount of fat. Saturated and trans-fatty acids increase and both n-6 and n-3 PUFA decrease the risk of CHD. Most of the knowledge about the effects of dietary fatty acids on CHD risk is based on observational studies and controlled dietary experiments with intermediate end points (e.g. blood lipoprotein fractions). Information from high-quality randomised controlled trials on fatty acids and CHD is lacking. The Netherlands Institute for Public Health has calculated the potential health gain that can be achieved if the fatty acid composition of the current Dutch diet is replaced by the recommended fatty acid composition. The recommendations of The Netherlands Health Council are: saturated fatty acids <10% energy intake; trans-fatty acids <1% energy intake; fish consumption (an indicator of n-3 PUFA) once or twice weekly. Implementation of this recommendation could reduce the incidence of CHD in The Netherlands by about 25,000/year and the number of CHD-related deaths by about 6000/year and increase life expectancy from age 40 years onwards by 0.5 year. These projections indicate the public health potential of interventions that modify the fatty acid composition of the diet.
在上个世纪，大量证据不断积累，表明从公共卫生角度来看，脂肪的类型比脂肪的摄入量更为重要。饱和脂肪酸和反式脂肪酸会增加冠心病风险，而n-6和n-3多不饱和脂肪酸（PUFA）则会降低冠心病风险。关于膳食脂肪酸对冠心病风险影响的大部分知识都基于观察性研究以及以中间终点（如血液脂蛋白组分）为指标的对照饮食实验。目前缺乏关于脂肪酸与冠心病的高质量随机对照试验的信息。荷兰公共卫生研究所计算了如果将当前荷兰饮食的脂肪酸组成替换为推荐的脂肪酸组成所能实现的潜在健康收益。荷兰卫生委员会的建议是：饱和脂肪酸摄入量<能量摄入的10%；反式脂肪酸摄入量<能量摄入的1%；鱼类消费量（n-3多不饱和脂肪酸的一个指标）为每周一次或两次。实施这一建议可使荷兰冠心病的发病率每年降低约25,000例，冠心病相关死亡人数每年减少约6000例，并使40岁及以上人群的预期寿命延长0.5岁。这些预测表明了改变饮食脂肪酸组成的干预措施在公共卫生方面的潜力。
