Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Figure 3
Effects on CHD risk of consuming PUFA, carbohydrate, or MUFA in place of SFA.
Predicted effects are based on changes in the TC∶HDL-C ratio in short-term trials (e.g., each 5%E of PUFA replacing SFA lowers TC∶HDL-C ratio by 0.16) [11] coupled with observed associations between the TC∶HDL-C ratio and CHD outcomes in middle-aged adults (each 1 unit lower TC∶HDL-C is associated with 44% lower risk of CHD) [15]. Evidence for effects of dietary changes on actual CHD events comes from the present meta-analysis of eight RCTs for PUFA replacing SFA and from the Women's Health Initiative RCT for carbohydrate replacing SFA (n = 48,835, ∼3%E reduction in SFA over 8 years) [39]. Evidence for observed relationships of usual dietary habits with CHD events comes from a pooled analysis of 11 prospective cohort studies [38].