Bør mettet fett erstattes med umettet?

Påvirker det å erstatte mettet fett med umettet risikoen for hjerte- og karsykdommer? Ja, konkluderer FAO

http://www.fao.org/docrep/013/i1953e/i1953e00.pdf

«Fats and fatty acids in human nutrition. Proceedings of the Joint FAO/WHO Expert Consultation

CONCLUSIONS AND RECOMMENDATIONS FOR SATURATED FATTY ACIDS (SFA)

Individual saturated fatty acids (SFA) have different effects on the concentration of plasma lipoprotein cholesterol fractions. For example, lauric (C12:0), myristic (C14:0) and palmitic (C16:0) acids increase LDL cholesterol whereas stearic (C18:0) has no effect.

There is convincing evidence that:

• Replacing SFA (C12:0–C16:0) with polyunsaturated fatty acids (PUFA) decreases LDL cholesterol concentration and the total/HDL cholesterol ratio. A similar but lesser effect is achieved by replacing these SFA with monounsaturated fatty acids (MUFA).

• Replacing dietary sources of SFA (C12:0–C16:0) with carbohydrates decreases both LDL and HDL cholesterol concentration but does not change the total/HDL cholesterol ratio.

• Replacing SFA (C12:0–C16:0) with trans-fatty acids (TFA) decreases HDL cholesterol and increases the total /HDL cholesterol ratio. Based on coronary heart disease (CHD) morbidity and mortality data from epidemiological studies and controlled clinical trials (using CHD events and death), itwas also agreed that:

• There is convincing evidence that replacing SFA with PUFA decreases the risk of CHD.

• There is probable evidence that replacing SFA with largely refined carbohydrates has no benefit on CHD, and may even increase the risk of CHD and favour metabolic syndrome development (Jakobsen et al., 2009).

• There is a possible positive relationship between SFA intake and increased risk of diabetes.

• There is insufficient evidence relating to the effect on the risk of CHD in replacing SFA with either MUFA or largely whole grain carbohydrates; however, based on indirect lines of evidence this could result in a reduced risk of CHD.

• There is insufficient evidence that SFA affects the risk for alterations in indices related to the components of the metabolic syndrome.

Based on cancer morbidity and mortality data, it was also agreed that:

• There is insufficient evidence for establishing any relationship of SFA consumption with cancer.

15Therefore, it is recommended that SFA should be replaced with PUFA (n-3 and n-6) in the diet and the total intake of SFA not exceed 10%E.

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