greater saturated fat intake assoc. with less progression coronary atherosclerosis

Thought provoking - potentially overturns a current common wisdom.

I hesitated before posting this here as against on articles of interest.

It raises interesting issues as to differences beween men and women and diet and on careful reading opens the door to the concept that limited saturated fats, may be less harmful, than addition of polyunsaturates (I guess veg oils high six on grounds of benificial comments as to fish oil).

As always it is complex etc etc but may give reassurance to those that enjoy a scrape of butter rather than margerine.

Happy reading if you have the time

RB

http://www.ajcn.org/cgi/content/full/80/5/1175

ABSTRACT

The optimal dietary pattern to reduce progression of atherosclerosis is not well established. On the basis of ecologic and animal studies, a reduction in the proportion of calories from fat, particularly saturated fat, is generally recommended (1). However, the results of prior studies have been conflicting regarding the relative importance of saturated fat intake on atherosclerotic progression (2, 3). Additionally, if the proportion of energy from saturated fat is reduced, it is uncertain whether replacement with polyunsaturated fat, monounsaturated fat, carbohydrate, or protein affects risk differently. High carbohydrate intake, for example, may adversely influence atherosclerotic risk (4-7). These questions are of considerable scientific and public health importance, particularly in light of the current controversy regarding the optimal diet and competing popular diets (4-14). Our understanding of the relations between nutrient intake and coronary heart disease (CHD) risk is also heavily weighted toward observations in men (15, 16), and there may be some differences in these relations in women (15, 17-22). The influence of diet in women may be particularly relevant after menopause, when changes in lipoprotein concentrations—particularly a decrease in HDL cholesterol—may mediate higher CHD risk (23).

We recently reported that modest fish intake was associated with less progression of coronary atherosclerosis among postmenopausal women (24). However, relations between other dietary factors and atherosclerotic progression in postmenopausal women are unknown. We therefore investigated the relations between usual dietary intake of major nutrients, assessed at baseline, and progression of coronary atherosclerosis during a 3-y follow-up of postmenopausal women enrolled in the Estrogen Replacement and Atherosclerosis (ERA) trial, a multicenter clinical trial evaluating the effects of hormone replacement therapy on atherosclerotic progression. We were particularly interested in evaluating the association of saturated fat intake with atherosclerotic progression and in estimating the effect of isocaloric replacement with other nutrients.