Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA.
Departments of Pediatrics and Medicine, University of California-San Francisco (UCSF).
Am J Clin Nutr. 2020 Jul 1;112(1):13-18. doi: 10.1093/ajcn/nqaa110.
Based on decades of research, there is strong evidence that supports ongoing dietary recommendations to decrease intakes of SFAs and, more recently, to replace SFAs with unsaturated fat, including PUFAs and MUFAs. Epidemiologic research has shown that replacement of SFAs with unsaturated fat, but not refined carbohydrate and added sugars, is associated with a reduction in coronary heart disease events and death. There is much evidence from controlled clinical studies demonstrating that SFAs increase LDL cholesterol, a major causal factor in the development of cardiovascular disease. When each (nonprotein) dietary macronutrient isocalorically replaces SFA, the greatest LDL-cholesterol-lowering effect is seen with PUFA, followed by MUFA, and then total carbohydrate. New research on full-fat dairy products high in saturated fat, particularly fermented dairy foods, demonstrates some benefits for cardiometabolic diseases. However, compared with food sources of unsaturated fats, full-fat dairy products increase LDL cholesterol. Thus, current dietary recommendations to decrease SFA and replace it with unsaturated fat should continue to the basis for healthy food-based dietary patterns.
基于数十年的研究,有强有力的证据支持持续的饮食建议,即减少 SFA 的摄入量,最近还建议用不饱和脂肪(包括多不饱和脂肪和单不饱和脂肪)来替代 SFA。流行病学研究表明,用不饱和脂肪替代 SFA,而不是用精制碳水化合物和添加糖来替代,与降低冠心病事件和死亡风险有关。有大量来自对照临床试验的证据表明,SFA 会增加 LDL 胆固醇,这是心血管疾病发展的一个主要致病因素。当每种(非蛋白质)膳食宏量营养素等热量替代 SFA 时,PUFA 对 LDL 胆固醇的降低作用最大,其次是 MUFA,然后是总碳水化合物。关于富含饱和脂肪的全脂乳制品(特别是发酵乳制品)的新研究表明,它们对心血管代谢疾病有一些益处。然而,与不饱和脂肪的食物来源相比,全脂乳制品会增加 LDL 胆固醇。因此,减少 SFA 并以不饱和脂肪替代 SFA 的现行饮食建议,应继续作为健康基于食物的饮食模式的基础。