Health & Fitness blog Uncategorized Fats and carbohydrates: will there be changes in dietary recommendations?

Fats and carbohydrates: will there be changes in dietary recommendations?

The role of fats and carbohydrates in the prevention of chronic non-communicable diseases, especially cardiovascular diseases, has recently been discussed. Can the guidelines for dietary recommendations change after the publication of the PURE study, which shows that higher fat intake is associated with a lower risk of total deaths, while for carbohydrates the risk is higher?
The PURE study (The Prospective Urban Rural Epidemiology) was presented at the Congress of the European Society of Cardiology (ESC 2017, Barcelona) and published in the August issue of the prestigious journal “Lancet”. It is a large epidemiological study with 135,335 participants aged 35-70 years from 18 countries (3 highly developed countries, 11 medium-developed countries including Poland and 4 underdeveloped countries). The observation period lasted 7.4 years. The diet was evaluated using validated questionnaires. Another look at the effects of carbohydrates and fats consumption It was found that higher carbohydrate consumption (the highest, fifth quintile, i.e. 1/5 of the examined persons with the highest consumption – 77.2% of energy derived from carbohydrates vs. the lowest, first – 46.4% of energy derived from carbohydrates) was associated with an increased risk of total deaths by 28% and non-cardiac deaths by 36%. However, no connection was found to the risk of cardiovascular incidents and deaths. On the other hand, higher fat intake (35.3% vs. 10.6% fat energy, respectively) was associated with a reduced risk of total deaths by 23% and non-cardiac deaths by 30%. The type of fat was also associated with a lower risk of total deaths. In cases of higher consumption of saturated fatty acids the risk reduction was 16%, while for monounsaturated and polyunsaturated fatty acids it was 19% and 20% respectively. The changes were statistically significant. Moreover, it was found that higher consumption of saturated fatty acids was associated with a 21% risk reduction of stroke. However, there was no significant correlation between the consumption of total fat and saturated and unsaturated fatty acids and the risk of heart attack or cardiovascular death. Results of the PURE study and dietary recommendations for carbohydrates and fats In their conclusions, the authors of the study indicate that the results of this large study deviate from the recent recommendations, according to which it is necessary to reduce fat consumption above 30% of total energy, and saturated fatty acid consumption to 10%, and according to American experts even below 7%. The authors point out that the current recommendations are mainly based on observational and clinical studies, which show that lowering the consumption of total fats and saturated fatty acids and replacing them with carbohydrates or unsaturated fatty acids results in a reduction of LDL cholesterol fraction and thus a reduction of cardiovascular incidents. In addition, European and North American populations have shown that a higher risk of coronary death is associated with higher consumption of saturated fatty acids. The advantage of the PURE study, on the other hand, is that it was conducted among inhabitants of different regions of the world, among which the consumption of individual macroelements is very different, which makes the results seem more reliable. However, the authors in the discussion emphasize that the work has some shortcomings, which may affect the interpretation of the results. Among the limitations, the following problems were mentioned: The intake was analysed only once at the beginning of the study, the consumption of trans-fatty acids and type of carbohydrates was not evaluated, high carbohydrate intake and low fat intake could be caused by poverty in the regions concerned, lack of education, tradition, etc. In conclusion, the results of the PURE study provide further evidence that the recommendations on fats and carbohydrates for the prevention of cardiovascular diseases in particular may need to be revised. Such suggestions were already made after publication of meta-analyses from other observational studies. However, it seems that further studies are needed to unequivocally demonstrate the most beneficial effects of diet. It should also be stressed that apart from diet, our health is determined by physical activity and other elements of our lifestyle. Therefore, it can be concluded that despite interesting, albeit controversial research results, we are bound by the dietary recommendations to date limiting the consumption of fat to 30% and saturated fatty acids to 10% and simple carbohydrates (sugar) to 10% of total energy. The task is financed by the National Health Programme for 2016-2020.

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