Departments of Pediatrics and Medicine, University of California-San Francisco, San Francisco, CA, USA.
Department of Nutritional Sciences and Toxicology, UC Berkeley, Berkeley, CA, USA.
Am J Clin Nutr. 2020 Jul 1;112(1):25-26. doi: 10.1093/ajcn/nqaa134.
There is ongoing debate as to whether public health guidelines should advocate reducing SFA consumption as much as possible to reduce the risk of chronic diseases, especially cardiovascular disease (CVD). In considering both sides of this question, we identified a number of points of agreement, most notably that the overall dietary patterns in which SFAs are consumed are of greater significance for cardiometabolic and general health than SFA intake alone. Nevertheless, there remained significant disagreements, centered largely on the interpretation of evidence bearing on 4 major questions: 1) does reducing dietary SFAs lower the incidence of CVD, 2) is the LDL-cholesterol reduction with lower SFA intake predictive of reduced CVD risk, 3) do dietary SFAs affect factors other than LDL cholesterol that may impact CVD risk, and 4) is there a sufficient rationale for setting a target for maximally reducing dietary SFAs? Finally, we identified specific research needs for addressing knowledge gaps that have contributed to the controversies.
目前，关于公共卫生指南是否应提倡尽可能减少 SFA 摄入以降低慢性病（尤其是心血管疾病，CVD）风险，存在持续争论。在考虑这个问题的正反两方面时，我们发现了一些共识，最显著的是，SFA 所摄入的总体饮食模式对心脏代谢和整体健康的意义大于 SFA 摄入量本身。然而，仍存在重大分歧，主要集中在对以下 4 个主要问题的证据解读上：1）降低膳食 SFA 是否会降低 CVD 的发生率，2）较低 SFA 摄入的 LDL 胆固醇降低是否可预测 CVD 风险降低，3）膳食 SFA 是否会影响 LDL 胆固醇以外可能影响 CVD 风险的其他因素，4）是否有充分的理由设定最大程度降低膳食 SFA 的目标？最后，我们确定了具体的研究需求，以解决导致争议的知识差距。
