Reduced or modified dietary fat for preventing cardiovascular disease


Hooper, L; Summerbell, CD; Higgins, JP; Thompson, RL; Clements, G; Capps, N; Davey, S; Riemersma, RA; Ebrahim, S; (2001) Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev (3). CD002137. ISSN 1469-493X DOI: https://doi.org/10.1002/14651858.CD002137

[img]
Preview
Text - Published Version
License: Copyright the publishers

Download (603kB) | Preview

Abstract

BACKGROUND: Reduction or modification of dietary fat can improve total cholesterol levels, but may also have a variety of effects, both positive and negative, on other cardiovascular risk factors. OBJECTIVES: The aim of this systematic review was to assess the effect of reduction or modification of dietary fats on total and cardiovascular mortality and cardiovascular morbidity over at least 6 months, using all available randomized clinical trials. SEARCH STRATEGY: The Cochrane Library, MEDLINE, EMBASE, CAB Abstracts, CVRCT registry and related Cochrane Groups' trial registers were searched through spring 1998, SIGLE to January 1999. Trials known to experts in the field and biographies were included through May 1999. SELECTION CRITERIA: Trials fulfilled the following criteria: 1) randomized with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) healthy adult humans, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Inclusion decisions were duplicated, disagreement resolved by discussion or a third party. DATA COLLECTION AND ANALYSIS: Rate data were extracted by two independent reviewers and meta-analysis performed using random effects methodology. Meta-regression and funnel plots were used. MAIN RESULTS: Twenty seven studies were included (40 intervention arms, 30,901 person-years). There was no significant effect on total mortality (rate ratio 0.98, 95% CI 0.86 to 1.12), a trend towards protection form cardiovascular mortality (rate ratio 0.91, 95% CI 0.77 to 1.07), and significant protection from cardiovascular events (rate ratio 0.84, 95% CI 0.72 to 0.99). The latter became non-significant on sensitivity analysis. Trials where participants were involved for more than 2 years showed significant reductions in the rate of cardiovascular events and a suggestion of protection from total mortality. The degree of protection from cardiovascular events appeared similar in high and low risk groups, but was statistically significant only in the former. REVIEWER'S CONCLUSIONS: The findings are suggestive of a small but potentially important reduction in cardiovascular risk in trials longer than two years. Lifestyle advice to all those at high risk of cardiovascular disease (especially where statins are unavailable or rationed), and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates.

Item Type: Article
Keywords: Adult, Aged, Cardiovascular Diseases/epidemiology/*prevention & control, *Diet, Fat-Restricted, Dietary Fats/administration & dosage, Humans, Middle Aged, Risk Factors, Adult, Aged, Cardiovascular Diseases, epidemiology, prevention & control, Diet, Fat-Restricted, Dietary Fats, administration & dosage, Humans, Middle Aged, Risk Factors
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 11687015
Web of Science ID: 292554305001
URI: http://researchonline.lshtm.ac.uk/id/eprint/12637

Statistics


Download activity - last 12 months
Downloads since deposit
37Downloads
322Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item